Certificate of Teaching Enhancement
Record of Participation in Outside Activity

This form is intended to document participation in activities designed to enhance teaching in learning if offered outside MSU (or if no sign-up sheet was available).  Please complete the information below and submit it to Julia Tietz in the Office of the Provost (212 Montana Hall or cfe@montana.edu).  Forms should be submitted immediately after attendance rather than all at one time.

Faculty Name: ____________________________________________________________________________________________

 

Department: ______________________________________________________________________________________________

 

Date(s) of Activity: __________________________________________________________________________________________

 

Total Hours of Attendance: ___________________________________________________________________________________

 

Title:  ____________________________________________________________________________________________________


Sponsoring Organization: _____________________________________________________________________________________

 

Location: __________________________________________________________________________________________________

 

Brief Description:

 

 

 

 

 How I will Incorporate what I learned into my teaching:

 

 

Your Signature:____________________________________________________________________________________________