Certificate Program Application

Screening Confirmation

Please complete the Certificate Program Screening Form before submitting this application.

Contact Information

Institution name:*

Title:*

Email:*

Certificate Program Information

Full program name:*

2020 CIP code and program name:*

Internal and External Approvals

If the arrangement requires prior approval from HLC, submit the Contractual Arrangement Application separately from the Certificate Program Application. Indicate this related request at the end of this form.

If the arrangement does not require HLC approval, provide a PDF of the email from HLC confirming that fact:

Accepted file types: pdf, Max. file size: 20 MB.

Curriculum Information

Credential level:*

Total credit hours:*

Note: Please only enter a whole number value. Do not enter decimal numbers, a range of values, or any labels or explanation.

List the courses in the certificate program that are not currently offered in any existing degree programs. Include the course name, number of credit hours, and a brief description of the course. List one course per line.*

List the courses in the certificate program that are currently offered in existing degree programs. Include the course name, number of credit hours, and a brief description of the course. List one course per line.*

Academic Control

Describe the nature of the certificate program.*

Describe the necessary qualifications of the faculty teaching in the certificate program (e.g., education and years of experience required). How does the institution ensure that new faculty meet these qualifications?*

Describe the processes for the assessment of student learning, such as development and measurement of learning objectives and continuous quality improvement.*

Describe the process of academic control of the program, such as in admission, program content and quality, and frequency and process of program review.*

Related Change Requests

Please explain:*

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Questions?

Application