New Class Information Form
Please complete the form below. You will be notified when your class had been accepted by the Curriculum Committee. Thanks!
Class Title
*
Semester
*
Fall
Winter/Spring
Number of Sessions
*
Please Select
1
2
3
4
Class Size (maximum)
*
Class Size (minimum)
Number of Instructors
*
Please Select
One Instructor
Two Instructors
Three instructors
Four instructors
Days, Times NOT AVAILABLE, e.g. Mon AM; Wed PM
*
PREFERRED Days, Times e.g. Mon AM
*
Class Description - "Catalog Ready"
*
Instructor's Name
*
First Name
Last Name
Instructor's Address
*
Instructor's e-mail address
*
Instructors's Phone Number
*
-
Area Code
Phone Number
Relevant Qualifications of Instructor
*
Instructor's Name - 2
First Name
Last Name
Instructor's Address - 2
Instructor's e-mail address - 2
Instructors's Phone Number - 2
-
Area Code
Phone Number
Relevant Qualifications of Instructor - 2
Instructor's Name - 3
First Name
Last Name
Instructor's Address - 3
Instructor's e-mail address - 3
example@example.com
Instructors's Phone Number - 3
-
Area Code
Phone Number
Relevant Qualifications of Instructor - 3
Instructor's Name - 4
First Name
Last Name
Instructor's Address - 4
Instructor's e-mail address - 4
example@example.com
Instructors's Phone Number - 4
-
Area Code
Phone Number
Relevant Qualifications of Instructor - 4
Equipment Needed
*
Digital Projector
DVD Player
White Board/Pad
Microphone
None of the above
Other Equipment Needs
Additional Comments
LLHHI Course Coordinator
*
YES, coordinator assigned
NO, coordinator needed
Course Coordinator
First Name
Last Name
Coordinator email
Coordinator Phone
-
Area Code
Phone Number
E-mail
E-mail
E-mail
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