Curriculum Committee
New Program Form
Curriculum Document Number
Agenda Item No. Month Year
(for committee use only)
Initiated by: __________________________________________________________
Signature of full-time faculty member
Date:
Program Information New Program
Title
Degree (pick one)
Program Type:
Certificate (check all that apply)
Short (1-11 cr.) Perkins (12+ cr.)
Financial Aid (16+ cr) WIA
list cr. hrs.
ICCB Curriculum Prefix
PCS.CIP Code
Department
Term first offered (semester/year)
Minimum credit hours
Admission requirements
Yes No
If yes, explain
Skills levels (occupational programs
sources)
Courses in program
Attach list of existing courses and new courses as they will appear in the program. Include prefix
and number, title, and credit hours.
See office of Curriculum and Assessment to create catalog pages reflecting new program.
Catalog pages (attachment)
Purposes of proposed program
Datatel Program Code
Anticipated student enrollment
Explain
Projected completers
Description of proposed program
(to appear in catalog)
Attach list of courses courses as they will appear in the program in sequence order by semester.
Term by Term sequence of courses
in proposed program
(check prerequisites)
Part-time
Full-time
T
e
T
e
T
e
T
e
Year 1 Year 2 Year 3
T
e
T
e
Year 3Year 2Year 1
Name(s) and
positions:
List names of Program Advisory
Committee and department
members with whom this course
has been discussed.
Labor Data (trends, supply,
demand, source)
If yes, describe
space needed.
Specialized Classroom Needed
NoYes
Specialized Equipment Needed
NoYes
List items
needed and
estimated cost
Local needs assessment
If yes, describe
sites and methods
of supervision
Clinical/Internship sites required?
NoYes
If yes, identify
agency and
explain how the
program prepares
students to be
licensed.
Students prepared for certifications
(identify)
External licensing or accreditation
required?
Yes No
Signatures Required
Coordinator/Department Chair Date
DateDivision Dean
DateCurriculum Committee Chair
DateVice President of Academic Affairs
Existing Adjunct faculty
New full-time faculty
Existing full-time faculty
Staffing
New Adjunct faculty
number
number
number
number
List degrees/
professional
certificates; field;
years of related
experience; and
years of teaching
experience.
Faculty qualifications
Print Form
Submit by E-mail
Catalog Page
I. General Education Core
credits
Area A: Communication (6 credits)
ENG 101 Composition I with a grade of C or better (3)
COMM 101 Principles of Communication (3)
Area B: Humanities (3 credits)
Area C: Mathematics demonstrated competence
Area D: Physical and Life Sciences (34 credits)
credits
II. Program Requirements
credits
III. Electives
Program Total:
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