PRO FORMA

Award of Excellence for Open and Distance Education Materials

Please check appropriate box:

CATEGORY A: innovations in print, electronically delivered materials or other low-cost media materials, such as audio, video, or a combination of these.

CATEGORY B: open educational resources (OER) – innovative creation and adaptation.

A. CONTACT INFORMATION
Name of Institution/Organisation:		
Type of Institution/Organisation:		
Country:		
Fullname:		
Designation:		
Address:		
Telephone (during office hours):		
Email:		

B. SUBJECT/COURSE/PROGRAMME OVERVIEW (no more than 500 words) 
Give a brief description of the subject/course/programme that the materials are used in.

This description should give an overview of the subject/course/programme that the materials are used in and demonstrate the materials’ fitness for purpose.  It must reflect the following:
•	The general goals and specific objectives of the study materials;
•	The copyright framework that has been adopted;
•	The educational context in which the materials are being used;
•	The subject/course/programme outcomes in which the materials are being used;
•	The profile of the learners who are studying the materials;
•	Length of time learners will study the subject/course/programme; and
•	How the materials are used.

Any other information that might assist the adjudicators in determining the fitness of the materials for need and purpose.

C. MATERIALS DESIGN (no more than 200 words)
Describe how the materials adhere to this criterion.  Provide evidence where appropriate. 

D. OER MATERIALS USED AND/OR REUSED (no more than 200 words)

E. SELECTION AND INTEGRATION OF APPROPRIATE MEDIA AND TECHNOLOGIES (no more than 200 words)
Describe how the materials adhere to this criterion.  Provide evidence where appropriate. 

F. ASSESSMENT STRATEGIES AND PRACTICES (no more than 200 words)
Describe how the materials adhere to this criterion.  Provide evidence where appropriate.

G. EVIDENCE OF LEARNER SUPPORT (no more than 200 words)
Describe how the materials adhere to this criterion.  Provide evidence where appropriate.

H. EVALUATION MECHANISMS TO MEASURE IMPACT AND QUALITY AND HOW IT INFORMED ADAPTATIONS AND DEVELOPMENTS (no more than 200 words)
Describe how the materials adhere to this criterion.  Provide evidence where appropriate.

I. ADDITIONAL INFORMATION (not compulsory)
Cover those things you may not have been able to outline above, but which are important to you.

J. CONCLUSION (no more than 200 words)
Answer the following questions:
•	What particular features of your materials are you most proud of?
•	Why do you think that your materials qualify for the award of excellence?

K. ATTACHMENTS
        Letter from Head of Institution/Organisation endorsing the submission.