University Policy Office

Policy Template Guide

Use this guide to help you fill out the Policy Template

Policy Number

A unique identifier that will be assigned by the policy coordinator.

Title

Title of the policy. Succinct description of the proposed policy.

Effective

Effective Date of the policy.

Example:

MM/DD/YYYY.

Senate Proposal

No/Yes. Indicates whether or not the policy originated from a University Senate proposal. If yes, the policy requires Senate approval for changes to the policy. If no, the policy is in the control of the Responsible Office.

Responsible University Officer

Title of the University officer (provost, vice president office) responsible for implementing the policy and ensuring necessary procedures and guidelines are developed.

Responsible Office

Name of University office with responsibility of implementation of the policy. This office also had control of the changes that are made to the policy in the future.

Policy Statement

A well-articulated, authoritative expression of philosophy and direction. Does not change frequently.

Policy Requirements

Required elements for any procedures supporting the policy.

Purpose

Provide background information for the need and result of the policy.

Scope

Information regarding who is affected by this policy, and which departments or individuals should especially be aware of its contents.

Related Policy Information

Include here any supporting information for this policy.

Exclusions

Exclusions (groups of individuals, funding, etc.) to the policy – if none, it is assumed that the policy applies across the University.

Contacts

Individuals who can be contacted regarding the policy.

Example:

Individual Title and/or Department Name—487-XXXX

Definitions

List unique terms, which by being defined, add to the reader’s understanding of the policy.

Example:

(Word and/or Phrase to Be Defined) – (Define the word and/or phrase to eliminate reader interpretation.)

Responsibilities

Individual areas of responsibility followed by the function to be performed. List all the various employees and/or department’s responsibilities.

Example:

(Title/Department of Responsibility 1) – (State their responsibilities).

Procedures

List of procedures that directly support this policy

Example:

Procedure 11.1.1 Establishing and Creating University Policy.

Forms/Instructions

The forms and associated instructions that are used in direct support of the policy.

Example:

Form: (Form Name)

Instructions: (Title of Instruction)

Appendices

Any lengthy or complex reference information that would disrupt the flow of the other sections.

History

Adopted: mm/dd/yyyy Approved by appropriate executive team member

Revised: mm/dd/yyyy Brief description of changes made.