Email Form
APPLICATION FOR ASSOCIATION
WITH THE USC AFRICAN AMERICAN STUDIES PROGRAM
We thank you for considering an affiliation with the USC African American Studies (AFAM) Program.
Please take a moment to fill out the form below so that we have basic background information on you.
Last Name: ______________________________
Preferred Form of Address:
Ms.
Mrs.
First Name: ____________________________
Mr.
Dr.
Rev.
Other: _____________
Department/Office/Company: ____________________________________________________________
Title: ________________________________________________________________________________
Work Address: ________________________________________________________________________
Daytime Phone Number: ___________________________ Fax No. ______________________________
Email Address: ________________________________________________________________________
Levels of Affiliation: There are three levels of formal affiliation with the USC African American Studies
program other than serving as a Core Faculty Member or Staff Member.
1. Affiliate Faculty Member: Full-time employees of the University who teach AFAM core, crosslisted, or “meets with” courses OR are persons whose research and publications are African
American-focused AND are willing to provide service to the AFAM Program (i.e. attend affiliate
faculty meetings and/or occasionally serve on an ad hoc committees, etc.)
2. Adjunct Faculty Member: Associates of the AFAM program who are not full-time employees
of the University, but who teach AFAM core, cross-listed, or “meets with” courses. 1
3. Friend of AFAM: Supporters of the AFAM program who are not are not currently active in
AFAM teaching, research, or service, but who wish to be identified with AFAM’s mission.
I wish to apply for the status of:
AFFILIATE
ADJUNCT
FRIEND
Supplementary Questions and Materials: Please answer any and all questions that are applicable; if a
question is not applicable you may leave it blank.
List your most recent research publications, grants and/or projects related to African American Studies (or
highlight on your vita/resume and upload/attach. This is optional for Affiliate Faculty Member or Friend
of AFAM applicants but required for Adjunct Faculty Member applicants):
1
Filling out this form is the first part of the process of applying to be an adjunct instructor at
USC.
List AFAM courses (core, cross-listed, or ‘meets with’) you currently teach or have taught (leave blank if
none or does not apply):
List the AFAM courses you would like to cross-list or develop, if applicable (especially in the next or
following semesters. Please attach a syllabus/syllabi if available):
List AFAM committees or other services you have provided to AFAM in the past 2 years (if applicable):
What community or job-related activities are you involved in that relate to African American Studies?
_____________________________________________________________________________________
Do you have any other comments or questions?
_____________________________________________________________________________________
Can you recommend other persons who we should contact? Are they likely to be interested in applying to
be an Affiliate Faculty Member, Adjunct Faculty Member, or a Friend of AFAM?
_____________________________________________________________________________________
THANK YOU!
Dr. Nancy Tolson, Assistant Director
University of South Carolina
African American Studies Program
Gambrell Hall Room 258
Columbia, SC 29208
[email protected]
803-777-1858