Fillable Form Submission: The non-substantive program revision form must (Arizona)

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Form Submission: The non-substantive program revision form must (Arizona)

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Arizona State Board for Private Postsecondary Education
PROGRAM MODIFICATION FORM –
Non-Substantive Revisions for Currently Licensed Programs
Non-substantive program revisions: A Non-substantive program revision form (attached)
must be submitted for any of the following revisions to approved programs:
1. a change of name of an existing program, or
2. Tuition/fee increases;
3. a change of less than 25% in the clock hours, credit hours, curriculum content or
program length of an existing program, or
4. a change in the mode of delivery of an existing program
Form Submission: The non-substantive program revision form must be typed. A separate form
is required for each location affected by the revisions/changes. Attach to the form a brief
narrative and a side-by-side comparison of the existing program to the revised program.
No fee is required for program revisions/changes.
To calculate the percentage of change in the clock/credit hours of a program, use the following;
The difference between the original clock/credit hours and the proposed clock/credit hours (box
1), multiply by 100 and divide by the original clock/credit hours. This is the percentage of
change for the program.
Credit/Contact/Clock
Hour Change
Original Total Credit/Contact/Clock
Percentage of Change
=
New Programs: A Supplemental License Application for a New Program is required if
one of the following occurs:
1. Revisions to a licensed program that is equal to or greater than 25% of clock hours,
credit hours, curriculum content or program length of the program.
2. Addition of Concentrations/Specializations/Majors to an licensed program
3. Distance Education Programs:
a. If the proposed distance education program is the first distance education
offering of the institution.
b. If the proposed distance education program (degree or non-degree) is unrelated to
current program offerings.
All Supplemental License Applications for New Programs can be found on the website at
www.azppse.gov. Please note the applications are different for vocational and degree programs.
All Supplemental License Applications and Non-Substantive Program must be completed using the
Service Request section of the e-Licensing portal at https://elicense.az.gov.
ARIZONA STATE BOARD FOR PRIVATE POSTSECONDARY EDUCATION
PROGRAM MODIFICATION FORM
NON-SUBTANTIVE REVISIONS FOR CURRENTLY LICENSED PROGRAMS
x100 Divided By
Please use this form to report NON-SUBSTANTIVE revisions/changes to currently approved programs.
Institution Name:
Address
City State Zip
Prepared by Title
Date
Contact Phone No. Fax No.
E-mail
The following NON-SUBSTANTIVE program modifications (check all that apply) are indicated
below:
Program Name Contact/Clock Hours Credit Hours
Program Length Delivery Mode * Curriculum Content
New Concentration Change in tuition and/or fees
Current Program Name
Proposed New Program Name
Credential:
Certificate Diploma Occupational Associate Academic Associate
Associated of Applied Science Bachelor’s Master’s Doctorate
Current Proposed Change
Tuition _______ _______
Fees _______ _______
TOTAL TUITION & FEES _______ _______
Number of Contact/Clock Hours _______ _______
Number of Credit Hours
___ Semester Credits _______ _______
___ Quarter Credits _______ _______
Program Length
__ Weeks _______ _______
__ Months _______ _______
__ Years _______ _______
0
0
Delivery Mode:
__ Residential _______ _______
__ Online _______ _______
*Explain how the proposed distance education program is appropriate for delivery through
distance education methods. Explain and describe the method of delivery to be utilized for the
proposed distance education program.
Curriculum Content – provide a side-by-side comparison
Current Curriculum Content
Proposed Changes to Curriculum Content
I hereby certify that all information reported on this form is correct and in compliance with Arizona statutes
and rules and, if accredited, the ___________ Standards of Accreditation.
Signature Date
The following is attached:
______ A brief narrative describing the changes from the existing program to the revised
program.
______ If accredited, a copy of the applicable standards of accreditation for the above program
modifications.
The Arizona State Board for Private Postsecondary Education acknowledges the proposed
revisions and updated the institutional file as required.
_______________________________________ ______________________
Signature Date
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Completed 12 August 2020

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