Approval Request Form for Course to be Taught or Received by Compressed Video or World Wide Web
· NOTE: Course submission deadline dates are as follows:
Courses must be submitted by the above deadlines to ensure consideration for approval.
Originating University:
Date of Submission:
Quarter and Year Course to be Offered:
Is this part of a duplicative program resolution? Yes No
Electronic Format to be Used: Compressed Video World Wide Web
If World Wide Web, will you use BlackBoard? Yes No
If Compressed Video, what time and days will course be offered?
A site agreement must be completed before the Louisiana Tech Electronic Learning Committee can act upon your proposal to teach a course by Compressed Video.
Has a Site Agreement been completed? Yes No Not Applicable
If Yes, list the participating schools; note which school will send the course and which school(s) will receive the course:
Department:
Course Title:
Course Number: Semester Hours' Credit:
Meeting Times:
Course Description, including information on how this course has been adapted for electronic presentation:
Instructor:
Summary of Instructor's credentials for teaching this course by distance technology:
Do you need training in the use of any instructional technology? Yes No
If Yes, specify type of training:
Instructor's Telephone Number:
Instructor's E-mail Address: