Contact Info
References
Course
Additonal Info
*Required Field(s)
This proposal is intended for:
Professional Learning Programs: Professional Education, IT@Emory, Paralegal, Six Sigma Green Belt, Six Sigma Black Belt
Evening at Emory (Certificates and Open Enrollment)
Osher Lifelong Learning Institute - OLLI (Senior Program)
Corporate Learning
Contact information:
Name:
Last*
First*
MI
Address:
Street*
City*
State
ZIP
Contact Information:
Phone (xxx) xxx - xxxx*
Email*
Website
Educational Credentials:
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References - Professional
1.
Title
Last Name
First Name
Relationship
Street
City
State
ZIP
Phone (xxx) xxx - xxxx
Email
2.
Title
Last Name
First Name
Relationship
Street
City
State
ZIP
Phone (xxx) xxx - xxxx
Email
3.
Title
Last Name
First Name
Relationship
Street
City
State
ZIP
Phone (xxx) xxx - xxxx
Email
Type in your resume
(Include your name, Address, etc.)
:
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How does the course support the mission / vision of ECE?
Course Title:
Short Description of Course: (100 words)
Format:
Days per week:
Hours per day:
Weeks:
Total contact hours:
Instructor Availability:
Daytime
Evenings
Weekends
Please provide learning objectives for the course:
If applicable, how will learning objectives be measured?
Please provide a short outline including each session of the course.
Please describe the intended audience:
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Please provide ISBN numbers or links for any published textbooks for this course:
ISBN:
or URL:
Are handouts available for this course?
Yes
No
Have you successfully taught a similar course in the past?
Yes
No
If so, where and when? What audience. Please provide references if possible.
Are you currently teaching the course elsewhere?
Yes
No
If so, where?
Facilities:
No
Yes
, specify:
What type of AV equipment is essential for the delivery of this course?
Do students need to bring a laptop for this course?
Yes
No
Do you need an online resource such as Blackboard for this course?
Yes
No
Are there any consumables/supplies that need to be purchased by the student for this course?
No
Yes
, specify:
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