Faculty/Staff
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MU Health System faculty, staff and volunteers interested in pursuing membership in the forYOU Team will be asked to complete this application for review by the Membership/Team Structure Committee.

A team lead will contact you regarding the upcoming course schedule.

For questions, please contact (573) 884-2373



* Indicates required information
Name * 
MU email addres * 
Phone (home/cell) 
Phone (work) 
Current unit/department * 
Current title * 
Primary shift worked * 
Clinical experience (years) 
What experience do you have in providing any of the following? 



Include specific information about the above checked experiences: 
How did you hear about the forYOU Team? 
Why would you like to become a member of the forYOU Team? 
Comments or additional information you would like us to know about you to aid in the forYOU Team selection process: 
I have the endorsement of my manager to request to join the forYOU Team * 
Date of endorsement by manager: * 
Manager's name: * 
 



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