Course Development Funding Request Form

Please fill out the following form to the best of your ability if you would like to submit a request for course development funding.

Contact Information

Department: If for any reason you need support or have questions please contact
Department Chair's Name:
Chair, Learning & Teaching Services
Farbod Karimi, (613) 727-4723 ext 3578
Department's Budget Officer Name: Support Officer, Learning & Teaching Services
Hilary Welsh, (613) 727-4723 ext 5448
Department's Budget Officer Email Address: Curriculum Administrator, Academic Development
Micheline Kraska, (613) 727-4723 ext 2486
Faculty/Developer Name:
Faculty/Developer Email Address:
Your Email Address if you are not the Faculty/Developer:

Course Details

Program Code:  
Program Title:  
Campus: Select all campuses where this program is delivered. For each campus, select all current program delivery modes.
Woodroffe: Perth: Pembroke:
Smith Falls: Perley Rideau: Renfrew:
Type of Course Development Request:
Course Title:  
Course Code(s):
Please list the course code(s) used at each applicable campus.

Woodroffe: Pembroke: Perth Smith Falls:

What level is this course part off?   How many hours is this course?   Fiscal Year  
When will this new Course launch for the first time?

<October 2018>