MAGEC South Request for Proposals

Name of Proposed Program: 

1. Briefly describe the educational program for which you are requesting partnership funding. Include:
   
   • the date and location
   • target audience (i.e. what groups of professionals are being targeted)
   • educational outcomes
   • anticipated number of professionals served
   • means of participant evaluation.
2. Address how this program fits with the mission of MAGEC South "to improve the quality of geriatric care provided to older adults through enhancing education, research and practice throughout south central Minnesota."
   
3. Is this a collaborative program focusing on interdisciplinary practice?
   Yes No
   If yes, please explain.
4. Identify the staff, faculty, and others who will be involved in planning and implementing the program. Clearly state each person's positions and role with the program.
   
5. Specify your funding request of MAGEC South. Include a project budget that details how the money will be used. Note specifically if you are requesting or have received funding for this program/project from other sources; and if so, specify the sources and amount.
   
6. Describe how MAGEC South's partnership funding of this program or project will be acknowledged or publicized.
   
7. The federal funding authorities for MAGEC require that we submit a report including the names and addresses of all education program participants, along with evaluation data for each funded program. Please include a statement that you will comply in providing this information following completion of your program/project.
   
8. Designate the contact person for the applicant organization, contact information and details regarding payment of any funds that are awarded. Email contact information is required, along with mailing address.