Fill - Free fillable Online-OTAApplication - Online Teaching Academy Application DRAFT PDF form

Oncetheformiscompletedandallsignaturesobtained,pleasesubmittoonlineinstruction@semo.edubyAugust15

,2018.

Online Teaching Academy Application

1. PleasecompletethefollowingapplicationtobeconsideredtoparticipateintheOnlineTeachingAcademy.

2. Participantswillcomplete5masterclassesscheduledfor:September5,2018;October5,2018;November30,2018;February22,2019;

andMarch22,2019.

3. Participantswillprepareapresentationwiththeirindividualgroupsandpresentaboutthe projecttheyworkedonatthegraduation

luncheoninApril2019.

4. Formoreinformationabouttheprogramortosubmityourapplication,pleaseemailonlineinstruction@semo.edu,

General Information

FacultyName: S0#:

College: Department:

Email: Telephone:



Faculty Information

IfacceptedtotheOnlineTeaching Academy,whatwouldbethebiggesttake‐awayyouwouldhopetogetfromtheprogram:



HowmanyyearshaveyoutaughtatSoutheast?______________________



Haveyouevertaughtafullyonlinecoursebefore(CircleOne)?YesorNo



Ifyes,howmanyyears’

experiencedoyouhaveteachingonline(atSoutheastorotherwise)?______________________



Ifyouselected“No”,pleaseexplainwhy:



Faculty Agreement



 IagreethatImustprepare,andtakeapartinaprojectwiththeindividualgroupIamassignedto.

 IagreethatImustattendall5masterclassesandtheOTAGraduation.

 IunderstandthattograduatefromtheOTAprogramImustattendall5

masterclassesandtakepartintheteamproject.FailingtodosocouldmeanthatI

donotgraduatefromtheprogram,thatIwillnotbeallowedtousethisexperienceasalineiteminmypromotionandtenuredocument,andthatIwill

notbeeligiblefor

theProvost’sAwardofExcellenceinOnlineTeaching.



FacultyPrintName:___________________________FacultySignature:___________________________________Date:_____________________

Department Chairperson Approval



 Iapproveoftheapplicant’sparticipationinthisprogramandsupportthetimecommitmentthatitentails.

 Iconfirmthisfacultymembercanmissregulardutiestoattendall5masterclassesandtheOTAGraduation.



DepartmentChairPrintName______________________________Signature____________________________________Date____________________

Dean Approval



DeanPrintName__________________________________Signature________________________________________Date_____________________



Southeast Online Acknowledgement



SoutheastOnlineRepresentativePrintName:_______________________________Signature:_________________________Date:___________



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