UTLC Consultation Request Form

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Please use this form to request a faculty consultation session with the UTLC and the ITS: Learning Technology and help us identify a coach who can work with you.

Note: all information collected is confidential and will not be shared with your academic department unless you make a formal request to do so. Please complete the information as fully as possible so that we can best prepare to meet your consultation needs.

Name *

Department/Program *

Email *

Select your Consultation Type *

Classroom observation with follow up consultation

Face-to-face meeting

Virtual meeting

If you selected "classroom observation," please indicate your class day(s), time, and location

Categories of Consultation Needs *

Classroom Technology (includes training on classroom tech or support on teaching tech tools)

Class Size, Student Engagement, and Classroom Management

Course/Syllabus (Re)Design

Equity and Inclusion in the Classroom

General Development

Hybrid, Hyflex, Online, and Face-to-face Course Differences

Implementing High Impact Practices and Innovative Pedagogy

Instructional Design Support

Student Learning Outcomes and Assessment

Technology-Enhanced Pedagogy

Other:

Required

If you would like, please elaborate on your consultation needs

General Scheduling Availability *

Monday Morning

Monday Afternoon

Tuesday Morning

Tuesday Afternoon

Wednesday Morning

Wednesday Afternoon

Thursday Morning

Thursday Afternoon

Friday Morning

Friday Afternoon

Required

Other Questions/Comments Prior to your Consultation

Submit

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