Distance Education Course Request by leader6


									Distance Learning Course Form

  Instructions: This form is completed by DABCC instructors requesting develop a Distance Learning Course or to deliver their class in a
  Distance Learning (DL) format (i.e. no or reduced face to face meetings with other interactions utilizing various distance learning
  technologies and strategies). Complete this form and submit to your immediate supervisor at least two weeks before the first draft of
  the overall class schedule is complete (check with your supervisor for schedule dates). Submission of this form is not an automatic
  approval. Final approval is granted by the Division Dean and CAO

               Date of Request               December 7, 2006

Instructor Information
                          Name           Susan Wood                                                      Email sandrusw@nmsu.edu
                   Office Phone          527-7711                                              Cell /
                                                                                               Home Phone

 Two categories of compensation are available under the current compensation model:

 Development Stipend – A $500.00 one-time development stipend is available for each approved new (or substantially revised) course put

 Distance Learning Differential / Supplemental Instructional Compensation – Faculty can be compensated at a rate of $125 per credit
 for teaching distance learning classes, up to a maximum of six credits per semester (e.g., $375.00 for a three credit course). Note: This
 category of differential compensation would apply to class sections that meet the student enrollment requirements that have been
 established for the corresponding onsite classes. Differential compensation for classes that do not meet the established student enrollment
 requirement must be approved by the Department Chair, Division Dean and Campus Academic Officer. Object Code 619300 is used to
 identify the payment in the E-Hire process.

 Explanatory Note – If an instructor teaches the same distance learning course in both Spring and Fall semesters, he or she would receive
 compensation each time, up to six credits per semester. A separate compensation form must be submitted for each course, each

Compensation Category (Check all that apply)

          Development Stipend          New Course              Existing Course (substantially revised)
    Instructional Compensation         Full-time Faculty (Differential)     Part-Time Faculty (Supplemental)

 Distance Learning Certification (DL Certification) – Faculty must also complete a training course for distance learning instructors in order
 to be compensated for course development or teaching a distance course. This training will be conducted through the Technology Resource
 Center, and will focus on the following subjects:

           • WebCT and other learning modalities as appropriate
           • Distance learning assessment
           • “Best Practices” instructional strategies
           • Copyright and Digital Rights Policies

 Alternative Certification — Faculty members who have attended other relevant training (i.e., WITs, ITAL, ITC training Services or
 Teaching Academy Programs), or who have formal education and experience teaching at a distance may request to be certified through the
 Technology Resource Center. Certification through this process is subject to review and verification.

 Explanatory Note: Faculty will receive a certificate upon course completion, and will not need to repeat the training for subsequent classes
 converted to a distance learning format.
DL Certification                        DL Certification Course Completed           Date
                                        Alternative DL Certification                Date

                                                         Continued on Next Page

                                                                                                                     Revised: July 17, 2012
                                                                                                               Editor: rderouen@nmsu.edu
                                                         DL Course Form, continued

Course Information
                      Semester          Fall              Spring              Summer I           Summer II

                           Year 2007
                      Start Date                                                End Date

           Classroom Location          Online/Technology-based                 DABCC-Espina           DABCC-EMC
                                       DABCC- GEC                              DABCC-SPEC             DABCC-WSMR
                                       Other Site
                    Course Title ENGL 218 – Technical and Scientific Communication
        Program or Department ENGL and Comm
                        Division General Studies
                   Course Prefix        ENGL                  Number    218              Section(s)                  Credit(s)     3
                  Max. Students         20                 Minimum Enrollment
                 Meeting Day(s)       M              T       W         Th         F         Sa        Su         Asynchronous
                 Meeting Times     (if applicable)

 Delivery Method Percentages: Please estimate the percentages for the various instructional modes that will be used by the students in
 your course (the percentages should total 100%).

               Delivery Methods    __100_____% -- WebCT (Web Course Tools)                            _______% -- Two-way video
                                   _______% -- Centra (Internet Conferencing)                _______% -- Email
                                   _______% -- Telephone conferencing                        _______% -- Videotape
                                   _______% -- On campus session(s) (face to face meeting at primary college location)
                                   _______% -- Remote site session(s) (face to face meeting at location close to student)
                                   _______% -- Videotapes, online video archive, or other correspondence materials
                                   _______% -- Other (specify):__________________________________________
                                   _______     -- Place an “X” here if you need instructional design assistance before deciding.
Instructor Information

                Instructor: Name        Susan Wood                                                     Cell/Home Phone
                   Office Phone         527-7711                                             Alternate Email
        NMSU/BANNER Email                 sandrusw@nmsu.edu

     Approvals: All appropriate signatures must be obtained to insure proper course scheduling.
     Routing: Department Chair/Director      → Division Dean → Department Secretary → CAO → Technology Resource Center

                              Instructor Signature                                Department Chair/ Director

                              Division Dean                                       Chief Academic Officer


                                                                                                                     Revised: July 17, 2012
                                                                                                               Editor: rderouen@nmsu.edu

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