The University of Memphis
Department of Mathematical Sciences
Request for Special Topics
 Address questions about this form to: Dr. Raymond A. Clapsadle.

This request must be accompanied by a completed Course Syllabi Form.

I. DEPARTMENT

II. TERM/YEAR

III. COURSE MASTER IDENTIFICATION
Subject Area Course Number Credit Hours Hegis/Taxonomy
Instructional Method 
Full Course Title 
Schedule/Transcript Title (23 characters or less)
Instructor's Name 
Note any special grading: 
Abbreviated Schedule (If course is offered for a time period other than the regular semester calendar, enter the beginning and ending dates) Start Date
End Date 

IV. APPROVALS
______________________________________ 
Department		 ______________ 
Date
______________________________________ 
College		 ______________ 
Date
______________________________________ 
Dr. Karen Weddle-West		 ______________ 
Date
______________________________________ 
Dr. Catherine Serex 		______________ 
Date

V. Please submit your name and e-mail address as a contact source for this form.
Name  E-Mail 
Date