Application to Participate in the Design for Learning: 21st Century Online Teaching and Learning Skills for Library Workers Training Program
We are in the process of recruiting the second group of 60 participants and would love your participation! You may read the full program description on our site at http://d4l.syr.edu/ 

This project was made possible in part by the Institute of Museum and Library Services, Laura Bush 21st Century Librarian Grant Project #RE-06-14-0014-14.

Este proyecto ha sido posible en parte por el Instituto de Servicios de Museos y Bibliotecas, Laura Bush 21st Century Bibliotecario Proyecto Grant # RE-06-14-0014-14.

To learn more, visit www.imls.gov and follow IMLS on Facebook https://www.facebook.com/USIMLS and Twitter https://twitter.com/us_imls. @US_IMLS
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Your First Name (Required) *
Your Last Name (Required) *
Your e-mail address *
(Please provide the email address that you most frequently use to read your e-mail.)
Your telephone number? *
 (The one you will answer most frequently please)
Where do you Work? *
(Name of library, company, organization)
If you work in or for a Library, What kind of library is it? *
Required
What is your Job Title? *
Briefly describe what your job entails. *
(100 or fewer words please)
Your Workplace Street Address: *
e.g., 1117 Meadowbrook Blvd.
Your Workplace City: *
Your Workplace State:
(Please use the 2 letter abbreviation.  e.g., OH for Ohio or IL for Illinois or NY for New York)
Your Workplace Zip Code: *
Have you ever taken a course online? *
Why do you wish to participate in the Design for Learning training program? *
(200 or fewer words please)
How will your participation in this program benefit your library and/or your community? *
(200 or fewer words please)
Have you ever used a formal instructional design strategy to design a course, workshop, or other unit of instruction? *
For more information on instructional design see: https://en.wikipedia.org/wiki/Instructional_design
If you answered Yes to the question above, did you design for teaching online, face-to-face, or a blend of both?
Check all that apply.
Have you ever taught a course, workshop, or other unit of instruction? *
If you answered Yes to the question above, did you teach online, face-to-face, or a blend of both?
Check all that apply.
Are you willing and able to commit to participating in the D4L training program for the following dates?  Check all that apply please. *
The time commitment for each module is approximately 5 hours per week (20 hours per month).
Required
Please list the names, email address, and telephone numbers of at least 2 professional references who support your application to participate in the D4L training program. *
How did you hear about the D4L program? *
Was your application deferred from Cohort 1?
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