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MODIFIED COURSE PROPOSAL FORM
Page 1 of 3 Revised Spring 2018
This form is intended for faculty who are converting an existing course from the traditional semester/half-
semester format to the short-term or hybrid format.
Existing Prefix & #
§
Existing Catalog Title for Course
Short-Term Hybrid
Date Submitted
Credit
(.125, .25, .50, .75, 1.0, or
variable, e.g., .25-.5)
Cross-listed Prefix & #
(if applicable)
§
Consult the Registrar for appropriate course numbers.
Instructions: Please complete this form and submit one signed electronic copy and the course syllabus to the chair of the
Curriculum Committee. This proposal will be reviewed by the Curriculum Committee within 1 week of submission;
approved proposals will then be brought before the faculty (at a faculty meeting) for final approval. If you are submitting
multiple related courses, please provide a cover page describing the overall justification. Please consult the chair of
Curriculum Committee with any questions.
Name of submitter
from Department/Program
1)
Mark an “X” in the requirements fulfilled by this modified course; include any cross references.
Please answer all questions…
Is this a participation course? (See list in Catalog)
Is the course repeatable for credit?
If so, how many times may it be taken for credit?
Is the course graded or credit/no credit?
Is the course a lecture course?
Is the course a lecture & laboratory?
Is the course a travel course?
Is the course cross-listed?
Are there pre/co-requisites for this course?
2)
Before the Curriculum Committee reviews any proposal, the submitter must discuss this proposal with either the
department chair or the INTG area coordinator. In the case of the submitter being the department chair, the
proposal must be shared with departmental members. Please confirm that you have done so by checking this
box .
3)
The course you are proposing will be taught starting in which semester?
Fall Spring Jan May of
4)
Check the anticipated frequency for this course offering:
Multiple sections each semester
One section each year
One section each semester
One section alternate years
Other pattern, please describe:
5)
What is the anticipated enrollment?
- Passed by Curriculum
Comm on ________
- Approved by faculty
on _________
(for Registrar’s use)
MODIFIED COURSE PROPOSAL FORM
Page 2 of 3 Revised Spring 2018
6)
How will the offering of this course be staffed?
This course will be a substitute for an older course that will be removed from the catalog.
This course will be taught by a faculty member who will not be teaching another course as frequently.
This course will NOT add to the departmental teaching load.
This course WILL add to the departmental teaching load. Please explain:
7)
Please provide a rationale for adding this course:
a)
Curriculum alignment/alteration of program goals and objectives.
b)
The specific need for the proposed course.
c)
A plan for assessing specific outcomes related to some aspect of the curriculum.
MODIFIED COURSE PROPOSAL FORM
Page 3 of 3 Revised Spring 2018
8)
Will this course require specialized resources that do not currently exist? Please explain.
9)
Please provide any additional comments:
(Email of completed form to the Curriculum Committee by the department chair constitutes the chair’s signature)
Signature of submitter
Date
Signature of Department Chair
Date
Signature of Program
Coordinator (if applicable)
Date
Signature of INTG area
Coordinator (if applicable)
Date
Signature of Chair from cross-
listed Department (if applicable)
Date
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Completed 1 February 2021

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