Fillable ETech Certification Application Fall 2019 eTech Certification Application

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ETech Certification Application Fall 2019 eTech Certification Application

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Arkansas Tech University
Certification_application.doc
Revised 9/4/19
DEADLINE: September 13 @ 5p.m.
eTech Online Certification Application
Please submit completed application to:
Jennifer Lackie, RPL 326
Faculty Information
Name
Department
Office Phone
E-mail Address
Teaching Load
Please list all courses (and number of sections) you will be teaching in the upcoming semester:
Topic interest
Please rank your interest in these topics (1 – highest, 6 – lowest):
_____ Assessing student achievement online
_____ Blackboard How to’s
_____ Face to face vs. online – what’s different?
_____ Meeting the needs of all students
_____ Student interaction online
_____ Technology best practices
Rationale for
participation:
(Why are you interested in this faculty development? Be specific.)
Online Experience
Have you previously taught
online?
Yes No
If so, what challenges did you face?
Moving Online
Which of your courses would
you be most interested in
moving online?
Do you have a specific concern regarding moving this course online?
Approvals, Notifications, and Understandings
Yes No
I understand this application is not complete unless signed by myself, my Department Chair, and my Dean.
Yes No
I understand that I am required to attend all classes and complete all assignments as part of the course.
Yes No
I understand that I must successfully complete all course assignments to be eligible for the technology incentive.
Required signatures:
___________________
Date
_________________________________________________
___________________
Date
_________________________________________________
____________________________________
Date
x
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ETech Certification Application Fall 2019 eTech Certification Application

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Completed 28 February 2020

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