Course Module Application

Name(Required)
Institutional Address(Required)
For the delivery of your curriculum enhancement kit. Please be sure to collect your kit soon after delivery, as kit materials may be time and/or temperature-sensitive.
Please select the module(s) you are interested in.(Required)
Select as many as apply.
Course Semester(Required)
Select the semester you intend to instruct using the enhanced curriculum.
Course Month, Catalog Number and Attendance(Required)
Module Name
Course Month
Catalog Number
Attendance
 
Which month(s) of your above selected semester do you intend to instruct using the curriculum enhancement kit? In addition, list the course catalog number and the number of students currently attending this course or the number you expect to attend this course. For timely delivery of kit materials. If you selected multiple modules, use the plus sign button to the right of the text entry box to add additional entries.
Please describe the course(s) and how the module(s) you selected will enhance your course curriculum. 250 word maximum.