COURSE CODE REQUEST FORM
2017-18 Submission Timeline
Course code requests are processed using an online submission portal. Requests for new course codes will be accepted twice annually as outlined below:

Fall Submission Deadline: November 1, 2017
Spring Submission Deadline : May 1, 2018


Department consideration timeline:
Fall submissions - on or after November 1, 2017
Spring submissions - on or after May 1, 2018

Following Department review, notification of the status for each request will be delivered, via email, to the LEA contact initiating such request.

For more information, contact JumpStart@la.gov

For a submission to be considered for a new code, it must meet one of the below criteria. Please check all that apply. *
Required
Date of Request *
MM
/
DD
/
YYYY
Contact Information *
Name
Your answer
*
Official Title
Your answer
*
LEA Affiliation
If selecting "Other", please provide LEA name below.
Your answer
*
School Affiliation. If no school affiliation, please respond with N/A.
Your answer
*
Email Address
Your answer
Action Requested: *
Course Title *
Your answer
Maximum Course Credit *
Maximum Class Size *
Course Category *
Course Description *
Your answer
What is the rationale for your request? *
Your answer
Credentials *
List area(s) of regular teacher certification. (N/A if not applicable)
Your answer
*
List area(s) of CTTIE teacher certification. (N/A if not applicable)
Your answer
*
Is an Industry Based Credential (IBC) required for teacher certification?
*
List the required Industry Based Credential (IBC); (N/A if not applicable)
Your answer
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