Blended- Course Development Request Form
Course ID
Course Name
Credits
Development Type
Funding Source
Developer Name
Developer Email
Developer Position
Campus
Campus
Please select your primary campus.
Central
North
South
Developer Zone
Developer Rank
Developer Supervisor Name
Developer Supervisor Email
If the developer's supervisor is a Dean, please skip to the next line to enter your Dean's email address.
Dean's Name
Dean's Email
Expected Start Date
mm/dd/yyyy
Faculty Reviewer
Faculty Reviewer Email
Other (Notes)
Please attach any documentation you would like to include.
Drop your files here
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