ADL5000

Course Review and Consent Form

ADL5000 Participant’s Name: ______

For Department Chair's Review & Consent

Department chair’s/program coordinator’s responsibility:

-Identify prospective faculty member (ADL5000 Participant):

-Identify faculty members/prospective faculty members who need to teach online courses. Hereafter, we will refer to the selected faculty member as the ADL5000 Participant.

-Get agreement from the prospective ADL5000 Participant to teach an online course within the guidelines provided below.

-Outline your expectations that the ADL5000 Participant

-Provide a deadline for completion of ADL5000 and consequences if they do not complete ADL5000 by the deadline.

-Identify online course:

-Identify an online course created by an IDL6543 certified faculty member that may be copied for the ADL5000 participant.

-Delivery mode of course must match the delivery mode you want the ADL5000 participant to use.

-Get permission to copy the course for the ADL5000 Participant.

-Identify Mentor:

-If the owner of the course being copied is not available, identify an IDL6543 certifiedfaculty member with knowledge of the course content to act as a mentor for the ADL5000 participant.

-Make sure the mentor understands the requirements of this role and get their agreement to support the ADL5000 participant.

-Make sure the ADL5000 participant knows how to contact their mentor.

-Completion of this form

-The department chair should complete the first section of this form titled “Course Section & Level of Modifications Allowed.”

-Please take time to consider the level of changes you will allow the ADL5000 Participant to make in their course.

-Take into consideration their experience teaching in the classroom and experience in the online environment.

-We recommend the mentor ANDADL5000 Participant complete the rest of the form together. Completing the form together provides them an opportunity to work together and develop a working relationship.

Course Status & Level of Modifications Allowed

(Department chair should complete this section of the form.)

  • What course will be copied for the ADL5000 participant (where do they get their course content):
  • Course Subject and Numbe r (Ex: ABC 1000): ______
  • Section No. (Ex: 0W01 or 0M01): ______
  • Term (Ex:Spring 2014): ______
  • Name of the course owner: ______
  • If the owner isnot the mentor for the ADL5000 participant, please send us an e-mail from the owner granting permission to copy the above course.
  • Have you reviewed the course and determined it is ready for delivery in the online environment? (Please contact Linda Futch or Pam Cavanagh if you need access to the course)

Yes

No

Comments:

  • What level of modification is the ADL500 participant allowed to make in their course? (check all that apply):

change instructor name throughout course (for contact purposes)

update discussion prompts

update/replace links that do not work or exist

edit time-sensitive content

update content to align with new textbook

re-organize content (for streamlining navigation)

re-sequence content/assignments/schedule to fit course timeframe (i.e. fall vs. summer)

syllabus and schedule (and related documents, e.g. schedule)

other, please specify:

______/____/2014

Department Chair’s/Program Coordinator’sDate

Signature

(electronic signature is acceptable)

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Mentor Information & Consent

(Mentor should complete this section of the form.)

The mentor to an ADL5000 participant is responsible for:

  • coaching the participant throughout ADL5000
  • coaching participant through the initial delivery of their online course

The mentor should help the new online faculty member:

  • interpret the pedagogical decisions of the course creator,
  • identify support strategies and how to manage an online course,
  • identify support and management strategies for students,
  • guide them through university/college/department policies,
  • guide them through their first time delivering an online course at UCF

The mentor is NOT responsible for technical support. Online@UCF Supportprovides technical support to faculty members and students.

  • Mentor name: ______
  • E-mail address: ______
  • Phone number: ____ - _____ - ______

I agree to mentor ______through ADL5000 and the first delivery of their online course.

______/____/2014

Mentor’s SignatureDate

(electronic signature is acceptable)

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ADL5000 Participant Information& Consent

The ADL5000 Participant should fill in their information and answer the following questions.

  • ADL5000 Participant Name: ______
  • E-mail address: ______
  • Phone number: _____ - _____ - ______
  • UCF ID: ______
  • NID: ______
  • Date of Birth: 00/00/1900
  • Last four of the SSN: ______
  • Assigned to Regional Campus

Yes – Which campus: ______

No – Orlando campus

  • Do you have any experience teaching online? If yes, what course management system did you use? How long have you taught online?
  • Do you have any experience teaching this course? If you have, in which mode did you teach the course (face to face, W/fully online, M/reduced seat time, mixed mode)?
  • Have you received modification guidelines from your college/department?

Yes

No

I agree to participate in ADL5000 including completion of the online course in a timely manner. Also, I will deliver the inherited course as is (with minor changes as outlined in the modification guidelines above).

______/____/2014

Participant’s SignatureDate

(electronic signature is acceptable)

University of Central Florida – CDWSPage13/25/2011