Dual Credit Course Request Form Eastern New Mexico University - Roswell Dual Credit Course Request Form Dual Credit Course Request This form is the final step in the Dual Credit Course Request process. Prior to submitting this form, the following should be completed: 1. Discuss request with appropriate contact for initial approval (see email) 2. Instructor must apply to or be active as an Adjunct Faculty. Visit the Human Resources webpage for more information Course Requested By:Name(Required) First Last Title(Required)High School(Required)Email(Required) Phone(Required)Signature(Required)Date(Required) MM slash DD slash YYYY Semester Information:Semester / Year(Required)Example: Fall 2024Beginning Date(Required) MM slash DD slash YYYY End Date(Required) MM slash DD slash YYYY Course Information:Academic Unit(Required)Please select the Academic Unit this course belongs to. School of Arts & Science Education School of Technical Education School of Health Sciences Subject (see current Catalog or MOU)(Required)COMM, ENGL, MATH, etc.Course Number (see current Catalog or MOU)(Required)1110, 2120, 102, etc.Course Title (see current Catalog or MOU)(Required)Intro to Literature, Statistical Methods, etc.Days(Required) Monday Tuesday Wednesday Thursday Friday Saturday Start Time(Required) Hours : Minutes AM PM AM/PM End Time(Required) Hours : Minutes AM PM AM/PM Special NotesAny additional information regarding meeting times, block schedules, etc. Maximum number of students enrolled?(Required)*Textbooks or Access Codes Needed?(Required)*Select Yes if new or additional textbooks or access codes will need to be ordered for this section. Select No if no new or additional textbooks or access codes will need to be ordered for this section. Yes No How many textbooks or access codes are needed?Instructor InformationInstructor Name(Required) First Last Instructor ENMU-Roswell IDIf instructor does not have an ID, contact the Dean's Office of the appropriate Academic Unit - determined by the Course Subject. Building(Required)Room(Required)AcknowledgementSubmission Acknowledgement(Required) I have discussed required fees with the Dean over this course. The high school administration is aware of any fees that will be charged for students who enroll in this course. The high school will notify students of any fees prior to enrolling. *Please note: Fees are subject to change
