Academic Institution Implementation Agreement The Online Academy Positive Behavior Support Team The University of Kansas Instructor's Agreement
The University Affiliated Program in collaboration with the Beach Center on Families and Disability agrees to make the Online Academy Positive Behavior Support modules ("Modules") available to ("Instructor") at ______("Institution") for instructional and technical assistance purposes within the Research and Training Center on Positive Behavior Support and the Technical Assistance Center on Positive Behavior Intervention and Supports. The Modules will be made available for instructional and technical assistance purposes at no cost to the Instructor as long as a commitment to implement the Modules is made in accordance with the Conditions of Utilization outlined below.
Conditions of Utilization: 1. The Modules or lessons may be offered as independent courses, integrated into regularly offered courses or as incorporated into staff development efforts. 2. The pricing policies of the Institution/Organization shall apply in the offering of the modules. 3. The Modules shall not be offered for Continuing Education credit. 4. The Instructor may add his/her name and course identification to the Modules; however, the University of Kansas credits for the development and design of the Modules must remain as embedded in the Modules. 5. No modifications shall be permitted to the content of the Module. The Modules, however, maybe used in total or in part. 6. The Instructor shall collaborate with the University of Kansas staff in evaluation activities including: • participation in interviews, • collecting data on users including number and demographic information, • gathering consumer satisfaction information. 7. The Online Academy and University of Kansas expressly disclaim any and all express or implied warranties and make no express or implied warranties or representations of any kind whatsoever including but not limited to warranties of merchantability, of fitness for a particular purpose, and that the use of the Modules will not infringe on any patent, copyright, trademark or other rights. Further, the Online Academy and the University of Kansas make no representations whatsoever that the Modules are free from liability for patent infringement or may be used without infringing any other patent, except to the limited extent that the Online Academy and the University of Kansas represent that, as of the effective date of this agreement, neither the Online Academy nor the University of Kansas has actual knowledge that the Modules infringe any valid and enforceable patent held by a third party.
The information on the following page is not necessary for obtaining access to the Modules but will help the Online Academy Positive Behavior Support Team evaluate the effectiveness of their dissemination efforts. It is voluntary, and is not used to determine class grades or access to information. It will be used only to assess program effectiveness and to help the authors better meet the needs of those using the Modules.
8. Modules may not be resold or distributed in any way in whole or in part without the prior written consent of the University of Kansas.
______date: date: Instructor Online Academy PBS Coordinator Instructor Demographic Information
Age (Circle the one that best applies) Under 18 18-25 26-40 41-60 Over 60
Gender: Male _____ Female _____
Ethnicity/Race (Check the one that best applies) _____ White _____ Black _____ Hispanic _____ Native American/Eskimo/Aleut _____ Asian/Pacific Islander
Level Of Education (Check the one that best applies) _____ Less than High School Diploma _____ High School Diploma _____ Some college experience _____ Bachelor’s Degree _____ Master’s Degree _____ Specialist Degree _____ Doctoral Degree
State of Residence: ______Do you have any need for assistance or accommodations? Yes _____ No _____ If so, what type? ______
Do you have any previous experience with online instruction? Yes _____ No _____
If so, how much? (Check all that apply)
_____ Less than 3 courses as a student _____ 3-6 courses as a student _____ More than 6 courses as a student _____ Teaching some online content as an instructor _____ Writing online instructional content