Graduate Student Mid-Course Review Request Form
Please use this form to request a CTL Mid-Course Review (MCR). To arrange for an MCR, please submit this request form at least two weeks prior to the date when you would like a Teaching Consultant to visit your class. All MCRs must be completed by March 13th, 2020. Requests for MCRs will close on Friday, March 6th, 2020.
Your Information
First Name *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Department *
Your answer
Status *
Cell Phone Number *
Required in case we need to contact you on the day of the scheduled observation.
Your answer
Mid-Course Review Date & Time
Desired Date of MCR *
Ideally, your MCR will take place early enough in the semester that you can implement changes to the rest of the course. Enter a specific date that you would like a consultant to visit your class. You must request your MCR at least two weeks in advance of the date listed.
Your answer
Time of Day *
Please note that consultants will need 15-20 minutes at the end of your class to speak with your students.
Your answer
2nd choice -Desired Date & Time *
If a consultant is not available on the first date you listed, please list another date for the MCR.
Your answer
3rd choice -Desired Date & Time *
Your answer
Course Context
Please provide some context for the MCR. What, in particular, would you like the consultant to be aware of regarding this MCR? *
Your answer
On which aspects of the course would you like particular feedback on from the students? (Select up to three) *
Required
Observation Logistics
Course Number & Title *
Your answer
Location (Building & Room Number) *
Please provide specific directions if needed for entering the building. If the room has not been confirmed, please enter TBD.
Your answer
Class Format *
Class Size *
Is this class conducted in a language other than English? *
Is there a blackboard or whiteboard available in the classroom? *
Any additional information or comments:
Your answer
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