OFFICE OF HIGHER EDUCATIONAPPLICATION FOR THE APPROVAL OR REAPPROVAL OFINSTITUTIONS AND PROGRAMS OF HIGHER EDUCATION

FOR OUT-OF-STATE INSTITUTIONSEffective February 15, 2017

The attached form, properly completed and with supporting documentation, shall serve as an application for approval under the provisions of Section 10a-34 of the General Statutes of Connecticut. The application must be filed at least nine months in advance of the date for which approval to operate is requested.

For guidance, you should review the State of Connecticut Regulations For Licensure and Accreditation of Institutions and Programs of Higher Education.

A hard copy and an electronic version of the completed application should be submitted with a cover letter to the following:

Vi Nguyen, Associate of Academic AffairsOffice of Higher Education

450 Columbus Boulevard, Suite 510Hartford, CT 06103

Email: vnguyen@ctohe.org

The institutional application must include the following materials:

A copy of the institution’s articles of incorporation, constitution, by-laws, or other operating documents.

A completed Program Licensure Application (see Appendix 1) for each academic program. See Appendix 2 for the required circulation instructions to Connecticut institutions. Note, the circulation document is the same as the program application minus the resource summary. Contact the Office of Higher Education for the latest distribution list.

The current catalog (a draft catalog is acceptable in the case of a new institutional application), the academic calendar, a copy of the student handbook, and a copy of the faculty policy manual.

A copy of any advertisements, brochures or promotional items currently in use or planned for use in the near future.

A copy of the institution’s strategic plan. An audited annual financial statement for the institution including any management letters

(and a certified budget for the activity in Connecticut in the case of a branch operation). A copy of the most recent letter of approval (notification) from your regional accrediting

association if you are not a Connecticut Institution. A description of the institutional approval process for new academic programs.

You will be required to send copies of the completed application to each member of a site evaluation committee when it is appointed.

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Office of Higher Education (Institutional Application)

Institution:

Street Address:

City: State: Zip code:

Institutional Accreditation (if any). Include date of last action:

Non-Profit or Proprietary:

Website:

Official Contact: Title:

E-mail:

Phone:

Other locations:

OBJECTIVES(See 10a-34-10)

1. Provide the mission and the vision of the institution.

2. How often is the mission reviewed and by whom?

3. Describe the clientele to be served by the institution (students, employers, professional groups, etc.).

4. To what extent is the institution involved in cooperative programs with other institutions? Explain how these efforts relate to the purposes of the institution.

ADMINISTRATION(See 10a-34-11)

5. Describe the type of ownership, control, and legal organization of the institution. Please indicate where this information is publicly stated.

6. Demonstrate that there is an institutional governing board such as a board of directors or a board of trustees. Indicate how board members are appointed and describe the terms and conditions of their appointment (length of terms, provision of overlapping terms, procedures and criteria for removal etc.). Provide written documents that outline the powers and duties of this board.

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7. Complete the following table for the governing board.

Board MembersName Date of first

appointmentAppointment term

Occupation Annual Compensation as Board Member (if any)

Represent Public Interest (y/n)

[Add rows as necessary]

8. Describe the extent to which the board, the president, other chief administrators, and the faculty, respectively, participate in the formulation of educational policies.

9. Provide the written documentation in which the powers and duties of the chief executive officer are outlined. Include documentation describing the roles and responsibilities of all other chief administrator positions. Demonstrate that there is a distinction among the roles and personnel of the board and the administration to ensure the appropriate separation of these functions.

10. Complete the following table for the chief executive officer and chief administrators of the institution.

AdministrationName of Administrator

Title Date assumed position

Highest degree earned/ institution

Experience relevant to current position

Teaching Assignments (courses and hours / week)

[Add rows as necessary]

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11. Describe the institution’s process for planning and evaluation, including how (a) goals and objectives are established, (b) resources are allocated to achieve these goals and objectives, and (c) progress is evaluated toward meeting targeted goals.

FINANCE(See 10a-34-12)

12. State in itemized form (a) the receipts of the institution last year, (b) its expenditures, and (c) its current financial resources. Explain, if necessary.

13. Provide a budget that identifies support for each program.

14. Certify that the financial records of the institution are maintained in such form that evaluation of its financial status is possible at any time, that there is an annual financial statement which is audited annually by an independent public accountant authorized to practice under Chapter 389 of the General Statutes or by a state auditor, and that copies of financial statements and audit reports shall be made available at the time of each institutional evaluation and otherwise upon request.

15. List the name of the chief financial officer of the institution, giving (a) the preparation by education (institutions and degrees) and experience for his work and (b) his/her involvement with the operation of the institution’s educational facilities and program.

FACULTY(See 10a-34-13)

16. Complete the following table for faculty members who will be teaching in each program:

Name of Faculty Member

PT/FT

Department Highest degree earned/ Field

Average credit load/ semester

Expertise/ relevant experience

Administrative assignments/ other duties

[Add rows as necessary]

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17. For each vacant or proposed position, provide title, position qualifications and proposed date of appointment.

18. Describe the faculty role in governance of the institution.

19. Describe the methods of supervising inexperienced or new teachers.

CURRICULA AND INSTRUCTION(See 10a-34-15 & 16)

20. For each academic program provide the intended student learning outcomes, and describe how learning materials and experiences are used by the faculty to evaluate these outcomes.

Program Evaluation of Student LearningName of program

Student learning outcomes Evaluation methods

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21. For undergraduate programs list general education requirements and describe advising or other functions that assist students in completing the requirements as well as in integrating what they learn in general education experiences into their overall academic programs.

22. Describe how the institution defines a credit hour, including the expected amount of time a student must spend in and out of class to earn one credit hour. Where is this information published?

23. What are the institutions policies for (a) transfer of credit and (b) awarding credit for prior educational experiences?

24. Indicate any requirements and arrangements for clinical affiliations, internships, and practicum or work experience. Describe how these will be administered, how students will be evaluated and how appropriate credits will be assigned.

RESOURCE CENTERS AND LIBRARIES(See 10a-34-18)

25. Provide an overview of the holdings in the institutional library by including the number of print volumes, electronic books, print/microform serial subscriptions, full-text electronic journals, and microforms. Describe any arrangements the institution has to provide students access to library materials beyond the holdings at the institution.

26. List the names and professional qualifications, including degrees and other preparation of all full-time and part-time librarians who are employed.

27. What is the average annual appropriation for purchase of new library resources, i.e., periodicals, etc.? What is the average annual expenditure per full-time student?

ADMISSION, STUDENT PERSONNEL, AND GRADUATION POLICIES(See 10a-34, 17 & 21)

28. Complete the following table describing the composition of the student body of your institution:

EnrollmentProgram Name Degree

levelFall 2009FT PT

Fall 2010FT PT

Fall 2011FT PT

Total[Add rows as necessary]

29. Describe the requirements for admission to the college/university and into specialized programs. What are the policies and requirements for academic achievement to remain enrolled in good standing?

30. Describe the student services of the institution including counseling, advising, health services, registration, financial aid, career services, special needs and tutoring services.

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31. Include the minimum number and level of credits which must be earned from this institution for each degree level or program. Also include a description of the institution’s residency requirement(s). What are the requirements, i.e., number of semester hours of college-level work completed, theses, oral or written examinations, performance tests, etc., for awarding the Associate degree? Bachelor’s degree? Graduate degree?

STUDENT AND ALUMNI RECORDS(See 10a-34-22)

32. What records are available concerning (a) college admissions, including official transcripts from secondary schools and other institutions or colleges; (b) cumulative records for individual students of the results of achievement and intelligence tests, college grades, participation in extracurricular activities, etc. Explain their location and accessibility.

33. Describe the policies on tuition, fees, refunds and other financial policies for full-time and part-time students. To what extent do official student records clearly indicate an amount of money paid and balances due from students for tuition, fees, and other charges?

34. What alumni records and other evidence are available concerning activities and achievements of grades, their occupational employment, or advanced or post-graduate study and other institutions to which students transfer? Explain their location and accessibility.

PHYSICAL PLANT AND FACILITIES(See 10a-34-19)

35. Describe the facilities available for student use. Include verification (in terms of current certification) of the institution’s compliance with all pertinent local, state and federal laws and regulations relating to fire, safety, health and access for the handicapped.

36. Describe the facilities for administrative offices, faculty offices, and clerical and supportive services.

CERTIFICATION

37. Provide certification that program and institutional hiring and admission practices are in compliance with all applicable state and federal laws, regulations, and orders; and that the institution will operate under the provisions of approved non-discrimination plans, including consideration for women and minorities and accessibility for the handicapped.

TIME SCHEDULE AND AUTHORIZATIONS

38. Indicate any specialized approval, licensure or accreditation, by any agency other than the Office of Higher Education to the extent that it is related to each program in Connecticut.

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Appendix 1OFFICE OF HIGHER EDUCATION

PROGRAM LICENSURE APPLICATION Effective February 15, 2017

Complete a program licensure application for each program you propose to offer.

Submit as a Word document via email and as a print copy through the mail.

Applicant Institution: Date:

Anticipated Initiation Date: Duration of the program:

Name of Proposed Program:

Mode of delivery (on ground, online, or hybrid):

On ground: instruction is exclusively face-to-face (includes web-assisted courses).Online: instruction is exclusively remote.Hybrid: a combination of on ground, online, or hybrid courses.

*Web-assisted: a course management system or website is used to post and exchange materials and information.Is the proposed program a degree or certificate program?

Title (and abbreviation):

Number of credits:

CIP Code No. (optional): Title of CIP Code (optional):

Department where the program will be housed:

Institutional Contact Person: Title: Telephone:Email:

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I. Accreditation1. Is your institution regionally or nationally accredited?

2. If yes, provide the name of accrediting body.

3. Provide the dates of the next comprehensive visit and the next interim report.

4. Do you anticipate that the proposed program will be accredited by a professional organization or other outside accreditor? If so, name the accrediting body.

5. Will this program provide eligibility for a state approved or other licensed profession? If so, identify.

6. If yes, attach a copy of the agency’s licensing or certification requirements.

II. Program Description1. Please provide a brief description of the program.

2. Describe the program content, stating how it relates to similar programs at your institution.

3. Describe the careers and professions available to graduates of the program.

4. Briefly describe how the program was developed. Please attach any internal documents (e.g., feasibility reports, department studies, etc.) that may provide greater clarification and support for the proposed program.

5. Has an advisory board been consulted in the development of the program? If so, what is its make-up and how does it meet industry and workforce needs? If an advisory board is planned, please provide a timeline for its convening.

6. Describe how the course development and sequencing support the degree level and address the stated objectives of the program.

7. Briefly describe how the program will be assessed (internally and externally) and how often this assessment will occur.

III. Purpose and Objectives 1. List the learning objectives of the proposed program, and briefly state how those

objectives relate to the institutional mission.

IV. Administration1. Provide the name and qualifications of the full-time administrator or faculty member

who will be responsible for the day-to-day operations of the program. Please list all administrative and teaching responsibilities, indicating whether this person will be responsible for any other programs at your institution. If this individual is still to be hired, indicate the timeframe for hiring and the desired qualifications.

V. Program Admissions and Special Requirements1. What are the admissions requirements for this program?

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2. Does this program have special graduation requirements (e.g., capstone or special project)? If so, please describe.

3. Does this program require fieldwork (e.g., clinical affiliations, internships, externships, etc.)? If so, please describe and attach copies of the contracts or other documents ensuring program support.

VI. Enrollment1. Describe your prospective students for the program.

2. Describe the academic or career backgrounds of students who might be interested in the program.

3. Describe how you plan to market the program.

VII. Faculty1. Provide the number of new faculty (designate full-time, part-time and adjunct) to be

hired for this program by year for the next 3 years.

2. How many full-time faculty will teach in the program’s core curriculum?

3. How many adjunct and part-time faculty will teach in the program’s core curriculum?

VIII. Resources1. Describe the library resources designated for the program.

2. Describe the facilities and equipment allocated to the program (e.g., lab space designated for faculty and students, office furniture, classroom and laboratory equipment, etc.).

IX. Online Delivery of ProgramIf you are requesting approval to offer the proposed program online, please describe your capacity to do so with reference to existing digital infrastructure (e.g., course management systems, technical support). Then answer the following:

1. How many programs are currently offered online?

2. Does your institution have approval from its regional or national accrediting body to offer online courses? If so, when was this granted?

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Appendix ACurriculum Table

Provide a list, in sequence, of the course requirements in the table below. Include course number and title. Please see page one for definitions of modalities.

Attach course descriptions and syllabi for all new courses in the program core and in each concentration/track/option.

Program Core Courses (with concentrations) Credit Hours New On

Ground Online

Elective Courses

General Education Courses

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Appendix BResource Summary Instructions

INSTITUTIONAL INFORMATION

Institution: Give name of institution and location where program will be offered.

Program: Give name of proposed program and degree abbreviation (e.g., B.S. for Bachelor of Science).

Name/Date: Type name of preparer, sign and date.

PROJECTED ENROLLMENT

Internal Transfers: Give the numbers of currently enrolled FT and PT students who are expected to enroll in the program.

New Students: Give the numbers of new FT and PT students expected to enroll in the program during each year.

NEW REVENUES

Tuition and Extension Fund: Calculate tuition and extension fund revenue based on the following:

Net increase in enrollment (new students). For full-time students, indicate the current annual FT tuition rate. For part-time students indicate current rate per credit and average number of credits per year

per PT student.

Other New Revenues: These may include grants or contracts with private or governmental entities or other sources. Please describe and identify amount of funds.

NEW EXPENDITURES

Faculty & Support Staff: Give number of FTE new faculty and support staff and their total salaries for each year. Please note figures for each year should be cumulative (new hires and their salaries should be carried forward to succeeding years).

Library: Give the amount of additional funds required for each year to support library resources for the new program.

Equipment: Give the amount of additional funds budgeted for each year to purchase new equipment for the program.

** Please attach the completed Resource Summary form to the Application.

Resource Summary

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I. Projected Enrollment

Provide projected enrollment numbers for internal transfers, new students, returning students, and total enrollment during each of the first three years of the program. Be sure to distinguish full-time and part-time students.

Projected Fall Year One Fall Year Two Fall Year Three Enrollment Full-time Part-time Full-time Part-time Full-time Part-time Internal TransfersNew StudentsReturning StudentsTotalEnrollment

II. Projected Revenue

Provide projected program revenue from tuition (full-time and part-time), student fees, other sources, and total revenue during each of the first three years of the program.

Projected Program Revenue Year 1 FY 20 Year 2 FY 20 Year 3 FY 20Full-time Tuition per Semester

Part-time Tuition per Semester

Student Fees per Semester

Other Sources (attach description)Estimated New Program Annual Revenue

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III. Projected Expenditures

Provide projected annual expenditures for administration (chair or coordinator), faculty (full-time and part-time), support staff, library resources, equipment or other learning resources, and total expenditures for each of the first three years of the program.

Year One Year Two Year Three

Annual Expenditures Number/Est. Cost Number/Est. Cost Number/Est. Cost

Administration (Chair)

Faculty (full-time total for

program)

Faculty (part-time total for

program)

Support Staff

Library resources proposed

Equipment (attach list)

Other (attach list and

explain)

Total Annual Expenditures

Appendix CFaculty Chart

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Provide a list of all faculty members who will be teaching in the program core and concentrations/tracks/options. Designate faculty to be hired with an *.

Name, Title, and Position

(full-time, part-time, adjunct)

Credential/InstitutionArea of

Specialization/Pertinent Experience

Other Administrative or

Teaching Responsibilities

NOTE: Institutions are required to have their current institutional program approval process on file with the Office of Higher Education.

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________________________________________________________________________

Please note that this application has been reformatted in Microsoft Word to enable ease of completion. Together, submit this application and a separate circulation document for the proposed program to the Office of Higher Education, which is responsible for circulating all proposed programs. Please submit as a Word document via email and as a print copy through the mail.

As a reminder, once the proposed program is circulated, a copy of the institutional responses to all comments must be sent to the Office of Higher Education at vnguyen@ctohe.org. All comments and responses will be considered in the programmatic review process.

For more information, contact:

Vi Nguyen, Associate of Academic AffairsOffice of Higher Education

450 Columbus Boulevard, Suite 510Hartford, CT 06103

(860) 947-1822Fax: (860) 947-1309

Email: vnguyen@ctohe.org

Rev 2/2017

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