ࡱ> Q bjbj55 ;WeWeOKPV V 87BYooo!"T#,9B;B;B;B;B;B;B$DRG_B-#y!"!-#-#_Boo tB&&&-#^8ooo@&-#9B&&;+>oE 7N"#j<[@B0B<HH#tHH4+>+>HH?>-#-#&-#-#-#-#-#_B_Bi&-#-#-#B-#-#-#-#HH-#-#-#-#-#-#-#-#-#V a: NEW NON-CREDIT TRAINING CERTIFICATE REQUESTSubmitted by: Email: Phone: Department: Columbia Gorge Community College (Double click on check boxes to activate dialog box) SECTION #1 OVERVIEWProposed Title:Proposed Clock Hours:Reason for new certificate: Requested implementation term:Is there impact on other areas of instruction? FORMCHECKBOX  Yes  FORMCHECKBOX  NoExplanation of issues and how they are being resolved:Has the certificate 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:Certificate CIP Code SECTION #2 PREREQUISITES AND OUTCOMESPROPOSED PREREQUISITESCourse NumberCourse Title or Placement levelCredits/Clock HoursIs this a limited entry program? Students must apply, via the department for program entry. FORMCHECKBOX  Yes  FORMCHECKBOX  NoPROPOSED OUTCOMESDescribe 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.)Students who complete this certificate will be able to: Section #3 proposed courseWORKList all courses in the term by term order that is to be displayed in the  HYPERLINK "http://www.cgcc.edu/catalog" catalog certificate map. Include elective list below. The information you provide on this form will be reflected in the Խ϶ij catalog pages. Please ensure it is correct. (If you need more lines to accommodate the courses, right click and insert rows.)Course NumberCourse TitleCert Outcome included?Clock Hours FORMCHECKBOX  Yes  FORMCHECKBOX  No FORMCHECKBOX  Yes  FORMCHECKBOX  No FORMCHECKBOX  Yes  FORMCHECKBOX  No FORMCHECKBOX  Yes  FORMCHECKBOX  No FORMCHECKBOX  Yes  FORMCHECKBOX  No FORMCHECKBOX  Yes  FORMCHECKBOX  No FORMCHECKBOX  Yes  FORMCHECKBOX  No FORMCHECKBOX  Yes  FORMCHECKBOX  No FORMCHECKBOX  Yes  FORMCHECKBOX  NoClock Hour TotalElectives (if applicable)Course NumberCourse TitleCert Outcome included?Clock Hours FORMCHECKBOX  Yes  FORMCHECKBOX  No FORMCHECKBOX  Yes  FORMCHECKBOX  No FORMCHECKBOX  Yes  FORMCHECKBOX  No FORMCHECKBOX  Yes  FORMCHECKBOX  No 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 New Non-Credit Training Certificate 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. 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. Unanswered questions may result in a submission being rescheduled for further clarification.     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