Quality Matters Peer Reviewer Certification Course Grant

Contact Information for QM Peer Reviewer Course registrant

First Name

Last Name

Title

Department or College

Street Address

Apt/Suite/Office

City

State

Postal Code

Country

Email Address (please use name.#@osu.edu)

Phone Number

Mobile Phone

URL

It is important to note that the Office of Distance Education & eLearning will cover the registration fee only for those who successfully complete the PRC course. The Office of Distance Education & eLearning Grants program is supported financially from the Wide Open West (WOW!) Affinity Program.

If you do not complete the course or if you do not cancel 24 hours before the course begins, you and/or your department will be responsible for payment of the $200 registration fee.

Upon your submission of this grant application, an email notice stating that you are registering for the course and the responsibility for payment in the case that you do not complete the course will be sent to the person you indicated as your department chair or dean and to your financial officer. You may want to speak with your department chair or dean before this email is sent to familiarize him or her with QM and your plans to take the PRC course.

Dean/Chair Contact Information

First Name

Last Name

Title

Department or College

Street Address

Apt/Suite/Office

City

State

Postal Code

Country

Email Address (please use name.#@osu.edu)

Phone Number

Mobile Phone

URL

Financial Officer Contact Information

First Name

Last Name

Title

Department or College

Street Address

Apt/Suite/Office

City

State

Postal Code

Country

Email Address (please use name.#@osu.edu)

Phone Number

Mobile Phone

URL

As indicated on the QM PRC grant web page, you must have:

Successfully completed the Applying the Quality Matters Rubric
Taught an online course within the past 18 months

Contact ltgrants@osu.edu for verification or to discuss further these requirements.

Please indicate your Peer Reviewer Certification Course eligibility. *This question is required.

Yes, I have successfully completed the Applying the Quality Matters Rubric workshop.
Yes, I have taught an online course in the past 18 months. ("Online" can include hybrid courses depending on the structure of the hybrid course.)

As described on the QM PRC web page, please confirm you accept the terms you must successfully complete the PRC or cancel 24 hours before the course begins in order for the Office of Distance Education & eLearning to sponsor your registration fee. *This question is required.

I accept the QM PRC Grant terms.

In return for the sponsorship of your $200 registration fee for the PRC course, the Office of Distance Education & eLearning will ask for your participation on two formal QM reviews for Ohio State without a stipend. Every effort will be made to arrange a review date that works with your schedule.

Note, upon completion of the PRC course, QM might call on you to be a peer reviewer for other courses. Usually these reviews are compensated with a stipend (around $150). You always have the option to decline QM's offer.

Please indicate your willingness to participate on two formal QM reviews on behalf of Ohio State within two years after receiving your Peer Reviewer Certification. *This question is required.

I agree to participate on two formal QM reviews within a two-year period on behalf of Ohio State.