Request for Assignment of a Suffix to a Special Topics Course

Instructors MUST be approved before requesting an assignment.

Campus requesting title
For what Semester/Year:
Course Number:
(e.g., CN ED 498)		 (May be assigned 497 or 496 instead)
Title
Short Title
Number of Credits:
Approved Instructor(s): (Note - do not request the special title until instructor is approved)
1.
2.
3.
Begin Date:
End Date:
Contact Person for questions:
Contact's telephone number:
Email address:

Additional Instructors/Comments/Information:

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