NEW PROGRAM PROPOSAL FORM

Sponsoring Institution(s):_____________________________________

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Program Title:_______________________________________________

Degree/Certificate:_______________________________________________

Options:_______________________________________________

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Delivery Site(s):_______________________________________________

CIP Classification:_________________________ (Please provide a CIP code)

Implementation Date:_______________________________________________

Cooperative Partners:_______________________________________________

Expected Date of First Graduation:__________________________________

AUTHORIZATION

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Name/Title of Institutional Officer     Signature     Date

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Person to Contact for More Information     Telephone