ITC SIGN-UP FORM

PLEASE NOTE - You must register from an ON-CAMPUS computer (either Brown or RISD).

A. IDENTIFICATION

Last Name (required)

First Name (required)

Department (required)

Status (required): Faculty Member Visiting Fellow Post doc

Graduate Student Undergraduate

Box #:

Phone #: (required)

E-mail address: (required)

Please indicate your preferred means of contact: (required) e-mail phone campus mail

Desired Date of Observation: (enter a specific date - month, day, and year) (required)

N.b. You must request your consultation at least 2 weeks in advance of the date
you wish to be observed.

Desired time of Observation: (required)

Please indicate precisely what time you would like Consultants to observe your class.This may not correspond exactly with the class meeting time (1 hour max).

Is this a "one time" teaching opportunity? (i.e. is this the only date/time that consultants will be able to observe your teaching during this semester?) (required)

yes no

B. OBSERVATION SESSION

Before filling out this section of the form, make sure that you have read and understand the ITC Guidelines.

1. This session: What are your pedagogical goals and teaching strategies for this session: HOW will you teach this subject to your students? (required)

2. Context: How will this session relate to the course as a whole (e.g. a unique lecture, discussion/lab to amplify faculty lecture, homework session)? Is the class being observed representative of other classes during the semester (or are you trying something new/different that you would like us to comment on)? (required)

3. Consultation Goals: On what aspect(s) of your teaching would you like feedback from this consultation? (e.g. teaching strategies, student learning, etc.) Are there any other aspects of your teaching you would like us to help you with (handouts, overheads, application of technology: powerpoint, newsgroups, etc.)? (required)

4. Logistics

Course Number/Title: (required)

Location and address of course. Please be as specific as possible (required).
RISD students - please indicate whether the location is on the East Side or downtown, and provide cross-street and walking directions from Brown, in addition to building name and room number. (required)

Format and Size: Lecture Language Class Lab Discussion / Section Other

Size:

Is class conducted in a language other than English? yes no

If possible, copy the text of your course syllabus in the field below or write down its URL, and eventually e-mail relevant handouts to the Center.

Videotaping of ITCs is standard. If there is any reason to preclude videotaping (such as the presence of a nude model in the classroom), please give the reason below.