Organizational Structure and Other Change

Please complete to initiate the approval process for organizational structure or other change. Please check the box at the end of the form to have a copy of this information sent to you for future use. Please note that you will not be able to “save” and “return” to the form before you submit a request. As such, we suggest you have the information needed to complete the request in hand before you start the process.

Name of Program/Action*

Sponsoring School*

From the dropdown menu provided, select the school that will host the proposed degree.

Select

Sponsoring Department*

Please specify primary Academic department or administrative unit coordinating this request.

Proposal Contact Full Name*

Indicate the name of the primary contact at the sponsoring school with whom IRA staff will work to manage the steps required to approve the certificate. If there are additional contacts closely involved in this proposal who you would like IRA staff to include on related correspondence, please provide their names and email addresses in the File Attachment (see below).

Faculty Contact*

School Compliance Contact*

Proposal Contact Email*

Enter the official UVA email address of the proposal contact (primary computing ID address, no alias or non-UVA email addresses, please).

Date of Submission*

Select the date you are submitting this initiation request.

Requested Effective Term of Proposed Program/Action*

Enter the term in which the school wants the proposed action to be effective.

Select or enter value

Other*

Upload a brief description (one page or less) word document or PDF describing the purpose of the request. Please specify the reason for the change, what you aim to accomplish through the proposed action, and if you are collaborating with another department within or outside of UVA. If related to a dual degree, please specify the UVA degree program, and the name and degree program of the partner University. If related to a joint degree, please specify the proposed degree program and academic departments at each school who would oversee the program. If you selected “Other” as the type of action you are requesting, please provide necessary context for IRA staff to initially process.

File Attachments*

If you selected "Other" as the type of action you are requesting, please provide necessary context for IRA staff to initially process. Please upload a Word documet or PDF with the information.

Drag and drop files here or

Contractual Agreement or Consortium*

Will the proposal initiate a program or courses through contractual agreement or consortium?

Yes

Approvals

Date of School Curriculum Committee Approval*

Indicate the date on which the proposed change was or will be reviewed and approved by the internal curriculum committee of the proposing school. If the committee meeting schedule is not yet known at the time of submission, indicate 09/01/YY if you anticipate review in the coming Fall semester, and 02/01/YY if you anticipate review in the coming Spring.

Date of Dean Approval*

Indicate the actual or anticipated date on which the proposed change was or will be reviewed and approved by the dean of the proposing school.

Notes

Please enter any additional information that you want to share with the Institutional Research and Analytics Team.

Additional Information to Communicate to the IRA Team

Send me a copy of my responses

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