Oxford Learning Institute, University of Oxford Tel: +44(0)1865 (2) 86813 www.learning.ox.ac.uk
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Enhancing Teaching Programme (ETP) Application Form Please complete all sections and provide as much information as possible to support us in assessing your application. Please indicate which Programme you are applying for: ETP Humanities and Social Sciences: ETP Sciences:
Please indicate your preferred start date for the Programme: Michaelmas Term: Hilary Term:
SECTION A: PERSONAL DETAILS
SURNAME:
FIRST NAME:
TITLE (Dr., Mr, Mrs, Miss, Ms etc.): GENDER:
SECTION B: CONTACT INFORMATION
EMAIL ADDRESS:
PHONE NUMBER: CORRESPONDENCE ADDRESS:
SECTION C: STATUS AND TEACHING RESPONSIBILITIES Oxford Learning Institute University of Oxford
JOB TITLE:
Please provide your full job title (e.g. stipendiary/non- stipendiary lectureship; junior research fellow; college lectureship; departmental lectureship etc.)
END DATE OF CURRENT JOB CONTRACT:
COLLEGE (if applicable):
DEPARTMENT (if applicable):
HUMANITIES DIVISION (please indicate): MATHEMATICAL, PHYSICAL AND LIFE SCIENCES (MPLS) MEDICAL SCIENCES SOCIAL SCIENCES
SUBJECT/DISCIPLINE areas in which you teach and level (Undergraduate/ Postgraduate):
Please give us a brief overview of your teaching experience to date. This must include the following information: length of experience and relevant dates; higher education institutions you have taught at (UK and overseas); the types of teaching you have been involved with (including examining & supervision):
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Please state what teaching you will be doing during the two terms in which the Enhancing Teaching Programme will run. This must include the following: details of the amount of teaching (contact hours) and the type of teaching (tutorials; lectures; practical classes; clinical/bedside teaching etc):
Please provide details of any additional teaching responsibilities you may have (e.g. course design; examining, etc.):
*Note: to be eligible to attend the Programme you must be engaged in some teaching at Oxford in the two terms during which the Programme runs. In some exceptional cases it may be possible to undertake the Programme if you only have teaching in the first of these two terms.
There are a limited number of places available on each ETP cohort. It is therefore helpful for us to understand your rationale/motivation for undertaking this programme.
Please provide a short statement explaining your motivation for applying to the Programme (max 200 words):
Please indicate here any circumstances which we should take into consideration in the event that the Programme is over- subscribed for your preferred chosen start date:
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Have you already completed YES/NO (delete as applicable) an accredited teaching programme? (e.g. leading to Associate Fellowship of the HEA (AFHEA); SEDA PDF Supporting Learning Award; Fellow of the HEA (FHEA); PGCE etc.)
Please provide full details, including qualification name(s); institution(s) and relevant date(s) of award(s):
How did you hear about the Enhancing Teaching Programme?
If you have a disability or health condition that may affect your learning, please let us know by ticking the box here and we will get in touch with you to discuss how we can help you get the most out of the programme.
I confirm that the information provided in this application is, to the best of my knowledge, complete and accurate.
I confirm I will be able to attend all seminars/workshops for the Enhancing Teaching Programme.
Signed:
Date:
Applications should be emailed to [email protected]
Alternatively, you may send your application by post to: The Oxford Learning Institute, Littlegate House, 16/17 St Ebbe’s Street, Oxford OX1 1PT.
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Statistical Supplement: Disability Full Name of Applicant: ______
The University is committed to making reasonable adjustments to enable students with disabilities including dyslexia, dyspraxia, students on the Autistic Spectrum or with long-term health conditions to participate fully in student life. In order to provide study support, relevant departments and colleges of the University may need to share information about your needs. Information will be shared on a need-to-know basis with relevant people such as the lecturers and tutors who will teach you, and any library and support staff. The information provided is also used to monitor rates of participation in Higher Education by particular groups of people, which is a statutory requirement; it does not form part of any assessment of your application. If you wish to discuss this section of the application form, or anything to do with University provision for such needs, please contact the Disability Advisory Service [email protected] or refer to their website http://www.ox.ac.uk/students/shw/das.
Please enter the code most appropriate to you:
00 I am not disabled 01 I have a disability and am in receipt of a UK Student Disability Allowance 02 I have a disability and am NOT in receipt of a UK Student Disability Allowance
If you have indicated that you have a disability, please enter the code in the box from the list of statements below which is most appropriate to you:
51 You have a specific learning difficulty such as dyslexia, dyspraxia or AD(H)D 58 You are blind or partially sighted 57 You are deaf or have a hearing impairment 56 You are a wheelchair user or have mobility difficulties 55 You have mental health difficulties 8 You have two or more impairments or disabling medical conditions 53 You have a social/communication impairment such as Asperger’s 54 You have a long standing illness or health condition such as cancer 96 You have a disability, impairment or medical condition not listed above
Statistical Supplement: Ethnicity Full Name of Applicant: ______
Please provide the number most appropriate to you:______
10 White 39 Other Asian background 15 Gipsy/Traveller 41 Mixed – White and Black Caribbean 21 Black or Black British – Caribbean 42 Mixed – White and Black African 22 Black or Black British – African 43 Mixed – White and Asian 29 Other Black background 49 Other Mixed background 31 Asian or Asian British – Indian 50 Arab 32 Asian or Asian British – Pakistani 80 Other ethnic background 33 Asian or Asian British – Bangladeshi 90 Not known 34 Chinese or other ethnic background – Chinese 98 You do not wish to provide this information
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