Request for Approval

Revised 10/20/08

REQUEST FOR APPROVAL

Incomplete forms will be returned to the school

TO ADD OR MODIFY A COURSE TO INSTRUCTIONAL PROGRAMS

FAX SIGNED REQUEST TO EXECUTIVE DIRECTOR OF SECONDARY PROGRAMS

Fax # 377-0167 or 377-0165

CONFIRMATION OF APPROVAL WILL BE FAXED TO YOUR SCHOOL

(School Year Needed: ______) Date of Request (mm/dd/yyy): ______

Please check the appropriate box: Modify (List modifications in Course Description Section) Add For Academic History Only College Course (Name of College or University): ______

Florida Course Code Directory Information:

Course Title: (20 Characters) ______

Course Number: ______( ) Level: 1 2 3

Subject Area: ______ Credits: ______Program #: ______

Honors Advanced Placement Academic Dual Enrollment Vocational Certif Dual Enrollment

Grade level(s): (A RANGE of grade levels, lowest to highest, who can enroll in this course)

School: ______ School Number: ______

Anticipated number of students: ______

MIDDLE SCHOOL COURSES: Subject Area ______ Course LVL for Grade Reporting ______

Course Title: (20 Characters) As written in Florida Course Code Directory ______

Vocational Courses: Vocational Subject Program ______ Vocational Job Prep: Yes No

Course Description: Including purpose, content, intended outcomes linked to Sunshine State Standards (Attach

DOE Course Description sheet.) If modifications are being made to a course, explain the purpose.

Submit entire packet to appropriate Subject Area Coordinator / Administrator

______

Administrator / Signature Principal / APC Signature