Course Request Form

Revised – Spring 2008

GENERAL EDUCATION PROGRAM COURSE COMPONENTS REVIEW FORM
Instructions: Complete required items (determined by category in which course is submitted) on both
sides of this form. If more space is needed for items 6 and 7, use a separate sheet. Return this form with a
copy of the syllabus for the proposed course that includes statements that support the request to your
representative on the Council on General Education.

Course Name/Catalogue Number: _________________________________________
Category(s) for which course is being proposed (Circle)
Foundation Skills:

IA

IB

IC

Liberal Knowledge:

IIA

IIB

IIC

Health and Personal Performance:

IIIA

IIIB

IIIB submissions - Answer only Questions 1-5 below.
General Education Electives:

IV

1. College: __________________________ 2. Department: _____________________________
3. Faculty Contact(s): Name(s) ___________ Department Chair: _____________________(sign.)
Phone: ___________________________________ E-Mail: _____________________
4. Catalogue Description:

5. Prerequisites to proposed course:
6a. For a course for Category I - Liberal Education Skills, indicate which ONE of the following
foundation skills is the main focus of the course:
_____ Writing
_____ Reading
_____ Quantitative Reasoning

______ Critical Thinking _____ Speaking and Listening
______ Mathematics
_____ Computing

If the course is proposed ONLY in Skills Category I, answer only Questions #1 - 6a of this course
components review form. The response to #6a should be incorporated into the course description on the
syllabus.

6b. Describe how students participate actively in their own learning in this course. Indicate how the course
incorporates active instructional approaches so that students are involved directly in their own learning.
Examples might include the use of technology such as computer data bases, the use of library resources for
assignments, or the incorporation of cooperative learning groups, simulations, and field work as useful
alternatives to lecture.

7a. For courses proposed for Categories II - Liberal Knowledge, IIIA - Health and Personal
Performance, or IV- General Education Electives, indicate at least TWO of the following learning
skills that are integrated within the content and evaluation measures utilized in the course.
_____ Writing
_____ Speaking
_____ Listening

_____ Mathematics
_____ Quantitative Reasoning
_____ Critical Thinking

_____ Viewing
_____ Computing
_____ Reading

In addition, answer Questions #7b, c, d, of this course components review form. The responses to these
questions (7b,c,d,) should be incorporated into the syllabus for the course, and the indicated learning skills
should be highlighted in the course description on the syllabus.

7b. Describe how students participate actively in their own learning in this course. Indicate how the course
incorporates active instructional approaches so that students are involved directly in their own learning.
Examples might include the use of technology such as computer data bases, the use of library resources for
assignments, or the incorporation of cooperative learning groups, simulations and field work as useful
alternatives to lecture.

7c. Indicate how the instructor of the course will consider overtly with students the values (academic,
human, etc.) that are reflected in the content and method of instruction.

7d. Indicate how this course helps students to understand both the history and philosophy of the discipline,
and its interrelationship with other disciplines in the arts, humanities, and the social, physical, and
biological sciences.