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_______________________________ Date_________ complete Address __________________________ Email: _____________________ in case of emergency, contact: Name ___________________................______________ Phone: ______________________________ Work Phone: ____________________ Pager: ___________________. If you are unable to complete the form, Please contact your instructor.
_______________________________ Date_________ complete Address __________________________ Email: _____________________ in case of emergency, contact: Name ___________________................______________ Phone: ______________________________ Work Phone: ____________________ Pager: ___________________. If you are unable to complete the form, Please contact your instructor.
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_______________________________ Date_________ complete Address __________________________ Email: _____________________ in case of emergency, contact: Name ___________________................______________ Phone: ______________________________ Work Phone: ____________________ Pager: ___________________. If you are unable to complete the form, Please contact your instructor.
Авторское право:
Attribution Non-Commercial (BY-NC)
Доступные форматы
Скачайте в формате DOC, PDF, TXT или читайте онлайн в Scribd
Email: ____________________________ Alternative Email ____________________
Home Phone _______________________________ Cell _______________________
Work Phone _______________________________ Pager ______________________
In case of emergency, contact: Name ________________________________________ Phone: ______________________ Cell _________________ Other _______________
1. Place of employment ______________________________________________
2. Current Position __________________________________________________ 3. Name of School(s) ________________________________________________ 4. Highest degree earned-PhD, EdD, EdS, MEd., MS, MBA, BA., BS., AA. List institutions and degrees earned below: Institution-Degree-Year ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ 5. What degree are you currently working? ___________ 6. List a few of your favorite states and foreign countries you have visited:_______ _________________________________________________________________ _________________________________________________________________ 7. Years of teaching experience: _____ Years of administrative experience: _____ 8. Voluntary (optional) Number of children/grandchildren, names, ages: _________________________________________________________________ _________________________________________________________________ 9. What do you enjoy doing when you are not working? _________________________________________________________________ 10. What is the highest position you want to obtain in your career? _________________________________________________________________ 11. Is there something about you that Dr. Kritsonis needs to be made aware of? (Please write on the back of this paper)
I, __________________________ am currently enrolled in the course entitled:
______________________________________. Dr. William Kritsonis is the professor. I have read the course expectations. I understand what is required and expected of me to satisfactorily complete the course.