Teaching Skills Attainment Award - Application Form

Name (As you would like it on your Award)

Department

Mailing Address

Phone Number

E-mail

Confirm E-mail

I am applying for the following award (please check the appropriate box)

Level I: Teaching Skills Attainment Award

Level II: Teaching Skills Attainment Award with Merit

Level III: Teaching Skills Attainment Award with Distinction

Summary Document

One file only.
20 MB limit.
Allowed types: pdf, doc, docx, zip.

If you need to upload more than 1 document, please send as a zip file.

Math question 5 + 7 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.