Policy PRES-IR-001 FORM A

Responsible University Administrator:President
Responsible Officer:Director of Institutional Research
Origination Date:October 8, 2012
Current Revision Date:N/A
Next Review Date:October 8, 2016
End of Policy Date:N/A
Policy Number:PRES-IR-001-Form A



PDF Version


Policy Statement

[The Policy Statement is generally two to four short sentences that provide a brief, general description of the University’s stance on particular subjects and/or its response to specific situations, including the policy’s intent, who must follow the policy, when the policy applies, and any mandated actions or constraints.] 


Reason for Policy/Purpose

[The information in this section answers questions as to why the policy exists.  It should state the legitimate interests of all parties, describe the problem or conflict the policy addresses, and cite any legal or regulatory reasons for the policy.] 


How Policy Works With, Conflicts With, or Negates Existing Policy

[If the proposed policy will substantively affect any existing policy, a statement describing how the propose policy will work with, conflict with, or negate existing policy is required.]


Who Needs to Know This Policy

[A list of constituencies that need to know about the proposed policy and/or who may be likely impacted by the proposed policy.] 


Website Address for this Policy

[The specific website address for the policy will be provided by Institutional Research.  Please contact Institutional Research to obtain this web address before printing out for signatures.]


[List unique terms that, by being defined, would add to the reader’s understanding of the basic policy or procedures.  Terms that are unfamiliar or technical, as well as terms with special meanings, should be defined.  The list of definitions will be posted in alphabetical order.]

Term Definition


[The policy itself.  The policy should follow a decimal numbering convention which uses a combination of numbers and decimal points to differentiate among levels of headings.  Policies and procedures benefit from the decimal numbering system for ease of cross-referencing sections.   The following example illustrates the relationship between the different level of headings and the decimal numbers used:


1.0       First-Level Heading

1.1       Second-level heading

1.2       Second-level heading

1.2.1    Third-level heading

1.2.2    Third-level heading Fourth-level heading Fourth-level heading

1.3       Second-level heading

2.0       First-Level Heading



The [Responsible University Officer listed by office only.  Example:  Director of Institutional Research] is responsible for review of this policy every four years.

[Provide the name of the Responsible University Officer responsible for review of the policy and the time period for review. All policies must be reviewed at a minimum of once every four years.]



[If there will be University-wide forms used in following this policy, identify the forms by name.  A hypertext link to these forms will be included.  If there are no forms, use NA to indicate such.]



[List any laws, regulations, or checklists that may pertain to the policy or that may supplement the information provided in the policy. Links may be provided for those listed.  If there are no appendices, use NA to indicate such.]


Related Information

[List any references to related policies or procedures.  A hypertext link to such related policies or procedures may also be provided.  If there is no related information, use NA to indicate such.]



Amendments: Month, Day, Year – summary of changes



[Before a policy is implemented, it must be approved by the following persons as evidenced by their signature.  Please make sure authorization begins on a separate page.]


Title:  [Title of the policy]

Policy number: [Policy number from page 1]




______________________________________                                  ______________________________

Responsible University Administrator                                        Date


______________________________________                                  ______________________________

Responsible University Officer                                                  Date





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Director of Compliance                                                            Date


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Office of General Counsel                                                        Date






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President                                                                               Date