College Now Request for Course Approval - No Signature Version

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College Now Request for Course Approval

INSTRUCTIONS:

This form is to request the addition of a new JCCC College Now course to a high school’s current College Now course offerings. This form MUST be submitted by the designated College Now Building Representative or College Now District Contact or it will not be accepted for review. An accompanying syllabus must be attached with this request form.

REQUESTOR INFORMATION:

Name:

Email:

School District:

COURSE INFORMATION:

High School Name:

High School's Name of the Course:

JCCC College Now Course Name:

Ex.: Composition I

JCCC College Now Course Prefix and Number:

Ex. ENGL 121

JCCC Course Descriptions: catalog.jccc.edu/coursedescriptions/

Name of Instructor Teaching College Now Course:

Length of Course:

Academic Year Offering:

Please attach the high school syllabus:

FOR JCCC DIVISION DEAN TO COMPLETE:

JCCC Dean: _______________________________________________ Email: _______________________________________________

Dean Comments:

Signature of JCCC Dean: _____________________________________________________________

Nondiscrimination Statement: JCCC provides equal opportunities and equal access to all individuals and is an affirmative action employer. JCCC does not discriminate on the basis of sex, race, color, national origin, ancestry, disability, age, religion, marital status, parental status, military status, veteran status, sexual orientation, gender identity, genetic information or other factors that cannot be lawfully considered in its programs fand activities, which includes employment and admissions, in accordance with Titles VI and VII of the Civil Rights Act of 1964, the Equal Pay Act of 1963, the Age Discrimination in Employment Act of 1967, the Age Discrimination Act of 1975, Executive Order 11246, Title IX of the Education Amendments of 1972, Section 503 and 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act, the Vietnam Era Veteran’s Readjustment Assistance Act, the Jobs for Veterans Act of 2002, the Kansas Acts Against Discrimination and all other applicable civil rights and nondiscrimination laws.

Inquiries concerning JCCC's compliance with its nondiscrimination policies (including Title IX, Title VI and Section 504 inquiries) may be referred to a Title IX Coordinator (TitleIX@jccc.edu), or Director of Human Resources, or the Dean of Students and Learner Engagement at Johnson County Community College, 12345 College Blvd, Overland Park, KS 66210, 913-469-8500; or to Office for Civil Rights, Kansas City Office, U.S. Department of Education, One Petticoat Lane, 1010 Walnut Street, Suite 320, Kansas City, MO 64106, Telephone: 816-268-0550, Facsimile: 816-268-0559, Email to: OCR.KansasCity@ed.gov.

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