Course Selection Form

Personal Information

Name *

Email Address *

Phone Ext. *

Sender Comments

Type of Request

Course Selection Type is a Key Field. The choice you select for this field will determine which fields will be presented for completion below so please make your selection here first before you fill out any of the fields below.

Course Selection Type *

Basic Course Information (SSASECT)

Term Offered *

(i.e. Fall 2014 or enter ADD if new type)

CRN *

(Enter CRN # or ADD)

Subject Code *

(i.e. ACCO)

Course No. *

Course Title *

(30 character limit)

Campus (Course) *

Year-Term *

FlexReg Catalog *

Notify Students? *

Do the students need to be notified?

Section Details

Is this course crosslisted (piggy backed) *

Piggy Backed CRN(s)

Please specify CRNs

Piggy Backed CRN 1 *

Piggy Backed CRN 2

Piggy Backed CRN 3

Piggy Backed CRN 4

Combined Seat Count? *

Specify Combined Seat Count *

Is this course taught at the same time as a credit class? *

CRNs for Credit Classes at Same Time

Credit Class CRN 1 *

Credit Class CRN 2

Credit Class CRN 3

Credit Class CRN 4

Campus (Section) *

Schedule Type *

Instructional Method *

Number of CEs or CEUs

(Enter 0 for Non-Credit or N/A)

Special Approval

Is special approval is needed to take this course?

Part of Term

Duration *

(Includes all days from beginning to end. Enter Not Applicable if appropriate.)

Beginning Date

Month

Day

Year

Last Date to Register

Month

Day

Year

(This is the last day for refund also)

End Date

Month

Day

Year

Last Date to Drop

Month

Day

Year

Last Date to Withdraw

Month

Day

Year

Is this class refundable?

Last Date for Refund *

Month

Day

Year

Credit Hours *

(Enter N/A if not applicable)

Weekly Contact Hours *

(Enter N/A if not applicable)

Annual Contact Hours (ACHs) *

Seat Count *

(Enter N/A if not applicable)

Course Type *

Taxonomy Code *

(Enter N/A if not applicable)

Display on Online Schedule? *

Course Registration through FlexReg? *

Assigned Instructor Block

(For Change Course Selection Forms, only indicate items which are changed.)

Is instructor new?

Instructor ID

(Nxxxxxxxxx)

Instructor Name

Required Co-Requisite CRN Block

(Please Note: Courses designated in this section will require mandatory concurrent enrollment.)

Co-Requisite CRN

Co-Requisite Subject Code

(i.e. ACCO)

Co-Requisite Course No.

Section Fees

Select Residency Tuition Type if the fee is based on where the student lives, i.e. In-District.
Select Flat Fee Tuition Type if the fee is not based on where the student lives. Generally for BDCS classes as well as Direct Credit courses or any course that doesn't have regular tuition based on where the student lives. For any other flat Fees, use blanks 1-4, if provided, to specify Description and Amount.
Flexible Registration Flat Fee should only be selected for Open Learning and CE courses.

Tuition Type is a Key Field. The choice you select for this field will determine which fields will be presented for completion below so please make your selection here first before you fill out any of the fields below.

Tuition Type *

Malpractice Fee (F17) $

Special Course Fee (F19) $

Non-Refundable Certification Fee (F21) $

Refundable Flat Fee (??) $

Non-Refundable Course Fee (NRCF) $

Internet Course Special Fee (F22) $

Enrichment Credit Course Fee (TCEC) $

Non-Business Development Fee (TCWN) $

Registration Flat Fee Type

Flexible Registration Flat Fee Amount $

Is this course being created for a specific third party?

Purchase Order Number

(Please enter purchase order number in space provided above.)

Other Flat Fees

Description 1

Amount 1

Description 2

Amount 2 $

Description 3

Amount 3 $

Description 4

Amount 4 $

Section Comments

Comments

(Additional Course Information)

The Registrar must approve all course selection form before they are submitted to the Scheduling Coordinator. When you complete and submit this form, it will automatically be routed to the Registrar's scheduling email alias (recordsch@swimch.edu).

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Course Selection Form