Course Application

Course proposals must be submitted at least three weeks before the proposed start date. After you submit this form, a confirmation email will be sent to you to keep for your records. NOTE: You cannot begin this form and save the data and come back to it later. It must be completed in one sitting.

COURSE INFORMATION
Primary Contact Email * Required
This contact will receive confirmation of form submission.
Submission Type * Required
New courses will require a syllabus or course outline to be attached for approval purposes.
- New Course
- Repeat Course
Course Title * Required
When was this course last offered? * Required
list the semester and year, ex Spring 2016
Has the course content changed since the last offering? * Required
- Yes
- No
INSTRUCTOR INFORMATION
Has the instructor previously taught K-12 PD for Boise State University? * Required
Current status as a Boise State faculty member does not automatically apply to K-12 Professional Development courses. If the instructor for this course has not previously taught a K-12 Professional Development course, please select ‘No’.
- Yes
- No
Instructor Name * Required
First Last
Boise State Employee/Instructor ID
Leave blank if you are unsure.
Instructor's Phone * Required
Instructor's Email * Required
- Use same email as primary contact email
- Use different instructor email
Instructor's Email * Required
Home Phone * Required
Home Address * Required
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Name of School/Organization * Required
Date of Birth * Required
mm/dd/yyyy
MM
DD
YYYY
Citizenship Status * Required
Country of Citizenship * Required
EDUCATION
Highest Degree Earned * Required
Area of Study * Required
Awarding Institution * Required
Year Awarded * Required
Areas of Endorsement/Certification * Required
PROFESSIONAL EXPERIENCE
Please list your work experience in chronological order, starting with your present position.
1. Title or Position * Required
School/Organization * Required
Dates of Employment * Required
2. Title or Position
School/Organization
Dates of Employment
3. Title or Position
School/Organization
Dates of Employment
SECONDARY INSTRUCTOR INFORMATION
Do you have a secondary instructor for this course? * Required
- Yes
- No
Has the secondary instructor previously taught K-12 PD for Boise State University? * Required
- Yes
- No
Secondary Instructor Name * Required
First Last
Secondary Instructor's Email * Required
If the secondary instructor has not previously taught a K-12 Professional Development course at Boise State University, they must complete an Instructor Application.
Secondary Instructor's Phone * Required
Boise State Employee/Instructor ID for Secondary Instructor
Leave blank if you are unsure.
Secondary Instructor's Date of Birth
mm/dd/yyyy
MM
DD
YYYY
COURSE DATES
Start Date of Course * Required
MM
DD
YYYY
End Date of Course * Required
MM
DD
YYYY
Date when all coursework must be completed. * Required
Last date assignments will be accepted to receive a passing grade.
MM
DD
YYYY
Date when registration should be closed. * Required
The last date students can register for PD credits.
MM
DD
YYYY
Course Type * Required
- Online
- In-person
- Hybrid (both in-person and online)
Which online platform do you plan to use? * Required
- Canvas
- Course provider’s website
Course Location * Required
The location of the in-person components of the course.
Do you plan to use an existing Boise State Canvas course for the online portion of this class? * Required
Extended Studies is not responsible for the creation of Canvas courses on behalf of professional development instructors. If using Boise State Canvas, registration must end five days before the start date of the PD course.
- Yes
- No
Total number of meetings * Required
Total number of contact hours * Required
Your course must have a minimum of 15 contact hours per credit to be considered.
Days and times class will meet * Required
Ex: MTWThF, 9 am – 1:30 pm
Location * Required
Number of PD credits * Required
Boise State PD credits require 15 contact hours per credit, are $60 each, and are Pass/Fail.
Name of school district, organization, or agency providing the course. * Required
COURSE DESCRIPTION
Course Description * Required
Educational goals/objectives of this course * Required
ADDITIONAL INFORMATION
Resources * Required
Please list any learning resources utilized for this course (training materials, readings/texts, videos, web tools, etc.)
Credit Requirements * Required
Please list any and all requirements (assignments and assessments, out-of-class work, readings, etc.)
PO OR UNIVERSITY DEPARTMENT PAYMENT
Will credit fees be paid by someone other than the student? * Required
This may be through a PO, a district invoice or a university department accounting code.
- Yes
- No
Will this Payment cover all or only some of the outstanding credit fees for each student, with the remaining balance to be paid by registrants? * Required
- All
- Some
How much of each registrant's fees will be paid? * Required
Is this part of a Grant? * Required
- Yes
- No
If a University Department, please include the account number
Payment Contact Name * Required
Payment Contact Phone * Required
Payment Contact Email * Required
Please note: Invoices will be dispatched via email. It is very important that the email address provided be current and accurately entered.
COURSE PROMOTION
Is this a district-specific offering? * Required
- Yes
- No
Is registration for this course open to the public? * Required
- Yes
- No
Would you like Boise State's K12 PD Program to promote your course? * Required
Promotion includes emails to K12 educators and a course listing on our website.
- Yes
- No
Do students need to enroll in the course using another link or website? * Required
- Yes
- No
Please provide the link to the page(s) that students will need in order to enroll in your course. * Required
What is the deadline for students to enroll in the course? * Required
MM
DD
YYYY
Boise State Credits are $60 per credit. Are there any other fees the student will pay? (Ex: course fee, enrollment fee, materials, etc.) * Required
- Yes
- No
How much is the additional fee? * Required
What does the additional fee cover (ex: enrollment fee, material fee, assessment fee, etc.)? * Required
SUPPLEMENTAL DOCUMENTS
It is strongly advised that you attach supplemental documentation to this form before submitting (i.e. course syllabus, schedule, instructional materials, etc.). File formats you may upload include PDFs and Word documents. You may upload a total of three documents with this form. If you need to provide more, please email them to k12professionaldevelopment@boisestate.edu.
File 1
Attach first supplemental document. Allowed file extensions include pdf, docx, doc. Max file size is 10MB
Accepted file types: pdf, docx, doc, Max. file size: 10 MB.
Maximum file size – 10 mega bytes.
File 2
Attach second supplemental document. Allowed file extensions include pdf, docx, doc. Max file size is 10MB
Accepted file types: pdf, docx, doc, Max. file size: 10 MB.
Maximum file size – 10 mega bytes.
File 3
Attach third supplemental document. Allowed file extensions include pdf, docx, doc. Max file size is 10MB
Accepted file types: pdf, docx, doc, Max. file size: 10 MB.
Maximum file size – 10 mega bytes.
Before Submitting
If there is an issue with the field when you click submit, you will be redirected to the top of the page. If this happens, your application has not been submitted successfully.

Your information will still be in the fields and any issues will be highlighted in red. A common error is the date format, which needs to be completed with mm/dd/yyyy.

If your application is successfully submitted, you will be directed to a confirmation screen with a blue checkmark. You will also receive a copy of the form in your email.

Course Application

COURSE INFORMATION

INSTRUCTOR INFORMATION

EDUCATION

PROFESSIONAL EXPERIENCE

SECONDARY INSTRUCTOR INFORMATION

COURSE DATES

COURSE DESCRIPTION

ADDITIONAL INFORMATION

PO OR UNIVERSITY DEPARTMENT PAYMENT

COURSE PROMOTION

SUPPLEMENTAL DOCUMENTS

Before Submitting