ࡱ> %` ~bjbj h̟̟2$l2l2l2P23`K84 X6X6X6X6\:f:4:JJJJJJJ$ MhrOJ9}>9::"}>}>JX6X6*K@@@}>XX6X6J@}>J@@:kF,FX6,4 Hkl2>dF J0K0`KFR$P9?$PF$PF$;;^@;L@<=;;;JJW@X;;;`K}>}>}>}>'h-h- Semester/Year: ____________ Date: REQUEST COURSE INFORMATION  FORMCHECKBOX  New Experimental Course (Attach Course Summary for new 900 requests) Complete both Course and Section Information below. Submit course summary with course request. Subject Area: ____________ Course Name/Title:________________________________________________________________________ Credit  FORMCHECKBOX  Credit Degree Applicable (DA) Grading  FORMCHECKBOX  Pass/No-Pass (P/NP) Repeatability  FORMCHECKBOX  0  FORMCHECKBOX  Credit Non-Degree (NDA)  FORMCHECKBOX  Letter (LR)  FORMCHECKBOX  1 (If Non-Credit desired, contact Dean.)  FORMCHECKBOX  Student Choice (SC)  FORMCHECKBOX  2  FORMCHECKBOX  3 Hours/Mode of Instruction Total # of hours for all instructional modes: Total # of Hours: Units: Lecture: __________ Laboratory: __________ Composition: __________ Activity: __________ Discipline/s: Pre-Requisite(s): Co-Requisite(s): (Complete and attach Pre/co-requisite validation form) Advisories: Schedule Description: __________________________________________________________________________________________________ SECTION INFORMATION (Only one section per 900 form) Day/s: _____________ Times: _______________ Dates: _________________ Room/s: _________________ Waitlist Max: ______ Instructor: _____________________________ Contract Type: A AC C Other Multiple: No Yes: ____________________ NEW HIRE (Check one) (If yes, note other course and section info.) SIGNATURES: Author: _________________________________________________________ Date: ________________ Dept. Chair: _____________________________________________________ Date: ________________ Dean/Sr. Dean: __________________________________________________ Date: ________________ Curriculum Committee Chair: ______________________________________ Date: ________________ President/Designee: ______________________________________________ Date: ________________ Office of Instruction Use Only: T.O.P.s Code: _____________ Class Max: ________________ Coop Work Exp:  FORMCHECKBOX  Yes  FORMCHECKBOX  No Class Code  FORMCHECKBOX  A Liberal Arts & Sciences (transferable) SAM Code  FORMCHECKBOX  A Apprenticeship Remediation Level  FORMCHECKBOX  ES Elementary and Secondary Basic Skills  FORMCHECKBOX  B Developmental Preparatory  FORMCHECKBOX  B Advanced Occupational  FORMCHECKBOX  P Pre-collegiate Basic Skills  FORMCHECKBOX  C Adult/Secondary Basic Education  FORMCHECKBOX  C Clearly Occupational  FORMCHECKBOX  B Basic Skills  FORMCHECKBOX  D Personal Development/Survival  FORMCHECKBOX  D Possibly Occupational  FORMCHECKBOX  NBS Not Basic Skills  FORMCHECKBOX  E For Substantially Handicapped  FORMCHECKBOX  E* Non-Occupational  FORMCHECKBOX  F Parenting/Family Support  FORMCHECKBOX  F Transfer, Non-Occupational  FORMCHECKBOX  G Community/Civic Development *Additional criteria needed  FORMCHECKBOX  H General and Cultural  FORMCHECKBOX  1 One level below transfer  FORMCHECKBOX  I Occupational Educational (non-transferable)  FORMCHECKBOX  2 Two levels below transfer  FORMCHECKBOX  3 Three levels below transfer  FORMCHECKBOX  3+ Four levels below transfer  Course/Section Details: Subject Area: ________________ Course #: ________________ Section: ________________Original: Office of Instruction Copies of top sheet to: Admissions Office, Department Chairperson, Counseling, Scheduling Specialist SUMMARY Department:_________________ Course Title: ___________________________ Departmental rationale for offering this experimental course: (Rationale should include why department wants to offer this course and why it is being proposed as an experimental, rather than permanent, course. Note: experimental courses are not transferable.) Is the experimental course proposed to count as a requirement or option to meet a degree or certificate requirement? If yes, please provide a rationale. Program-Level Student Learning Outcomes (PSLOs): Identify the program (eg. Nursing, Engineering), major (eg. Music, Chemistry), or sequence of courses (eg. ESL) to which this course belongs. List 3-8 over-arching or broad student learning outcomes for the program, major, or course sequence that this course is designed to help students attain. Course-Level Student Learning Outcomes (CSLOs): What abilities will the student have at the end of this course? List 3-8 over-arching or broad student learning outcomes for this course. These are the course objectives written in terms of what the student will know or be able to do at the end of the course. Title V requires that courses for Associate Degree credit must have SLOs that reflect critical thinking and the understanding of application of concepts determined by the curriculum to be at college level. Relate these course-level SLOs to the program-level SLOs and/or Institutional SLOs, as appropriate. Please refer to the Curriculum Handbook for more information on how to complete this section and for the Curriculum Committees criteria for evaluating this section of the course outline. Assessment: What instruments (eg. tests, papers, projects, assignments etc.) will be used to assess student learning outcomes? For each CSLO, list the assessment instrument/s that will be used to evaluate student achievement. Assessments should include a final exam, final paper or final project. Method of Evaluation/Grading: Explain how the course provides for measurement of student performance in terms of stated course objectives, Title V. (Ӱɴý calls objectives, CSLOs.) Grading should be based on demonstrated proficiency in achieving the learning outcomes. Indicate the percentages or points (or a range of percentages or points) for each type of assignment. Course Content: Provide the detailed content of the course Instructional Methods: Check all the instructional methods that will be used in teaching this course. Keep in mind that the method of instruction and activities should relate to the CSLOs.  FORMCHECKBOX  Lecture  FORMCHECKBOX  Lab  FORMCHECKBOX  Activity  FORMCHECKBOX  Problem-based Learning/Case Studies  FORMCHECKBOX  Collaborative Learning/Peer Review  FORMCHECKBOX  Demonstration/Modeling  FORMCHECKBOX  Role-Playing  FORMCHECKBOX  Discussion  FORMCHECKBOX  Computer Assisted Instruction  FORMCHECKBOX  Other (explain) ________________________________________ Textbooks: Indicate name of text (or list of text choices), author, publisher and date of publication. Date of publication has to be within 5 years of authoring course outline. For degree applicable courses, text should be College Level. Include sample pages and the contents page of the instructor designed module if it is the only text. If approved, the Curriculum Committee authorizes this experimental course to be offered for up to three times in the subsequent 24 months. If the department wants to make the course permanent, a complete course outline must be submitted for approval to the committee by the catalog deadline during the fall semester for the course to be offered the following catalog year. Please consult with your Dean/Senior Dean to work through the process and deadlines to create a permanent course. 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