6.13.19
E-Learning, Innovation, and Teaching Excellence Course Development Program
Course Development and ESH Request Form
( Return by: 11/15 (Spring), 3/15 (Summer), 5/15 (Fall) )
When completing this information, you should TAB between fields. The fields will expand as you enter information.
Your Name: __________________________________________________________
Date Online Teaching Training Completed (if applicable) : ______________________
Department Chair: ____________________________________________ Dean: ____________________________________________
Course to be developed:
Semester for which you are requesting esh: ____________________________________________
Course Title (eg ENGL 101): _______________________________________________________
Is this course currently offered in a distance or OER format? Yes No
Delivery mode (eg Blackboard, Collaborate, OER): ___________________
Number of esh requested: ______________________
Expected delivery semester for the first offering of the course: ______________________________
Number of distance and/or OER of this course offered collegewide for this current academic year: _______________
Number of enrolled students in those sections: _______________
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Faculty's Signature Date
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Department Chair's Signature Date
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Dean's Signature Date
I agree to develop and deliver the course identified above.
I agree to the development and delivery of the course identified.
This course falls within the Department goals.
I agree to the development and delivery of the course identified.
This course falls within the Unit and College goals and is
acceptable from a staffing perspective.
When completed, return to: Office of E-Learning, Innovation, and Teaching Excellence, Mannakee Building,
attn: Jeana Beaulieu
Do not write in this area - To be completed by the Office of E-Learning, Innovation, and Teaching Excellence
A signed copy of this form will be sent to the Faculty, Department Chair, and Dean.
This request has been reviewed and is is not approved.
Reason if not approved:
_______________________________________________________ ____________________________________
Vice President of E-Learning, Innovation, and Teaching Excellence Account Number to enter on the PAF