The University Of Toledo

PROGRAM REQUIREMENT REVISION FORM

Administrative Use Only

Code*:   
Date Received: (mm/dd/yyyy)
Effective Date: (mm/dd/yyyy)

Please list the proposed program structure. Attach additional pages as necessary.

College:     Dept/Academic Unit:
Contact Person: Phone: Email:
Program Name :
Program Level:   Undergraduate   Graduate
Changes and Reason for Changes
Attachment(If  more than 5000 bytes are needed for the change description):
     No Attachment
Department Curriculum Authority: Date (mm/dd/yyyy)
Department Chairperson: Date (mm/dd/yyyy)
College Curriculum Authority: Date (mm/dd/yyyy)
College Dean: Date (mm/dd/yyyy)
After college approval, submit the original signed form to the Faculty Senate (UH 3320) for undergraduate-level courses; for graduate-level courses submit the original signed form to the Graduate School (UH3240).
FS Acad. Programs or Graduate Council: Date (mm/dd/yyyy)
Office of the Provost : Date (mm/dd/yyyy)
Registrar's Office: Date (mm/dd/yyyy)