Click to enter the Policy # and Title

Administrative Responsibility: [REQUIRED: Click here to enter the POSITION, not name of the individual, responsible for interpreting and revising the policy]

PURPOSE

[REQUIRED: Click here to enter a statement describing the purpose of this policy.]

SCOPE

[REQUIRED: Click here to enter a statement indicating the employee groups that are impacted by this policy.]

DEFINITIONS

[Click here to enter a numbered list of terms and definitions related to this policy or enter “N/A” if not applicable]

POLICY

[Click here to enter a formal statement outlining the ways in which the organization intends to conduct its affairs and act in specific circumstances.]

PROCEDURE

[Click here to enter a numbered list of steps by which the policy can be accomplished.]

APPENDICES

[Click here to enter a numbered list of documents by title that supplement this policy, or enter “N/A” if not applicable.]

RELATED UNIVERSITY/BOARD POLICIES

[Click here to list any related University/Board policies by number and title, or enter “N/A” if not applicable.]

Effective Date: REQUIRED: Click here to enter the date the policy was first put into effect.

Revised Date: Click here to enter the date the policy was last revised (reviewed with changes).

Reviewed Date: Click here to enter the last date the policy was reviewed without revisions.

To be reviewed, at minimum, every three years and/or revised as needed by: [REQUIRED: Click here to enter the POSITION, not name of the individual, responsible for reviewing the policy.]

Next Review By Date: Click here to enter the date the policy will next be reviewed

SUPERSEDES POLICY

[Click here to enter a numbered list with the superseded Policy # and title, or “N/A” if not applicable]

HISTORICAL DATES

[Click here to list all previous revision dates or “N/A” if not applicable]