FORM B GLOBAL CLASSROOM

GLOBAL CLASSROOM

FORM B: AFTER THE SESSION
GENERAL INSTRUCTION

This form should be submitted once the global classroom session has been completed. ONE FORM for ONE COURSE only.
SECTION A: INSTRUCTOR
INSTRUCTOR'S FULL NAME (WITH DESIGNATION)*
with salutation
SECOND INSTRUCTOR FULL NAME
with salutation
THIRD INSTRUCTOR FULL NAME
with salutation
PHONE NUMBER*
Please enter a valid phone number.
INSTRUCTOR'S OFFICIAL UMPSA EMAIL*
cirel_admin@umpsa.edu.my
FACULTY*
COURSE CODE*
COURSE NAME*
APPROVER DETAILS

Please fill in your approver's detail.
FACULTY'S DEPUTY DEAN (ACADEMIC & STUDENT DEVELOPMENT AFFAIRS) EMAIL*
cirel_admin@umpsa.edu.my
FACULTY'S JK E-LEARN EMAIL*
cirel_admin@umpsa.edu.my
COLLABORATOR DETAILS

Please fill in the details of your collaborator.
FULL NAME (WITH DESIGNATION)*
OFFICIAL EMAIL*
example@example.com
UNIVERSITY / INDUSTRY ADDRESS*

Address Line 1

Address Line 2 (insert - if not available)

CityState

Postal / Zip Code
UNIVERSITY / INDUSTRY COUNTRY*
COLLABORATOR PICTURE*

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2nd COLLABORATOR DETAILS

Please fill in the details of your collaborator.
FULL NAME (WITH DESIGNATION)
OFFICIAL EMAIL
example@example.com
UNIVERSITY / INDUSTRY ADDRESS

Address Line 1

Address Line 2 (insert - if not available)

CityState

Postal / Zip Code
UNIVERSITY / INDUSTRY COUNTRY
COLLABORATOR PICTURE

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SESSION DETAILS

Please fill in the details of your global classroom session.
NUMBER OF GC SESSIONS THAT HAVE BEEN CONDUCTED*
First Session
DAY*
DATE*

DayMonthYear
START TIME*

Hour Minutes

AM/PM Option
END TIME*

Hour Minutes

AM/PM Option
Second Session
DAY*
DATE*

DayMonthYear
Date
START TIME*

Hour Minutes

AM/PM Option
END TIME*

Hour Minutes

AM/PM Option
Third Session
DAY*
DATE*

DayMonthYear
Date
START TIME*

Hour Minutes

AM/PM Option
END TIME*

Hour Minutes

AM/PM Option
Fourth Session
DAY*
DATE*

DayMonthYear
Date
START TIME*

Hour Minutes

AM/PM Option
END TIME*

Hour Minutes

AM/PM Option
Fifth Session
DAY*
DATE*

DayMonthYear
Date
START TIME*

Hour Minutes

AM/PM Option
END TIME*

Hour Minutes

AM/PM Option
GC SESSIONTYPE*

BASICSTANDARDADVANCED
VENUE*

LECTURE HALL / LABGLOBAL CLASSROOM @ PSPeOther
NUMBER OF UMPSA STUDENT INVOLVED*
NUMBER OF EXTERNAL STUDENT INVOLVED*
Please put 0 if none
PROOF OF STUDENT ATTENDANCE LIST*

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MODULE / TOPIC DETAILS

Please fill in the module / topic conducted in the global classroom session.
Shared Module/Topic Name
Collaborative Learning Topics
Course Outcomes (*please mention in term of partner, course level, language etc)
Suggestions For Improvement to CIReL
Upload Proof (*please uplaod screen shot or image of session. If video, please upload screenshot of video)*

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Upload Lesson Materials / Activities*

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Upload Lesson Assessment

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Should be Empty:

GLOBAL CLASSROOM

GENERAL INSTRUCTION

SECTION A: INSTRUCTOR

APPROVER DETAILS

COLLABORATOR DETAILS

2nd COLLABORATOR DETAILS

SESSION DETAILS

First Session

Second Session

Third Session

Fourth Session

Fifth Session

MODULE / TOPIC DETAILS