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Course Modification Form

Office of the Vice Chancellor for Academic Affairs

Please fill in the appropriate information below for all course changes. Click on the submit button at the end of the form when you are finished. Reset will bring you back to a blank form. By clicking the submit button, the form will be automatically submitted to Shannon Kouns. You will be notified when your requested change is approved. Thank you.

Date: ,
Submitted by:
Email Address:
Requested by: (department chair)

Semester:
Year:

Course Title:
Course Number:
Division Number:
Course Credit Hours:

Days:  Monday Tuesday Wednesday Thursday Friday Saturday TBA
Start Time: :          End Time: :
Instructor:

Continuing Education Course  Yes     No
If yes, what is the Project Number:  -
If yes, what is the location?

Requested Change:
Reason For Request:

If you are requesting a course cancellation, please fill in the following information:
Textbook Title:
Number of Books Ordered:

If you are requesting a course addition, please fill in the following information:
Course Title:
Maximum Class Size:
Pattern:
Textbook Required? Yes No
    If yes, please provide the following information:
    Textbook Title:
    Number of books required:
If the course begins or ends on a non-standard date, please fill in the following:
    Date Course Begins: ,
    Date Course Ends:   ,

Comments::

                                            

 
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