Instructional Design Services Request Form
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1. University of Cincinnati / Instructional and Research Computing /410 Zimmer Hall / 556-9033

Providing creative, effective solutions to higher education leaders. Please fill out the form below so we can begin helping you.

1. Please provide your name and contact information.

Please provide your name and contact information. Name:
College:
Department:
Email Address:
Phone Number:

2. Type of class you're seeking help with?

Type of class you're seeking help with?

3. If you're...

- teaching an online course and needing some help, or
- wanting to get away from lecturing in class, or
- looking for ways to teach students a difficult concept, or
- interested in learning what technology tools are available to help you teach...

...we can help, with these and more! Please tell us you what need some help with below.

If you're... - teaching an online course and needing some help, or - wanting to get away from lecturing in class, or - looking for ways to teach students a difficult concept, or - interested in learning what technology tools are available to help you teach... ...we can help, with these and more! Please tell us you what need some help with below.

4. Every instructional design project is unique in the amount of time it might take to complete. We can help you with determining timelines for completion, but ideally what date would you like to be able to roll out your project to your students?

	MM		DD		YYYY
1	Every instructional design project is unique in the amount of time it might take to complete. We can help you with determining timelines for completion, but ideally what date would you like to be able to roll out your project to your students? 1 Month	/	Day	/	Year

Instructional Design Services Request FormExit this survey

1. University of Cincinnati / Instructional and Research Computing /410 Zimmer Hall / 556-9033

Instructional Design Services Request Form
Exit this survey