Curriculum Committee
Program Modification/Drop Form
(duplicate on green paper)
Curriculum Document Number
Agenda Item No. Month Year
(for committee use only)
Proposed Action:
End/change Effective Date:
Initiated by: __________________________________________________________
Signature of full-time faculty member
Program Information Current Program Information New Program Information
Program Title
ICCB Curriculum Prefix #
Datatel Program Code
Minimum credit hours
(Use complete sentences)
Current Program Type:
Technical Certificate (16+ credit hours Career Studies Certificate (1-15 credit hours)
Complete required information. Save using course prefix and number as the file name. Print copy. Process with signatures for
Committee Agenda.
Career Studies Certificate (1-15 credit hours)Technical Certificate (16+ credit hours
New Program Type:
Signatures Required
Coordinator/Department Chair Date
DateDivision Dean
DateCurriculum Committee Chair
DateVice President of Academic Affairs
Reason for proposed changes
Other changes
Catalog pages (attach)
Drop (list course prefix #
Change (list course prefix #
Add (list course prefix #
Provide course prefix # - Title, Cr. Hrs., as they will
appear in revised program for each course added or
changed on an attached sheet..
Course changes in program
Print Form
Submit by E-mail