FORM UPDATED 9/9/2011
OFFICE OF THE
CURRICULUM COORDINATOR
REQUEST FOR INSTRUCTIONAL MATERIALS FEES
(Due to the Curriculum Office no later than FEB. 1, 2012 to be effective for the 2012-2013 academic year)
Department: _____________________________________________________________________
(ex. ACCT, CDI, HIST – NOTE: Use only one department code per form)
Course #(s): _____________________________________________________________________
Is this course cross-listed? Yes No If “Yes”, please list all cross-listings:
Course Cross-listing(s): __________________________________________________________
New Fee Change to Existing Fee Delete Existing Fee
Materials Fee: $ __________ Course Fee Detail Code: __________
Materials Fee FOAP: _______________ _______________ _______________ _______________
(See attached FOAPs)
FUND ORG ACCT PROG
Description of tangible materials the student will receive for fee (must be of continuing value to the student):
Identify how materials relate to course objectives:
Division Dean Date
Letha Jeanpierre, VP of Budget and Finance Date
Christina Espinosa-Pieb, VP of Instruction Date
Teri Gerard, Budget Analyst Date
FOR ADMINISTRATIVE USE ONLY: Entered: FMP ______
BANNER ______
Primary cross-listing course requesting fee? YES NO DATE ENTERED: ________________
INITIALS: ________________
