Secondary Course Request Application
Part I: Information about School, Department and Instructor Requesting the Course. Course Catalog
Date School Year Requested Grade Level (s)
School Department Teacher
Principal Signature
Part II: Course Information for Course Catalog
A. To be Completed by the School, Department, or Teacher
Course Title
State Core Code CIP Code (CTE only) Type of Credit
The credit unit offered for this course (check one): Sem
ester (.50) Full Year (1.0) Both (.50/1.0)
Course Description: List the description of this course as you would like it to appear in the catalog.
B. To be Completed by the District
1. District Curriculum Department Review (required for all courses)
Curriculum Representative Signature Date
2. Secondary Course Committee Recommendation (check one)
Course is recommended for addition to the curriculum
Course is not recommended for addition to the curriculum
Committee Representative Signature Date
SKYWARD NUMBER
Revised 9/30/2015
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signature
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signature
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signature
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Part III: Justification for Course
Please provide a brief response to each of the following items in the space allotted. (Note: It is unlikely that the
proposed course will be strong in all of these areas. Please do not artificially inflate the value of the course.)
A. Please list the core standard(s) to which
this course will align. How does this course prepare students to excel in
core classes?
B. Please indicate how this course provides students with essential life skill experiences and specifically how the
course will give them an advantage in applying those valuable life skills.
C. Desc
ribe specifically how this course contributes to a healthy school climate.
D. How does this course provide students with skills needed to demonstrate competency on performance and
academic assessments.
E. How will the students’ experiences in this course prepare them for further career and/or human development
opportunities?
Part IV: Student Learning Objectives
Before a course request receives final approval to
be included in the Jordan District Secondary Course Catalog.
Student Learning Objectives (SLO’s) must be written in collaboration with a Jordan District consultant.
A. For course requests which are tied directly to a core curriculum area, the teacher requesting the course must
contact the Jordan District curriculum consultant for that core curriculum area to make arrangements for
help
with writing the SLO’s for the course.
B. For course requests not directly tied to a core curriculum area, the teacher must contact the Jordan District
Curriculum and Staff Development Staff Assistant for help with writing the SLO’s for the course.
Arrangements have been made to write Student Learning Objectives for this Course (check one):
Yes No
Signature of District Curriculum Consultant or Staff Development Staff Assistant Date
Revised 9/30/2015
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