ࡱ> Q &bjbj55 ;4WeWe WPV V 87DBo ! ! ! M"$$HAAAAAAA$&DFA$+""M"$$A! ! A((($^8! ! ?($A((;=! wI"5%jA<?B0DBY<\G%G0==G=$$($$$$$AA($$$DB$$$$G$$$$$$$$$V a: CERTIFICATE REVISIONSubmitted by: Email: Phone: Department: Columbia Gorge Community College (Double click on check boxes to activate dialog box) SECTION #1 OVERVIEWCurrent Title:Proposed Title:Current Credits: Proposed Credits:Overview and rationale for proposed changes:List of specific changes being proposed which may include, addition or deletion of courses, title changes, credit changes, prerequisite changes, outcome changes, course changes etc. Use consistent words Add, Remove, Increase, Decrease, Change Is this a Related Certificate? FORMCHECKBOX  Yes  FORMCHECKBOX  NoIs this a Career Pathway? FORMCHECKBOX  Yes  FORMCHECKBOX  NoIf yes, what is the base degree?Will the proposed changes affect the base degree or certificate? FORMCHECKBOX  Yes  FORMCHECKBOX  NoIf yes, how?Is this a statewide certificate? FORMCHECKBOX  Yes  FORMCHECKBOX  NoIf yes, have the changes been approved by the consortium? FORMCHECKBOX  Yes  FORMCHECKBOX  NoDoes the revision impact other areas of instruction? FORMCHECKBOX  Yes  FORMCHECKBOX  NoExplanation of issues and how they are being resolved:Has the revision been validated by the Advisory Committee? FORMCHECKBOX  Yes  FORMCHECKBOX  NoIf yes, have you talked with impacted departments and resolved any and all possible issues? FORMCHECKBOX  Yes  FORMCHECKBOX  NoDate of Advisory Committee meeting:Requested Implementation Term SECTION #2 REVISION AREASDoes the revision involve changing certificate requisites? FORMCHECKBOX  Yes  FORMCHECKBOX  NoNote that degree/certificate/program entry prerequisites are only enforceable in limited entry programs. Program prerequisites for open entry programs only have meaning when they are representative of prerequisites associated to specific courses within the program. Prerequisites that students are not able to test out of using multiple measures result in hidden degree/certificate requirements and should be avoided. (Courses that may be tested out of using multiple measures include: WR 115, MTH 65, MTH 95, MTH 98, MTH 105, MTH 111, MTH 112.)CURRENT PREREQUISITES (Required whether or not prerequisites are being changed.)Course NumberCourse Title or Placement levelRequisites (if any)CreditsPROPOSED PREREQUISITES (No change, leave blank.)Course NumberCourse Title or Placement levelRequisites (if any)CreditsCERTIFICATE OUTCOMES All certificate outcomes will be reviewed by the committee regardless of whether or not outcomes have changed.Describe what the student will be able to do out there (in their life roles as worker, family member, community citizen, global citizen or lifelong learners). Outcomes must be measurable through the application of direct and/or indirect assessment strategies. Three to six outcomes are recommended. Start each outcome with an active verb, completing the sentence starter provided. (See  HYPERLINK "/sites/default/files/curriculum/writing-learning-outcomes.pdf" Writing Learning Outcomes on the curriculum website.)Does the revision involve changing certificate outcomes?  FORMCHECKBOX  Yes  FORMCHECKBOX  NoCURRENT CERTIFICATE OUTCOMES (Required whether or not outcomes are being changed.)Students who complete this certificate will be able to:PROPOSED CERTIFICATE OUTCOMESStudents who complete this certificate will be able to:RELATED INSTRUCTIONDoes the revision involve changing or adding Related Instruction? FORMCHECKBOX  Yes  FORMCHECKBOX  NoIf yes, complete the Related Instruction Template which may be found on the  HYPERLINK "http://www.cgcc.edu/curriculum/forms" curriculum website.Additional Comments Or Changes Section #3 course by course comparisonList all courses (current AND proposed) in the term by term order that is to be displayed in the  HYPERLINK "http://www.cgcc.edu/catalog" catalog certificate map. List course requisites under Course Title. Include elective list below. If you are adding a course, place it in the preferred term, identify such a course with (add) and bold the text in the line. If you want to rearrange the order of courses within the term-by-term sequence, do so on this form. If you are removing a course, identify the course with (remove) and bold the text. If the course title is changed, identify the course with (title change) and bold the text. If the course credits have changed, identify the course with (increase or decrease credit) and bold the text. If you need more lines to accommodate the courses, right click and insert rows. The information you provide on this form will be reflected in the Խ϶ij catalog pages. Please ensure it is correct.Current Certificate InformationProposed Certificate InformationCourse NumberCourse Title / RequisitesCreditsCourse NumberCourse Title / RequisitesCreditsCredit totalCredit totalElective List Include all electives. Identify elective changes by stating if the elective is to be added or deleted and bold the text. If you need more lines to accommodate the courses, right click and insert rows.Current ElectivesProposed ElectivesCourse NumberCourse Title / RequisitesCreditsCourse NumberCourse Title / RequisitesCredits Section #4 Department ReviewI vouch that this submission has been reviewed by the affiliated department chair and department dean/director and that they have given initial authorization for this submission. I am requesting that it be placed on the next Curriculum Committee agenda with available time slots. I understand that I am required to complete and submit, prior to the day my submission is reviewed by the Curriculum Committee, a Degree or Certificate Signature Form signed by the department chair and dean/director.SubmitterEmailDateDepartment Chair (enter name of department chair): Department Dean/Director (enter name of department dean/director):  Next steps: Save the completed Certificate Revision Request Form and submit as an e-mail attachment to  HYPERLINK "mailto:curriculum@cgcc.edu" curriculum@cgcc.edu or  HYPERLINK "mailto:slewis@cgcc.edu" slewis@cgcc.edu. If needed, attach the completed Related Instruction Template to the same e-mail. Refer to the curriculum office website for the Curriculum Committee  HYPERLINK "/curriculum/committee" meeting schedule and submission deadlines. You are encouraged to send submissions prior to the deadline so that the Curriculum Office may review and provide feedback. Submissions will be placed on the next agenda with available time slots, and you will be notified of your submissions estimated time for review. The Curriculum Office will send a signature page to your department chair and department dean/director that may be completed electronically. Signature pages must be received by the Curriculum Office the day before the Curriculum Committee meeting for which the submission is scheduled. Submissions without signed signature pages will be postponed. It is required for a representative to attend the Curriculum Committee meeting in which your submission is scheduled for review. The representative will be asked to describe the proposal and respond to any committee questions. 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