Course Design Institute Application

Wed, 06/15/2011 - 17:06 — admin

Please complete the following form to apply for participation in a Course Design Institute. Priority will be given to those applicants who apply by a deadline of three weeks before the first day of his or her chosen institute. Applications submitted later will be considered if seats are still available.

First Name: *

Preferred Name:

Last Name: *

Email Address: *

Please use your name.#@osu.edu (if you have one).

Department:

Campus Address: *

For which Course Design Institute would you like to apply?: *

Spring 2013 (Wednesdays, 1/16, 1/23, 1/30, 2/6, 2/13 - 11am–2pm)

Spring Break 2013 (Monday–Friday, 3/11–3/15, 10am–1pm)

May 2013 (5/9, 5/14, 5/16, 5/21, 5/23 - 10am–1pm)

June 2013 (Monday–Friday, 6/3–6/8, 12–3pm)

Can you attend all five sessions of the Course Design Institute you have selected?: *

Yes

If your answer is "no," please explain:

Title (or proposed title) of the course you intend to work on: *

Term in which you plan to teach the above course: *

Please describe the course in one or two sentences: *

In 300 words or less, please explain what you hope to gain from participating in the Course Design Institute: *

Additional information you would like us to know: