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PORTLAND STATE UNIVERSITY REVIEW FORM for NEW COURSE

INSTRUCTIONS: Use this form to prepare departmental requests for new courses.  This table was created so that you can respond directly in the appropriate column, which will expand to accommodate responses of any length. You may save and title the file as you wish.  Please save and utilize this form as a Word document.  Replace bracketed information with information you supply.  See “Directions for Completing Course Review Form” for detailed explanations of each item.

Schools/colleges should submit ONE paper copy with ALL REQUIRED SIGNATURES to Academic Affairs; in addition please submit via email one electronic copy in Word format (which may be unsigned) to Steve Harmon in Academic Affairs ([email protected]).

ELEVATING STUDENT SUCCESS: As you develop the content, pedagogy and delivery method of your course, keep in mind how your course is culturally responsive, reflects a diversity of voice and accounts for a wide variety of learning styles. For insights into the diversity of some of our students, click here.

1. College/School and Effective Term College/School: Effective term : (The effective term may be delayed to a later term if the proposal is approved by Faculty Senate after the requested term’s pre- term registration has begun, i.e., May for fall/summer, November for winter, and February for spring term.) 2. General Catalog and Banner Information 2a. Department 2b. Course prefix and number 2c. Catalog course title (max 100 chars) 2d. Short [BANNER] title. As it will appear in the Schedule of Classes (max 30 chars) 2e. Catalog course description (max 50 words – strictly enforced) (Include any expected preparation if it is to appear in catalog description) 2f. Credit hours: 2g. Clock hour lecture ____ distribution: lab/studio ____ field work ____ online ____ practicum ____ other ______

OAA: DivIncl Oct 2016 2h. Course prerequisite(s): 2i. Is concurrent No ____ enrollment in the indicated Yes ____ prerequisite permitted? 2j. Course co- requisite: 2k. Is course No ____ repeatable: Yes ____ 2l. If course is Maximum of ____ credits or repeatable what is the limit? Maximum of ____ times. 2m. Grading option: Letter only ____ P/NP only ____ Both letter and P/NP ____ 2n. Course intended undergraduates ____ for: graduates ____ both undergraduates & graduates ____ doctoral only ____ 2o. Teaching method lecture ____ (identify ONE or at seminar the most TWO): ____ (Used by Registrar experiential ____ for coding in activity ____ Banner.) discussion ____ [See definitions.] recitation ____ research ____ lab/studio ____ (See definitions in the Instructions for this form.) 3. Enrollment Projections 3a. Expected distribution of lower division ____ % enrollment per section upper division ____ % graduate ____ % total 100%

OAA: DivIncl Oct 2016 3b. Students would take this check all that apply: course as ____ a community-based learning course with ______# of service hours required (The number of service hours required of the students must be noted.) ____ a prerequisite for ______(Please note some ____ a requirement for a major in ______additional submissions (A Program Change form must be submitted to add this requirement to the program.) may be required related ____ a requirement for a graduate program in ______to specific categories.) (A Program Change form must be submitted to add this requirement to the program.) ____ an elective leading to specialization in ______an elective contributing to general or liberal education ____ an elective in a graduate program in ______a part of a professional program in ______a part of a licensure or certification program in ______a course satisfying UNST Cluster ______(A University Studies cluster proposal must be submitted to the UNST Council.) 4. Rationale 4a. Reason for the proposal [describe briefly] at this time 4b. Additional comments 5. Syllabus 5a. A syllabus is required. A Syllabus should include:  Title  Course Prefix and Number  Course description  Prerequisites/co-requisites  Course Objectives  Student Learning Outcomes  Outline of Course Content (major content topic w/ main subdivisions)  Course requirements (exams, assignments, papers, etc.)  Required Texts and/or Required Reading List  Method of Evaluation (letter graded or P/NP and calculation of course grade) Appropriate distinctions in required coursework and method of evaluation for both undergraduate and graduate students for an UG/GR slash course. 5b. Diverse perspectives. [Identify how the course objectives, student learning outcomes and course content reflect a wide range of students and represent a broad diversity of voices. For information on culturally responsive and inclusive curriculum refer to the PSU Library guide at http://guides.library.pdx.edu/culturallyresponsivecurriculum.] 6. Overlap 6a. Potential shared subject [course number(s) and title(s)] [describe and explain the overlap] matter with other courses in your department 6b. Potential shared subject [course number(s) and title(s)] [describe and explain the overlap] matter with courses in other departments. 6c. Comments and [Identify contact(s) in other [Mandatory: post statements directly attributions from contact department(s) with whom you have attributable to the contact person(s) person(s) in other discussed this proposal] with whom you have discussed shared departments with whom subject matter. You may attach you’ve discussed documentation.] overlap. 7. Instructor information

OAA: DivIncl Oct 2016 7a. Course instructor(s): [full name] Instructor status: tenure-related____ fixed term____ adjunct____ (submit a c.v. for any adjunct teaching this course) Other (explain): 7b. Faculty with primary [if different from instructor above] Faculty status: ongoing responsibility for tenure-related____ course content and Other (explain why this is appropriate): review if instructor is fixed term or adjunct. 8. Teaching and Learning 8a. Course objectives [list specific course objectives]

8b. Learning outcomes [list specific learning outcomes]

8c. Student activities [describe activities students will engage in to learn material; differentiate undergrad and grad requirements for 400/500 level classes]

8d. Methods of evaluation [describe what students will do to demonstrate what they have learned; differentiate evaluation methods to be used for graduate and undergraduate students for 400/500 level classes] 8e. Diversity engagement [describe how the content, pedagogy and method of delivery is culturally responsive and reflects the diversity of voices and variety of learning styles of students. For information refer to the PSU Library guide at http://guides.library.pdx.edu/culturallyresponsivecurriculum.] 9. Resources 9a. Who is the department/program’s [full name] [Mandatory: post statements directly Disciplinary Librarian? attributable to the disciplinary librarian(s) with whom you have discussed whether [A statement from the disciplinary the library resources are adequate. You librarian is required.] may attach documentation.]

9b. Are technological resources Yes ____ No ____ Describe: adequate? 9c. Are there any additional costs to the Yes ____ No ____ If yes, explain: student beyond tuition and textbooks (e.g., course-specific fees and materials costs)? 10. College/School and department/division information 10a. Course to be annually ____ alternate years ____ other: ______offered: In which term(s): fall ____ winter ____ spring ____summer ____ 10b. Anticipated enrollment per term in first 2 years: 10c. Optimal enrollment per section:

OAA: DivIncl Oct 2016 10d. Educational [describe briefly] purpose of adding this course to the department’s curriculum 10e. Place in the [describe briefly] University’s curriculum 10f. Faculty % FTE tenure = % FTE fixed term % FTE adjunct = Existing $: New $: Assignment = Specialized space ____ sq. ft. Explain: Equipment & List Explain: Supplies Additional List personnel and Explain: personnel (TA, FTE: clerical, etc.) Other expenses: List: Explain: Additional funding Source(s): Total: Total: for expenses:

OAA: DivIncl Oct 2016 New Course Signature Page

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OAA: DivIncl Oct 2016