Thank you for seeking approval to offer an online degree program to students in Oregon.

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1 From: To: Subject: Date: Attachments: Gingerich, Sam Maley, Katie FW: ODA- Missing a form and fee Tuesday, May 17, :48:16 PM Initial Approval Request form.pdf Practicum supervisor qualification.pdf Katie, Here s another one. Thanks. From: Allison M. Jacobi Sent: Wednesday, May 04, :38 PM To: Gingerich, Sam Subject: ODA- Missing a form and fee Thank you for seeking approval to offer an online degree program to students in Oregon. The Oregon Office of Degree Authorization is committed to: Ensuring access to quality online higher education for Oregon students Protecting Oregon students from substandard and fraudulent degree providers Protecting Oregon citizens from users of substandard or fraudulent credentials Online degree programs may be exempt from state authorization if an ODA review determines that: the degree offered is valid for use in Oregon, and that the program does not have any assistance in the state of Oregon, as defined by Oregon Administrative Rule (23). Please note that assistance under Oregon rules includes, but is not limited to, any practicum, internship, recruitment, supervision, tutoring, proctoring, or experiential learning component that occurs in Oregon. Online degree programs that include any assistance within the state as described above and more fully in Oregon Administrative Rule (23), must be individually approved by ODA before they are offered to students in Oregon. Exempt status will be determined by review, and only after submission of a complete application file. Please note that only complete application files will receive a letter acknowledging receipt by July 1, ONLINE PROGRAMS WITH NO ASSISTANCE as defined in OAR (23) A complete application file for purely online programs includes: 1. Initial Approval Request form 2. A list of degree programs offered 3. A description for each degree program that explains the structure, learning goals, delivery method, basis for assessment and award of credit, and any other requirements

2 4. Information regarding requirements, fees and policies affecting Oregon students 5. Payment of the review fee: a check for $250 payable to State of Oregon ODA ONLINE PROGRAMS WITH PRACTICUM OR OTHER ASSISTANCE A complete application file for online+practicum programs will include: 1. Initial Approval Request form 2. A list of online+practicum programs offered 3. A description for each degree program that explains the structure, learning goals, requirements, delivery method, basis for assessment and award of credit 4. Information regarding requirements, fees and policies affecting Oregon students 5. A description of the structure and supervision model for the practicum that explains the learning goals, criteria for site selection, and role and qualifications of site supervisor. 6. Programs that offer preparation for the practice of a licensed profession in the state of Oregon must show evidence that they prepare students to meet any standards established by the appropriate Oregon licensing board. 7. Practicum Supervisor Qualification sheet for all supervisors, proctors, or other mentors assisting students in the practicum 8. Payment of the review fee by the institution, by check payable to State of Oregon ODA. The review fee for an online program with practicum or other assistance is $500 per program. If you have additional questions about the approval process or the forms, please send these by and allow one week for response time. We regret that we are unable to respond to phone inquiries regarding online approvals at this time. Sincerely, Jennifer Diallo, M.Ed. Interim ODA Administrator Oregon Student Assistance Commission 1500 Valley River Dr., Suite 100 Eugene, OR (541) FAX (541) Messages to and from this address may be available to the public under Oregon law

3 1500 Valley River Drive, Suite 100 (541) Eugene, OR This preliminary screening form is intended to determine the appropriate application form and evaluation process needed for a new program or a substantial change to an existing degree program. Please return to either the or mailing address above. GENERAL SCHOOL INFORMATION: Name of school: Primary location (city and state where chartered/licensed): Accreditation: NONE CANDIDATE STATUS ACCREDITED Name of accrediting body: Person responsible for the school s program(s) in Oregon: address: Mailing Address: Phone: Fax: PROGRAM DESCRIPTION: Check all of the programs that you will offer in Oregon: Non-degree CEU/CPD courses Associate Bachelor Master Doctorate Certificate / Diploma Please attach a list of all programs that will be offered to Oregon students Check all statements that are true for the programs that you will offer in Oregon: This is a non-degree program and credits from this program will not be transferable to a degree program at a later date. (Examples of this may include courses used as stand-alone credit for professional development or community education). If credits are intended to be transferable to a degree program in the future, do not check this box. Instead, check the partial degree program box. This is a terminal professional certificate or diploma program offered by a degree-granting school This is a partial degree program and credits earned may be used toward a degree in the future. This is a full degree program (Oregon residents can earn a degree entirely through this program) This is a practicum, clinical, student teaching, internship, externship or other experiential learning activity ONLY, and there will be no classes or learning activities at a site in Oregon. Delivery or methodology used in your program(s): This is a primarily on-site program with courses/learning activities taught by faculty in Oregon This is an entirely online program offered to private individuals via a personal internet connection This program is a hybrid program with both online and practicum or on-site components in Oregon

4 FOR REGIONALLY ACCREDITED NON-PROFIT SCHOOLS ONLY: Please indicate which, if any, of these conditions are applicable to your proposed program(s): The program(s) will only be offered for a limited time; Advice and assistance are easily accessible to students in Oregon; Tuition refund policies meet Oregon requirements as stipulated in OAR (18); Program evaluation is done systematically by the school and faculty at the school provide supervision and oversight for any experiential learning by students (such as for a practicum); Curricula for Oregon residents are identical to those at a main campus; Instruction is received in Oregon just as it was presented to students on the main campus; Academic assignments and testing and grading policies for Oregon students are identical to those for students on the main campus; All members of the faculty teaching from Oregon, or teaching Oregon resident students, hold degrees meeting Oregon standards as established in OAR (4); The school provides full library services to students, or ensures students access to full library services provided under contract by another party; The school employs persons qualified by a higher degree and experience to judge the quality of the degree program; There is a designated site coordinator who will assist this office with any inspections and provide information or respond to inquiries or complaints about the Oregon program. FOR SCHOOLS WITH NO LEGAL AUTHORITY TO OFFER DEGREES: Oregon Administrative Rule allows an education provider that does not have legal authority to offer degrees elsewhere to request approval to offer college-level courses for credit, under the same standards as a degree applicant, for a limited period. If your school is requesting approval to offer college-level courses under these conditions, please indicate by checking this box: We intend to seek approval to offer college-level courses that are not part of a degree program. We understand that the duration of this approval will not exceed three years and we intend to establish a transfer agreement with at least one accredited college. FOR SCHOOLS SEEKING EXEMPTION FOR RELIGIOUS DEGREE PROGRAMS ONLY: Oregon Revised Statute permits some schools to offer specific degrees for limited use under a Religious Exemption. To qualify for this exemption, the school must meet all requirements in the statute. If you intend to apply for Religious Exempt status, your degree program must meet the conditions below. Check all statements below that apply to your school and degree program: The school meets all requirements in the statute and requests Religious Exempt status. CERTIFICATION STATEMENT FOR ENTIRELY ONLINE PROGRAMS: By checking this box, the named representative certifies that all courses or other learning activities offered by the school are available to Oregon students only through online delivery to the student as an individual, via a personal computer, and that no Oregon student will engage in a learning activity for credit or evaluation or receive a grade for any project, work, or learning or practicum experience taking place at any public or private site in Oregon. Name of school representative: Title:

5 SCHOOL NAME: Qualifications of Teaching Staff Name of teacher: Year hired: Usual number of credit hours Full-time Part-time If on-line, provide state of residence taught per term: On-line Non-teaching duties, if any, e.g., administration, advising, committees. COURSES TAUGHT AT THIS SCHOOL: Include past, current and projected Course Title Course Number Credits Taught in past Teaching now Expected in future QUALIFICATION BY EDUCATION: Include only earned academic degrees. Do not include work that did not lead to a degree. Provide complete information as indicated in table below. Degree Title (e.g. BS, PhD) Year Major Institution (use exact name) Location (city/state (show country if not U.S.) QUALIFICATION BY RELEVANT POST-SECONDARY TEACHING EXPERIENCE: List any post-secondary level teaching experience before hire at applicant school. Provide complete information as indicated. Post-secondary Institution Years taught (e.g ) Fields (e.g. History, Art) OTHER RELEVANT PROFESSIONAL EXPERIENCE: PROFESSIONAL LICENSURE AND/OR CERTIFICATION: Indicate type of license and name and state of licensing body. (e.g., RN - OR Board of Nursing, Initial Teaching lic OR TSPC, CPA, CNA, etc) COMPENSATORY PROFESSIONAL FIELD EXPERIENCE FOR NON-DEGREE PROGRAMS: If you would like ODA to consider professional experience or training in lieu of academic credentials for an instructor in a Certificate or Diploma program, or in an AAS or AOS degree program in a technical field, please attach a resume outlining the relevant experience in detail. Please note that information provided in this resume is meant to allow consideration of individuals with long-term and clearly relevant professional experience for instructor positions in non-degree or specific occupational training degree programs, if these individuals are not otherwise qualified as required by OAR (4). The resume should provide enough detail to allow a fair assessment as to whether this experience is sufficient to compensate for the deficit in education and teaching experience. The compensatory experience should be directly applicable to teaching the courses in the instructor s proposed assignment, and sufficiently extensive to compensate for any deficit in the instructor s academic preparation in the field. 1

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