Zoho Creator-

Blended Learning Fellowship Application 2009-2010

Please complete the following form to apply for the Blended Learning Fellowship.

Please review the FAQ's before filling out the application.

Fields with an asterisk (*), must be filled in.

Program applying for: *

Applicant Name *

Primary Campus *

Germantown
Rockville
Takoma Park/Silver Spring

Faculty Status *

Full Time
Part Time

Contact Number *

Email [Montgomery College] *

Alternate Email

Department *

Academic Dean or Department Chair *

Courses You Currently Teach

Do you have a personal webpage? List URL here:

Please upload your reponses via a MS Word document and paste your responses below.

1. List and describe some elements of your course that work well in a face-to-face class.
2. List and describe some online tools you believe are available to help students learn and teachers teach.
3. Why are you interested in participating in the Full Time Faculty Blended Learning Fellowship?
4. How would you describe blended learning to an uninitiated colleague or peer? 2 to 3 sentences is sufficient.

Please upload your essay questions

Copy and paste your responses into this box. Do not worry about formatting. *

Assignment/Powerpoint or other document which demonstrates your teaching style

Please upload your CV or resume *

If not selected, would you be interested in participating in an alternative CTL program about online instruction? *

How would you describe your ability to facilitate class discussion? *

I tend to step back and allow students to self-govern discussion.
I like to control the discussion and step in to redirect if needed.
I assign students roles and attempt to structure the discussion.
I use a combination of techniques mostly with success.
I include discussion in class, but don't employ any strategies.

Have you ever taken or taught on online class? *

Yes
No

If yes, please describe the experience here:

Which of the following describes your level of interaction with Internet technolgoies *

I only use the Internet for email and web searches
I personally participate in Web 2.0 technologies (i.e. YouTube)
I utilize Internet technologies in the classroom
I create assignments for my students which include the Internet

Tech Skills Check List...check the options in which you have a 'working' knowledge *

Creating and Editing Audio
Creating and Editing Video
E-mail Managment
File Management (creating directories, changing files names etc)
File sharing/Video sharing
MyMc Course Tools
Grading Assignments via the Web
Writing for the Web
Social Bookmarking

Software applications you have a working knowledge of...select all that apply *

Camtasia
iTunes
MS Word
MS Excel
MS Powerpoint
Respondus
Snag-It
WebCT
WinZip

Describe your experience in using My MC Course Tools to supplement your face to face course. *

I understand that part of the fellowship involves attending face to face and online meetings with other full time faculty fellows. *

If I am selected as a Fellow, I will ensure that my schedule does not conflict with the scheduled meeting hours. *

I understand that as part of my commitment to the CTL, I will design at least one blended course to be taught in my content area at Montgomery College within six months of my completion of the fellowship. *

I also agree to serve as a resource for other faculty interested in designing blended courses and that any materials I create for this purpose, may be disseminated at college-wide events, conferences, and on the CTL website. *

Please type your full name followed by the words 'mc ctl blend' *

I confirm that the person above knowingly and willingly submitted this form. *

PLEASE PRINT THIS FORM for your records...upon submission, you will also receive an email copy of your responses.