<p> The Fall 2016 Northwest PULSE Departmental Transformation Workshop</p><p>October 14-16, 2016, Seattle WA Application for Institutional Team Due June 3, 2016</p><p>Please complete this team form and a form for each individual member of the team (located after the team form) and email your completed application forms to Gary Reiness: [email protected]</p><p>Institution: Institution Type (Community College, Liberal Arts, Regional Comprehensive, or Research 1): Are you a minority serving institution or do you have a high population of underrepresented students? (e.g. rural, first generation, etc.)</p><p>Team Lead Name (primary contact person): </p><p>1. Please describe why you believe that your department is ready to embrace a strategic planning process to improve undergraduate education in the life sciences consistent with the AAAS Vision and Change (V&C) Report.</p><p>2. Please describe why the composition of your team is appropriate for strategic change in undergraduate life science teaching and learning at your institution. </p><p>PULSE founded by the National Science Foundation, Howard Hughes Medical Institute, and National Institute of General Medical Sciences. Northwest PULSE workshops funded by NSF Grant #DBI #1346583 3. Briefly describe what goals your departmental team hopes to achieve, work on, or develop as the result of your participation in this workshop.</p><p>4. We understand that if selected to participate in the workshop, each member of our team will commit to completing pre-workshop activities. These will include each institutional team using the V&C document and a series of PULSE rubrics (see PULSECommunity.org for more information) to assess the current status of their department. </p><p>____ Yes _____ We cannot make this commitment at this time</p><p>5. We understand that if selected to participate in the workshop, one member of our team will commit to attending the follow-up symposium at the NW Biology Instructors’ Annual Meeting in May 2017.</p><p>____ Yes _____ We cannot make this commitment at this time</p><p>Email your completed application form to Gary Reiness: [email protected]</p><p>Questions about the workshop should be directed to Gary Reiness: [email protected]</p><p>The NW PULSE fellows on the Steering Committee: Joann Otto (Western Washington University, Co-PI), Pamela Pape-Lindstrom (Everett Community College, co-PI), Bill Davis (Washington State University, PI), Gary Reiness (Lewis & Clark College, co-PI), Gita Bangera (Bellevue College), Alyce DeMarais (University of Puget Sound) and Jenny McFarland (Edmonds Community College). </p><p>PULSE founded by the National Science Foundation, Howard Hughes Medical Institute, and National Institute of General Medical Sciences. Northwest PULSE workshops funded by NSF Grants #DBI #1346583 and #1346583 The Fall 2016 Northwest PULSE Departmental Transformation Workshop</p><p>October 14-16, 2016, Seattle WA Application for each Team Member</p><p>Institution: </p><p>Participant Name: </p><p>Mailing Address: </p><p>E-Mail Address:</p><p>Phone: </p><p>Current Position / Title:1</p><p>Department: </p><p>1. Please list the courses you have taught in the last 5 years and their levels. Also, please indicate your role in the course (lecturer, TA, organizer) and the course size.</p><p>2. Please discuss your motivation(s) for attending this workshop. What you would most like to accomplish, begin, and/or learn?</p><p>Have you incorporated any of the recommendations in the Vision and Change document into your teaching? If so, which ones?</p><p>1 Please note if you are in an adjunct, part-time or temporary/interim position.</p><p>PULSE founded by the National Science Foundation, Howard Hughes Medical Institute, and National Institute of General Medical Sciences. Northwest PULSE workshops funded by NSF Grants #DBI #1346583 and #1346583 How will your team’s participation in this workshop serve your own teaching and your students?</p><p>3. Please describe a previous faculty development activity, workshop, or conference that has changed how you teach and has the potential to affect others in your department. </p><p>4. I understand that if selected to participate in the workshop, I commit to attending the entire workshop.</p><p>____ Yes, I can attend the entire workshop _____ I cannot make this commitment at this time</p><p>If an emergency prevents your attendance, please contact us in advance as soon as possible so that we can plan accordingly. </p><p>PULSE founded by the National Science Foundation, Howard Hughes Medical Institute, and National Institute of General Medical Sciences. Northwest PULSE workshops funded by NSF Grants #DBI #1346583 and #1346583</p>