TEXAS STATE UNIVERSITY
CERTIFICATE PROGRAM ADD FORM
Administrative Information
1. Program Name:
2. Proposed CIP Code and Standard Occupational Classification Code:
3. Number of Semester Credit Hours Required:
4. Brief Program Description: Describe the program and the educational
objectives.
5. Academic Administrative Unit – Identify where the program would fit within the
organizational structure of the university.
6. Implementation Date – Report the first semester and year that students would
enter the program:
7. Contact Person – Provide contact information for the person who can answer
specific questions about the program:

Name:

Title:

E-mail:

Phone:
8. Academic Program Coordinator: - Provide faculty name with degree
credentials or other qualifications appropriate to the certificate who is also
reported as program coordinator in Faculty Records and in the outcomes
assessment:
 Name:
 Title:
 E-mail:
 Phone:
 Qualification (should include highest degree earned, awarding institution,
number of years teaching, research areas, special awards/credentials):
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9. Required Reviews:

Faculty

Department/School Curriculum Committee or Department/School Faculty

Department Chair/Program Director/School Director

College Curriculum Committee

College Council

College Dean

Dean of The Graduate College (if applicable)

Associate Vice President for Academic Affairs

Provost

University Curriculum Committee

Faculty Senate

Council of Academic Deans

President

Texas State University System Board of Regents

Texas Higher Education Coordinating Board (if applicable)

Southern Association of Colleges and Schools Commission on Colleges
(if applicable)
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Program Information
I. Need
A. Job Market Need – Provide short- and long-term evidence of the workforce
needs in the job market.
B. Student Demand – Provide short- and long-term evidence of demand for the
program.
C. Enrollment Projections – Use this table to show the estimated number of new
students, cumulative headcount, full-time student equivalent enrollment, attrition,
and graduates for the first five years of the program.
Year 1
Year 2
Year 3
Year 4
Year 5
FYXXXX FYXXXX FYXXXX FYXXXX FYXXXX
New
Students
Headcount
FTSE
Attrition
Graduates
II. Quality
A. Admission Requirements - Provide a narrative description of the admission
requirements for entry into the program.
B. Curriculum Requirements - Use these tables to identify the required courses
and prescribed electives of the program.
Prefix
and
Required Courses
Number
Total
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SCH
Prefix
and
Prescribed Elective Courses
Number
SCH
Total
D. Faculty – Use these tables to provide information about faculty. Add an
asterisk (*) before the name of the individual who will have direct administrative
responsibilities for the program.
Name of Faculty
and Faculty Rank
Highest Degree and
Awarding Institution
e.g.: Robertson,
David
Asst. Professor
PhD. in Molecular
Genetics
Univ. of Texas at Dallas
Courses
Assigned
in Program
MG200, MG285
MG824 (Lab
Only)
% Time
Assigned
To Program
50%
E. Library – Provide an assessment of library resources available for the
program.
F. Facilities and Equipment – Describe the availability and adequacy of facilities
and equipment to support the program.
G. Accreditation and Licensure – If the discipline has a national accrediting body,
describe plans to obtain accreditation or provide a rationale for not pursuing
accreditation. If the discipline requires a license to enter the workforce, describe
how the certificate requirements will fulfill the licensure requirement.
III. Costs and Funding
Five-Year Costs and Funding Sources - Use this table to show five-year costs and
sources of funding for the program.
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Five-Year Costs
Personnel1
Facilities and Equipment
Library, Supplies,
and Materials
Other2
Total Costs
$0
Five-Year Funding
Reallocated Funds
Anticipated New Formula
Funding3
Special Item Funding
$0
$0
Other4
Total Funding
$0
$0
$0
$0
$0
$0
$0
1. Report costs for new faculty hires, graduate assistants, and technical support
personnel. For new faculty, prorate individual salaries as a percentage of the time
assigned to the program. If existing faculty will contribute to program, include costs
necessary to maintain existing programs (e.g., cost of adjunct to cover courses
previously taught by faculty who would teach in new program).
2. Specify other costs here (e.g., administrative costs, travel).
3. Indicate formula funding for students new to the institution because of the program;
formula funding should be included only for years three through five of the program and
should reflect enrollment projections for years three through five.
4. Report other sources of funding here. In-hand grants, “likely” future grants, and
designated tuition and fees can be included.
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Texas State University
(insert name of new certificate program)
Signature Page
1. I certify that the above new certificate has been approved in accordance with the procedures outlined
in the Texas Higher Education Coordinating Board Rules, Chapter 5, Subchapter C, Section 5.44 and
5.48.
____________________________________________________________
Provost and Chief Academic Officer
Date
2. I certify that my institution has notified all public institutions within 50 miles of the teaching site of our
intention to offer the program at least 30 days prior to submitting this request. I also certify that if any
objections were received, those objections were resolved prior to the submission of this request.
_____________________________________________________________
Chief Executive Officer
Date
3. Board of Regents Certification:
(a) The certificate program has institutional approval.
(b) The certificate program meets all other criteria in Section 5.48 of this title (relating to Criteria for
Certificate Programs at Universities and Health-Related Institutions):
(c) Certificate programs for which academic credit is granted at universities and health-related
institutions must meet the following criteria:
(1) They must meet identified workforce needs or provide the student with skills
and/or knowledge that shall be useful for their lives or careers.
(2) They must be consistent with the standards of the Commission on Colleges of the
Southern Association of Colleges and Schools.
(3) They must meet the standards of all relevant state agencies or licensing bodies
which have oversight over the certificate program or graduate.
(4) Adequate financing must be available to cover all new costs to the institution five
years after the implementation of the program.
(d) The following certificate programs do not require Board approval or notification:
(1) certificate programs for which no collegiate academic credit is given,
(2) certificate programs in areas and at levels authorized by the table of programs of
the institution with curricula of the following length:
(A) at the undergraduate level of 20 semester credit hours or less,
(B) at the graduate and professional level of 15 semester credit hours or less.
(e) The following certificate programs shall be approved if the following conditions are met:
(1) The proposed certificate is an upper-level undergraduate certificate of 21-36 hours
in disciplinary areas where the institution already offers an undergraduate degree
program.
(2) The proposed certificate is a graduate-level and professional certificate of 16-29
hours in disciplinary areas where the institution already offers a graduate program
at the same level as the certificate.
On behalf of the Board of Regents, I certify that the new program meets the criteria specified under TAC
Chapter 5, Subchapter C, Section 5.44.
_______________________________________________________________
Board of Regents (Designee)
Date
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