Faculty Center
Faculty Center
Engaging Faculty in Teaching and Learning

Faculty Request Form for SCOT

Todays Date:
Name:
Office Address:
Office Hours:
Office Phone:
E-mail:
May the student call you at home if necessary to arrange an appointment, confirm dates, times, etc.?
Faculty Home Phone:

I would like a student consultant for the following class:

Department:
Course number:
Course Title:
Day(s) and Time:
Location:
Semester/Term and Year:
Please check all options for SCOT service that you are interested in (See Options for Faculty: Ways to Use SCOT):
Recorder or Observer
Faux Student
Focus Group Facilitator
Primed Student
Student Consultant
Other
If Other Please Explain:

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