Du educational program change form revised 12 11
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This document is a request form for changing an educational program at a university. It collects information about the proposed change such as the program name, department, type of change requested (e.g. new program, modification, deletion), rationale, impact, and requires signatures from various approving bodies like department chairs, deans, and curriculum committees.
![EDUCATIONAL PROGRAM CHANGE Request Form
(Use for program proposal, significant modification of program [three or more changes],
or for deletion of program)
Deadline for Submission for 2013-14 catalog: March 15, 2013
Date: __________________ Title of request: _________________
(Provide a three- to four-word description of request.)
Educational Program __________________________________________________________
Department/School ____________________________________________________________
College ______________________________________________________________________
Change Requested (Check all that apply)
Educational Program Name
Modification of an Existing Educational Program
Educational Program Retained as Minor – Attached Curriculum
Educational Program Not Retained as Minor
Significant modification (more than two courses), attachments provided:
current curriculum – educational program
proposed curriculum – educational program
student learning outcomes – educational program
Replacement of an Educational Program
If yes, which program? __________________________
New Educational Program
Statement of Need - Attached
New Program Proposal:
Curriculum Attached
Student Learning Outcomes Attached
Deletion of Educational Program
Educational Program Curriculum - Attached
Educational Program Review – Attached
Change Relevant and/or Needed to Support QEP? If yes, explain._______________________
_____________________________________________________________________________
DU Educational Program Change Form Page 1 Office of Academic Affairs
Last modified 2/2011
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Du educational program change form revised 12 11
- 1. EDUCATIONAL PROGRAM CHANGE Request Form (Use for program proposal, significant modification of program [three or more changes], or for deletion of program) Deadline for Submission for 2013-14 catalog: March 15, 2013 Date: __________________ Title of request: _________________ (Provide a three- to four-word description of request.) Educational Program __________________________________________________________ Department/School ____________________________________________________________ College ______________________________________________________________________ Change Requested (Check all that apply) Educational Program Name Modification of an Existing Educational Program Educational Program Retained as Minor – Attached Curriculum Educational Program Not Retained as Minor Significant modification (more than two courses), attachments provided: current curriculum – educational program proposed curriculum – educational program student learning outcomes – educational program Replacement of an Educational Program If yes, which program? __________________________ New Educational Program Statement of Need - Attached New Program Proposal: Curriculum Attached Student Learning Outcomes Attached Deletion of Educational Program Educational Program Curriculum - Attached Educational Program Review – Attached Change Relevant and/or Needed to Support QEP? If yes, explain._______________________ _____________________________________________________________________________ DU Educational Program Change Form Page 1 Office of Academic Affairs Last modified 2/2011 l
- 2. Change Relevant and/or Needed to Support Compliance with Accreditation Standards? If yes, explain._______________________________________________________________________ Abstract of Proposed Program (if new or significantly changed): Student Learning Outcomes Rationale for Request Current Status (Check all that apply) Status with Change Program Includes Course in Core Program Includes Requirement of Another Major Meets All SACS, Educational Program Criteria Program Enjoys Additional Accreditation Status If yes, which agency? _______________ ANTICIPATED IMPACT of Requested Change(s)? None Yes (If yes, explain.) Accreditation implication_________________________________________ Budget ___________________________________________________________ Instructional support (faculty) _________________________________________ Instructional space __________________________________________________ Effect on other academic programs _____________________________________ Cross-listed with other course(s) - Which College (s)?______________________ Current prerequisite for other course(s) __________________________________ Proposed prerequisite for other course(s) ________________________________ Duplicates existing course ____________________________________________ REVIEW/APPROVAL: Name /Signature Date Review within College DU Educational Program Change Form Page 2 Office of Academic Affairs Last modified 2/2011 l
- 3. Coordinator, Educational Program_________________________________________ _____ Chair, Department/School________________________________________________ _____ Chair, Curriculum Committee, College ___________________________________ _____ Dean, College _______________________________________________________ _____ Review External to College Signature Date If Cross-Listed Course, Dean - Second College ______________________________ _____ Chair, University Curriculum Committee __________________________________ _____ Faculty Senate, President ______________________________________________ _____ Faculty General Assembly, President _____________________________________ _____ Provost and Senior Vice President for Academic Affairs _______________________ _____ Senior Cabinet, President _______________________________________________ _____ Board of Trustees, President _____________________________________________ _____ Dean, Records/Registration ____________________ Change(s) Made:__ Date Recorded: ____ Note to Department/School and College Curriculum Committee Both a complete, signed hard copy and digital copy along with a curriculum checksheet must be submitted one week PRIOR to the meeting of the University Curriculum Committee. DU Educational Program Change Form Page 3 Office of Academic Affairs Last modified 2/2011 l
- 4. Please submit to the Chair, University Curriculum Committee. DU Educational Program Change Form Page 4 Office of Academic Affairs Last modified 2/2011 l