TEP Registration Form

Please print this page, complete, and return to Sue Gittens in the Center for Teaching, Learning & Leadership by August 31.

Name: ___________________________________________

Title: ____________________________________________

Full-time___________ Full-time temp___________  Adjunct ____________ 

Department: ______________________________    Campus: _____________________

Email: _____________________     Phone: __________________

Please describe your previous teaching experience:

Have you ever taken a class totally online? ________ yes _________ no

If yes, which platform did you use?

Have you ever taught online? If yes, please tell us if it was enhanced, hybrid, or fully online; the platform used and types of online tools you have used; and number of courses and/or semesters you have taught online.