Request for Approval of New/Revised Credit Course
Please complete this form and submit electronically with appropriate paperwork to the Curriculum Technician.
For assistance in completing this form, please utilize the Supplemental Instruction Guide.
1. General Information
a. Type of Curriculum Change:
☐ New Course ☐ Substantial Course Change * ☐ Unsubstantial Course Change ☐Change status from INACTIVE to ACTIVE
b. If a Substantial Change, will this replace and inactivate a current
course?* ☐ Yes ☐ No
d. Academic Division: Click here to enter text.
c. If so, list course: Click here to enter text.
Please list CURRENT course information
a. Current Course ID (e.g. ENGL 1001) Click here to enter text.
c. Current Units:
(MIN) Click here to enter text.
b. Current Course Title:
Click here to enter text.
d. Current T.O.P. Code: Click here to enter text.
(MAX) Click here to enter text.
New Courses: Complete all fields; Course Changes: Complete only applicable fields
a. New Course ID: Click here to enter text.
b. New Course Title:
(MIN) Click here to enter text.
(MAX) Click here to enter text.
c. Units:
Click here to enter text.
d. T.O.P. Code: Click here to enter text.
e. Proposed Course Description (For current changes show bold for new additions and strike-through for deletions): Click here to enter text.
☐ No other changes have been made to this course
(If additional changes are required, e.g. C-ID, TMC, etc., please complete the appropriate fields, otherwise please sign and date the form and submit electronically
with appropriate paperwork. If this is a new course, please complete the entire form. )
f. SAM Priority Code: Click here to enter text.
*For explanation of code, please see supplemental
h. Basic Skills Status: ☐ Yes ☐ No
g. Credit Status: ☐ Degree Applicable ☐ Not-degree Applicable
i. Program Status: ☐ Program Applicable
☐ Not-program Applicable
j. Transfer Status: ☐ CSU/ UC
☐ CSU Only ☐ Not Transferable
k. IF CSU OR UC transferable, list at least three institutions that offer a similar course (include Dept/Course Number and Title):
Click here to enter text.
l. Prior to Transfer Level: Click here to enter text.
*For explanation of code, please see supplemental
m. Participates in Cooperative Work Experience Education Program:
☐ Yes ☐ No
n. Funding Agency:
☐ Primarily developed using Economic Development funds
(exceeds 40% of total development costs)
☐ Not Applicable
☐ Partially developed using Economic Development Funds
o. Is this an “approved special class for students with disabilities (and therefore repeatable?) ☐ Yes ☐ No
p. Classification Status: Click here to enter text. *For explanation of code, please see supplemental
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q. Is the course eligible for any of the following? (mark all that apply)
☐ Credit by Examination
☐ Eligible for Pass/No Pass
☐ Repeatable
If yes, what is the justification? Click here to enter text.
r. Financial Impact on the Bookstore:
Cost of book:
Click here to enter text.
Textbook rental:
Click here to enter text.
Edition date:
Click here to enter text.
Alternate text:
Choose an item.
*A change to any of the follow is a substantial change and will result in the formation a new course: TOP Code, Credit Status, Units, Basic Skills Status, SAM Code,
Prior to College Level, Noncredit Category, or Funding Agency Category
2. Justification
a. For what student population is this course intended? Click here to enter text.
b. Course Justification: Click here to enter text.
c. Are there existing courses with similar content? ☐Yes ☐ No
If yes, list the considered courses:
1. Click here to enter text.
2. Click here to enter text.
3. Click here to enter text.
AND answer the following questions:
1. Why are they not suitable for the content of this course? Click here to enter text.
2. How might they be affected by offering this course? Click here to enter text.
3. Articulation
a. Baccalaureate Credit
☐ Yes
☐ No
b. Course ID Number System
☐ Yes
☐ No
c. Transfer Model Curriculum
☐ Yes
☐ No
d. Part of a major preparation
☐ Yes
☐ No
C-ID Number: Click here to enter text.
If yes, then which degree and at what institution?
Institution: Click here to enter text.
Degree: Click here to enter text.
e. Submit for UC Transfer
☐ Yes
☐ No
f. CSU Breadth Pattern
☐ Yes
☐ No
g. Intersegmental General Ed Transfer Curriculum (IGETC)
☐ Yes
☐ No
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Mark all that apply:
A.A./A.S. Credit
☐ Major: Click here to enter text.
Required in major: ☐ Yes ☐ No
Elective for the major: ☐ Yes ☐ No
☐ Certificate: Click here to enter text.
Required for certificate: ☐ Yes ☐ No
Elective for the certificate: ☐ Yes ☐ No
☐ Pre-collegiate: Click here to enter text.
☐ Taft College general education:
☐ Natural Science
☐ Social & Behavioral Science
☐ English Composition (Language & Rationality)
☐ Communication & Critical Thinking
Prepared by: Click here to enter text.
Date: Click here to enter a date.
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