MODIFICATION TO EXISTING ACADEMIC DEGREE PROGRAM

Institution:	Choose an item.

Date of anticipated modification implementation:	Click or tap to enter a date.

Modification request:	☐Rename ☐Consolidate

Responsible academic unit:	Click or tap here to enter text.
Institutional contact: Phone: Email:	Click or tap here to enter text.

List any institutions within the State offering similar programs:	Click or tap here to enter text.

RENAMING - Complete this section if modification being requested is the renaming of an academic degree program.
Program title as it currently appears on Academic Program Inventory, Diploma, and Transcript:	Click or tap here to enter text.
New program title as it will appear on Academic Program Inventory, Diploma, and Transcript:	Click or tap here to enter text.
Degree(s) awarded:	Click or tap here to enter text.
Six-digit CIP code, IHL sequence code:	Click or tap here to enter text.
Total credit-hour requirement:	Click or tap here to enter text.

CONSOLIDATING - Complete this section if modification being requested is the consolidation of academic degree programs.
Program titles as currently appears on Academic Program Inventory, Diploma, and Transcript:	Click or tap here to enter text.
New consolidated program title as it will appear on Academic Program Inventory, Diploma, and Transcript:	Click or tap here to enter text.
Degree(s) to be awarded:	Click or tap here to enter text.
Six-digit CIP code, IHL sequence code for consolidated program:	Click or tap here to enter text.
Six-digit CIP code, IHL sequence code for program(s) that are to be eliminated through the consolidation process: (Deletion forms do not need to be completed for these.)	Click or tap here to enter text.
Total credit-hour requirement for new consolidated program:	Click or tap here to enter text.

Please respond to the questions on the following pages to aid the institution and IHL staff in making recommendations to the IHL Board of Trustees regarding this proposal.

Chief Academic Officer Signature – Date	Institutional Executive Officer Signature – Date

Number of students enrolled in last 5 years: (For consolidation request, combine numbers for all programs to be consolidated)	Number of graduates expected in next 5 years in renamed/consolidated program:
Year 1	Click or tap here to enter text.	Year 1	Click or tap here to enter text.
Year 2	Click or tap here to enter text.	Year 2	Click or tap here to enter text.
Year 3	Click or tap here to enter text.	Year 3	Click or tap here to enter text.
Year 4	Click or tap here to enter text.	Year 4	Click or tap here to enter text.
Year 5	Click or tap here to enter text.	Year 5	Click or tap here to enter text.
Total	Click or tap here to enter text.	Total	Click or tap here to enter text.

Program summary:
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Program Modification Questions:
1	Describe how the proposed modification fits within the mission of the institution.
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2	Is this modification unnecessarily duplicative of other programs within the IHL system?
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3	Describe the anticipated institutional impact including any research efforts associated with this program.
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4	Are there any anticipated budget savings associated with the proposed modification?
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5	Are there any changes to the educational objectives of the degree program associated with the proposed modification?
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6	Are there any changes to the curriculum of the degree program associated with the proposed modification?
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7	Describe how the proposed modifications will affect program faculty.
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8	Describe the evaluation process which led to the request for the proposed modification.
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