OFFICE OF HIGHER EDUCATION

CIRCULATION DOCUMENT
Effective September 13, 2018 (submit as a word document)

Applicant Institution / Date Circulated
Name of Proposed Program / Anticipated Initiation Date
Mode of delivery:On ground Online Hybrid
On ground: exclusively face-to-face*
Online: exclusively remote
Hybrid: a combination of on ground and online
*includes web-assisted / Anticipated First Graduation Date:
Is the proposed program a degree or certificate program?
Degree: Title of degree (and abbreviation):
Certificate: Number of credits:
CIP Code No. (optional) / Title of CIP Code(Optional)
Unit within the institution where the program will be housed:
Location(s) where the proposed program will be offered(e.g., main campus, branch campus, or off campus):
Institutional Accreditation(if applicable): Date of last action:
Name of accrediting body:
Nature of action:
Program accreditation:
Do you anticipate that the proposed program will be accredited by a professional organization or other outside accreditor? YES NO If yes, name of accrediting body:
Will this program provide eligibility for a state approved or other licensed profession?
YES NO If yes, identify:
If you have answered “YES” to either of the above questions, please provide a brief description of how the proposed program will meet the accrediting standards and/or licensing requirements.
Institutional Contact Person / Title / Telephone:
e-mail:
Project Manager
(To be assigned) / Date application received:
Purpose and Objectives:
  • Provide a description of the program that includes thelearning objectives of the proposed program. Briefly describe how the proposed program will be assessed for student learning outcomes.
  • Address the need for the program.
  • Describe how the program objectives align with the institutional mission?

Administration: Provide the name and qualifications of the full-time administrator or faculty member who will be responsible for the day-to-day operations of the program. If this individual is to be hired indicate the time frame for hiring and proposed qualifications.
Faculty: Will courses in this program be taught by current faculty members?YES NO
  • Complete the attached table to describe full-time faculty members who will teach in this program. Include any anticipated positions for the first three years of the program.
  • What percentage of the proposed program will be taught by adjunct faculty?
  • What are the minimum qualifications for adjunct faculty?

Resources: Does the institution anticipate new resources will be required for the proposed program? YES NO
  • If yes, summarize how resources will be provided-existing resources, reallocation and/or new resources.

Curriculum: Providethe requirements for each major component of the proposed program including the core or major area of specialization and the general education component (for undergraduate programs).Attach course descriptions for all new courses within the program’s core.

Program Core Courses (with concentrations) / Credit Hours / New / On Ground / Online

Elective Courses

General Education Courses

Briefly outline any program requirements, including but not limited to total number of credits for the degree, special admission requirements, and any capstone or special project requirement. Indicate any requirements and arrangements for clinical affiliations, internships, and practical or work experience.

Faculty Members

List the faculty members who will teach in the proposed program’s core (attach additional pages if needed). Designate all faculty to be hired with an *.

Name, Title, and Position (full-time, part-time, adjunct)* / Credential/ Institution / Area of Specialization/
Pertinent Experience / Other Administrative or Teaching Responsibilities

* * * * * *

Please return both a print and electronic copy to the Office of Higher Education for circulation. Once the proposed program is circulated, a copy of the institutional responses to all comments must be sent to the Office of Higher Education at . All comments and responses will be considered in the programmatic review process.

Rev. 2/2017