Educational Institutions interested in learning more about our services.
This form is for inquires about partnering with Instructional Connections to provide services with an university or college to support online, asynchronous courses.
Full Name
*
Dr.
Mr.
Mrs.
Ms.
Miss
Mx.
NA
Prefix
First Name
Last Name
Title/Position
*
University/College Name
*
Department/College
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
Confirmation Email
Phone Number
*
-
Area Code
Phone Number
What programs and/or areas are you interested in discussing with Instructional Connections to assist your university?
*
Business - Undergraduate
Business - Graduate
Education - Undergraduate
Education - Graduate
Nursing - Undergraduate
Nursing - Graduate
Criminal Justice - Undergraduate
Criminal Justice - Graduate
Other - Undergraduate
Other - Graduate
Other
How did you hear about Instructional Connections?
*
Website/Internet Search
Social Media
Colleague
Conference
IC Partner University
IC Employee
Other
Additional Comments
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