Curriculum Committee
Course Modification/Drop Form
(duplicate on yellow paper)
Curriculum Document Number
Agenda Item No. Month Year
(for committee use only)
Proposed Action:
End/change Effective Date:
Initiated by: __________________________________________________________
Signature of full-time faculty member
Date:
List the names and titles of
representatives of your
department, other affected
departments and programs,
and your advisory
committee members with
whom you have shared this
proposal.
Program Impact:
Course Information Current Course Information New Course Information
Course Prefix/Course Number
Course Title
Prerequisites:
(required blocks
registration)
recommended
required
Lecture/Lab hours per wk: Cr. hrs.
Course Description for catalog and
official course outline.
List
Programs
Impacted:
click to sign
signature
click to edit
Signatures Required
Coordinator/Department Chair Date
DateDivision Dean
DateCurriculum Committee Chair
DateVice President of Academic Affairs
Class size limit (with rationale)
Reason for proposed changes
Lab fee (changed at March Board of
Trustees meeting only)
Course Title
Print Form
Submit by E-mail
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
dd mmm yyyy
dd mmm yyyy
dd mmm yyyy
dd mmm yyyy