Institution name and country *
Responsible academic or programme lead *
Institutional contact email *
Decision authority and evidence *
Decision date *
Institutional status * Choose… Exploring use Trial planned Institutional commitment Implementation begun Implemented
Programme / course, learner group, five modules or subset *
Instructor, delivery mode, observation, rubric and moderation *
Access, class ownership, support, release and training needs
Conditions before use: content, language, accessibility, data and approvals
Intended start date
Responsible person, resources and continuation beyond project
Authorised decision, minutes, letter or email reference *
Permission to publish institutional statement * Choose… No Yes Restricted / agreed wording
Authorised representative, role and date *
Follow-up or review date
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