Circulated __________________________
Comments Due ______________________
Submit on blue paper E-Z Program Change Request Form
COLLEGE pick one
This form is to be used only for minor changes to program requirements and/or check sheets. The proposed changes must have limited scope and impact*. If they are complex or have broad impact, the
Program Change Request Form should be completed.
Requested effective date: (Semester/Year) Implemented by Registrar, effective:
1. Describe briefly the nature of the proposed change. Program Name:
2. Please attach and show the proposed changes on A) a checksheet and B) the current/most recent Catalog description of the program (please be sure to make the changes obvious on both documents).
3. Rationale/need for change:
1
Position
Proposer Tel: 419-
Position:
APPROVED:
Name (print or type) Signature Date
4 Dean of College
5 Provost/VPAA
REVIEWED AND IMPLEMENTED BY:
John M. Fischer
6 Registrar
Following review and approval by the curriculum committee and the Dean, the original of this form should be submitted to the Office of the Provost/VPAA.
*If the proposed change has impact on other programs, the Program Change Request Form should be completed.
Chair/Director, curriculum committee, dean, or provost may ask for additional information or for the use of the complete
Program Change Request Form.