Course Prefix and Number:

Course Title:

Program:

Academic Dept.:

Is this course part of an entire program that has been approved as an Online/Hybrid Program? Select One Yes No

If yes, indicate which certificate/diploma/degree Programs this course supports:

Division: Choose One AS BPS HE IET

This course will be:   Select One Fully Online Hybrid

If hybrid, indicate meeting pattern:

Full-time Developer(s):

Anticipated term for first-time delivery of course:
Who will teach this course the first semester?

Rationale for developing course in online or hybrid modality:

List any special training needs:

List any special web-development needs:

The appropriate Dean has approved this course delivery format

Submitted by (Dept. Head):

Note: Only existing approved courses may be developed in online/hybrid format.  If this course does not already exist, you must first go through the Curriculum Committee approval process.