id
1743676214
Date Entered
4/3/2025
Your Email Address
Course Title
Combined Course Library Pre-fix and Number
Is this course fee waived for authorized individuals
YES
NO
If yes, what industry/individuals are fee waived?
Location of class
Begin Date/Time
EndDate/Time
If times differ on different days, please note the date and times for each day:
Number Of Hours
State the Lead Instructor and the number of hours he/she will instruct.
List each instructor with the number of hours each instructor will instruct beside his/her name
Maximum Number of Students allowed to register for class (can be listed as unlimited)
Does this class lead to an federal, state, or industry recognized credential?
NO
YES
If yes, what is the organization and credential?
Does this course have clinical hours contained in the total number of hours
YES
NO
If yes, how many of the total hours are considered clinical hours?
Does this course have lab hours contained in the total number of hours
YES
NO
If yes, how many of the total hours are considered lab hours?
Is this course completely on-line?
YES
NO
If completely on-line is it synchronous (meets specific date and time on-line) or asynchronous (students do not have specific date and time, course is always available) or both.
Synchronous
Asynchronous
Both
If the course meets synchronous on-line at any point, give dates and times.
If this course is on-line, hybrid, or web-assisted, please give instructions that can be forwarded to students in reference to gaining access to the course on-line.
Yes, it is Hybrid
Yes, it is Web Assisted
No, this course is not Hybrid or Web Assisted
If yes, (hybrid or web-assisted), what is the first date seated (in person)?
What is the first date on-line?
How many hours will be designated as seated (in person)
How many hours will be designated as on-line? This number will then be used to divide into the number of weeks that the class will meet on-line. EX: 30 hours of on-line for 10 weeks would be 3 hours per week.
How many hours will the class meet on-line each week?
What days will the class meet in-person each week and what hours?
How many hours will be designated as on-line? This number will then be used to divide into the number of weeks that the class will meet on-line. EX: 30 hours of on-line for 10 weeks would be 3 hours per week.
How many hours will the course meet on-line prior to the 10% census date:
How many hours will the course meet seated before the census date?
Instructions For Online Access
If books and or supplies are required for this course please indicate the title, author, and ISBN number for books, supplies that must be purchased, and where books and supplies may be purchased.
Other than continuing education course costs, are there any other costs associated with this course?
Is there a day that the class will meet for orientation prior to the start date of the class?
YES
NO
If yes, please indicate the date, time, and location of the orientation day.
Is there any additional instructions or information that you need to provide regarding this course?
Upload your course syllabus and/or class schedule
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