Peer Observation Request

Peer Observation Request
Faculty Name: *

First Name Last Name
Department: *
Faculty Email: *
example@example.com
Deadline for Receiving Teaching Summary and Peer: *

Month Day Year
Date
Preferred Reviewer #1 Name *
Department Preferred Reviewer #1
Preferred Reviewer #2 Name
Department Preferred Reviewer #2
Preferred Reviewer #3 Name
Department Preferred Reviewer #3
Comments about Preferred Reviewers:
If you have comments please add them.
Peer Review Setting: *
Course Information
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First Course Name: *
First Course Number: *
First Course Room:
Leave in Blank if the lecture happens online
Course Type

Classroom Zoom Canvas Pre-recorded
Add link and instructions in how to access your course (canvas, zoom id/password, Box link)
Lecture #1 Title: *
Lecture #1 Date: *

Month Day Year
Date
Lecture #1 Time: *

Hour Minutes

AM/PM Option
Lecture #1 Add link and instructions in how to access your lecture (canvas, zoom id/password, Box link)
Lecture #1 Duration (In Hours) *
Lecture #2 Title:
Lecture #2 Date:

Month Day Year
Date
Lecture #2 Time:

Hour Minutes

AM/PM Option
Lecture #2 Duration (In Hours)
Lecture #2 Add link and instructions in how to access your lecture (canvas, zoom id/password, Box link)
Lecture #3 Title:
Lecture #3 Date:

Month Day Year
Date
Lecture #3 Time:

Hour Minutes

AM/PM Option
Lecture #3 Add link and instructions in how to access your lecture (canvas, zoom id/password, Box link)
Lecture #3 Duration (In Hours)

Add a Second Course...
Second Course Name:
Second Course Number:
Second Course Room:
Second Course Type

Classroom Zoom Canvas Pre-recorded
Add link and instructions in how to access your lecture (canvas, zoom id/password, Box link)
Lecture #1 Title:
Lecture #1 Date:

Month Day Year
Date
Lecture #1 Time:

Hour Minutes

AM/PM Option
Lecture #1 Duration (In Hours)
Add link and instructions in how to access your lecture (canvas, zoom id/password, Box link)
Lecture #2 Title:
Lecture #2 Date:

Month Day Year
Date
Lecture #2 Time:

Hour Minutes

AM/PM Option
Add link and instructions in how to access your lecture (canvas, zoom id/password, Box link)
Lecture #2 Duration (In Hours)
Lecture #3 Title:
Lecture #3 Date:

Month Day Year
Date
Lecture #3 Time:

Hour Minutes

AM/PM Option
Add link and instructions in how to access your lecture (canvas, zoom id/password, Box link)
Lecture #3 Duration (In Hours)

Add a Third Course...
Third Course Name:
Third Course Number:
Third Course Room:
Third Course Type

Classroom Zoom Canvas Pre-recorded
Add link and instructions in how to access your lecture (canvas, zoom id/password, Box link)
Lecture #1 Title:
Lecture #1 Date:

Month Day Year
Date
Lecture #1 Time:

Hour Minutes

AM/PM Option
Lecture #1 Duration (In Hours)
Lecture #2 Title:
Lecture #2 Date:

Month Day Year
Date
Lecture #2 Time:

Hour Minutes

AM/PM Option
Lecture #2 Duration (In Hours)
Lecture #3 Title:
Lecture #3 Date:

Month Day Year
Date
Lecture #3 Time:

Hour Minutes

AM/PM Option
Lecture #3 Duration (In Hours)

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