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Rural Collective
With funding from the University of Minnesota Rural Health Program at the Clinical and Translational Sciences Institute (CTSI) and the Office of Academic Clinical Affairs (OACA), the Collective will provide a way for faculty and staff from across the University of Minnesota to connect on rural-relevant work. Please complete the following form to apply for membership for the Collective. Questions about the Collective or application process can be directed to Dr. Carrie Henning-Smith,
henn0329@umn.edu
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* Indicates required question
Name
*
Your answer
Title
Your answer
Email Address
*
Your answer
Campus
*
Crookston
Duluth
Extension (state-wide)
Morris
Rochester
Twin Cities
College/School
*
Your answer
Department
*
Your answer
Individual URL, if applicable
Your answer
May we publish your name and URL on a member directory?
*
Yes
No
Center/Institute, if applicable (e.g. Rural Health Research Center)
Your answer
Center/Institute URL, if applicable
Your answer
If affiliated with a Center/Institute, may we list that entity as a member of the Collective in an online directory and in Collective materials?
Yes
No
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What is the primary focus of your rural-relevant work?
*
Research
Education
Programming
Other:
What is the scope of the majority of rural-relevant work that you do?
*
International
National
Regional (e.g. Midwest)
State
Other:
In just a few words, what substantive area do you focus on within your rural work (e.g., cancer, food access, transportation)?
*
Your answer
What do you most hope to gain from joining the Collective?
*
Your answer
Is there anything else you would like to share?
Your answer
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