The purpose of this form is to collect information on general education and significant learning outcomes. The college will use this information to determine if there is an outcome category in which students are demonstrating a weakness, the types of curricular changes being made to improve outcomes, and what additional support instructors need from the college to make these changes.

Please provide the following information:

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* 1. Please provide the following information:

Semester

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* 2. Semester

Enter the CRN(s) for the course. Each course will need to be reported on a separate form.

For example, your report on your PSY 101 course will need to be on a different form than the report on your PSY 102 course. Multiple sections of the same course, however, may be reported on the same form--just list all the CRNs for that course.

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* 3. Enter the CRN(s) for the course. Each course will need to be reported on a separate form.

For example, your report on your PSY 101 course will need to be on a different form than the report on your PSY 102 course. Multiple sections of the same course, however, may be reported on the same form--just list all the CRNs for that course.

Provide one significant learning outcome from your course outline in which student performance improvement is needed.

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* 4. Provide one significant learning outcome from your course outline in which student performance improvement is needed.

Identify the category for this outcome.

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* 5. Identify the category for this outcome.

Which of the following intervention(s) relate to your plan to improve this significant learning outcome?  Select all that apply:

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* 6. Which of the following intervention(s) relate to your plan to improve this significant learning outcome?  Select all that apply:

As you work to improve student performance, what can the College do to support or help you (e.g., professional development, instructional design)?

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* 7. As you work to improve student performance, what can the College do to support or help you (e.g., professional development, instructional design)?

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