SCHEDULE CHANGE JUSTIFICATION REQUEST
Reporting a change made by an Academic Department To Provost Office
This Justification is requested by:
This is the individual filling out this form and not the chair or faculty
The Department Chair is aware of this justification request
Course Prefix and Number
Example: PSYC 100
FOR WEBCT PURPOSES ONLY
Is This Justification Request for WebCT Purposes only
If yes fill out the next 3 fields of information only and click submit
If yes, and you would like to assign a footnote code for either an Online, Hybrid, or Supplemental Course
Please check the appropriate box
F for Supplemental
M for Online
L for Hybrid
Please list all cross list crns if applicable
Type in the Cross List Code
FOR NON WEBCT PURPOSES ONLY
Description of Changes
Does this Justification Request impact the budget?
If so, have you obtained approval to make this change?
Enter a rationale for the Justification Request
Does this Justification Request impact any other courses that are being offered?
If so, How?
Students have been notified of this change, if necessary:
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