Last Name: First Name: MI:
Rocket ID: First Semester Enrolled (term/year):
Certificate: Occupational Health
College: Health and Human Services
Expected Graduation (term/year):
List all graduate courses required for the degree
Course
Alphanumeric
Code
Course Title
Term
Grade
#
of
Credits
Graduate
College
use
only
PUBH 5020
Occupational Health
3
PUBH 5310
Chemical Agents
3
PUBH 5410
Hazard Control
3
PUBH 5620
Physical Agents
3
Advised Elective
Certificate Total
Original Submission Date:
Amended
Date:
RETURN TO: School of Population Health
Health Science Campus
Collier Building 4416
Mail Stop 1027
Plan of Study for the Graduate Certificate
Program
Occupational Health (OH)
Description: The Plan of Study serves two main purposes. By defining a student’s course of study, it provides focus and direction to
his or her graduate program and it constitutes an agreement that successful completion of the proposed course of study and the
general certificate requirements will result in the awarding of the certificate. Each student working for a certificate is required to file a
Plan of Study with the College of Graduate Studies prior to the completion of 6 credit hours. This plan must be approved by the
Advisor, the Program Chair and the College Dean before being submitted to the College of Graduate Studies. It is understood that
the first “Plan of Study” filed by a student may be subject to change as he/she progresses. However, it is the student’s responsibility
to notify the College of Graduate Studies of any changes to an approved plan of study. According to the University of Toledo
General Catalog, it is the policy that credit applied towards certificate programs must have been earned within the period of four
years immediately preceding the time the certificate is awarded.
Instructions:
1. List all credits earned or to be earned that you would like to apply toward fulfillment of the Certificate requirements.
2. Under “Course Alphanumeric Code,” give department and course number as they were taken or are to be taken. Give the
course title in the second column. Enter term and grade information as appropriate.
3. Complete the Credits “column for all courses listed.
4. Obtain all required signatures and forward to the College of Graduate Studies for final approval.
5. If there are significant changes, a new “Plan of Study should be completed. If there are minimal changes, a “Plan of
Study Course Substitution” form may be
used.
9/16/2016
Additional program degree requirements (please check all that apply):
Other
(please specify)
Other (please specify)
Meets requirements of Catalog Term/Year
Comments/Notes/Justification Regarding Transfer and/or Substituted Courses
General Approvals:
Student Signature Date
Advisor Signature Date
Program Chair Signature Date
Dean, College of Health and Human Services
Signature
Date
Dean, College of Graduate Studies
Signature
Date
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signature
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