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#17-005057-0009
Supplemental Questionnaire

Last Name
First Name

 

***Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit.***


1.

Do you possess a doctorate degree?

Yes No
2.

Do you have at least 2 years experience of direct staff oversight?

Yes No
 

If yes, please explain in detail your experience, including dates and places of employment.  If you do not have this experience, please write N/A.

3.
Do you have at least 1 year experience in digital learning, including online and blended learning modalities?  
 
Yes No
 

If yes, please explain in detail your experience, including dates and places of employment.  If you do not have this experience, please write N/A.

 


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