Course Module Request Form
Submit your proposal for a new course module to enhance our curriculum.
Your Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Department or Program
*
Course Name or Code
*
Proposed Module Title
*
Brief Description of the Module
*
Learning Objectives for the Module
*
Intended Audience for the Module
*
Please Select
Undergraduate Students
Graduate Students
Faculty/Staff
Other
Preferred Delivery Method
*
In-person
Online Synchronous
Online Asynchronous
Hybrid
Other
Estimated Duration of the Module (in hours)
*
Justification for Adding this Module
*
Required Resources or Materials (if any)
Upload Supporting Documents (optional)
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Additional Comments or Notes
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