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First Name:
Last Name:
Home Address:
City:
State:
Zip Code:
Teaching Employment Status:
Home Campus:
Telephone No.: (Daytime)
Telephone No.: (Evening)
Email Address:
Verify Email:
Please provide us with the last 2 digits of your social security number:
Please check each term you will be interested in teaching a course
Fall 2008 ( Fall 2008 Application Deadline: May 2, 2008 )

*Full Time CCC Faculty Only: (Effective Fall 2008)* Full Time CCC faculty who are applying to teach for the Center for Distance Learning (CDL) must make a written request to their campus Vice President with the following information: The term of your application. The course(s) that you have applied to teach. If one course, specify if the course is for load or special assignment. If two courses, specify which course is for load and which course is for special assignment. *The written approval of your campus Vice President must be provided as part of your CDL application process.* Please keep in mind that Full Time CCC faculty are permitted to teach up to 2 CDL courses per term (only 1 for load); however, the number of courses assigned by CDL is based on campus requirements and student demand. Assignment of a course or courses is subject to review, including, but not limited to, completion of required ION courses, appropriate academic credentials, and district-wide seniority.
Please tell us about your "Academic Qualification" in your teaching field(s):
Please list your highest academic degree(s), and/or number of graduate credit hours earned, in your primary and/or secondary field(s) of instruction. Please note: A minimum of a Masters degree is required for any primary field(s), and a minimum of 30 graduate semester credit hours is required for qualification in any secondary field(s).

Official copies of transcripts must be on file with the college in order for this application to be considered. If your transcripts are already on file with CDL, please indicate via email fstewart@ccc.edu. Otherwise, please request an official copy of all appropriate transcripts to be sent to the following: Center for Distance Learning Kennedy-King College 6343 S. Halsted Street Room W240 Chicago, IL, 60621 Attn: Francine Stewart
Please describe any other experiences, and/or courses taught, using a distance learning delivery method (please also include the date(s) when you taught a distance learning course(s):

Please indicate any other experience, and/or courses taken as a student which utilized a distance learning delivery system (please be sure to include the courses sponsoring organization (i.e. CDL, ION, etc.):

Please tell us about your technical skills: Please list the operating systems, computer software programs, Internet-based applications, and course management systems with which you are most familiar.

Professional References Response Required Please provide the names, phone numbers and e-mail addresses of at least three professional references. If you have previously been employed within CCC, please include at least one faculty and/or administrative representative from your home campus.

From the list below, please select the course(s) you would like to express your interest in facilitating for CDL. Please choose only those courses you are QUALIFIED to facilitate.
Course 1:
Course 2:
Course 3:
"I UNDERSTAND THAT PROVIDING FALSE INFORMATION, INCOMPLETE OR INCORRECT STATEMENTS OR MATERIAL OMISSIONS ON MY APPLICATION OR RESUME WILL SERVE AS CAUSE FOR REJECTION OF MY APPLICATION OR IF HIRED FOR DISCHARGE FROM EMPLOYMENT."