Summer Request Form
Requesting Department: _____________________________________________ Date: ______________
Course Information: ____________ ______________ _______________________________________
Academic Year CRN Course Number/Prefix/Section (e.g. CH181-01)
Workload Hours: _________ Student Credit Hours: _________ Anticipated Enrollment: _________
Preferred Delivery Mode: ______________________ Part of Term: ______________________
F2F, Web, Blended, ITV, CCC
Faculty Information:
*Adjunct _____ Regular Faculty _____ Faculty Name (if known): ____________________________________
Justification for request:
Will other sections of this course be offered this summer? Yes /
No
Is this request due to increased enrollments or program interest
? Yes / No
Why is it importan
t that this course is offered in summer instead of fall/spring?
What type of students could take this course (i.e. majors, minors, or general education)?
Additional justification or information
for multiple sections:
Department Chair Signature: Date:
Dean’s Approval Signature: Date:
Provost’s Approval Signature: Date:
Course Title: _________________________________________________________________________
Preferred Delivery Mode: ______________________ Part of Term: ______________________
*NOTE: Terms will be compensated as Adjuncts in summer.
Updated: 01/02/2019
F2F, Web, Blended, ITV, CCC
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