‫ﮐﺎﺭﺑﺮﮒ ﺷﻤﺎﺭﻩ ‪۱‬‬ ‫ﺷﻨﺎﺳﻨﺎﻣﻪ ﺑﺮﻧﺎﻣﻪ ﺩﺭﺳﯽ‬

‫ﮐﺪﺷﻨﺎﺳﻪ‬ ‫ﻋﻨﻮﺍﻥ ﺑﺮﻧﺎﻣﻪ ﺩﺭﺳﯽ‬

‫□ ﻋﻤﻮﻣﯽ‬
‫ﺗﺎﺭﯾﺦ ﺗﺎﯾﯿﺪ‬ ‫ﻧﻮﻉ ﺩﻭﺭﻩ‬ ‫ﻣﺪﺕ ﺑﻪ ﺳﺎﻋﺖ‬
‫□ ﺗﺨﺼﺼﯽ‬
‫□ ﻋﻠﻮﻡ ﭘﺎﯾﻪ‬
‫□ ﻓﻨﯽ ﻭ ﻣﻬﻨﺪﺳﯽ‬
‫□ ﻋﻠﻮﻡ ﺍﻧﺴﺎﻧﯽ‬
‫ﺭﺷﺘﻪ ﺁﻣﻮﺯﺷﯽ‬ ‫ﮔﺮﻭﻩ ﺁﻣﻮﺯﺷﯽ‬
‫□ ﻋﻠﻮﻡ ﭘﺰﺷﮑﯽ‬
‫□ ﮐﺸﺎﻭﺭﺯﯼ ﻭ ﻣﻨﺎﺑﻊ ﻃﺒﯿﻌﯽ‬
‫□ ﻫﻨﺮ‬
‫‪.۱‬‬
‫‪.۲‬‬ ‫ﻣﺨﺎﻃﺒﺎﻥ‬
‫‪.۳‬‬
‫ﻧﺎﻡ ﻭ ﻧﺎﻡ‬
‫ﺷﻤﺎﺭﻩ ﺗﻤﺎﺱ‬ ‫ﻣﺮﺗﺒﻪ ﻋﻠﻤﯽ‬ ‫ﻣﻘﻄﻊ ﻭ ﺭﺷﺘﻪ ﺗﺤﺼﯿﻠﯽ‬ ‫ﺳﻤﺖ‬
‫ﺧﺎﻧﻮﺍﺩﮔﯽ‬
‫ﻣﺸﺎﻭﺭﺍﻥ‬
‫ﺑﺮﻧﺎﻣﻪ ﺩﺭﺳﯽ‬

‫ﺍﻫﺪﺍﻑ‬
 ‫ﺳﺮﻓﺼﻞ ﻫﺎ‬
‫ﺭﺋﻮﺱ ﻣﻄﺎﻟﺐ‬

‫ﻣﻨﺎﺑﻊ‬

‫□ ﮐﻼﺱ ﺩﺭﺱ )ﺳﺨﻨﺮﺍﻧﯽ(‬ ‫□ ﮐﺘﺒﯽ‬

‫□ ﮐﺎﺭﮔﺎﻩ ﺁﻣﻮﺯﺷﯽ‬ ‫ﺭﻭﺵ ﺍﺭﺍﺋﻪ ﻣﺤﺘﻮﺍ‬ ‫□ ﺷﻔﺎﻫﯽ‬ ‫ﺭﻭﺵ ﺍﺭﺯﯾﺎﺑﯽ‬

‫□ )ﻏﯿﺮ ﺣﻀﻮﺭﯼ(‬ ‫□ ﭘﺮﻭﮊﻩ ﺍﯼ‬

‫ﻭﺍﺣﺪ ﺩﺍﻧﺸﮕﺎﻫﯽ‪ /‬ﺣﻮﺯﻩ‬

‫ﺩﺍﻧﺸﮑﺪﮔﺎﻥ ‪:‬‬
‫ﭘﯿﺸﻨﻬﺎﺩ ﺩﻫﻨﺪﻩ‬