Fillable Materials-fee-request-fall-2019 Materials Fees Request Form

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Materials-fee-request-fall-2019 Materials Fees Request Form

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MATERIALS FEES REQUEST FORM
Course Prefix/Number/Name: ______________________________________________________
Division: ________ Department: _____________ Term/Year Fee Becomes Effective: _________
In proposing an instructional materials fee, the following information must be provided to the Office of Academic Services:
1. The course for which the fee will be charged
2. The proposed fee to be collected
3. The specific materials that will be purchased with the fees collected
4. The per-student cost of these materials if the student were to purchase them on the open market (documented with
an internet screen, vendor information, something tangible and attached)
5. The term when the fee should be effective
BP5031 Instructiona lMaterials Fees(Board Policy)
AP5031_Instructional Materials Fees (Administrative Procedures)
Student Fee Handbook 2012--Material Fee page 8
Materials Fees Calculation Per Student
"Instructional and materials" mean any tangible personal property which is owned or primarily controlled by an individual student.
ITEM
DESCRIPTION
QUANTITY
AMOUNT
1
2
3
4
5
8
9
10
Total Course Materials Fee
$
Does this proposed materials fee meet the minimum amount required to satisfy the course objectives? Yes ___ No___
Total cost per student/Proposed fee to be collected:
$
Faculty
________________________________________ Date_________________
Dean
___________________________________________ Date_________________
VP Academic Services ______________________________
Date_________________
Other_____________ ______________________________ Date_________________
Revised 8/30/19 nh
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Materials-fee-request-fall-2019 Materials Fees Request Form

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Completed 18 November 2019

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