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.
Instructor of Record Information: Check this box if a new instructor of record (listed in the section below)
has been assigned to the course.
Full-time Part-time Adjunct
Requested Course Information:
(* 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:
Requestor Date Division Dean Date
Records and Registration
equest to Revise the Published
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: ________