II. Reason for Request
Provide a rationale for the proposed change including an assessment of its impact on the affected administrative unit(s) and on the institution as a whole.

III. Role and Mission
If the proposed administrative change alters the role and mission of the institution, explain the nature of the change in role and mission and provide a rationale.

IV. Resources

A. Describe any expansion of the institution's course inventory that will result from approval of the proposed change.
B. Describe any changes in facilities (additions, renovations or alterations) that will be required as a result of approval of the proposed change.
C. Provide an itemization of new equipment that will be required during the next five years as a result of the proposed change.

V. Costs
Provide estimates of additional costs to the institution which will result from approval of the proposed administrative change. Also, provide sources of funding to cover these increased costs.

1. Submit organizational charts showing the present administrative scheme and the proposed administrative scheme.
2. Submit a letter certifying adequacy of funding.
3. Forward five copies of the completed proposal to the Mississippi Institutions of Higher Learning, Office of Academic Affairs, 3825 Ridgewood Road, Jackson, MS 39211-6453
4. Direct questions concerning the Request Format to the Office of Academic Affairs (601) 432-6501.

Requests to establish new administrative entities that require Board of Trustees approval should be submitted for staff review to the Office of Academic Affairs of the Board of Trustees for Institutions of Higher Learning before the Board of Trustees November meeting for consideration at the February Board of Trustees meeting or before the April Board of Trustees meeting for consideration at the July meeting.