Arts and Sciences Center for Instructional Technology
Applying to be a CTIP Faculty Partner
College Technology Interns Application

Fields marked with a * are required.

Personal Information
Name*     Email*

Department*
UVA P.O. Box*

Work phone*     Home phone

Personal web site urls, if any (use commas to separate multiple entries):


Current technology skills, if any (for ex., Word, Excel, Dreamweaver, etc.):*



Course Information
Course you would like to develop under the auspices of CTIP (if you are interested in developing more than one course, please fill out an application for each course):
Course Number*     Course Name*
Course url (if any)     # students
Course Description:*


What technology tools do you currently use in this class (if any)?*


Write a paragraph up to 350 words describing your ideas and technology needs for using technology to enhance your class:*


Write a short paragraph up to 200 words indicating what technology and other skills you are interested in developing as a Faculty Partner:*


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