Regional CTE ProgramOf Study… 2017 Application(continued)


Office of Educational Improvement and Innovation

Public Service Building
255 Capitol Street NE
Salem, OR 97310-0203
503-947-5600
Fax 503-378-5156
/ /

Oregon Department of

Community Colleges and

Workforce Development

Public Service Building
255 Capitol Street NE
Salem, OR 97310-0203
503-378-8648
Fax 503-378-3365

Career and Technical Education

RegionalProgram of Study Application

2017 Version

(Full Application)

Directions—please enter information into ALL the fields in this application.If you have technical problems with this application, contact Kenzie Mozejko, .)

(For detailed information on how to complete this application consult the Guide to Using the Oregon CTE Program of Study Application 2017.) DEADLINE for submission: June 30, 2017; (Early Bird: April 28, 2017)

Regional Coordinator/Contact: / Select Regional Coordinator Name 1A--Debby Robertson 1B--Tami Schild 2A--Beth Molenkamp 2B--Jenn Edgar 2C--Jeanne Yerkovich 03--Ed Woods 3A--Jim Orth .u04--Dale Moon 05--Kristin Gunson 07--Tracy Blue 08--Brian Robin 09--Brook Rich 10--Brook Rich 11--Brook Rich 12--JennifeCarnes 13--Stefen Maupin 14--Stefen Maupin 15--Sarah Dorn
Regional CTE POS—Title:
Career Area: / Select Career AreaAgriculture, Food & Natural Resources--AFNRArts, Information & Communication--AICBusiness & Management--B&MHealth Sciences--HSHuman Resources--HRIndustrial & Engineering Systems--I&E
Cluster Area: / Select ClusterAFNRS--AgricultureAIC--Arts, A/V, Performing and Comm. Technology AIC--Info & Communication Tech (ICT)B&M--Business Management & Administration (BMA)B&M--FinanceB&M--Hospitality TourismB&M--MarketingHS--Health SciencesHR--Education & TrainingHR--Government & Public AdministrationHR--Human Services HR--Law, Public Safety, & SecurityI&E--Architecture & ConstructionI&E--Automotive & Heavy EquipmentI&E--Engineering TechnologyI&E--ManufacturingI&E--Transportation
Focus Area (if applicable):
Secondary CIP Code & Title:(Link to CIP website) / (6 digit)
Community College CIP & Title:(Link to CIP website) / (6 digit)
Community College Name:(Contact add multiple colleges) / Select Community CollegeBlue Mountain Community CollegeCentral Oregon Community CollegeChemeketa Community CollegeClackamas Community CollegeClatsop Community CollegeColumbia Gorge Community CollegeKlamath Community CollegeLane Community CollegeLinn-Benton Community CollegeMt. Hood Community CollegeOregon Coast Community CollegePortland Community CollegeRogue Community CollegeSouthwestern Oregon Community CollegeTillamook Bay Community CollegeTreasure Valley Community CollegeUmpqua Community College
College Point of Contact: / Click to select College Point of Contact BMCC Jan Keough COCC Vickery Viles hem Tim Pierce Clack Bill Waters Clatsop Donna Larson CGCC Susan Lewis KCC Jamie Jennings CC Melanie Brown LBCC Sally Widenmann MHCC Susanne Rose CCC Cindy Carlson PCC Sally Earll RCC Laura Bennett SOCC Debbie Daniels TBCC Ann Hovey TVCC Ron Hanks UCC Kristi Hurt
Community College CTE Program Title:
Community College Award: / Select College Program Award (highest available)Certificate of Completion (46-89 credits)Certificate of Completion (90-108 credits)Associate of Applied Science
Visual/Roadmap:
Secondary Technical Skill Assessment (TSA):Use the code from this table for your selected TSA.
CC Technical Skill Assessment (TSA):Use the code from this table for your selected TSA.
1st Secondary School Name:
Secondary School District:
Secondary School ID Number:
Secondary teacher:
Teacher CTE Endorsement: / Select Current Teacher CTE Endorsement AFNRS--Agriculture Science & TechnologyAGNRS--Environmental ServicesAFNRS--Natural Resources ManagementAIC--Publishing & BroadcastingAIC--Information & Communications TechnologyAIC--Visual, Performing & Media ArtsBM--Business Management & AdministrationBM--FinanceBM--Hospitality TourismBM--Information & Communications TechnologyBM--MarketingHR--Education & Related FieldsHR--Hospitality TourismHR--Human ServicesHR--Public ServicesHS--Health SciencesIES--Construction TechnologyIES--Engineering TechnologyIES--Information & Communications TechnologyIES--ManufacturingIES--Transportation Technology
Visual/Roadmap:(Insert link, oridentify location where sample of visual can be found)
2ndSecondary School Name:
Secondary School District:
Secondary School ID Number:
Secondary teacher:
Teacher CTE Endorsement: / Select Current Teacher CTE Endorsement AFNRS--Agriculture Science & TechnologyAGNRS--Environmental ServicesAFNRS--Natural Resources ManagementAIC--Publishing & BroadcastingAIC--Information & Communications TechnologyAIC--Visual, Performing & Media ArtsBM--Business Management & AdministrationBM--FinanceBM--Hospitality TourismBM--Information & Communications TechnologyBM--MarketingHR--Education & Related FieldsHR--Hospitality TourismHR--Human ServicesHR--Public ServicesHS--Health SciencesIES--Construction TechnologyIES--Engineering TechnologyIES--Information & Communications TechnologyIES--ManufacturingIES--Transportation Technology
Visual/Roadmap: (Insert link, oridentify location where sample of visual can be found)
3rdSecondary School Name:
Secondary School District:
Secondary School ID Number:
Secondary teacher:
Teacher CTE Endorsement: / Select Current Teacher CTE Endorsement AFNRS--Agriculture Science & TechnologyAGNRS--Environmental ServicesAFNRS--Natural Resources ManagementAIC--Publishing & BroadcastingAIC--Information & Communications TechnologyAIC--Visual, Performing & Media ArtsBM--Business Management & AdministrationBM--FinanceBM--Hospitality TourismBM--Information & Communications TechnologyBM--MarketingHR--Education & Related FieldsHR--Hospitality TourismHR--Human ServicesHR--Public ServicesHS--Health SciencesIES--Construction TechnologyIES--Engineering TechnologyIES--Information & Communications TechnologyIES--ManufacturingIES--Transportation Technology
Visual/Roadmap:(Insert link, oridentify location where sample of visual can be found)
4thSecondary School Name:
Secondary School District:
Secondary School ID Number:
Secondary teacher:
Teacher CTE Endorsement: / Select Current Teacher CTE Endorsement AFNRS--Agriculture Science & TechnologyAGNRS--Environmental ServicesAFNRS--Natural Resources ManagementAIC--Publishing & BroadcastingAIC--Information & Communications TechnologyAIC--Visual, Performing & Media ArtsBM--Business Management & AdministrationBM--FinanceBM--Hospitality TourismBM--Information & Communications TechnologyBM--MarketingHR--Education & Related FieldsHR--Hospitality TourismHR--Human ServicesHR--Public ServicesHS--Health SciencesIES--Construction TechnologyIES--Engineering TechnologyIES--Information & Communications TechnologyIES--ManufacturingIES--Transportation Technology
Visual/Roadmap:(Insert link, oridentify location where sample of visual can be found)
5th Secondary School Name:
Secondary School District:
Secondary School ID Number:
Secondary teacher:
Teacher CTE Endorsement: / Select Current Teacher CTE Endorsement AFNRS--Agriculture Science & TechnologyAGNRS--Environmental ServicesAFNRS--Natural Resources ManagementAIC--Publishing & BroadcastingAIC--Information & Communications TechnologyAIC--Visual, Performing & Media ArtsBM--Business Management & AdministrationBM--FinanceBM--Hospitality TourismBM--Information & Communications TechnologyBM--MarketingHR--Education & Related FieldsHR--Hospitality TourismHR--Human ServicesHR--Public ServicesHS--Health SciencesIES--Construction TechnologyIES--Engineering TechnologyIES--Information & Communications TechnologyIES--ManufacturingIES--Transportation Technology
Visual/Roadmap:(Insert link, oridentify location where sample of visual can be found)
6thSecondary School Name:
Secondary School District:
Secondary School ID Number:
Secondary teacher:
Teacher CTE Endorsement: / Select Current Teacher CTE Endorsement AFNRS--Agriculture Science & TechnologyAGNRS--Environmental ServicesAFNRS--Natural Resources ManagementAIC--Publishing & BroadcastingAIC--Information & Communications TechnologyAIC--Visual, Performing & Media ArtsBM--Business Management & AdministrationBM--FinanceBM--Hospitality TourismBM--Information & Communications TechnologyBM--MarketingHR--Education & Related FieldsHR--Hospitality TourismHR--Human ServicesHR--Public ServicesHS--Health SciencesIES--Construction TechnologyIES--Engineering TechnologyIES--Information & Communications TechnologyIES--ManufacturingIES--Transportation Technology
Visual/Roadmap:(Insert link, oridentify location where sample of visual can be found)
7thSecondary School Name:
Secondary School District:
Secondary School ID Number:
Secondary teacher:
Teacher CTE Endorsement: / Select Current Teacher CTE Endorsement AFNRS--Agriculture Science & TechnologyAGNRS--Environmental ServicesAFNRS--Natural Resources ManagementAIC--Publishing & BroadcastingAIC--Information & Communications TechnologyAIC--Visual, Performing & Media ArtsBM--Business Management & AdministrationBM--FinanceBM--Hospitality TourismBM--Information & Communications TechnologyBM--MarketingHR--Education & Related FieldsHR--Hospitality TourismHR--Human ServicesHR--Public ServicesHS--Health SciencesIES--Construction TechnologyIES--Engineering TechnologyIES--Information & Communications TechnologyIES--ManufacturingIES--Transportation Technology
Visual/Roadmap:(Insert link, oridentify location where sample of visual can be found)

CTE Teacher: Submit completeelectronic application materials to your CTE Regional Coordinator.

Regional Coordinator:Submit application and addenda using the FTP process described in 10 above, to this mailbox: ). (Alternatively, using Step 10(c) on the last page, a jump drive or CD ROM can be used to send files to ODE.).

DEADLINE for submission: June 30, 2017

Oregon Department of Education | Oregon Department of Community Colleges and Workforce Development | Revised September 2016

2017Regional CTE Program of Study Application Form Page 1 of 11

Regional CTE ProgramOf Study… 2017 Application(continued)

Regional CTE POS Course Lists—Secondary

Please list the CTE Program of Study Secondary Coursesin which the CTE teacher will:

  • Teach with intent and purpose the CTE POS knowledge and skills identified in the CTE POS Skill Set
  • Assess and record student achievement of those standards
  • If courses differ among the secondary schools, list them in groups by school in the order of schools entered on the cover page, using that

number (1st, 2nd, 3rd, etc.) in the School Course number box (e.g., course 1210 at the 2nd listed school would be shown as 2-1210 in the

School Course box below; course 235 at the 3rd school listed would be shown as 3-235, etc.).Remember to group by school!

  • Additional courses may be listed (and supported with Perkins funds) if they support the identified skill set; do not mark those as “TSA

Required”

  • If you need help adding additional lines to the matrix below in order to list more courses, please contact Kenzie Mozejkoat

.

Secondary Core CTE Courses(Please be complete; this information will be entered intothe CTE Program Update database and all fields are required)

TSA*
Required / School Course # / Secondary Course Name / # of
Credits / 5-digit
NCES Code / Course Description (brief)
(boxes below will expand) / Articulating College
(if applicable) / College
Course # / College Course Name
Select CollegeBlue Mountain Community CollegeCentral Oregon Community CollegeChemeketa Community CollegeClackamas Community CollegeClatsop Community CollegeColumbia Gorge Community CollegeKlamath Community CollegeLane Community CollegeLinn-Benton Community CollegeMt. Hood Community CollegeOregon Coast Community CollegePortland Community CollegeRogue Community CollegeSouthwestern Oregon Community CollegeTillamook Bay Community CollegeTreasure Valley Community CollegeUmpqua Community College
Select CollegeBlue Mountain Community CollegeCentral Oregon Community CollegeChemeketa Community CollegeClackamas Community CollegeClatsop Community CollegeColumbia Gorge Community CollegeKlamath Community CollegeLane Community CollegeLinn-Benton Community CollegeMt. Hood Community CollegeOregon Coast Community CollegePortland Community CollegeRogue Community CollegeSouthwestern Oregon Community CollegeTillamook Bay Community CollegeTreasure Valley Community CollegeUmpqua Community College
Select CollegeBlue Mountain Community CollegeCentral Oregon Community CollegeChemeketa Community CollegeClackamas Community CollegeClatsop Community CollegeColumbia Gorge Community CollegeKlamath Community CollegeLane Community CollegeLinn-Benton Community CollegeMt. Hood Community CollegeOregon Coast Community CollegePortland Community CollegeRogue Community CollegeSouthwestern Oregon Community CollegeTillamook Bay Community CollegeTreasure Valley Community CollegeUmpqua Community College
Select CollegeBlue Mountain Community CollegeCentral Oregon Community CollegeChemeketa Community CollegeClackamas Community CollegeClatsop Community CollegeColumbia Gorge Community CollegeKlamath Community CollegeLane Community CollegeLinn-Benton Community CollegeMt. Hood Community CollegeOregon Coast Community CollegePortland Community CollegeRogue Community CollegeSouthwestern Oregon Community CollegeTillamook Bay Community CollegeTreasure Valley Community CollegeUmpqua Community College
Select CollegeBlue Mountain Community CollegeCentral Oregon Community CollegeChemeketa Community CollegeClackamas Community CollegeClatsop Community CollegeColumbia Gorge Community CollegeKlamath Community CollegeLane Community CollegeLinn-Benton Community CollegeMt. Hood Community CollegeOregon Coast Community CollegePortland Community CollegeRogue Community CollegeSouthwestern Oregon Community CollegeTillamook Bay Community CollegeTreasure Valley Community CollegeUmpqua Community College
Select CollegeBlue Mountain Community CollegeCentral Oregon Community CollegeChemeketa Community CollegeClackamas Community CollegeClatsop Community CollegeColumbia Gorge Community CollegeKlamath Community CollegeLane Community CollegeLinn-Benton Community CollegeMt. Hood Community CollegeOregon Coast Community CollegePortland Community CollegeRogue Community CollegeSouthwestern Oregon Community CollegeTillamook Bay Community CollegeTreasure Valley Community CollegeUmpqua Community College
Select CollegeBlue Mountain Community CollegeCentral Oregon Community CollegeChemeketa Community CollegeClackamas Community CollegeClatsop Community CollegeColumbia Gorge Community CollegeKlamath Community CollegeLane Community CollegeLinn-Benton Community CollegeMt. Hood Community CollegeOregon Coast Community CollegePortland Community CollegeRogue Community CollegeSouthwestern Oregon Community CollegeTillamook Bay Community CollegeTreasure Valley Community CollegeUmpqua Community College
Select CollegeBlue Mountain Community CollegeCentral Oregon Community CollegeChemeketa Community CollegeClackamas Community CollegeClatsop Community CollegeColumbia Gorge Community CollegeKlamath Community CollegeLane Community CollegeLinn-Benton Community CollegeMt. Hood Community CollegeOregon Coast Community CollegePortland Community CollegeRogue Community CollegeSouthwestern Oregon Community CollegeTillamook Bay Community CollegeTreasure Valley Community CollegeUmpqua Community College
Select CollegeBlue Mountain Community CollegeCentral Oregon Community CollegeChemeketa Community CollegeClackamas Community CollegeClatsop Community CollegeColumbia Gorge Community CollegeKlamath Community CollegeLane Community CollegeLinn-Benton Community CollegeMt. Hood Community CollegeOregon Coast Community CollegePortland Community CollegeRogue Community CollegeSouthwestern Oregon Community CollegeTillamook Bay Community CollegeTreasure Valley Community CollegeUmpqua Community College
Select CollegeBlue Mountain Community CollegeCentral Oregon Community CollegeChemeketa Community CollegeClackamas Community CollegeClatsop Community CollegeColumbia Gorge Community CollegeKlamath Community CollegeLane Community CollegeLinn-Benton Community CollegeMt. Hood Community CollegeOregon Coast Community CollegePortland Community CollegeRogue Community CollegeSouthwestern Oregon Community CollegeTillamook Bay Community CollegeTreasure Valley Community CollegeUmpqua Community College
Select CollegeBlue Mountain Community CollegeCentral Oregon Community CollegeChemeketa Community CollegeClackamas Community CollegeClatsop Community CollegeColumbia Gorge Community CollegeKlamath Community CollegeLane Community CollegeLinn-Benton Community CollegeMt. Hood Community CollegeOregon Coast Community CollegePortland Community CollegeRogue Community CollegeSouthwestern Oregon Community CollegeTillamook Bay Community CollegeTreasure Valley Community CollegeUmpqua Community College
Select CollegeBlue Mountain Community CollegeCentral Oregon Community CollegeChemeketa Community CollegeClackamas Community CollegeClatsop Community CollegeColumbia Gorge Community CollegeKlamath Community CollegeLane Community CollegeLinn-Benton Community CollegeMt. Hood Community CollegeOregon Coast Community CollegePortland Community CollegeRogue Community CollegeSouthwestern Oregon Community CollegeTillamook Bay Community CollegeTreasure Valley Community CollegeUmpqua Community College
Select CollegeBlue Mountain Community CollegeCentral Oregon Community CollegeChemeketa Community CollegeClackamas Community CollegeClatsop Community CollegeColumbia Gorge Community CollegeKlamath Community CollegeLane Community CollegeLinn-Benton Community CollegeMt. Hood Community CollegeOregon Coast Community CollegePortland Community CollegeRogue Community CollegeSouthwestern Oregon Community CollegeTillamook Bay Community CollegeTreasure Valley Community CollegeUmpqua Community College
Select CollegeBlue Mountain Community CollegeCentral Oregon Community CollegeChemeketa Community CollegeClackamas Community CollegeClatsop Community CollegeColumbia Gorge Community CollegeKlamath Community CollegeLane Community CollegeLinn-Benton Community CollegeMt. Hood Community CollegeOregon Coast Community CollegePortland Community CollegeRogue Community CollegeSouthwestern Oregon Community CollegeTillamook Bay Community CollegeTreasure Valley Community CollegeUmpqua Community College
Select CollegeBlue Mountain Community CollegeCentral Oregon Community CollegeChemeketa Community CollegeClackamas Community CollegeClatsop Community CollegeColumbia Gorge Community CollegeKlamath Community CollegeLane Community CollegeLinn-Benton Community CollegeMt. Hood Community CollegeOregon Coast Community CollegePortland Community CollegeRogue Community CollegeSouthwestern Oregon Community CollegeTillamook Bay Community CollegeTreasure Valley Community CollegeUmpqua Community College
Select CollegeBlue Mountain Community CollegeCentral Oregon Community CollegeChemeketa Community CollegeClackamas Community CollegeClatsop Community CollegeColumbia Gorge Community CollegeKlamath Community CollegeLane Community CollegeLinn-Benton Community CollegeMt. Hood Community CollegeOregon Coast Community CollegePortland Community CollegeRogue Community CollegeSouthwestern Oregon Community CollegeTillamook Bay Community CollegeTreasure Valley Community CollegeUmpqua Community College
Select CollegeBlue Mountain Community CollegeCentral Oregon Community CollegeChemeketa Community CollegeClackamas Community CollegeClatsop Community CollegeColumbia Gorge Community CollegeKlamath Community CollegeLane Community CollegeLinn-Benton Community CollegeMt. Hood Community CollegeOregon Coast Community CollegePortland Community CollegeRogue Community CollegeSouthwestern Oregon Community CollegeTillamook Bay Community CollegeTreasure Valley Community CollegeUmpqua Community College

*TSA required—Technical Skill Assessment required course—required courses that, when completed, trigger TSA assessment eligibility for the student

Oregon Department of Education | Oregon Department of Community Colleges and Workforce Development | Revised September 2016

2017Regional CTE Program of Study Application Form Page 1 of 11

Regional CTE ProgramOf Study… 2017 Application(continued)

Regional CTE POS Course Lists—Post-Secondary

Post-secondary CoreCTE Courses:

Enter the name of the college program that is the postsecondary component of this POS

Select the highest level of this component offered by the college

List only the courses included in the Course/Skill Set crosswalk matrix

Make duplicates of this page for additional colleges. (Contact to add multiple colleges)

Name of Certificate or Degree Program / Enter name of college program / Degree or Certificate: / Select certificate or degreeAASCertificateAAOTASOT
College Course # / Post-Secondary Course Name / Number of
Credits / *College Now?

* CN = College Now—course identification as College Now (or articulated courses)

Course-to-Skill Set Crosswalk/Matrix

Please use the Excel spreadsheet posted online at ( (or use one you’ve created locally) to crosswalk the identified skill set to the listed secondary and post-secondary courses.

  • You may use the same matrix for both secondary and post-secondary courses.
  • It is only required to map courses to the standards (Knowledge and Skill Statements); it is not necessary to map the performance indicators, duties, or tasks.
  • Be sure to identify the selected skill set in your matrix.
  • If your selected skill set is not from the Oregon Skill Sets website, please identify its origin and how it was industry validated.

Secondary: (check this box to indicatesecondary course-to-skills crosswalk is complete and attached)

Post-secondary:(check this box to indicatepost-secondary course-to-skills crosswalk is complete and attached)

Oregon Department of Education | Oregon Department of Community Colleges and Workforce Development | Revised September 2016