Certificate in Technology Application

If you are a Northwest College faculty member who has completed either the Basic or Advanced certificate as part of the Certification in Instructional Technology (CIT) program, fill out the form below for verification. This information will be reviewed by the Director of Technology & Instructional Computing at the college.

Full Name (Required)

Your first and last name

Employee ID (Required)

Your HCCS employee ID as found on your paycheck

Department (Required)

Your current department

E-mail Address (Required)

Your HCC e-mail address

Employment Status (Required)

Your current employment status at HCCS

Full-time
Part-time

Certificate (Required)

The certificate type you have completed

Basic Certificate
Advanced Certificate

Portfolio Review Completed (Required)

For advanced certificate only

Yes
No

Date of first course completed (Required)

The date of the first CIT course you completed

/ /

Date of last course completed (Required)

The date of the last CIT course you completed

/ /

Comments

Any additional comments for reviewers

Sections

Personal tools

Certificate in Technology Application