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Item67457 (Louisiana State University)

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APPENDIX I
Policy Statement Approval/Review Routing Form
(Please attach the drafted Policy Statement, with revisions indicated, as well as any additional documents to this form)
Proposed or Current Title:_____________________________________________________________________
Policy Statement Number (if existing PS):_________ ____ New ____ Revised ____ Rescind
Functional Classification (identify):
Institutional Governance
& Administration
Auxiliary &
Enterprises
Faculty & Staff
Employment
Facilities Operation
& Maintenance
Student Services
Health & Safety
Instruction
Information
Technology
Research
Initiating Unit:_______________________________________________________________________________
Submitted by:_______________________________________________________________________________
Date Submitted to Office of Academic Affairs for Review:_____________________________________________
Provide for special preliminary review by the following (identify):
Budget &
Planning
Deans
Council
Faculty
Senate
Facility Services
Human Resource
Management
Student
Government
University
Planning
Council
University
Registrar
Other:
______________
Other:
______________
Does the PS require review by legal counsel? Yes
No
Date Sent to legal counsel:__________________ Date received from legal counsel:__________________
Council of Vice Chancellors Review (Please check and date to indicate consent. Attach any comments):
Athletics
[ ] initial:_______
[ ] comments attached
Finance & Administrative Services
[ ] initial:_______
[ ] comments attached
Research & Economic Development
[ ] initial:_______
[ ] comments attached
Strategic Initiatives
[ ] initial:_______
[ ] comments attached
Student Life & Enrollment
[ ] initial:_______
[ ] comments attached
_________________________Other
[ ] initial:_______
[ ] comments attached
Executive Vice Chancellor & Provost Recommendation: [ ] Approve [ ] Disapprove
_______
_____________________________________ _________________
Stuart R. Bell, Executive Vice Chancellor & Provost date
Chair, Council of Vice Chancellors
Final Action by Chancellor: [ ] Approved [ ] Disapproved
________________
______________________________________________
F. King Alexander, President & Chancellor
date
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Item67457 (Louisiana State University)

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Completed 25 July 2020

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