JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Learning Fellows Applicant Information
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Please enter your last name (of record)
*
Your answer
Please enter your first name (of record)
*
Your answer
Please enter your phone number.
*
Your answer
Please enter your department.
*
Your answer
Please enter your school/college.
*
Your answer
Please enter your academic rank (Professor, Assistant Professor, Lecturer, etc.)
*
Your answer
Please enter in the last name, first name of your department chair or dean.
*
Your answer
Please enter in the email address for your department chair or dean.
*
Your answer
Have you participated in Learning Fellows 1.0, the Assessment Learning Community, or been the recipient of either a Glennan Fellowship Award or a Nord Grant? Please check all that apply.
Learning Fellows 1.0
Glennan Fellowship
Nord Grant
Assessment Learning Community
For how many years have you been teaching at CWRU?
*
Your answer
For how many years have you been teaching?
*
Your answer
Are there any additional questions you have about this program?
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Case Western Reserve University.
Report Abuse
Forms
