Form PC - Program Change
PROGRAM CHANGE FORM
1. Submitted by: _________________________________________
2. Type of Program Change (Check those that apply):
_____ Title change only
_____ Combination program created out of closely allied existing programs
_____ Option(s) added to existing program(s)
_____ Addition of single-semester certificate program (C0) to existing parent degree
_____ Addition of one-year certificate program (C1) developed from existing parent degree
_____ Addition of free-standing single-semester certificate program
_____ Delete program(s)
_____ Delete option(s)
_____ Program placed on "Inactive Status" list
_____ Other (attach description)
- In the left section of the table below, place the program (and options) as they currently appear in the MDHE inventory.
- In the right section, place the program (and options) as they would appear after changes have been approved.
- For certificates, place the title, degree and CIP for the parent program in the left section
|Current Program||Program after the Proposed Change|
|Title||Degree||CIP Code||Title||Degree||CIP Code|
4. Attach a copy of the "before and after" curriculum, as applicable, and a rationale for the proposed change.
5. Intended date of program change, additional options, or "Inactive Status":
Name/Title of Institutional Officer Signature Date
Person to Contact for More Information Telephone Number