PORTLAND STATE UNIVERSITY
REVIEW FORM for NEW COURSE
INSTRUCTIONS: Use this form to prepare departmental requests for new courses.
 This table was created so that you can respond directly in the appropriate column, which will expand to
accommodate responses of any length. You may save and title the file as you wish.
 Please save and utilize this form as a Word document.
 Replace bracketed information with information you supply.
 See “Directions for Completing Course Review Form” for detailed explanations of each item.
Schools/colleges should submit ONE paper copy with ALL REQUIRED SIGNATURES to Academic Affairs; in
addition please submit via email one electronic copy in Word format (which may be unsigned) to Steve Harmon
in Academic Affairs (harmons@pdx.edu).
1. College/School and Effective Term
College/School:
Effective term :
(The effective term may be delayed to a later term if the proposal is approved by Faculty Senate after the requested term’s preterm registration has begun, i.e., May for fall/summer, November for winter, and February for spring term.)
2. General Catalog and Banner Information
2a.
Department
2b.
Course prefix and
number
2c.
Catalog course title
(max 100 chars)
2d.
Short [BANNER]
title.
As it will appear in
the Schedule of
Classes (max 30
chars)
2e.
Catalog course
description
(max 50 words –
strictly enforced)
(Include any
expected
preparation if it is to
appear in catalog
description)
2f.
Credit hours:
2g.
Clock hour
distribution:
lecture ____
lab/studio ____
field work
____
online ____
practicum
____
other ______________________
2h.
Course
prerequisite(s):
January 2015:OAA:swh
Page 1 of 6
2i.
Is concurrent
enrollment in the
indicated
prerequisite
permitted?
No
____
Yes
____
2j.
Course corequisite:
2k.
Is course
repeatable:
No
____
Yes
____
If course is
repeatable what is
the limit?
Maximum of ____ credits or
Grading option:
Letter only ____
2l.
2m.
Maximum of ____ times.
P/NP only ____
Both letter and P/NP ____
2n.
Course intended
for:
undergraduates ____
graduates ____
both undergraduates & graduates ____
doctoral only ____
2o.
Teaching method
(identify ONE or at
the most TWO):
(Used by Registrar
for coding in
Banner.)
lecture ____
[See definitions.]
recitation ____
seminar ____
experiential ____
activity ____
discussion ____
research ____
lab/studio ____
(See definitions in the Instructions for this form.)
3. Enrollment Projections
3a.
Expected distribution of
enrollment per section
OAA: January 2015
lower division
upper division
graduate
total
____ %
____ %
____ %
100%
3b.
Students would take this
course as
(Please note some
additional submissions
may be required related
to specific categories.)
check all that apply:
____ a community-based learning course with ______ # of service hours required
(The number of service hours required of the students must be noted.)
____ a prerequisite for __________
____ a requirement for a major in __________
(A Program Change form must be submitted to add this requirement to the program.)
____ a requirement for a graduate program in ____________________
(A Program Change form must be submitted to add this requirement to the program.)
____ an elective leading to specialization in __________
____ an elective contributing to general or liberal education
____ an elective in a graduate program in ____________________
____ a part of a professional program in __________
____ a part of a licensure or certification program in ____________________
____ a course satisfying UNST Cluster _________________________
(A University Studies cluster proposal must be submitted to the UNST Council.)
4. Rationale
4a.
Reason for the proposal
at this time
4b.
Additional comments
5. Syllabus
5a.
A syllabus is required.
6. Overlap
6a.
Potential shared subject
matter with other
courses in your
department
6b.
Potential shared subject
matter with courses in
other departments.
6c.
Comments and
attributions from contact
person(s) in other
departments with whom
you’ve discussed
overlap.
7. Instructor information
OAA: January 2015
[describe briefly]
A Syllabus should include:
 Title
 Course Prefix and Number
 Course description
 Prerequisites/co-requisites
 Course Objectives
 Student Learning Outcomes
 Outline of Course Content (major content topic w/ main subdivisions)
 Course requirements (exams, assignments, papers, etc.)
 Required Texts and/or Required Reading List
 Method of Evaluation (letter graded or P/NP and calculation of course grade)
Appropriate distinctions in required coursework and method of evaluation for both
undergraduate and graduate students for an UG/GR slash course.
[course number(s) and title(s)]
[describe and explain the overlap]
[course number(s) and title(s)]
[describe and explain the overlap]
[Identify contact(s) in other
department(s) with whom you have
discussed this proposal]
[Mandatory: post statements directly
attributable to the contact person(s)
with whom you have discussed shared
subject matter. You may attach
documentation.]
7a.
Course instructor(s):
7b.
[full name]
Instructor status:
tenure-related____
fixed term____
adjunct____ (submit a c.v. for any
adjunct teaching this course)
Other (explain):
Faculty status:
tenure-related____
Other (explain why this is appropriate):
Faculty with primary
ongoing responsibility for
course content and
review if instructor is
fixed term or adjunct.
8. Teaching and Learning
8a.
Course objectives
[if different from instructor above]
8b.
Learning outcomes
[list specific learning outcomes]
8c.
Student activities
[describe activities students will engage in to learn material; differentiate
undergrad and grad requirements for 400/500 level classes]
8d.
Methods of evaluation
[describe what students will do to demonstrate what they have learned;
differentiate evaluation methods to be used for graduate and undergraduate
students for 400/500 level classes]
[list specific course objectives]
9. Resources
Who is the department/program’s
9a.
Disciplinary Librarian?
[full name]
[Mandatory: post statements directly
attributable to the disciplinary librarian(s)
with whom you have discussed whether
the library resources are adequate. You
may attach documentation.]
[A statement from the disciplinary
librarian is required.]
9b.
9c.
Are technological resources
adequate?
Are there any additional costs to the
student beyond tuition and textbooks
(e.g., course-specific fees and
materials costs)?
Yes ____
No ____
Describe:
Yes ____
No ____
If yes, explain:
10. College/School and department/division information
10a.
Course to be
offered:
annually ____
alternate years ____
other: _____________________
In which term(s):
fall ____ winter ____ spring ____summer ____
10b.
Anticipated
enrollment per
term in first 2
years:
10c.
Optimal
enrollment per
section:
10d.
Educational
purpose of
adding this
course to the
department’s
curriculum
OAA: January 2015
[describe briefly]
10e.
10f.
Place in the
University’s
curriculum
[describe briefly]
Faculty
Assignment
% FTE tenure =
% FTE fixed term
=
Specialized space
____ sq. ft.
Explain:
Equipment &
Supplies
List
Explain:
Additional
personnel (TA,
clerical, etc.)
List personnel and
FTE:
Explain:
Other expenses:
List:
Explain:
Additional funding
for expenses:
Source(s):
OAA: January 2015
% FTE adjunct =
Existing $:
New $:
Total:
Total:
New Course Signature Page
Proposing
Proposal prepared
by
Dept.
Curriculum
Chair
Dept. Chair
College/School
Curriculum
Chair
Dean
OAA: January 2015
Date of
Review
Signature
Approve (√)
Role
Name (print)
Course prefix, number and title:____