Form d to be used only in Conjunction with an approved Form a or Form B



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Effective: September 2016

FORM D

To be used ONLY in Conjunction with an approved Form A or Form B

to Request General Education Course Status for a Course with Prior Curriculum Committee Approval
Atlantic Cape Community College

General Education Certification
Submit this form to the General Education Subcommittee secretary four weeks prior to the next scheduled Curriculum Committee meeting. (The specific deadline dates can be found in the college academic calendar.) The subcommittee will act on the proposal and may require the originator to attend the meeting to answer questions. Complete the form and include all requested material.
Course No. (Alpha #): _____________________
Course Title: _______________________________________________________________
Course Originator: _________________________________________________________
Department: ______________________________________________________________
Applicable General Education Course Category: (A Diversity course may have a second category)
___ Communication (Written & Oral Communication) (Goal 1)

___ Math (Quantitative Knowledge & Skills) (Goal 2)

___ Science (Scientific Knowledge & Reasoning) (Goal 3)

___ Technology (Tech. Competency) (Goal 4)

___ Social Science (Society & Human Behavior) (Goal 5)

___ Humanities (Humanistic Perspective) (Goal 6)

___ History (Historical Perspective) (Goal 7)

___ Diversity (Global & Cultural Awareness) (Goal 8)


Applicable Integrated Goal(s):

___ Ethical Reasoning and Action

___ Information Literacy
SUBMITTED BY
Area Coordinator and/or Chair Date

(Signature verifies that the proposal has been approved by full time faculty of the department.)

Dean Date


GENERAL EDUCATION STATUS REVIEWED BY
____ APPROVED as meeting required general education course criteria and/or integrated goals. The General Education Subcommittee will forward this form along with all other proposal materials to the Curriculum Committee for informational purposes.
____ DENIED as meeting required general education course criteria and/or integrated goals. Suggestions will be forwarded to the course originator:

General Education Subcommittee Chair Date



(Signature of chair indicates that the proposal has been reviewed by the subcommittee.)

Vice President of Academic Affairs Date



If seeking approval of a new general education course follow Steps #1 and #2 below.
STEP #1: Attach Course Syllabus to Form with Notations

1. On the course syllabus, highlight/mark the course goals and student learning outcomes that meet the General Education Goal(s) outlined by the NJ Community Colleges (NJCC) for the area(s) of study designated for this course.


2. Describe how the Learning Outcome(s) comply with the NJCC GE Learning Goal(s) being requested.
3. How do course activities help students obtain the knowledge or skills?
4. How do students demonstrate their acquisition of it?
5. Next to every highlighted/marked course goal and student learning outcome on the syllabus, write the number(s) of the corresponding General Education Goal(s) outlined by the NJCC.
6. Attach the notated course syllabus to the form to complete the general education

certification application for this course proposal.



STEP #2: Complete the Checklist of Required Elements
___ The proposed course complies with New Jersey state guidelines for general

education.


See NJCC General Education Learning Goals and Suggested Individual College-Wide Learning Objectives and NJCC General Education Course Criteria
___ The course is broad, having a foundation or basis that is wide in range:

comprehensive or extensive. It is not focused on “majors” or academic and

vocational specializations.
___ The course supports Atlantic Cape’s general education mission: to enable students to

develop the skills of inquiry, to communicate effectively, and to make informed

judgments about themselves and their natural, cultural, and social worlds.
If seeking approval of Integrated Course Goal(s) for an existing or new general education course follow the instructions below.
Attach Course Syllabus to Form with Notations
1. On the course syllabus, highlight/mark the outcome and assessment tool that meets the

General Education Integrated Goals outlined by the NJ Community Colleges (NJCC) for the area of study designated for this course.


2. Attach the notated course syllabus and the “Request for General Education Integrated Goal” spreadsheet to this form to complete the application for this course proposal.


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