Classroom Observation Request form by beh18617

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									Classroom Observation Request form – Winter 2010
Your name ___________________________________________________________

Department ___________________________________________________________

Campus Mailing Address________________________________________________

Campus Telephone number_______________________________________________



Your Evaluator will observe a session of your class during the Winter 2010 semester. Please indicate three unique dates when
your Evaluator could visit. Please submit this completed form to your Evaluator.




Class to be observed                Class start time-class end time    Location of class              Observation dates               Topic
                                                                                                      (January 18 – April 9)

Example: CM 241                     10:15 am – 12:30 p.m.              406 CSC                Monday, February 1               Proteins


__________________                  _________________________          ______________                 _______________          ____________________

__________________                  _________________________          ______________                 _______________          ____________________

__________________                  ________________________           ______________                 _______________          ____________________


Please provide a copy of the syllabus for each class listed.


Your Evaluator will conduct your classroom observation. If you have any questions please call Sandy Andrews, 234-4223 or Deb DeWent, 234-3920.




  Classroom Observation Request Form W 2010                                                                                           Revised August 2009

								
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