Grad Cert Planning Form

Academic Program Completion Plan
For Disability Studies Certificate

Student Name: __________________________

Student ID Number: ______________________

Student’s Phone: ________________________

Email: _________________________________

Home Department: _______________________

Course Name and Number

Credit Hours


Term Taken

1. Core Knowledge


OC TH 6350 Interdisciplinary Course in Disability Studies



2. Coursework: Total hours from 2(a) and/or 2(b) must equal at least 5-9 credits. 5-9 credits


(a) Courses Selected From Approved Disability Studies Course List

(b) Discretionary Courses and Associated Projects (List courses and explain how associated assignments/projects were tailored to focus on disability. Additional documentation must be attached.)


3. Capstone Experience 2-6 credits
(Indicate course number and nature of project. Attach a brief project proposal/explanation.)


4. Disability Studies Research Forum 1 credit


OCTH 6860 – Disability Studies Forum


Total Credit Hours (15 minimum): ________________

Student Signature and Date:


Home Department Advisor’s Signature and Date:


Disability Studies Advisory Committee Chair and Date:


Modifications may be made by mutual consent of the Disability Studies Advisory Committee Chair, the Home Department Advisor, and the student.

For office use only: Status Confirmation: ______________________