Office of the Provost & Vice President for Academic Affairs
Wetherby Administration Building 239
Phone: 745-2296
Fax: 745-5442
COURSE FEE REQUEST FORM (approved October 2010)
Academic Department: Complete each section of the form. When adding a new course fee or increasing an existing fee,
include an explanation of what the fee will be used for and a detailed accounting of the expenses to be covered by the fee.
Forward the form and supporting documentation to the Dean of your College. If approved, the Dean forwards the form to
the Provost’s Office. Course fee request forms should be submitted by August 1, if the fee is to go into effect for the Winter
term or Spring semester, by November 1 if the fee is to go into effect for the Summer term, and by February 1 if the fee is to
go into effect for the Fall semester.
Reports on usage of course fee revenue are required to the Provost’s Office on a semi-annual basis (Summer/Fall by
January 15 and Winter/Spring by July 15). Expenditures are restricted to those purposes identified in the
department’s approved course fee request.
Action requested:
Add new course fee
To be effective starting:
Course Number
Summer
Change existing course fee amount from
Fall
Winter
Spring
to
Year
Course Title
Use the space below to explain how the course fee will be used.
☐ Statement of Estimated Revenues & Expenditures is attached (REQUIRED)
☐ Additional documentation is attached (additional documentation as necessary to justify proposed fee)
Contact name
Phone #
Requestor’s Signature
Date
Endorsement by Dean’s Office
Date
Date received by Provost’s Office
Authorizing Signature
Approved
Denied
Date