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1 | Foundations of Emergency Medicine Program Roster, AY 2024-2025 | ||||
2 | To use this form, FILE > DOWNLOAD> MICROSOFT EXCEL; complete and SAVE AS, using the PROGRAM NAME as the document title. Then, return to the registration form and upload the completed roster. If your institution's IT settings block external Gmail messages, please provide an alternate, non-institutional, email address we can use to communicate important FoEM information and updates, including password changes. | ||||
3 | Program Name | ||||
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5 | Program Leadership Team | ||||
6 | *List all members of your program's Foundations Leadership/Instructional Team (big picture planning and/or organizing and/or leading educational sessions). This is the group that will be notified of password changes and other important FoEM updates. Please add additional rows as needed. **We will not share email addresses with any outside organizations.** | ||||
7 | LEADER First Name | LEADER Last Name | Role in utilizing FoEM content at your program [Instructional Lead, Program Coordinator, Resident Teacher, etc.] | LEADER Email | Alternate Email (if needed) |
8 | FoEM Instructional Leader | ||||
9 | Program Coordinator | ||||
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15 | Site Learners | ||||
16 | *List all learners at your program who will be utilizing FoEM content during AY 2024-2025 (resident learners, resident instructors, PA/NP learners), except DO NOT include medical students. | ||||
17 | **We will not share email addresses with any outside organizations** | ||||
18 | LEARNER First Name | LEARNER Last Name | Learner Level | LEARNER Email | Alternate Email (if needed) |
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