Teaching Mentorship Application

Use this form to submit your application.

Your last name, first name  

Your E-mail address  

Name of your institute  

Name of your mentor  

Title of the course  

Module code /name  

Term  

Summer 2024Winter 2024/2025Summer 2025Winter 2025/2026Summer 2026Winter 2026/2027Summer 2027Winter 2027/2028Summer 20028

Hours per week  

123456

Form of examination  

oralwritten

Pre-requisites List any pre-requisites needed for this course

Concept for the course   Attach a description of the content of the proposed course.