Corequisite MyLab Consultation Request Form

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* 1. Email address:

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* 2. First name:

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* 3. Last name:

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* 4. School name:

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* 5. State:

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* 6. What course area/s are you building corequisite courses for? (select all that apply)

Intermediate Algebra

Liberal Arts Math

Quantitative Reasoning

Modeling

College Algebra

Precalculus

Statistics

Other (please specify)

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* 7. Will you be creating a course that is ultimately used by other instructors in your department (even if they are free to make changes), or will you be the sole owner of this course?

I will be creating a course that will ultimately be used by other instructors

I will be the sole owner of this course

For now I will be the sole owner, but that may change over time

Other (please specify)

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* 8. Have you already chosen a text and MyLab course? If yes, please indicate what title below:

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* 9. STUDENTS: Will your students be comingled or a cohort? See the image below for a definition of these two terms.

Comingled

Cohort

Unsure

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* 10. INSTRUCTORS: Will your corequisite course have two instructors (one for support, one for credit course) or will one instructor teach both? See image below for additional information about this question.

1 instructor

2 instructors

Unsure

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* 11. SUPPORT/REMEDIATION: Will this content be covered in a concurrent or consecutive manner in your corequisite course? See image below for additional information on these approaches.

Concurrent

Consecutive

Unsure

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* 12. SUPPORT/REMEDIATION: How many hours a week will be devoted to your support portion of your corequisite course?

1 hour

2 hours

3 hours

4 hours

Unsure

Other (please specify)

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* 13. SUPPORT/REMEDIATION: How will your classroom time be spent? (Select all that apply)

Lecture and homework

Lab setting

Completely self-paced student work

Activities and/or group work based

Online

Unsure

Other (please specify)

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* 14. SUPPORT/REMEDIATION: Will students attend or work on support content prior to, or after their weekly credit course time?

Before

After

Unsure

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* 1. Email address:

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* 2. First name:

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* 3. Last name:

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* 4. School name:

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* 5. State:

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* 6. What course area/s are you building corequisite courses for? (select all that apply)

Question Title

* 7. Will you be creating a course that is ultimately used by other instructors in your department (even if they are free to make changes), or will you be the sole owner of this course?

Question Title

* 8. Have you already chosen a text and MyLab course? If yes, please indicate what title below:

Question Title

* 9. STUDENTS: Will your students be comingled or a cohort? See the image below for a definition of these two terms.

Question Title

Question Title

* 10. INSTRUCTORS: Will your corequisite course have two instructors (one for support, one for credit course) or will one instructor teach both? See image below for additional information about this question.

Question Title

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* 11. SUPPORT/REMEDIATION: Will this content be covered in a concurrent or consecutive manner in your corequisite course? See image below for additional information on these approaches.

Question Title

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* 12. SUPPORT/REMEDIATION: How many hours a week will be devoted to your support portion of your corequisite course?

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* 13. SUPPORT/REMEDIATION: How will your classroom time be spent? (Select all that apply)

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* 14. SUPPORT/REMEDIATION: Will students attend or work on support content prior to, or after their weekly credit course time?

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* 15. Are there additional faculty members we should include in the initial planning meeting? If so, please provide names and email addresses.