University_teaching_qualification

Personal details

Sex

Title *

Initial(s) *

First name: *

Surname at birth *

Date of birth *

Place of birth *

E-mail address *

Faculty/Departmental Information

Faculty *

Department *

E-mail address manager *

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

yes

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

yes

Cost centre ('ordernummer or WBS element') *

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

Username VU-net-ID (if applicable) *

(Work) Address *

Postal code *

City *

Email address contactperson for the payment *

Reference code *

Position and teaching experience

Position *

Years of teaching experience *

Concise description of teaching experience *

Nature and content of teaching *

List of any previous teacher training *

Remarks

Registration for University Teaching Qualification (UTQ) *

University Teaching Qualification (UTQ)

Fast-track University Teaching Qualification (UTQ-ft)

Individual University Teaching Qualification (UTQ-i)

Please specify day *

Please specify course period *

I agree to be bound to the general conditions (in Dutch) *

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