Date:____________ |
Name: ________________________________________________________________________
|
Department: _________________________________________________________________________
|
Title and Course Number:
_______________________________________________________________
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Prerequisites: _________________________________________________________________________
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Semester and Year
Proposed for Course Delivery: F__ Sp__ Su__ Yr______
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Are you requesting
funds? from Dept._____ from Dean_____
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If funds requested,
for what purpose?(check all that apply) TA__ Media__ Instr. Design__
Other (specify) _________________________________________________________________
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Primary teaching method:
Lecture__ Discussion__ Learner-based__ Other (specify)____________
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Proposed method of
delivery (check all that apply): Web__ Videotape__ Videoconference__
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Target student base:
___________________________________________________________________
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Existing or proposed
multimedia materials (e.g. PowerPoint, video, slides): _____________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
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Approval
of Department Chair ______________________________
Approval
of Curriculum Coordinator _________________________
Approval
of Dean __________________________________________
|