Academic Coach Request Form (Initial Steps)
This form is just to make CIDT aware of your Academic Coach request. CIDT's secretary, Katy Davis (kdavis@se.edu), will be the one to get in contact with Instructional Connections to properly fill in your request with them.
Instructor Name
*
First Name
Last Name
Phone Number
Can be full number or campus office extension
Email
*
example@se.edu
Which semester are you requesting to have a coach added?
Ex: Fall 2022
How many COURSES are you requesting to add coaches to for the semester above?
*
1
2
3
If a course has multiple sections, then that should be counted as 1 course.
Once you select how many courses you are requesting, the rest of this form will appear below.
Course 1
Course Name
*
ex: Introductory Psychology
Course ID Number
*
ex: PSY-1113
Section Number(s)
*
ex: W1, G1, 1, etc. If this course is remotely broadcast to other sections, include all sections here.
If you have a preferred coach (or coaches), please list their names here.
*
Course 2
Course Name
*
ex: Introductory Psychology
Course ID Number
*
ex: PSY-1113
Section Number(s)
*
ex: W1, G1, 1, etc. If this course is remotely broadcast to other sections, include all sections here.
If you have a preferred coach (or coaches), please list their names here.
*
Course 3
Course Name
*
ex: Introductory Psychology
Course ID Number
*
ex: PSY-1113
Section Number(s)
*
ex: W1, G1, 1, etc. If this course is remotely broadcast to other sections, include all sections here.
If you have a preferred coach (or coaches), please list their names here.
*
Do you have any additional instructions or comments on your coach request?
Enter the message as it's shown
*
Submit
Should be Empty: