Application to Join a Community of Practice (CoP) [Insert CoP Topic Title Here] Nakatani Teaching and Learning Center Name: Rank/Position: Department: Telephone Number: College/Division: E-Mail: Complete if you are applying to be a member of a NTLC Communities of Practice: Answer the following questions using one to two paragraphs; please limit your answers to two pages. 1. If you are applying as a participant, briefly describe why you would like to be a member of this community of practice. 2. In what ways do you think that this experience will benefit you as a teacher and your students as learners? How will it support your faculty development? 3. If this CoP is course-focused, indicate a course(s) and topic you would like to try out [Topic of CoP] in and describe what you want your students to take away from the experience. 4. Since some participants struggle with effectively assessing student learning and project outcomes, provide a brief overview of your experience with [Topic of CoP] assessment (it is okay to note if you are not familiar with [Topic of CoP] assessment measures). 5. Describe your comfort, enthusiasm and plans regarding encouraging other colleagues to engage in [Topic of CoP]. Members of a CoP are expected to: 1. meet at least twice a month throughout the fall and spring semesters, 2. assess their work and their students’ learning outcomes for the CoP, 3. present at the NTLC MayDay Celebration held in May 2014; they are encouraged to share their results in other venues as well. Upon completing the CoP, participants will receive a financial incentive and a recognition letter addressed to their dean and chair. Once this application is completed, please send it in an electronic format to Renee Howarton. Thank you for completing this form. Form Adapted from Miami University, Revised June 2013 Application Signature Page NTLC Community of Practice (CoP) [insert Topic of CoP Here] 1 Facilitator/Applicant’s Signature If I am selected as a participant/facilitator in this Communities of Practice [insert Topic of CoP here], I agree to participate fully in the community’s activities and I will complete the research, readings, projects, reports, and documents associated with this CoP. I also agree that I will share the results I learn with other faculty and staff. Facilitator/Applicant’s Signature: Date: Department Chair’s Signature I endorse the above applicant’s participation in the Community of Practice [insert Topic of CoP here] and will support the implementation of the community’s work. Department Chair’s Signature: Date: Once signed, please send this either in an electronic format or via campus mail to Renee Howarton, 301 MLNM. You may also fax your completed signature page to 232-1691. Thank you for completing this document. 2