EZ Program Change Request Form

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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.

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