Follow the steps to fill out your application with ease.

1. Press the ‘Get Form’ button to access the application form and open it in the online editor.
2. Begin by filling in your community affiliation. Select one of the following options: Flint, Lansing, Midland, Traverse City, Upper Peninsula, or Southeast Michigan.
3. Indicate the department you are requesting appointment in by checking any applicable boxes, such as Emergency Medicine, Pediatrics & Human Development, Family Medicine, and others listed.
4. In the name section, provide your first, middle, and last names. Follow this with your date of birth and gender selection.
5. Specify your citizenship status by selecting one of the options provided, which includes U.S. Citizen, Non Resident Alien, Non-Citizen National of U.S., or Permanent Resident.
6. Fill out the type of visa and country of citizenship if applicable.
7. Complete the ethnicity/race section by checking at least one option regarding your ethnicity and race.
8. Enter your preferred mailing address and select whether it is a home, office, or other address.
9. Provide your contact information, including home, cell, and business phone numbers, as well as your email address.
10. Fill out the emergency contact information by providing the name, phone number, and address for your emergency contact.
11. Include your medical practice name and group affiliation along with their respective addresses.
12. Complete the education section by listing your degrees, major fields of study, institutions, and dates of degree received.
13. Provide information about your postgraduate training, including internships, residencies, and fellowships.
14. Fill out your national provider ID and medical license information, including the license number and state.
15. Indicate any previous academic experience by providing names of institutions, positions held, and years of service.
16. Respond to questions about relatives employed by MSU, financial interests related to MSU responsibilities, and commitments to disclose past conduct.
17. Affirm the personal certification statement by signing and dating the application to ensure the accuracy of the submitted information.
18. Finally, review all filled sections for accuracy, save your changes, and complete your application by downloading or printing it, if needed.

Take the next step in your career by completing the MSU CHM Application For Clinical Or Adjunct Faculty Appointment online today.