College of Graduate Studies Degree Plan for Graduate Certificate in Gerontology Part I – Student Information Name: MTSU ID # M Current Mailing Address: City, State, Zip: MTSU Email Address: Degree Sought: Major: If applicable: Concentration: Choose One: Specialization: Thesis Option Minor: Non-Thesis Option I understand that if human or animal subjects are involved in my research(including thesis research), it is my responsibility to file a research protocol application with the Institutional Review Board (Sam H. Ingram Building, 011B) before I begin collecting data. Failure to secure this permission prior to conducting my data collection using human or animal subjects will negate the use of that data for any academic purpose including thesis. Signature of Student Date Part II – Signatures and Approvals Signatures in this area are required for approval of all degree plans. I certify that the following program, when successfully completed, meets all coursework requirements for this degree. Graduate Advisor Name (Print) Signature College of Graduate Studies Approval Date Date Signatures in this area are required for approval only if applicable to degree program. This individual holds a professional license, or licensure requirements will be met by the courses listed below. Teacher Licensure Office Approval (Print) Signature Date Signature Date Signature Date Programs that require educational component Chair of Educational Leadership/Elementary Education (Print) Minor Advisor Graduate Minor Advisor (Print) A Tennessee Board of Regents Institution MTSU is an equal opportunity, non-racially identifiable, educational institution that does not discriminate against individuals with disabilities. Name: MTSU ID # M Part III – Course Information List ONLY graduate-level courses to be counted toward the degree. Include those completed as well as those still to be taken to fulfill degree requirements. Candidate must complete 15 hours in the following course of study. Transfer Credit Course ID Course ID Course Title Cr Hrs Grade Institution Core Requirement (3 Hours) All students are required to complete at least one core course from the following PSY 5610 Adult Psychology and Aging 3 SOC 5020 Sociology of Aging 3 SOC 6550 Seminar on Aging 3 Electives (12 Hours) The remaining hours are to be selected from the following courses in conjunction with career goals and aspirations. Additional core courses may be completed as electives. CDFS 5390 Families in Later Life 3 CDFS 5391 Aging Health and Development 3 CDIS 5800 Speech and Language Disorders in the Adult 3 Population LSM 5380 Disabilities and Diversity in Leisure, Sport 3 and Tourism LSM 5470 Leisure and Aging 3 NFS 5210 Nutrition in Aging 3 PSY 5610 Adult Psychology and Aging 3 PSY 5630 Death and Dying 3 SOC 5020 Sociology of Aging 3 SOC 5030 Topics in Gerontology 3 SOC 5040 Health Care Delivery Issues 3 SOC 5800 Special Projects SOC 6510 Independent Study 3 SOC 6550 Seminar on Aging 3 SOC 6661 Program Evaluation 3 SOC 6670 Mental Health and Aging 3 SOC 6680 Counseling Elders 3 SOC 6900 Practicum: Applied Analysis 3 Department must verify that all admission conditions(s) were or were not met: Department Admissions Conditions Met? Yes No A Tennessee Board of Regents Institution MTSU is an equal opportunity, non-racially identifiable, educational institution that does not discriminate against individuals with disabilities.