2.2 Policy Template
The following is a copy of the template to be used for policy creation and revisions.
New Policy Revision to Existing Policy Remove Policy
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Policy Title:
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Submitted by:
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Department/Office:
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Office of Oversight:
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Applies to:
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Approved by:
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Approval Date:
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Effective Date:
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Policy Statement:
Procedures:
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For Human Resources Use Only (initial and date when completed):
Added to Policy Manual: ____________________________________________________________
Sent to Dean of Students for inclusion in student handbook (if applicable): _______________
Sent to Website Manager for inclusion on website (if applicable): _____________________________________________________
Added to PN Policies and Procedures page: ___________________________________
Communicated to Faculty & Staff: _____________________________________________________
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