Oncetheformiscompletedandallsignaturesobtained,pleasesubmittoonlineinstruction@semo.edubyAugust15
th
,2018.
Online Teaching Academy Application
1. PleasecompletethefollowingapplicationtobeconsideredtoparticipateintheOnlineTeachingAcademy.
2. Participantswillcomplete5masterclassesscheduledfor:September5,2018;October5,2018;November30,2018;February22,2019;
andMarch22,2019.
3. Participantswillprepareapresentationwiththeirindividualgroupsandpresentaboutthe projecttheyworkedonatthegraduation
luncheoninApril2019.
4. Formoreinformationabouttheprogramortosubmityourapplication,pleaseemailonlineinstruction@semo.edu,
General Information
FacultyName: S0#:
College: Department:
Email: Telephone:

Faculty Information
IfacceptedtotheOnlineTeaching Academy,whatwouldbethebiggesttakeawayyouwouldhopetogetfromtheprogram:
HowmanyyearshaveyoutaughtatSoutheast?______________________
Haveyouevertaughtafullyonlinecoursebefore(CircleOne)?YesorNo
Ifyes,howmanyyears’
experiencedoyouhaveteachingonline(atSoutheastorotherwise)?______________________
Ifyouselected“No”,pleaseexplainwhy:
Faculty Agreement
IagreethatImustprepare,andtakeapartinaprojectwiththeindividualgroupIamassignedto.
IagreethatImustattendall5masterclassesandtheOTAGraduation.
IunderstandthattograduatefromtheOTAprogramImustattendall5
masterclassesandtakepartintheteamproject.FailingtodosocouldmeanthatI
donotgraduatefromtheprogram,thatIwillnotbeallowedtousethisexperienceasalineiteminmypromotionandtenuredocument,andthatIwill
notbeeligiblefor
theProvost’sAwardofExcellenceinOnlineTeaching.
FacultyPrintName:___________________________FacultySignature:___________________________________Date:_____________________
Department Chairperson Approval
Iapproveoftheapplicant’sparticipationinthisprogramandsupportthetimecommitmentthatitentails.
Iconfirmthisfacultymembercanmissregulardutiestoattendall5masterclassesandtheOTAGraduation.
DepartmentChairPrintName______________________________Signature____________________________________Date____________________
Dean Approval
DeanPrintName__________________________________Signature________________________________________Date_____________________
Southeast Online Acknowledgement
SoutheastOnlineRepresentativePrintName:_______________________________Signature:_________________________Date:___________
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