New Program - Registered Institution On-Site Delivery Part A. Guidelines Is this the right form? Use this form if you are a registered (not accredited) institution with a new On-Site Delivery Program that you wish to offer. A new program is one that is not currently registered with the Agency. (Note: Do not use this form if your program includes any Distance Delivery.) How will I know I am using the current version of the application form? If you have not already done so, please visit the PCTIA website at www.pctia.bc.ca to download the most current version of this application. Previous versions will not be accepted. Can I start to advertise my program now? No. You must wait until you receive a letter from the Agency approving your new program. Applications for a new program must be submitted to the Agency before the institution advertises, recruits, enrolls, or starts classes in the program. New Program Applications normally take up to 12 weeks to be processed once a complete application is received. Be sure to submit your application at least 12 weeks prior to the date you plan to start marketing the program. Processing will take longer than 12 weeks if additional documentation or a site visit is required. The Agency may require a site visit that may include an external subject matter expert if the Registrar determines that the proposed program requires specialized facilities or equipment Costs associated with the use of a subject matter expert must be borne by the institution. INS.140.013 Page 1 of 25 2012.10.13 New Program - Registered Institution On-Site Delivery Part A. Guidelines You must have received the Agency’s signed official program approval letter before advertising or running a program. How do I know if my application is complete? You should answer all questions on the enclosed Part B. New Program – Registered Institution - On-Site Delivery Application and use the Part C. Checklist to ensure that you include all necessary attachments. Your application will be reviewed for completeness when it is received. Applications that are incomplete will not be processed and may be returned to you for resubmission. When all required components, including fees and regulatory body approval letters, are received and the application is determined to be complete, it will be processed. How long do I have to get everything submitted? Applications for new programs will expire if outstanding requirements have not been met within six months from the date any additional information has been requested. What are the application fees? The application fee for a new program is $500 per program The application fee for a new short duration program is $100 per program Note: A short duration program is one that is less than $1000 in tuition or is less than 40 hours in duration. Application fees are not refundable. INS.140.013 Page 2 of 25 2014.04.13 New Program - Registered Institution On-Site Delivery Part A. Guidelines Completing Part B – Registered Institution New Program Application – On-Site Delivery Institution Operating Name: Enter the same operating name you have registered with PCTIA. Institution Number: This is the Institution ID number assigned to your institution when you first register with PCTIA. You can find this number on your PCTIA Registration Certificate or on the PCTIA website at http://www.pctia.bc.ca. Program Information Program Title: Enter the name of your program as it will appear on the credential issued upon completion of the program. Please avoid using abbreviations in your program title. You should ensure that your program title has meaning to the Agency and the general public. For example, name it “Hospitality Management” instead of “HM program”. You should not use the words “Certificate”, “Diploma”, “Post-Diploma” or “Program” in the program title although you may use these words when advertising your program. You should not use any restricted term such as “degree”, “post-graduate” or “masters” or terms which may be misleading such as “guaranteed” or “approved”. Applications containing program titles that use restricted or misleading terms will not be approved and you will be asked to submit a different program title. Proposed Start Date: When indicating your start date, you should consider that it will normally take up to 12 weeks to process your application. Please note that the application process INS.140.013 Page 3 of 25 2014.04.13 New Program - Registered Institution On-Site Delivery Part A. Guidelines will take longer if your application is incomplete, if additional documents are required or if a site visit by a subject matter expert is required. Maximum Single Class Size per Site: What is the maximum number of students you estimate you will have at any one time in a course included in this program? Credential Awarded: Choose from Certificate or Diploma or specify if it is something else. A credential must not be a certificate of attendance or a certificate of participation. Program Duration: Please indicate the program duration in total instructional hours and total months and total weeks. Program hours include classroom hours with an instructor, as well as work experience hours and lab hours where students are supervised by an instructor. Lab times without an instructor/ facilitator, home projects or self-study are not considered program hours. Months are calculated by dividing the number of program weeks by 4.3. A weeks-to-months conversion table is available for download at http://www.pctia.bc.ca Program Delivery: Choose from: Full Time (normally 20 hours or more of supervised instruction per week) or Part Time (normally less than 20 hours of supervised instruction per week). Does this Program require approval by a governing body? Wherever there is a provincially recognized governing body for the program you are planning to offer, you will need to provide documentation of program INS.140.013 Page 4 of 25 2014.04.13 New Program - Registered Institution On-Site Delivery Part A. Guidelines approval by this body – a letter, certificate or e-mail from the governing body noting the institution name, location, program and date of approval. In those cases where the provincially recognized body will not consider approval until the program has been running for a period of time, or where access to the discipline is difficult for the institution to obtain but the program will provide student entry into that discipline, the institution must demonstrate to the Agency that their students are, in fact, employable in the field for which they are trained or demonstrate that the institution has conditional approval from the recognized governing body to offer the program Does this Program include a Work Experience? The PCTIA Bylaws provide for four different types of work experience placements. Institutions are limited to using these titles to describe work experience in their programs: Practicum A supervised and mandatory portion (required for graduation) of the educational program emphasizing the practical application of the previously learned theory, methods, skills, professionalism, orientation and ethics in a specialized area of study. Students must be supervised and evaluated by the employer or host organization and monitored by their instructor/institution while engaged in productive work (not merely observing). Preceptorship A required (for graduation from an educational program) and final work experience in which the student performs actual or other professional procedures in a real life setting under the immediate supervision of a single fully qualified practitioner. The fully qualified practitioner must agree to supervise, support and evaluate the student in an environment that is safe for both the student and clients and approved by the employer of the fully qualified practitioner. Clinical Placement INS.140.013 Page 5 of 25 2014.04.13 New Program - Registered Institution On-Site Delivery Part A. Guidelines A required (for graduation from an educational program) part of an educational program in a real-life setting (hospital, clinic, lab, etc.) where a student performs actual clinical procedures on real patients/clients under the direct supervision of an instructor, and where the instructor/student ratio does not exceed 1:12 Co-op Education A required work period within a program of study that alternates periods of study with periods of employment in a formalized sequence beginning with and ending with an academic term. Indicate the duration of each work experience required for the program in total hours and weeks. The PCTIA Bylaws state that work experience must not exceed 50 percent of the total program of study. Explain how your program meets these requirements by showing how you calculate the work experience percentage of the program. If your program includes a work experience placement you must attach a copy of your work experience policy as a part of your new program application. Your policies should include the requirements for a student to be eligible for a placement, the major activities performed on a placement, how placements are selected, the responsibilities of the student/institution/employer, and what happens if the student fails to complete or receives an unsatisfactory assessment on the practicum. Policy and assessment tool examples are available for download at http://www.pctia.bc.ca. If your program includes a work experience placement you must also attach a list of work placements sites that have agreed to host students in this program. The placement sites need to be in appropriate facilities where students would be able to practice the specific skills taught in the program and achieve the learning outcomes required for the program. INS.140.013 Page 6 of 25 2014.04.13 New Program - Registered Institution On-Site Delivery Part A. Guidelines Will this program be delivered in a language other than English? If you intend to deliver this program in any language other than English, you must ensure that all text books, assessment instruments, examinations (including external examinations) are available in that language and provide evidence such as a letter of confirmation from the external examining body as a part of your application. Program Costs: All program costs must be stated in Canadian Dollars. Tuition Fee: This is the fee for tuition only. This does not include textbooks, materials or administrative fees. Note that tuition fees normally cover the basic costs of the institution like rent, instructor salaries, classroom equipment, etc. and that these costs of running the business should not be included in administrative fees. Registration Fee: This is an application processing fee that may be charged to a student one time only. Each new student who applies for admission to an institution may be charged this fee. The fee charged may not exceed $250 for domestic students or $1000 for international students. Textbooks: This should be the total cost of the textbooks that the student will need to purchase to complete this program. This fee may be paid directly to the institution if all books are provided by the institution. Supplies/Materials: This should be the total cost for all required supplies and materials (i.e. paint and brushes, safety goggles, hard hat etc.) that the student will need to purchase to complete this program. This fee may be paid directly to the institution if all supplies and materials are provided by the institution. INS.140.013 Page 7 of 25 2014.04.13 New Program - Registered Institution On-Site Delivery Part A. Guidelines Lab Fees: This is a fee sometimes charged by an institution to cover specific costs associated with operating a specialized lab or clinic. Uniforms: When a program requires students to wear a uniform, the amount shown here should be the total cost of the uniform. This fee may be paid directly to the institution if the uniform is provided by the institution. Other (please specify): This area is used for indicating any other costs associated with the program such as a medical certificate or a criminal record check. Total Program Costs: This is the total of all the program costs listed for the items noted above. Basic Education Standards Information Please state your institution’s Mission Statement: Please state your Mission Statement in its entirety even if you have already submitted it to the Agency. List the potential career options for students completing this program: This information is used to decide the National Occupation Classification Code (NOC Code) to be assigned to this program. You should list the position title(s) of the career/ occupation for which this program trains (i.e. Carpenter, Office Assistant, Bookkeeper, Accounting Clerk, Dental Assistant, Residential Care Aide, etc.) Please summarize the student performance outcomes of the program and explain how they are observable, measurable and achievable: Performance outcomes are the anticipated learning outcomes for the program. These specify what learners’ new behaviors will be after completing a course or a program and should be listed on your Program Outline. They state the knowledge, skills, and attitudes that the students will gain through your INS.140.013 Page 8 of 25 2014.04.13 New Program - Registered Institution On-Site Delivery Part A. Guidelines program. Learning outcomes begin with an action verb and describe something observable or measurable. Examples At the end of this program you will be able to: Use a standard hotel management reservations system. Create a restaurant menu. Demonstrate the safe use of housekeeping cleaning materials. What are the admission requirements for entry to this program? List what the prospective student has to do or provide to the institution in order to be accepted for study. Examples High School Graduation (transcript required) OR be 19 years of age or older; Pass an admission test. The minimum passing score on our admission test is 70%. Provide a certificate from a physician certifying that the applicant is physically able to work as a Resident Care Aide. List the minimum qualifications for instructors of this program. If more than one instructor is delivering this program, please list the courses and the qualifications that each course would require on the Course-by-Course Minimum Instructor Qualifications Spreadsheet. (located on PCTIA Website at www.pctia.bc.ca.). The PCTIA Bylaw requirements for full and part-time instructors teaching in the referenced subject areas are as follows: A bachelor’s degree in the assigned academic subject area is required for instructors teaching general education and other academic courses that are part of a career-training program. For career programs, a degree/diploma/certificate related to the field of instruction supplemented by 24 months of full-time occupational experience in the field of instruction or 10 years of demonstrated experience in the field of study. INS.140.013 Page 9 of 25 2014.04.13 New Program - Registered Institution On-Site Delivery Part A. Guidelines For language programs a bachelor’s degree and a credential demonstrating specialist training in language instruction or a degree/diploma/certificate related to language instruction supplemented by 24 months of full-time occupational experience in language instruction or 10 years of demonstrated full-time occupational experience in language instruction. For designated or recognized trade programs, an appropriate trade qualification supplemented by 48 months of occupational experience in the field of instruction. Note that you are not listing the qualifications of the instructors you currently have, but the minimum qualifications that you are looking for when you are hiring an instructor for this program. All of your instructors will need to meet these minimum requirements. If you have instructors in the program who will teach more general courses (for example English or business courses in a health care program), list the requirements for those instructors separately. Be specific in your minimum instructor qualifications. Give details as to type of experience, the acceptable fields of study for the degree/diploma, and any other licensing, certification you may require. Not Acceptable: Two years experience and a certificate. Acceptable: 24 months of full-time occupational experience in a management position in a spa, plus A diploma in esthetics, including some business management courses. 1 year of teaching experience. Provincial instructor’s diploma or its equivalent. What methods were used to develop the curriculum for this program? Please explain how you decided what information needed to be included in this program. Why did you choose to include the courses that you have included? Please provide information that demonstrates that the program duration is comparable to a similar program that is delivered using on-site delivery methods. INS.140.013 Page 10 of 25 2014.04.13 New Program - Registered Institution On-Site Delivery Part A. Guidelines Please provide an explanation of how this program is similar in duration to other programs of its type that are delivered via on-site delivery. If not, why have you chosen to deliver a different duration? Does this program include training provided by a third party? If so, provide details and attach evidence the third party organization meets Agency requirements. This section is used to identify what external parties/organizations will provide portions of the program. For example, will St. John’s Ambulance provide the CPR training? Why did you choose to have an outside party provide this portion of the program? If the program does not include any portion provided by a third party, please enter “Not Applicable” on the application form. Does this program have multiple entry points? If so, please explain. Will all students completing this program start at the same time or are there several points during the program where new students can join students who are already in progress. If new students can join students who are already in progress how do you make sure that the new students get the information they need in the same sequence as the students who are already in progress? If the program does not include multiple entry points, please enter “Not Applicable” on the application form. Please describe the ownership/usage rights of the curriculum for this program. Provide details on the ownership of the curriculum for this program and attach evidence of curriculum ownership or usage rights for the duration of the program. Describe the assessment strategies that will be used to evaluate student progress in this program. Provide an explanation of the methods that will be used to evaluate student progress throughout the program. INS.140.013 Page 11 of 25 2014.04.13 New Program - Registered Institution On-Site Delivery Part A. Guidelines At which points will students receive written feedback on their progress in the program? Explain when students will receive written feedback on their progress in the program. Program Delivery Information: Describe the physical facilities you will use in delivering this program. Give a brief description of the place(s) where this training will occur. Will students receive training in a classroom? A clinical laboratory? A seminar room? A computer lab? Attach a floor plan of your institution showing which room(s) will be used for this program. Please include a floor plan even if you have submitted one to the Agency with previous applications. Please explain how your institution will accommodate this new program given the space you have available. Given that you may already have students studying in other programs, please provide a brief explanation of the room scheduling you will use to make sure that the rooms needed to deliver this program are available at the time(s) they will be needed. Please provide a list of equipment you will use in delivering this program and the quantity of each item listed. Please use a separate sheet if this space is insufficient. This list should be an inventory of the equipment you will use to deliver this program. For example: For a dental assisting program you would want to list the classroom equipment as well as the equipment available for student use in the dental operatory. Do you have one operatory? Seven operatories? How many sterilizers do you have? What kind are they? For a trade program you will want to list the type and number of tools you have available for presenting this program. INS.140.013 Page 12 of 25 2014.04.13 New Program - Registered Institution On-Site Delivery Part A. Guidelines Indicate equipment that has not been received yet and provide a copy of the purchase orders and indicate the date all outstanding equipment will be on site. Please provide a list of resources that are available for student use, including the quantity of each item listed. Please use a separate sheet if this space is insufficient. Resources are items that are available for student use in completing the program that offer information over and above what is discussed in the texts. For example: Does your institution have a library or some reference books available for student use? Provide an inventory of these. Are there computers with internet access available to students outside of class time? How many? Please indicate which method(s) of instructional delivery you will use to deliver this program and the number of hours for each method. Lecture – An instructor provides information to students. This method is sometimes enhanced with the use of handouts. Demonstration – An instructor shows students how to do something using equipment that is used in industry. Hands on practice – Students use the equipment used in industry to practice the skill. Lab Time – Time spent conducting laboratory activities. Projects – Students research and present a completed project for marking. Group Work – A group of students may complete a project together. Other – List any other methods of program delivery you will use in presenting this program. Please explain how students can access instructor assistance outside of class time. What are the opportunities for a student to meet one-on-one with an instructor? Does the instructor have regular office hours when a student can make an appointment? Is the instructor available by email or telephone to provide assistance to students completing the program? Please explain how students can access the resources you have available outside of class time. INS.140.013 Page 13 of 25 2014.04.13 New Program - Registered Institution On-Site Delivery Part A. Guidelines What is the system used for students to take advantage of the resources that are available? Can the resources only be used at the institution? Or can students borrow them to take home? Describe the system that will be used by students to assess instructor effectiveness in the program. What opportunities will students have to evaluate their instructor(s)? Does the institution conduct regular surveys? Course end surveys? What questions in the survey are used to evaluate instruction? How is this information used once it is collected? Declaration: This section must be completed by a person who is authorized to sign applications on behalf of the institution. The contact information provided by the applicant will be used if the Agency has questions about the application or requires clarification of further information. Required Attachments: Please use the Part C. Checklist to make sure that you include all required attachments with your application. Incomplete applications will not be processed. Completed Part B. Registered Institution New Program Application - On-Site Delivery Make sure you complete all sections of the form. New Program Fees (Career Training: $500 / Short Duration: $100). Make sure you include the correct fees. Make your cheque payable to “Private Career Training Institutions Agency” or “PCTIA”. Do not combine program application fees with any other fees you may be sending to the Agency. Program Outline. The program outline should give a brief description of the program. It should also state the program duration and give information about how the program is delivered, what the student needs to do in order to be admitted to the program INS.140.013 Page 14 of 25 2014.04.13 New Program - Registered Institution On-Site Delivery Part A. Guidelines and what the student needs to do in order to graduate from the program. The Program Outline should also indicate the sequence in which the program’s courses will be presented. A sample Program Outline is available for download at http://www.pctia.bc.ca. Course Outlines. A course outline should include the course name and description, class schedule, course content, learning resources, marking scheme, materials and textbooks needed, and requirements for successful completion. A sample Course Outline is available for download at http://www.pctia.bc.ca. Program Delivery Sequence. A completed program delivery sequence should list all courses, their duration and placement in delivery sequence, and delivery method. The program delivery sequence should also indicate which courses are program entry points. A Program Delivery Sequence template is available for download at http://www.pctia.bc.ca. Letter of approval from governing body (if applicable). The letter, email or certificate of approval from a governing body and indicate the same program name as the program that you are applying for. If the program is not overseen by a governing body, please indicate “Not Applicable”. Evidence that all curriculum, exams and external assessments are available in the language of instruction if the program is delivered in a language other than English (if applicable). If the program will be delivered in a language other than English, provide evidence such as a letter of confirmation from the external examining body that all text books, assessment instruments and examinations (including external examinations) are available in that language. INS.140.013 Page 15 of 25 2014.04.13 New Program - Registered Institution On-Site Delivery Part A. Guidelines Course-by-course Minimum Instructor Qualification Spreadsheet (if applicable) If more than one instructor is delivering this program, list the qualifications that each course would require on this spreadsheet. A Course-by-Course Minimum Instructor Qualification Spreadsheet is available for download at http://www.pctia.bc.ca. Floor plan of the institution showing where this program will be delivered. Please submit this floor plan with your program application even if you have submitted a floor plan to the Agency before. List of equipment, including the quantity of each item that will be used in delivering this program. Please submit this equipment list with your program application even if you have submitted an equipment list to the Agency before. List of resources available for student use when completing this program. Please submit this resource list with your program application even if you have submitted a resource list to the Agency before. Photographs of the space where this program will be delivered and of any special equipment required in the program. Please submit photographs with this application even if you have submitted photographs to the Agency before. These photographs do not need to be high quality, but do need to be clear enough for the Agency to see the program delivery space and equipment. A sample of the transcript that will be issued to students enrolled in this program. The transcript sample should show the information that will appear on the transcript issued to students who graduate from this program. A sample Transcript is available for download at http://www.pctia.bc.ca. A sample of the credential to be awarded to students completing this program. INS.140.013 Page 16 of 25 2014.04.13 New Program - Registered Institution On-Site Delivery Part A. Guidelines The program credential is the Certificate, Diploma or other credential issued to graduates of this program. A sample credential is available for download at http://www.pctia.bc.ca. Evidence of curriculum ownership or usage rights for the duration of the program. Provide documentation indicating that your institution owns the curriculum or has usage rights for the curriculum for the duration of the program. Copies of any contracts between the institution and a third-party if program delivery is undertaken in partnership with or on behalf of another organization (if applicable.) If the program/courses are being delivered by a third-party or in partnership with another organization, please provide a copy of the contract for delivery of the program/courses. If this program includes a work experience placement, you must also attach: Written evidence that a work component is required for successful completion of the course of study. This evidence could be a copy of guidelines from a professional association. A copy of the work experience policy provided to students. Please submit a copy of this policy as a part of your application even if it was previously submitted to the Agency. A sample Work Experience policy is available for download at http://www.pctia.bc.ca. A list of the work experience placement sites that have agreed to take students from this program including the business name, address and telephone number and the name of the contact person at each placement site. The list should only include work experience placement sites who have already agreed to host students completing this program. INS.140.013 Page 17 of 25 2014.04.13 New Program - Registered Institution On-Site Delivery Part A. Guidelines A copy of the training plan giving details of the work to be performed during the work experience placement. The training plan for work experience placement should outline the work that the student will complete while on work experience that is directly related to anticipated learning outcomes of the program. A sample Training Plan is available for download at http://www.pctia.bc.ca. A sample of the evaluation tool that will be used for the joint evaluation of the student’s performance while completing the work experience placement. The joint evaluation is used at the end of the work experience placement during a meeting between the institution and the work experience host to review the student’s performance. The student may or may not be included in the meeting. The student should also have the opportunity to evaluate the work experience and the placement with the host. A sample Work Experience Joint Evaluation tool is available for download at http://www.pctia.bc.ca. A description of how the institution will monitor the students’ performance while on work experience. This description should indicate how often the institution is in contact with the work experience host and with the student during completion of the work experience. Evidence that insurance is in place for work experience students while they are on-site at the host organization. The institution’s general liability insurance does not necessarily cover students who are completing work experience placements, so additional liability insurance may be required. This evidence might be a copy of your general liability insurance policy indicating that students on work experience are covered or it might be a copy of a letter from your insurer outlining the coverage that is in place for work experience students. INS.140.013 Page 18 of 25 2014.04.13 New Program - Registered Institution On-Site Delivery Part B. Application Institution Operating Name Institution Number PROGRAM INFORMATION Program Title YYYY-MM-DD Proposed Start Date (YYYY-MM-DD) Credential Awarded: Program Duration: Program Delivery: Maximum single class size per site Certificate Other (please specify): Diploma Hours: Weeks: Full Time (20+ hours per week) Months: Part Time Does this Program require approval by a governing body? If yes, please provide a copy of the approval letter. Yes No Does this Program include a work experience? If Yes, what type of work experience is included? Yes Practicum Clinical No Preceptorship Co-op If Yes, what is the duration of the work experience in weeks? Will this program be delivered in a language other than English? If Yes, please attach evidence that all program materials, including exams, are available in the other language. Weeks Hours Yes No PROGRAM COSTS Program Costs in Canadian Dollars: Tuition Domestic Costs International Costs $ $ Registration Fee $ $ Textbooks $ $ Supplies/Materials $ $ Lab Fees $ $ Uniforms $ $ Other (please specify): $ $ INS.140.013 Page 19 of 25 2014.04.13 New Program - Registered Institution On-Site Delivery Part B. Application TOTAL PROGRAM COSTS $ $ BASIC EDUCATION STANDARDS INFORMATION Please state your institution’s Mission Statement. List the potential career options for students completing this program: Please summarize the student performance outcomes of the program and explain how they are observable, measurable and achievable. What are the admission requirements for entry to this program? List the minimum qualifications for instructors of this program. If more than one instructor is delivering this program, please list the courses and the qualifications that each course would require on the Courseby-Course Instructor Qualifications Spreadsheet. What methods were used to develop the curriculum for this program? Please provide information that demonstrates that the program duration is comparable to a similar program that is delivered using on-site delivery methods. Does this program include training provided by a third party? Yes No If yes, provide details and attach evidence the third party organization meets Agency requirements. Does this program have multiple entry points? If so, please explain. INS.140.013 Page 20 of 25 2014.04.13 New Program - Registered Institution On-Site Delivery Part B. Application Please describe the ownership/usage rights of the curriculum for this program. Describe the assessment strategies that will be used to evaluate student progress in this program. At what point will students receive written feedback on their progress in this program? PROGRAM DELIVERY INFORMATION Describe the physical facilities that you will use in delivering this program. Please explain how your institution will accommodate this new program given the space you have available. Please provide a list of equipment you will use in delivering this program and the quantity of each item listed. Please use a separate sheet if this space is insufficient. Please provide a list of resources that are available for student use, including the quantity of each item listed. Please use a separate sheet if this space is insufficient. Please indicate which method(s) of instructional delivery you will use to deliver this program and the number of hours for each method. Lecture hrs Demonstration hrs Lab Time hrs Hands on practice hrs Projects hrs Group Work hrs Other (please specify:) Please explain how students can access instructor assistance outside of class time. Please explain how students can access the resources you have available outside of class time. INS.140.013 Page 21 of 25 2014.04.13 New Program - Registered Institution On-Site Delivery Part B. Application Describe the system that will be used by students to assess instructor effectiveness in the program. DECLARATION By signing this application, the Applicant confirms that: All of the information contained in this application and any attachment is true, accurate and complete. He/she understands that the Agency may request additional information as necessary to enable the Manager, Compliance & Investigations to review this application and that the applicant must provide the information requested. He/she will provide an opportunity for representative(s) of the Agency to make a site to validate the program once it is in operation or sooner if required. He/she understands that this application will expire six (6) months from the date of the original application if the institution has not yet successfully completed the requirements for registration of this new program. He/she understands that application fees paid are not refundable. Name of Applicant Title Signature of Applicant Date Signed Email Address Telephone Number PCTIA USE ONLY Approved Not Approved Expired Comments: Reviewer Name Date Signed PCTIA Staff Signature NOC CODE INS.140.013 Page 22 of 25 2014.04.13 New Program - Registered Institution On-Site Delivery Part B. Application CIP CODE Date and Initial Item Institution currently in good standing / Application form is complete / Correct application fee attached / All required attachments included / Instructor Qualifications meet minimums / INS.140.013 Page 23 of 25 2014.04.13 New Program - Registered Institution On-Site Delivery Part C. Checklist Institution Operating Name Institution Number Application Checklist IMPORTANT: All of the items listed below must be attached to your application for a new program. Incomplete applications cannot be processed. Application processing will normally take up to 12 weeks from the date the complete application is received by the Agency. Completed Part B. Registered Institution New Program Application - On-Site Delivery New Program Fees (New program: $500/New short duration program: $100) Program Outline Course Outlines Program Delivery Sequence Letter of approval from governing body (if applicable) Not applicable Evidence that all curriculum, exams and external assessment are available in the language of instruction if the program is delivered in a language other than English. Not applicable Course-by-Course Minimum Instructor Qualification Spreadsheet Not applicable Floor plan of the institution showing where this program will be delivered List of equipment, including the quantity of each item that will be used in delivering this program. List of resources available for student use when completing this program. Photographs of the space where this program will be delivered. A sample of the transcript that will be issued to students enrolled in this program. A sample of the credential to be awarded to students completing this program. Evidence of curriculum ownership or usage rights for the duration of the program. Copies of any contracts between the institution and a third-party if program delivery is undertaken in partnership with or on behalf of another organization. If this program includes a work experience placement: Not Applicable Written evidence that a work component is required for successful completion of the course of study. INS.140.013 Page 24 of 25 2014.04.13 New Program - Registered Institution On-Site Delivery Part C. Checklist A copy of the work experience policy provided to students. A list of the work experience placement sites that have agreed to take students from this program including the business name, address and telephone number and the name of the contact person at each placement site. A copy of the training plan giving details of the work to be performed during the work experience placement. A sample of the evaluation tool that will be used for the joint evaluation of the student’s performance while completing the work experience placement. A description of how the institution will monitor the students’ performance while on work experience. Evidence that insurance is in place for work experience students while they are on-site at the host organization. INS.140.013 Page 25 of 25 2014.04.13