<p> EXPERIMENTAL COURSE FORM</p><p>Originator(s): Date: Department Chair: Institute Dean: Course Code: (Four letter discipline code. Registrar determines number) Short Title: (30 character limit) Long Title: Proposed term to offer course: Course Level (Course level criteria is available by selecting the comment icon on the right and in the Curriculum Handbook.) 100 level 200 level course Basic Skills Stand-alone course Instructional Method (Fill in number of credits and lecture, lab, clinical hours, etc. as appropriate. Add lab fee, if any) Course Credits: Clinical Hours: Lecture Hours: Studio Hours: Lab Hours: Other – Internship: Lab Fee: Course Description: Clearly and concisely describe course content and course competencies. If appropriate, identify the audience and where it fits in the instructional sequence. May include necessary or special information such as field trips, special equipment, extra expenses or additional time requirements.</p><p>Prerequisites and/or Corequisites: Prerequisite(s): Corequisite(s): Prerequisite(s) or corequisite(s): Rationale (Address the need for the course. How will the course serve students? What is the expected enrollment?)</p><p>History Was this course previously offered? If yes, identify the year, term and enrollment.</p><p>Resources required: (Library, technology, etc.)</p><p>Attach syllabus.</p><p>APPROVAL/REVIEW for </p><p>DEPARTMENT CHAIR DATE </p><p>Reviewed by DEPARTMENT CHAIR COUNSELING DATE </p><p>INSTITUTE DEAN DATE (Courses crossing disciplines must be reviewed and signed by the appropriate Institute Dean.) Reviewed by INSTITUTE ADMINISTRATOR DATE </p><p>SEND THIS FORM VIA EMAIL (to [email protected] ) and HARD COPY (with signatures) TO THE OFFICE OF THE VICE PRESIDENT FOR LEARNING.</p><p>Reviewed by Institute Deans DATE </p><p>REGISTRAR DATE</p><p>VICE PRESIDENT FOR LEARNING DATE</p><p> cc: Academic Council (informational) </p>