Instructor Application Form: Student Review of Teaching


fields marked * are required

Instructor Information


[First Name] *


[Last Name] *


[Email Address] *


[Office Location] *


[(xxx) xxx-xxxx] *


Course Information


[Department]


[School]


[Course Name]


[Course Number]


[Section Number]


[Course Location]


Course Meeting Days

What days does the course meet? Check all that apply.








Course Meeting Times

[Course Start Time]     

[Course End Time]     


Student Visitor

Would you have a date preference for the student visitor?
  


[Date Preference]