Professional Biography of Instructor — CAPP Program

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In addition to this electronic Professional Biography you MUST have your official sealed University transcript indicating Masters Degree or above sent to:

Whitney Elder, Program Secretary
Collaborating Academic Partnership Program
College of Education
Aurora University
347 S. Gladstone Avenue
Aurora, IL 60506

Complete all relevant sections of this form, and click the Submit Request button to send the document.

An asterisk (*) indicates required fields. The system will not accept the form until all required fields are completed.

GENERAL INFORMATION
* Name of Collaborating Academic Partnership you will be teaching for:
* Name of Instructor (Last, First, Middle Initial):
Maiden Name if Applicable:
* Address:
* City:	* State: * ZIP:
Home Telephone:	* Area Code: * Phone Number:
Cell Telephone:	* Area Code: * Phone Number:
* Email Address:
* Social Security Number:
* School/Business:
Work Phone:	* Area Code: * Phone Number:
* Work Email Address:
EDUCATIONAL RECORD
Undergraduate Education
Undergraduate Degree:
Date:
Institution:
Major:
Minor:
Masters or Professional Education
Masters or Professional Degree:
Date:
Institution:
Field(s)
Doctoral Education
Have you earned a doctorate degree?	Yes No (If "no", skip ahead to Certification)
Degree Held
Date:
Institution:
Field(s):
Dissertation Title:
CERTIFICATION
Certification:
EMPLOYMENT RECORD
List Position or Title, Dates of Employment, and Employer's Name and Location for last two positions held:
List prior post-secondary teaching experience; include course name, institution or organization, and dates:
Academic Activities, Memberships and Honors:
Publications (Please give complete bibliographical information):
ACKNOWLEDGEMENT INSTRUCTOR RESPONSIBILITIES
We are fortunate to have highly qualified instructors participating in the various staff development programs offered through a myriad of Aurora affiliated partnerships. Your knowledge and practical experience permit the Collaborating Academic Partnership Program to fulfill its role in fostering the continued professional growth of our state's K-12 teachers. As an instructor in the Aurora University's Collaborating Academic Partnership Program (CAPP), you are employed by a member partner and approved by the University to instruct appropriate off campus courses in the CAPP program. Consequently the designated partnership contact person for each respective partnership is responsible for acquainting you with the appropriate University policies and procedures regarding course scheduling, instruction and grade reporting, and new course development. You are responsible for reviewing and conforming to the University's policy on Harassment and Anti-Sexual Harassment. The appropriate partnership designated contact will supply the following to the instructor: Syllabus development guidelines with required syllabus template. Copies of the approved course syllabus for each participant. Class Roster and Grade Sheet with instruction page attached. Course Registrations/Transcript Forms Student Perception of Teaching forms with instructions and mailing envelope. The instruction sheet for registration, class roster completion, grading reporting, etc., accompany the Class Roster/Grade sheet multiple colored set. The class roster becomes the official university hard copy verifying student course completion. Please take care in its completion. Be certain to allow sufficient time at the first course session for students to register properly and receive a copy of the approved course syllabus. An important reminder: It is vital for proper accounting and grade reporting that the exact approved Aurora University course number, course title, and course location is reported accurately. Grades are due no later than two weeks after the last course session. Please submit them to the partnership designed contact for transmittal to the Collaborating Academic Partnership Program office. Type your name and date as verification that you have read, and will adhere to, these responsibilities. After submitting this page, you will receive a reply page. Please save and/or print a copy for your records.
* Your name
* Date