Supporting Document to the Form 40G
for Adding Distance Delivery
To:
Purdue University Graduate Council
From:
Faculty Member:
Department:
[click here and type department]
Campus:
[click here and type campus]
Date:
Subject:
Request to Add Distance Delivery
Contact for information
if questions arise:
Name: [click here and type name]
Phone: [click here and type phone #]
Email: [click here and type email addr]
Address: [click here and type campus addr]
Course Subject Abbreviation and Number:
[click here and type course]
Course Title: [click here and type course title]
New graduate degree program policies and guidelines, approved by the Indiana Commission for
Higher Education on August 10, 2012, require additional documentation regarding modes of
delivery. Please complete the sections below when adding an additional mode of delivery to an
existing graduate course.
1
A. Justification for Adding Distance as a Schedule Type:
(Complete)
•
"[click here and type detailed justification for adding distance delivery]"
B. Learning Outcomes and Method of Evaluation or Assessment:
(Complete if different from approved mode of delivery)
Describe the course objectives and student learning outcomes that address the
objectives (i.e., knowledge, communication, critical thinking, ethical research,
etc.). Expand lists and sub lists as needed.
•
Objectives and Student Learning Outcomes
o [click here and type course objective]
 [click here and type learning outcome that addresses course objective]
 [click here and type learning outcome that addresses course objective]
 [click here and type learning outcome that addresses course objective]
o [click here and type course objective]
 [click here and type learning outcome that addresses course objective]
 [click here and type learning outcome that addresses course objective]
 [click here and type learning outcome that addresses course objective]
•
Methods of Evaluation
Describe the methods of evaluation or assessment of student learning outcomes.
(Include evidence for both direct and indirect methods.) Expand table rows as
needed.
Learning Objective
Methods of Evaluation
[copy outcome from above, here]
[click here and type method]
[copy outcome from above, here]
[click here and type method]
[copy outcome from above, here]
[click here and type method]
[copy outcome from above, here]
[click here and type method]
[copy outcome from above, here]
[click here and type method]
[copy outcome from above, here]
[click here and type method]
2
•
Grading Criteria
Grading criteria (select from checklist); include a statement describing the criteria
that will be used to assess students and how the final grade will be determined.
Add and delete rows as needed.
•
Grading Criteria
(replace with check for all that apply)
Weight Toward
Final Grade
Exams and Quizzes
[click here and type points or %]
Papers and Projects
[click here and type points or %]
Homework
[click here and type points or %]
Laboratory Exercises
[click here and type points or %]
Attendance and Class Participation
[click here and type points or %]
Extra Credit
[click here and type points or %]
Methods of Instruction
Identify the method(s) of instruction and describe how the methods promote the
likely success of the desired student learning outcomes. Add and delete rows as
needed.
Method of Instruction
Hours
(replace with check for
per
all that apply)
Week
Contribution to Outcomes
Lecture
[click here and explain contribution]
Recitation
[click here and explain contribution]
Presentation
[click here and explain contribution]
Laboratory
[click here and explain contribution]
Lab Prep
[click here and explain contribution]
Extra Credit
[click here and explain contribution]
Studio
[click here and explain contribution]
Distance
[click here and explain contribution]
Clinic
[click here and explain contribution]
Experiential
[click here and explain contribution]
Research
[click here and explain contribution]
Independent Study
[click here and explain contribution]
Practice/Observation
[click here and explain contribution]
Seminar
[click here and explain contribution]
3
C. Prerequisite(s):
(Complete if different from approved mode of delivery)
List prerequisites and/or experiences/background required. If no prerequisites are
indicated, provide an explanation for their absence. Add bullets as needed.
•
•
•
•
"[click here and type course abbreviation, number, and title]"
"[click here and type course abbreviation, number, and title]"
"[click here and type course abbreviation, number, and title]"
[click here and type other experience or background expected]
D. Course Instructor(s):
(Complete)
Provide the name, rank, and department/program affiliation of the instructor(s). Is
the instructor currently a member of the Graduate Faculty? (If the answer is no,
indicate when it is expected that a request will be submitted.) Add rows as needed.
Name
Rank
Dept.
Graduate Faculty
or expected date
[click here and type name]
[Rank]
[Dept]
[Yes, no, or date]
[click here and type name]
[Rank]
[Dept]
[Yes, no, or date]
[click here and type name]
[Rank]
[Dept]
[Yes, no, or date]
[click here and type name]
[Rank]
[Dept]
[Yes, no, or date]
[click here and type name]
[Rank]
[Dept]
[Yes, no, or date]
E. Course Outline:
(Complete if different from approved mode of delivery)
Provide an outline of topics to be covered and indicate the relative amount of time
or emphasis devoted to each topic. If laboratory of field experiences are used to
supplement a lecture course, explain the value of the experience(s) to enhance the
quality of the course and student learning. For special topics courses, include a
sample outline of a course that would be offered under the proposed course.
(This information must be listed and may be copied from syllabus).
I.
[click here and insert outline]
4
F. Reading List (including course text):
(Complete if different from approved mode of delivery)
A primary reading list or bibliography should be limited to material the students
will be required to read in order to successfully complete the course. It should not
be a compilation of general reference material.
A secondary reading list or bibliography should include material students may use
as background information.
•
Primary Reading List
o
o
o
o
o
o
•
[click here and insert citation]
[click here and insert citation]
[click here and insert citation]
[click here and insert citation]
[click here and insert citation]
[click here and insert citation]
Secondary Reading List
o
o
o
o
o
[click here and insert citation]
[click here and insert citation]
[click here and insert citation]
[click here and insert citation]
[click here and insert citation]
G. Library Resources
(Complete if different from approved mode of delivery)
Describe any library resources that are currently available or the resources needed
to support this proposed course.
•
•
•
•
•
[click here and type library resource name or description citation]
[click here and type library resource name or description citation]
[click here and type library resource name or description citation]
[click here and type library resource name or description citation]
"[EXPLAIN WHY NO LIBRARY RESOURCES NEEDED]"
5