Wufoo
CEPD - Project request form
Contact Name
*
First
Last
Contact Email Address
*
Job Title & Pathway (eg BA; HLS etc)
*
Which support/media service would you like assistance with on your project?
*
Video recording, editing & production
Video Cameras (Handheld camcorders)
Multimedia Learning Object creation
Web based video reflection (DIVER tool)
Curriculum development (course integration with technologies)
Website development & advice
Advice on embedding technology-enhanced learning (TEL) within modules
Assistance with a research project involving TEL
Other (technology/research/advice) related
Brief description of the project (including title)
*
Number of students involved
*
Please list any other staff involved (internal & external)
*
Date you propose to start project
*
MM
/
DD
/
YYYY
Date project is intended to end
*
MM
/
DD
/
YYYY
Is project externally funded?
Yes
No
Other
If funded externally or internally please indicate funding source and details
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