2018 STEM Pedagogy Institute Application Form

Institutional Affiliation *

Type of Institution *

Community college

4-year college or university

Team Leader's First Name *

Team Leader's Last Name *

Team Leader's Title *

Team Leader's Department *

Team Leader's Email *

Team Leader's Phone Number *

How many additional people are in your team? *

Team Member's Information

Team Member's First Name

Team Member's Last Name

Team Member's Title

Team Member's Department

Team Member's Email

Team Members' Information

Team Member 1's First Name

Team Member 1's Last Name

Team Member 1's Title

Team Member 1's Department

Team Member 1's Email

Team Member 2's First Name

Team Member 2's Last Name

Team Member 2's Title

Team Member 2's Department

Team Member 2's Email

Please briefly describe a curricular issue in one or more courses, etc. that your team will work on at the Institute. Provide as much detail as possible at this time. You do not need to have a fully developed plan for working on a project. *

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CEITL

Center for Excellence and Innovation in Teaching & Learning

2018 STEM Pedagogy Institute Application Form