Credit by Assessment Incentive Proposal Form
Department:
This application is for:
 Development of a new credit by assessment procedure
 Review/revision of an existing credit by assessment procedure
Course number and name:
Credit hours:
Typical annual enrollment:
Course objectives or student learning outcomes
List the objectives or student learning outcomes for the CBA-designated course and attach a sample
syllabus from the course.
Impact/Benefit
Provide a brief discussion addressing why the department believes development of a credit by
assessment procedure for this course would be beneficial. How many students do you expect to take
advantage of this CBA?
Relevance/Need
Why does the department believe students may acquire course competencies through extrainstitutional learning? What sort of extra-institutional mechanisms might provide the necessary
content? Have you ensured that allowing students CBA will not violate any relevant accreditation
standards or certification requirements?
Assessment Plan
Describe in as much detail as possible the assessment procedures to be used to determine whether
students will receive credit for the course. If you are proposing a CBA procedure revision, tailor your
responses, as applicable.
Instrument: What assessment instrument will the department utilize? For example, will the
department develop its own measure or will the process require the use of a standardized exam or
some other existing assessment? What steps will faculty take to ensure the instrument is valid and
reliable? If a standardized exam will be used, describe the department’s role in administering and
evaluating it (e.g., how the proposed exam would be different from a standard CLEP test).
Administration: How, where, and by whom will the assessment be administered? Will faculty be
involved in administering/proctoring the assessment and/or evaluating results? What facilities and
equipment will be used? When and with what frequency will the assessment be offered? What steps
will the departmental faculty take to ensure the sustainability of its CBA procedure?
Scoring: How will assessment results be evaluated? Will the department develop rubrics? What steps
will the department take to safeguard student privacy and ensure that scores are stored securely?
Notification: How and when will students be notified of their scores?
Awarding Credit: What is the process that will be used to have credit recorded by the Registrar? How
will the department facilitate prerequisite overrides for students passing the assessment?
Responsible Personnel
If the department intends to develop an in-house assessment, indicate who will work on the project
and describe what steps will be taken by faculty to develop the assessment procedure described
above, including a realistic timeline.
If this proposal relates to the revision of an existing credit by assessment procedure, indicate who will
work on the project and describe what steps will be taken by faculty to review/update the procedure
described above, including a realistic timeline.
Marketing and Communication Plan
Describe how the department intends to market or publicize its new or existing credit by assessment
procedure. What steps will be taken to ensure that prospective/transfer students are aware of the
opportunity? Will there be any eligibility requirement students will need to know about? Does the
department anticipate making any test preparation materials (e.g. study guides) available to
interested students?
Use of Incentive Funding
Provide a brief explanation of how the department anticipates using the incentive funding provided
by the Office of the Provost.
Acknowledgement of Report Requirement
 The department understands that it must submit a report detailing completion of the steps
outlined above within 12 months of proposal approval in order to receive the second half of the
incentive funding.
Signatures of Department Faculty Involved in CBA Development/Review
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Faculty Member
Date
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Faculty Member
Date
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Faculty Member
Date
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Faculty Member
Date
Department Head Approval
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Department Head
Date
College Dean Approval
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College Dean
Date