Authorized Virtual Education Provider Survey Thank you for your interest in becoming an Authorized Virtual Education Provider. Please review the CSL Policies and Procedures and discuss Considerations and Best Practices with your leadership team before completing this survey. When you submit your survey response, please email Misha Brigham (mbrigham@csl.org) and you will then be contacted with details to proceed with the authorization process. Question Title * 1. Have you read and discussed the Policies and Procedures with your leadership? Yes No Question Title * 2. What are the benefits you hope to realize in your community by offering online/mixed delivery education? Question Title * 3. Please briefly describe your experience(s) teaching in a virtual environment (online or mixed delivery). Question Title * 4. What challenges have you faced teaching online/mixed delivery? Please check all that apply and explain briefly. Technology Issues Student Retention Curriculum Delivery No Challenges Other (please describe below) Please briefly describe your challenge(s). Question Title * 5. Please briefly describe the successes you have had teaching online/mixed delivery. Question Title * 6. What types of training would be valuable for your community to successfully offer courses online/mixed delivery? Facilitation Technology Curriculum Development Marketing Other (please specify) Question Title * 7. Briefly describe how you see CSL Home Office supporting your success. Question Title * 8. What questions do you have with regard to providing education online? Question Title * 9. Please provide your contact information Name Community Address City/Town State/Province ZIP/Postal Code Country Email Address Phone Number Question Title Thank You!