Extension Course Proposal Request Form

When an instructor wishes to create a new UC Merced Extension course, a course proposal should be submitted to the Extension Dean for approval. The course proposal will first be reviewed by Extension staff. If there are questions regarding the proposal, the originating instructor will be contacted as soon as possible. Once the Extension Dean approves the course, and obtains any additional required approvals, the instructor will be notified.

CEUs/Professional Development: Continuing Education Units (CEUs) represent a measure of contact time and participation suitable for seminars, short workshops and other types of courses and programs that do not require participants’ work be evaluated, or “graded”.

Non-Credit/Personal Enrichment: Professional, personal, and cultural enrichment learning opportunities. Participation does not result in a student record. (i.e. Master Gardener Series)

Course Information

Course Title

Proposed Location of Course

Provide name of place, city, zip.

Prospective Instructor Name(s)

Enter 1-10 names on separate lines.

Proposed Term

Year

e.g. 2018

Participants

1-100+

Hours

of Instruction
(500 max)

CEUs

(50 max)

5-9 hours calculates to 0.5 CEU's

10-14 hours to 1.0 CEU's

15-19 hours to 1.5 CEU's

20-24 hours to 2.0 CEU's, etc.

Academic Credit?

In addition to CEUs?

Course previously offered through UC Merced Extension?

Term Offered

Year Offered

e.g. 2018

Provide course description of major areas to be covered

Your Information

First Name

Last Name

Street Address

City

Zip

Phone No.

Sponsoring Agency?

Examples: County Office of Education, City School District, School of Natural Sciences, etc

Sponsoring Agency Name

Data Form ID

Contact Information