Dixie State University

Course Proposal

All new classes must be approved by the ICL council prior to the start of each semester.

Course proposals can be submitted by anyone wishing to be a course instructor. Please complete the following form to tell us a little more about yourself and your course.


Course Proposal

Personal Information

Necessary for acquiring a parking permit
(If there are no changes from the current catalog or Learning Stream, put "Same")
(If there are no changes from the current catalog or Learning Stream, put "Same")

Course Description/Outline

(If there are no changes from the current catalog or Learning Stream, put "Same")

Course Specifics

Number of sessions
Please note: classes are now restricted to 50 minutes due to logistical issues. If you need an exception, please provide your justification in the Comments section.
Classroom/Zoom Format
Number of students permitted in class
If so, a username and password (technology tag) will be provided by ICL.
Please describe any pre-requisites or limitations you will have regarding this class, i.e., participants must have keyboarding skills, participants must have completed Spanish - Beginning, etc.

Teaching Schedule

Please indicate your preferred teaching schedule. Keep in mind, however, that your preferred day of the week or time of day may not work into DSU’s schedule of vacant classrooms. Every effort will be made to meet your requests.

Code of Conduct/ Release of Liability

CODE OF CONDUCT: I understand that there shall be no conflict of interest between a class instructor or guest speaker and the subject matter or interest of the students attending the ICL activity in question. I further understand that no person associated with ICL is permitted to, or may cause to sell, mention products, services, or recruit regarding any business activity, during any ICL activity. (Please consult Article 5 of the ICL Code of Conduct for further elaboration of conflict of interest. RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT: I the undersigned, in conjunction with the Institute for Continued Learning (ICL) allowing me to register for participation in ICL classes and activities, do freely and voluntarily agree to release, save, hold harmless,, and indemnify ICL from any and all claims of loss, injury or damage, suit, action, demand, fine, judgement, or decree and any expense thereof, including a reasonable attorney's fee that may happen or occur to me as a result of or consequence of having attended and/or participated in any ICL class or activity. This release includes all representatives of said organization including staff, volunteers, affiliates, directors, sponsors or other employees. ICL does not carry an accident or health insurance policy on participants. A participant is responsible for costs incurred as a result of accident or injury. ICL will not be held responsible or liable for any accident or injury unless there is negligence on our part. If I participate in any off-campus activities associated with ICL, I further agree that: 1. I understand that there is a risk of injury resulting from participation in the activity or event. I assume full responsibility for my personal health and well-being and my personal property while participating in this activity; and, 2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, and assume full responsibility for my participation; and, 3. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the activity of instructors or coordinators. I certify that the information provided in this application is true and correct and to the best of my knowledge and that I have read the Release of Liability and Assumption of Risk Agreement and the Code of Conduct, I fully understand the terms, understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement. I understand that ICL dues are not tax deductible. By entering my name below, I certify that I understand and agree with the Code of Conduct and the Release of Liability.
(This is for form changes only) By entering my name, I certify that I understand and agree with the Code of Conduct and the Release of Liability.