Certification-Form-for-103-Computer-Software-Courses
Certification for 103 Courses Credit and Continuing Education Credit I wish to be certified to teach the following 103 computer software courses: Course Title Course Number Please provide Rationale “Why” I am qualified to teach the above course(s): Education --formal and informal (List dates, course titles, hours, location, etc.): Occupational Experience (List employer, dates employed, duties performed relevant to course(s) teaching & hours spent performing these duties.): ________________________________ Faculty Name (Print) ________________________________ Faculty Signature ______________ Date APPROVAL: I have ascertained that this instructor has sufficient competence to teach the course(s) listed above: _________________________________ Signature of Program Manager _________________ Date Western Technical College, Certification, A-115, 400 Seventh St. N., P.O. Box C-0908, La Crosse, WI 54602- Rev 7/17/11
