Requesting Center Credit Form

This form is to request credit for

• participating in teaching professional development activities if it is offered outside of MSU OR
• participating in teaching events sponsored by MSU with the goal of enhancing teaching OR
• watching a recording of a Center teaching workshop including the Early Career Success Certificate workshops.

Please complete the information below and submit it to [email protected].  Forms should be submitted immediately after attendance rather than all at one time.

• Download a word document version of the Outside Activity Form
  
  

Faculty Name: ____________________________________________________________________________________________

Department: ______________________________________________________________________________________________

Date(s) of Activity: __________________________________________________________________________________________

Total Hours of Attendance: ___________________________________________________________________________________

Title:  ____________________________________________________________________________________________________

Sponsoring Organization: _____________________________________________________________________________________

Location: __________________________________________________________________________________________________

Brief Description:

 How I will Incorporate what I learned into my teaching:

 Please be specific here. We want to know what you will do with what you learned. How will this impact your students?

Your Signature:____________________________________________________________________________________________

Updated: December 2018