At the top of the page, include:

• Submitting institution name
• Type of program change:
  • Title change only
  • Combination program created out of closely allied existing programs
  • Option(s) added to existing program(s)
  • Addition of certificate program developed from approved existing parent degree
  • Addition of free-standing single-semester certificate program
  • Delete program(s)
  • Delete option(s)
  • Program placed on "inactive status" list
• Intended date/semester of program change, additional options, or "inactive status"

For the program information, include:

• Before the proposed change:
  • Title of old program or certificate option
  • Degree
  • CIP code
• After the proposed change:
  • Title of new program or certificate option
  • Degree
  • CIP code

Attach a copy of the "before and after" curriculum, as applicable, and a rationale for the proposed change.

Include the name, phone number, and email address of the main point of contact for more information.

Include authorization/signature from the Institutional Officer, along with their title and the date.