Course Information Form

For Course Offered Online or Via Compressed Video

This form must be completed each time an online or compressed video course is offered. It supplies the information required for the administrative support of such courses. This form does NOT take the place of PVC Form 94, which is required for the approval of an internet course. To complete the form, click on each data entry field. Either choose the appropriate option from the drop down box provided, or type in the requested information. When you have completed the form, rename it, using the Course Number (i.e. ENG 101) as the name of the file, and save it. E-mail that file as an attachment to: . Note: at no time should you unlock the data fields. Unlocking them will result in the loss of all of your data.

This form is for a course that is: If “Recurring”, term it was last offered: ,

This course will be offered: Year:

Course Subject & Number: Section Number:

Credit Hours: Enrollment Capacity:

Official Course Title:

Official Course Description:

Keywords (Words you anticipate might be useful in locating this course using a database search. This list might include the discipline, specific course content areas, etc.):

Method of Delivery: If an online course, it will be offered using:

URL for the actual course home page (for online courses):

URL for the course syllabus: (This page should have open access and provide sufficient information for students to assess whether the course is a viable choice for them.)

URL of home page for course information: (This page should have open access and provide sufficient information for students to assess whether it is a viable choice for them.)

Prerequisites: Course # Course Title

Course # Course Title

Course # Course Title

Other:

Instruction for this course is: Latest start date: Latest End date:

Number of face-to-face meetings scheduled for this class (for online courses):

Specify the date, and time, and location of each scheduled face-to-face meeting:

Day, Date /

Start Time

(specify a.m./p.m.) /

End Time

(specify a.m./p.m.) / Location to be Assigned? / If Assigned
Building & Room
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo

Instructor

Name:

E-Mail Address:

Telephone:

Personal Web Page URL: (if available):

Course Contact (if other than instructor). For graduate level course, give Graduate Program Director information:

Name:

E-Mail Address:

Telephone:

Personal Web Page URL (if available):

Is admission to a specific program required for enrollment in this course? (Yes/No)?

If Yes, please provide:

the program name:

the URL of any existing program admission information:

the URL of the program home page, if applicable:

the program advisor’s:

Name:

Phone number:

E-mail address:

Department offering this course:

URL of the department home page, if applicable:

Textbook(s):

Required/
Optional / Title / Author / Edition/Publish Date / Publisher / ISBN#
RequiredOptional
RequiredOptional
RequiredOptional
RequiredOptional
RequiredOptional

Supplemental materials required (i.e. E-Pack):

Item / Source

Technical requirements:


All Blackboard courses will be required to have the following basic technical requirements:

For Windows PCs: Netscape 7.1 or higher, Internet Explorer 5.5 (tested in Windows 2000, not fully tested in Windows XP), Internet Explorer 6.0, or Firefox 1.0. For MAC OS machines: Netscape 7.1, Internet Explorer 5.2, Firefox 1.0, Safari 1.1 or 1.2

28.8 kiobits per second or faster network connection

An active SIUENET account (e-ID and password)

Additional technical requirements:

Software Name /

Version Number

/

IBM Compatible or Macintosh

Adobe Acrobat / 8.0 / IBM or Macintosh
Real Player / 10.0 / IBM or Macintosh
IBM OnlyMac OnlyIBM or Mac
IBM OnlyMac OnlyIBM or Mac
IBM OnlyMac OnlyIBM or Mac

Other Requirements (including special testing, practicum, etc.)

Other Course Notes:

Tuition & Fees:

Standard Undergraduate

Standard Graduate

Other (specify)

Special Fees Associated w/ this course (specify)

Subject (CIP Code): Locate and select your course subject area from within the SIUE unit categories below:

CAS: AD-HUM (Select 1)AD (except AD065, 075, 085, 095) - 230101AD 065, 075, 085, 095 - 270101ANTH - 450201ART - 500701BIOL - 260101CHEM - 400501CHIN - 160101CJ 430101DANC - 500301ENG - 230101ENVS - 030102ESCI - 400799FAC - 309999FL - 160101FR - 160101GEOG - 450701GER - 160101GRK - 160101HIST - 450801HUM - 240103 / CAS: ITAL-WMST (Select 1)ITAL - 160101LAT - 160101LIBS - 240401MATH - 270101MC - 090403MUS - 500901PAPA - 440401PHIL - 380101PHYS - 400801POLS - 451001RUSS - 160101SCI - 300101SOCW - 440701SPAN - 160101SPC - 231001STAT - 270501THEA - 500501WMST - 309999 / BUSINESS (Select 1)AS - 290101ACCT - 520301BSED - 131303CMIS - 521201EBUS - 520201ECON - 450601FIN - 520808GBA - 520201MBA - 520201MGMT - 520201MKTG - 521401MS - 521301MSC - 290101PROD - 520201
EDUCATION (Select 1)ADED - 131202CI - 131202EDAD - 130401EDFD - 130901EDUC - 139999GRN - 301101HED - 131307IT - 130501KIN - 310501PSYC - 420101SPE - 131001SPPA - 510204 / ENGINEERING (Select 1)CE - 140801CIS - 110101CNST - 151001CS - 110101ECE - 141001IME - 141701ME - 141901 / NURSING (Select 1)NURS 100-499 - 511601NURS 500+ - 511699
PHARMACY (Select 1)PHAS - 512001PHEP - 512001PHPR - 512001PHPS - 512001PHPT - 512001 / UNIVERSITY BASED (Select 1)DS - 309999IS - 309999UNIV - 309999

*Illinois Articulation Initiative Number:

* Items for office use only.

The contents of this form are subject to change in order to adapt to changes in information required by IBHE, the Illinois Virtual Campus (IVC), and/or the University.

Last updated: 9/30/2009