Propose Public FLEX Activity

Students, this form is only for Activity Supervisors who are recruiting students.

Students have a separate upload system which keeps their student-initiated projects from being made widely available to other students.

All fields marked with an asterisk ( ) must be filled in.

Some information is missing or invalid, and has been marked in red. Please correct it and resubmit the form.

Contact Information

The individual submitting this proposal. Can be different from the Activity Supervisor.

Contact Name

Email Address

Confirm Email Address

Activity Description

Activity Title

Activity Summary

Please provide 3-5 high-level points that describe your Activity and area of interest.

Detailed Description

Please provide a high level overview of your program or area of interest. Specifically, please outline the role(s) that a student might play as part of this Activity. If needed, please outline how your activity (or components of it) could be completed remotely and what access can be provided to help the student do so (e.g. VPN access).

Prerequisites

Does the student require any particular background or competency to engage in your Activity (training, experience, etc.)?

Populations
(check all that apply)

Populations who disproportionately experience adverse health care interactions and health outcomes.

Disability Health/Chronic health care needs
Mental illness
Older Adults with complex health conditions
People who use substances
Populations with adverse health outcomes not listed here
Not Applicable

Potential Outputs
(check all that apply)

Along with a literature review (required by the FLEX program), what deliverables or outcomes will the students produce? If so please list them below. Please note that these should be discussed with the student(s). (Examples: documentation, educational material, publications, presentation, public workshop, etc.)

Conference Presentation/Discussion Group/Workshop
Manuscript
Production of learning resources for agencies, community groups, etc.
Production of learning resources for Medical Undergraduate Program (MDUP)
Research project
Short Course
Other

Activity Delivery and Location Details

Location Options

Will the student need to travel to your activity’s site or can the student work on the proposal remotely from any location – as long as they have a good internet connection (i.e. distance learning)?

On site only
Distance learning available

Information regarding primary location of proposal

Select if this is the primary location

Location Name

City

Province

Country

Other Relevant Location Details

Supervisors

Select if this is the primary supervisor

First Name

Last Name

Phone Number

Email Address

Name of Organisation and Affiliations

City

Province

Country

Activity Period

Please specify how long this proposal should remain in the FLEX Catalogue. Minimum duration is 12 months from Start Date.

Note: This proposal will be deactivated from the FLEX Catalogue by your indicated End Date. Contact the FLEX Manager (niki.giannopoulos@ubc.ca) for any required edits or updates.

Start Date

End Date

Activity Timing

Please check the cycles in which your proposal is available and the maximum and minimum number of students (click CYCLE box first, then fill in MAX #, MIN # OF Students and Est. # of Hours). For the exact dates for the current academic year, please see the "Call for Proposals"

Year 1 Students (MEDD 419)

	MEDD 419 Cycle	Start Date	End Date	Description	# of Hours		# of Students
	MEDD 419 Cycle	Start Date	End Date	Description	Max	Est.	Min	Max
	FLEX Block (32 hrs/wk)	Apr	Jun	6 weeks full time	188

Year 2 Students (MEDD 429)

	MEDD 429 Cycle	Start Date	End Date	Description	# of Hours		# of Students
	MEDD 429 Cycle	Start Date	End Date	Description	Max	Est.	Min	Max
	FLEX Half-Days (4 hrs/wk) + FLEX Block (32 hrs/wk)	Sep	May	18 half-days (Sep-Apr) + 3 weeks full time (mid April-early May)	164

Year 4 Students (MEDD 449)

	MEDD 449 Cycle	Start Date	End Date	Description	# of Hours		# of Students
	MEDD 449 Cycle	Start Date	End Date	Description	Max	Est.	Min	Max
	FLEX Block (32 hrs/wk)	Nov	Dec	4 weeks full time	128

You can request edits to an existing activity at any time by contacting the Flex Manager (niki.giannopoulos@ubc.ca)