Adjunct/Overload Form (For courses to be offered in Fall 2013)

For full consideration, deadline for submission of this form to the Office of Academic Affairs: Friday, February 8, 2013. Please submit a separate form for each adjunct/overload taught course (multiple sections per form allowed).

Department Chair Name: *

Department and Course Number: *

E-mail Address: *

Course Title: *

Number of Sections Requested: *

Instructor (if known):

What was the total number of sections of all courses offered by the department in Fall 2012?:

Total expected number of sections of all courses offered by the dept./prog. in Fall 2013, including this adjunct/overload course?:

Total number of sections of courses at the level (100-400) of the proposed course offered by the dept./prog. in Fall 2012?:

Total number of sections of courses offered by the dept./prog. at this level in Fall 2013, including this adjunct/overload course?:

Total number of sections of THIS course (same number) offered by the dept./prog. in Fall 2013, including this adjunct/overload course?:

Please briefly describe the department's/program's reasons for requesting this course:

Adjunct/Overload Form (For courses to be offered in Fall 2013)

Office of Academic Affairs

Academic Affairs Division