UTQ-flex

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Surname at birth *

Date of birth *

Place of birth *

E-mail address *

Faculty/Departmental Information

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Department *

E-mail address manager *

Do you currently work at the Vrije Universiteit (VU)? *

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Do you currently work at UMC (location VUmc)? *

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Cost centre ('ordernummer or WBS element') *

Username VU-net-ID (for access to Canvas) *

Cost centre ('ordernummer or WBS element') *

Username VU-net-ID (if applicable) *

Position and teaching experience

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Years of teaching experience *

Concise description of teaching experience *

Nature and content of teaching *

List of any previous teacher training *

Remarks

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Module 3: Course design

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