Online Survey Software | Qualtrics Survey Solutions

The purpose of this survey is to facilitate the evaluation of course content to determine if a course meets the criteria for being designated a Community-Based Learning Course at UW-Whitewater. Please answer the ten questions posed below and provide additional information when prompted. You may be asked to indicate the section/pages of your syllabus that document your response. You will have an opportunity to upload a PDF version of your syllabus at the end of the survey. Please include page numbers in your syllabus and highlight relevant sections of the syllabus to facilitate the evaluation process. This survey needs to be completed in one sitting.

Please provide us with information on your course.

Course name

Anticipated term to be offered

Subject

Catalog No. (3-digit)

Please provide us with information about you (i.e. person proposing CBL course designation):

Your first name

Your last name

Your email address

Please state your department:

Please state your department chair name and E-mail address (we will send a copy of this submission to him/her/them for their reference).

Please state your department ADA name and E-mail address (we will send a copy of this submission to him/her/them so that the course designation can be added to the departmental class schedule during the proofing stage, as required by the Registrar).