For information concerning this form and/or filling out this form, please go to the Cover Page Directions page. After all data have been entered into the form, please use your browser's print command to print the form. Address questions or comments to: Dr. Catherine Serex for undergraduate courses, or Dr. Karen Weddle-West for graduate courses.

I. COURSE LEVEL

Graduate Undergraduate

II. DEPARTMENT

III. TYPES OF CHANGES REQUESTED

	Program Changes (include Catalog Revision pages and proposals, if needed).
	Course additions, deletions, or revisions (include Course Request forms).
	Editorial changes (indicated on Catalog Revision pages).
Include here an EXPLANATION or JUSTIFICATION to clarify requests for those reviewing changes. Additional pages may be attached.

IV. APPROVALS

		Approved	Approved Except  as Noted
______________________________________  Departmental Committee	______________  Date
______________________________________  Departmental Chair	______________  Date
______________________________________  College Committee	______________  Date
______________________________________  College Dean	______________  Date

V. Please submit your name and e-mail address as a contact source for this form.
Name  E-Mail