| Name: |
* |
| DMACC ID#: |
* |
| Program/Department: |
* |
| Date: |
* |
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Please complete item 1 or 2 (whichever is appropriate), and item 3. |
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Credit/Non-Credit Course*
OR
Activity (not a
class) |
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| 1. Credit/Non-Credit
Course |
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Title: |
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Sponsoring Institution: |
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Dates from: |
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Dates to: |
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Credits/Contact Hours: |
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| Instructional Competency to be met:
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Demonstrates competence in content knowledge appropriate to the
faculty position.
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Demonstrates competence in planning and preparing for instruction,
counseling, library services. |
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Selects strategies to engage all students in learning and personal
growth. |
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Incorporates a variety of methods to evaluate student learning and
personal development. |
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Demonstrates competence in classroom management, student behavior,
and crisis management. |
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Engages in professional growth. |
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Fulfills professional responsibility to institution. |
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| 2. Activity (not a class) (click
here for more information) |
| Title: |
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| Organization: |
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| Dates from: |
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Dates to: |
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| TIs Requested: |
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Instructional Competency to be met: (please
check the option below that applies best) |
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Demonstrates competence in content knowledge appropriate to the faculty position.
|
|
|
Demonstrates competence in planning and preparing for instruction, counseling, and library services. |
|
|
Selects strategies to engage all students in learning and personal growth. |
|
|
Incorporates a variety of methods to evaluate student learning and personal development. |
|
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Demonstrates competence in classroom management, student behavior, and crisis management. |
|
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Engages in professional growth. |
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Fulfills professional responsibility to institution. |
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| 3. Rationale
for how this activity/class improves competence, teaching skills, and/or
professionalism. |
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Upon completion of workshop, seminar or course, submit evidence of completion to Human Resources.
Examples of evidence may include grade reports, conference schedules,
itineraries, email of attendance
and number of hours ect.
Enter your Provost/Dean/Director's email address
so this form can be sent to your supervisor for approval:
*
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If Staff Development Units (SDUs) will also be requested, Form P-40 must be completed. |
Ankeny