Vous êtes sur la page 1sur 86

Private Vocational Institutions Office 401-1181 Portage Avenue Winnipeg, MB R3G 0T3 Ph.: 204-945-8515 www.manitoba.

ca/pvi APPLICATION FOR PROGRAM REVIEW - CHECKLIST Private Vocational Institutions will need to provide all information required on this checklist, and in the order provided. A Program Submission package example has been prepared for you to ensure that your submission is well-organized. Please consider the following when preparing your submission: 1) 2) 3) 4) There are no typographical errors in your application. There are no calculation errors in your application. Your Employer/Industry Association Attestations are independent sources. All mandatory components listed below are submitted in your application.

PRIVATE VOCATIONAL INSTITUTIONS OFFICE DOCUMENTS TAB 1) PART I - INSTITUTION AND PROGRAM INFORMATION ......................................... PART II - ENTRANCE REQUIREMENTS .................................................................. PART III - GOALS & OBJECTIVES ........................................................................... PART IV - LABOUR MARKET ANALYSIS ............................................................... PART V - PROGRAM REVIEW .............................................................................. PART VI - STUDENT EVALUATION ........................................................................ PART VII - DECLARATION .................................................................................... TAB 2) PROGRAM REVIEW CONTENT ..............................................................................

SUPPORTING DOCUMENTATION & APPENDICES TAB 3) TAB 4) TAB 5) TAB 6) TAB 7) TAB 8) EMPLOYER ATTESTATIONS (MINIMUM 3 REQUIRED) SAMPLE LESSON PLAN (1 REQUIRED) SAMPLE EXAM (1 REQUIRED) ............................................

.................................................................. .............................................................................. ..................................................

SAMPLE DIPLOMA/CERTIFICATE (1 REQUIRED) SAMPLE TRANSCRIPT (1 REQUIRED) INSTRUCTOR DECLARATIONS (FORM 2)

.................................................................. ............................................................

The instructor declaration(s) is/are not necessarily required at the time of program submission if the instructor(s) have not been hired. However, a Form 2 will be required prior to program offering.

TAB 9)

PRACTICUM/WORK EXPERIENCE DOCUMENTATION


Evaluation, Guidelines, etc.

............................................

TAB 10) COMPLETE CURRICULUM (1 REQUIRED) TAB 11) LABOUR MARKET ANALYSIS

............................................................... ...............................................

PLEASE MAKE CHEQUE PAYABLE TO THE MINISTER OF FINANCE

Private Vocational Institutions Office 401-1181 Portage Avenue Winnipeg, MB R3G 0T3 Ph.: 204-945-8515 www.manitoba.ca/pvi APPLICATION FOR PROGRAM REVIEW NOTE: 1) Hand-written material will not be accepted, including Employer Attestations. 2) All shaded areas in FORM 3 (PARTS I to VII) must be completed in full. 3) An incomplete program submission will not be considered and will be returned to the educational institution. PART I - INSTITUTION AND PROGRAM INFORMATION 1) Institution Name 2) Program Name 3) Contact Person 5) Email Address 6) Website Program Cost Information (a) Tuition (b) Training Completion Fund (c) Books & Supplies (d) Registration Fee (Max. $225) (e) Admin/Other Fees (specify)* (f) Total Program Cost Program Duration Information (in hours) (g) Theory Component (h) Practical Component (i) Practicum Component (j) Total Program Duration 0 + + + $ $ + + + + 4) Phone Number

PART II - ENTRANCE REQUIREMENTS Include the educational and age minimum requirements, as well as any required aptitude tests for entry into this program.

FORM 3 - PROGRAM SUBMISSION

2 OF 86

PART III - GOALS AND OBJECTIVES Provide a comprehensive summary of the skills and knowledge a student may acquire from the program and a statement of what the student will be able to accomplish as a result of successful completion of each phase of the program.

PART IV - LABOUR MARKET ANALYSIS (a) Provide a description of the specific types of employment for which a graduate of the program would be qualified (supporting documents also required):

(b) Provide the specific local or provincial need for graduates of the proposed program, verified by recent labour market analysis (sources include industry sectors, organizations, councils, etc.)

(c) Please note that 3 attestations are required for the Labour Market Component of this application. Refer to your Program Submission Checklist for where those attestations are placed in the order of your submission. PART V - PROGRAM REVIEW (a) How will this program be delivered? Please indicate all that apply. Classroom Self-directed learning Distance education

FORM 3 - PROGRAM SUBMISSION

3 OF 86

PART V - PROGRAM REVIEW (con't) (b) Please provide a breakdown of the theory, practical and practicum hours by unit/lesson or course name: Unit/Lesson/Course Name Theory Practical Practicum Total 1 0 2 0 3 0 4 0 5 0 6 0 7 0 8 0 9 0 10 0 11 0 12 0 13 0 14 0 15 0 16 0 17 0 18 0 19 0 20 0 21 0 22 0 23 0 24 0 25 0 26 0 27 0 28 0 29 0 30 0 31 0 32 0 33 0 34 0 35 0 36 0 37 0 38 0 39 0 40 0

FORM 3 - PROGRAM SUBMISSION

4 OF 86

PART V - PROGRAM REVIEW (con't) Total Theory Hours Total Practical Hours Total Practicum Hours Total Program Duration (in Hours) 0 0 0 0 0 0 0

(c) There are discrepancies in your theory, practical, or practicum calculations if any of the hours below do not equal 0. (Hours on Page 1 compared to Hours calculated above in Part V) Total Theory Hours 0 Total Practical Hours 0 Total Practicum Hours 0 Total Program Duration (in Hours) 0 (d) List the details of the equipment that will be used in the delivery of the program and the availability to students: 1 3 5 7 9 2 4 6 8 10

(e) List the details of the textbooks/print materials to be used or acquired by the student in completing the program. Also provide publication dates of required texts. Detail of required textbooks/print materials 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Publication Date

FORM 3 - PROGRAM SUBMISSION

5 OF 86

PART VI - STUDENT EVALUATION The student evaluation component of your program submission must include the following documents/samples, etc. Please refer to your Program Submission Checklist for where this section of your submission must be located. TO BE ARTICULATED IN APPENDIX 2 - (PROGRAM REVIEW - CONTENT) (a) (b) (c) (d) Student Feedback received from evaluation process Assistance available to students upon completion of the program Clear description of student progress and final competencies Required pass mark for each course/section of the program and for the overall program

TO BE ATTACHED TO YOUR PROGRAM SUBMISSION APPLICATION (see Checklist) (e) (f) (g) (h) Sample Lesson Plan (TAB 5) Sample Exam (TAB 6) Sample Diploma/Certificate (TAB 7) Sample Transcript (TAB 8)

PART VII - DECLARATION FEE PAYABLE BY A REGISTRANT FOR APPLYING TO HAVE A PROGRAM OF INSTRUCTION CONSIDERED FOR APPROVAL IS ATTACHED: NEW PROGRAM AMENDED PROGRAM $275.00 $100.00

AS REGISTRANT OF THE INSTITUTION, I DECLARE THAT THE INSTITUTION OWNS, OR HAS A CONTROLLING INTEREST IN THE PROGRAM CURRICULUM AND, IF REQUIRED, CAN PROVIDE APPROPRIATE DOCUMENTATION OF PROGRAM OWNERSHIP. AS REGISTRANT OF THE INSTITUTION, I DECLARE THAT THE INSTITUTION IS NOT SUBJECT TO ANY CONTRACTUAL PROVISION THAT MIGHT INTERFERE WITH THE ADMINISTRATION AND DELIVERY OF THIS PROGRAM.

Submitted by:

Date

Signature

FORM 3 - PROGRAM SUBMISSION

6 OF 86

Private Vocational Institutions Office 401-1181 Portage Avenue Winnipeg, MB R3G 0T3 Ph.: 204-945-8507 www.manitoba.ca/pvi

PROGRAM REVIEW CONTENT

Course Information 1 0

Course Description

Theory Practical Practicum Passing Grade

0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)


Page 7

Course Information 2 0

Course Description

Theory Practical Practicum Passing Grade

0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 8

Course Information
0

Course Description

3 Theory Practical Practicum Passing Grade Evaluations (Assignments, tests, etc.) 0 0 0

Competencies to be achieved:

Page 9

Course Information
0

Course Description

4 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 10

Course Information
0

Course Description

5 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 11

Course Information
0

Course Description

6 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 12

Course Information
0

Course Description

7 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 13

Course Information
0

Course Description

8 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 14

Course Information
0

Course Description

9 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 15

Course Information
0

Course Description

10 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 16

Course Information
0

Course Description

11 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 17

Course Information
0

Course Description

12 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 18

Course Information
0

Course Description

13 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 19

Course Information
0

Course Description

14 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 20

Course Information
0

Course Description

15 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 21

Course Information
0

Course Description

16 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 22

Course Information
0

Course Description

17 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 23

Course Information
0

Course Description

18 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 24

Course Information
0

Course Description

19 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 25

Course Information
0

Course Description

20 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 26

Course Information
0

Course Description

21 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 27

Course Information
0

Course Description

22 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 28

Course Information
0

Course Description

23 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 29

Course Information
0

Course Description

24 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 30

Course Information
0

Course Description

25 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 31

Course Information
0

Course Description

26 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 32

Course Information
0

Course Description

27 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 33

Course Information
0

Course Description

28 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 34

Course Information
0

Course Description

29 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 35

Course Information
0

Course Description

30 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 36

Course Information
0

Course Description

31 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 37

Course Information
0

Course Description

32 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 38

Course Information
0

Course Description

33 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 39

Course Information
0

Course Description

34 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 40

Course Information
0

Course Description

35 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 41

Course Information
0

Course Description

36 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 42

Course Information
0

Course Description

37 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 43

Course Information
0

Course Description

38 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 44

Course Information
0

Course Description

39 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 45

Course Information
0

Course Description

40 Theory Practical Practicum Passing Grade 0 0 0

Competencies to be achieved:

Evaluations (Assignments, tests, etc.)

Page 46

Page 47

Page 48

Page 49

Page 50

Page 51

Page 52

Page 53

Page 54

Page 55

Page 56

Page 57

Page 58

Page 59

Page 60

Page 61

Page 62

Page 63

Page 64

Page 65

Page 66

Page 67

Page 68

Page 69

Page 70

Page 71

Page 72

Page 73

Page 74

Page 75

Page 76

Page 77

Page 78

Page 79

Page 80

Page 81

Page 82

Page 83

Page 84

Page 85

Page 86