Faculty Interest Form

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Faculty Interest Form

Thank you for your interest in teaching with PBI Education. Please tell us more about yourself and why you are interested in working with us at this time. All submissions will be carefully reviewed by our Faculty Selection Committee. Applications will only be considered for individuals who are considered to be in good standing with their regulatory agency and the professional community. Should your submission meet our criteria, we will contact you.

First Name*
Last Name*
Degree
Specialty, if applicable

(e.g., Cardiology, Dermatology, etc.)
Phone number*
Email address*
Please describe your current work status (i.e. currently working full-time, retired, etc.)*
Why do you want to work with PBI?*
What course(s) would you have the most interest in teaching?*
Please describe what teaching experience you have.
If you are licensed, is your license current, active, and unrestricted? If no, please explain.*
Are you in good standing with your regulatory board/agency (i.e. no former or pending accusations, investigations, probationary terms, discipline, lawsuits)?*
Is there anything else you would like PBI to know about you at this time?
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Name
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