Unt Policy Routing Request

Unt Policy Routing Request

UNT POLICY ROUTING REQUEST

POLICY NUMBER: / pOLICY tITLE: / cHAPTER nUMBER: / cHAPTER tITLE: / nEW pOLICY nUMBER1:
ACTION: ☐ NEW ☐REVISION ☐DELETION ☐REVIEW / REQUESTED IMPLEMENTATION DATE:
ROUTING
TO: / ACTION: / SIGNATURE: / DATE:
FACULTY SENATE2
PRINT NAME: / RECOMMEND
VP AREA OF RESPONSIBILITY
PRINT NAME: / REVIEW
UNIVERSITY POLICY OFFICE (UPO)
PRINT NAME: / REVIEW
POLICY SUMMARY – ALL FIELDS REQUIRED. Incomplete form will be returned to policy contact.
  1. State Reason(s) for Policy Action (required):

Click here to enter text. /
  1. Provide Summary of Changes (required for policy revision only, otherwise enter NA):

Elaborate on any legal, regulatory, financial, operational, accreditation, technological, and/or social requirements. /
  1. Timing Priority (check one, required):

☐HIGH (specific explanation required, otherwise UPO will route STANDARD)______
☐STANDARD (12+ weeks depending on complexity. No explanation required)
  1. Indicate name and number of related compliance items (required, if none, enter NA in OTHER):

☐STATE LEGISLATION:______
☐SACSCOC:______
☐SYSTEM REGULATION:______/ ☐FEDERAL LEGISLATION:______
☐ REGENT RULE:______
☐OTHER:______
POLICY CONTACT NAME: / DIVISION/DEPT.:
E-MAIL: / PHONE NUMBER:
POLICY CONTACT SIGN AND DATE (required): / ENCLOSURES (required, if none, enter NA):
DATE: / Click here to enter text. /

POLICY BACKGROUND INFORMATION

POLICY NUMBER: / pOLICY tITLE: / cHAPTER nUMBER: / cHAPTER tITLE: / nEW pOLICY nUMBER1:
ACTION: ☐ NEW ☐REVISION ☐DELETION ☐REVIEW / REQUESTED IMPLEMENTATION DATE:
SECTION I. – NEW POLICY ONLY (required, see “Instructions” or contact UPO for guidance)
  1. Policy Statement

Click here to enter text. /
  1. Consistency with UNT’s Mission, Goals, Other Policies, and Related External Documents

Click here to enter text. /
  1. Entities, Offices, and other UNT Community Members Affected by this Policy

Click here to enter text. /
  1. Stakeholders who were Consulted in Developing this Policy

Click here to enter text. /
  1. System Changes Required

Click here to enter text. /
  1. Communications and Training Activities to Build Awareness and Enable Implementation.

Click here to enter text. /
  1. Compliance Mechanisms Existing or to be Created

Click here to enter text. /
SECTION II. – POLICY DELETION OR REVIEW ONLY (required, check all that apply)
  1. Policy is duplicative of or will be incorporated into another policy?☐Yes ☐ No
If “Yes”, list policy number(s) here (required):
  1. Policy provides clear and sufficient guidance for responsible parties to satisfy policy objectives and
compliance requirements? (see OGC Legal Sufficiency Review Guide)☐Yes ☐ No
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