Curriculum Consultation Form

Curriculum Consultation Form
It is the responsibility of the department initiating curriculum proposals to assess the impact of the proposed changes and consult with those who may be affected by the changes.

If the recipients have objections to the changes, it is their responsibility to promptly notify the initiating department of the reasons for the objection.

Both parties are then expected to work together to attempt to find a solution to their differences.

The library will automatically receive an FYI in Leepfrog on all curriculum proposals.
Your name:*

First NameLast Name
Your email address:*
example@example.com
Department Initiating Proposal*
Initiating division:
Initiating Dept. Head Email Address
example@uni.edu
Are you the Department Head?*

YesNo
BTS Int. Department Head Email
example@example.com
Department Heads of the impacted departments you select below will be contacted.

Please use the following table to look up department head email addresses:
How many departments do you want to send this proposal to?
The maximum number of departments you can send a proposal to on this form is 6. If you would like to send this proposal to more than 6 departments, a second form must be completed for any department over 6.
Department #1*
Dept. Head/Curriculum Designee Name:

First NameLast Name
Dept. Head/Curriculum Designee Email:
example@uni.edu
PLEASE NOTE:
Due to recent department head changes, please verify that the department head name is correct and the email address is entered correctly.
Department #2*
Dept. Head/Curriculum Designee Name:

First NameLast Name
Dept. Head/Curriculum Designee Email:
example@uni.edu
PLEASE NOTE:
Due to recent department head changes, please verify that the department head name is correct and the email address is entered correctly.
Department #3*
Dept. Head/Curriculum Designee Name:

First NameLast Name
Dept. Head/Curriculum Designee Email:
example@uni.edu
PLEASE NOTE:
Due to recent department head changes, please verify that the department head name is correct and the email address is entered correctly.
Department #4*
Dept. Head/Curriculum Designee Name:

First NameLast Name
Dept. Head/Curriculum Designee Email:
example@uni.edu
PLEASE NOTE:
Due to recent department head changes, please verify that the department head name is correct and the email address is entered correctly.
Department #5*
Dept. Head/Curriculum Designee Name:

First NameLast Name
Dept. Head/Curriculum Designee Email:
example@uni.edu
PLEASE NOTE:
Due to recent department head changes, please verify that the department head name is correct and the email address is entered correctly.
Department #6*
Dept. Head/Curriculum Designee Name:

First NameLast Name
Dept. Head/Curriculum Designee Email:
example@uni.edu
PLEASE NOTE:
Due to recent department head changes, please verify that the department head name is correct and the email address is entered correctly.
Teacher Ed.
Name

First NameLast Name
Teacher Ed Email
example@example.com
Additional departments can be added/removed by adjusting the dropdown labeled "How many departments do you want to send this proposal to?" above.
Submission date

MonthDayYear
Date
Date

MonthDayYear
Date
Summary of Proposed Curriculum Change:*
Does this proposal have an impact on teacher education?*

YesNo
The department initiating curriculum proposals should identify the changes being proposed and the likely impact such changes may have for the department/college being consulted or the LAC. The responding body should take no more than two weeks to reply to this consultation request during the regular academic year. Even if there are NO objections from responding body, this should be noted in this document and returned to requesting department with a signature.
Email
example@example.com
Email
example@example.com
Should be Empty: