This form is designed for use by faculty to request a course addition/deletion to the course schedule after the course
schedule has been approved for publication. Approval validates course need and instructor’s academic load.
Date: Requestor:
Instructor of Record Information: Check this box if a new instructor of record (listed in the section below)
has been assigned to the course.
Instructor’s Name
Instructor’s Banner ID #
Instructor’s Status
Full-time Part-time Adjunct
Requested Course Information:
Action
Course
Prefix
Course
Number
Section
Number
Course Registration
Number (CRN)
*Revise
Delete
Add
(* indicates required fields for revision requests. Please indicate the requested changes only in the above section for courses marked for revision).
Justification for Request:
Does this course require additional compensation? Yes No
**Web-based courses require approval:
**Director of e-Learning: ____________________________________ Date: __________________
Instructor’s Current Course Load: Current Total Credit Hours:
Course
Registration
Number
Course
Prefix
Course
Number
Section
Number
Number of
Registered
Students
Number of
PAID
Students
Requestor Date Division Dean Date
*Year
*Semester
Part of
Term
Days
Offered
Campus
Code
Building
Code
Room
Number
Number
of Seats
Start
Time
End
Time
Records and Registration
R
equest to Revise the Published
Course Schedule
______________________________________________________
VC for Academic Affairs and Workforce Development/Date:
RO: Request to Add a Course: 06/15:07/15:07/16:07/17:08/19-LR
Registrar’s Office: Processed by: _________
Date Processed: ________