Enrolment

This enrolment form automatically enrols you in ULT.

The ULT program is designed to be completed over a 6 - 12 month period. An extension beyond 12 months may be granted when requested in writing.

EXEMPTION

Academic staff members may wish to apply for an exemption from the University requirement to undertake the ULT Course as a condition of appointment - please refer to the ULT policy at:
https://intranet.uow.edu.au/ard/policies/UOW058702.html for further details.

Application form for exemption can be found at: Application for Exemption

Personal details

Title: (Dr, Ms etc):

Given Names:

Family Name:

Extension No:

Home Phone:

Mobile Phone:

UOW Username:

UOW Staff/Student Number:

Faculty:

Department:

Campus Location

	Wollongong			Batemans Bay
	SBS Sydney			Moss Vale
	Bega			Shoalhaven
	UOW Southern Sydney			iC

	Other - Specify:

Education and experience

Teaching Qualifications:

University teaching experience:

Other teaching experience:

Appointment details (Current or Past)

Date of Entry:

Position:

Classification:

Academic Staff
General Staff
PhD Candidate

Employment Status:

Continuing Appointment
Fixed Term
Casual/Sessional

Are you enrolling for ULT Course as a condition of your appointment?

	Yes	Probation Date:
	No

If NO, please indicate your reason(s) for enrolling below:

University Learning and Teaching

ULT Pathway

bULT:1A - a one or two session blended program of study.
bULT:1C - credit for equivalent achievements (portfolio)
ULT Unit(s) - please specify Unit 2 or Unit 3:
(only available to participants who have previously completed a Unit/Units)

Course information is available at the website:
http://www.uow.edu.au/asd/ULT/

Last reviewed: 14 March, 2012