APPLICATION FOR APPROVAL

CHANGE OF OWNERSHIP OR CONTROL

SUBMIT ONE HARD COPY: EMAIL ONE PDF COPY:

Council on Occupational Education alex.wittig@council.org7840 Roswell Road, Bldg. 300, Suite 325Atlanta, GA 30350ATTN: Dr. Alex Wittig(800) 917-2081, ext. 202

NAME OF INSTITUTION

STREET ADDRESS

CITY, STATE, ZIP CODECHIEF ADMINISTRATOR

TELEPHONE / EXT.

E-MAIL ADDRESS

ACCREDITATION LIAISON OFFICERThis is a permanent staff member at the main campus with whom COE staff will discuss accreditation matters concerning the institution when the On-Site Administrator is not available.

ACCREDITATION LIAISON OFFICER

TELEPHONE / EXT.

EMAIL ADDRESSEstimated date of the institution’s next accreditation visit

This application must be typed; hand-written application will not be accepted.

(March 2019)

GENERAL INFORMATIONChange of Ownership or Control

Accreditation of an institution by the Commission ceases at the time that a change of ownership or control occurs. Change of ownership is defined in the Handbook of Accreditation as follows:

(a) For-Profit Corporation—A change of ownership is the transfer of at least 50% of the assets to another person. A change of ownership or constructive ownership of stock occurs at the time a person obtains or accumulates at least 50% of the total combined voting power of all classes of stock entitled to vote or at least 50% of the total value of shares of all classes of stock. Person includes an individual, trust, estate, partnership, association, company, or corporation. Any change from one ownership structure to another constitutes a change of ownership.

EXCEPTION: In cases when the owner of an institution dies and the owner’s interest is transferred to either a family member or another current owner of the corporation (either of whom has been active in the management of the institution for the past two years prior to the aforementioned action) will not be treated as a change of ownership.

Accreditation does not transfer with a change of ownership or control of an institution, even in such cases when the owner of an institution dies. Following final approval of a change of ownership or control, an eligible institutional representative must attend required workshops, complete a self-study, and host a full accreditation team visit. The timing of the accreditation visit may be adjusted to accommodate the change of ownership process but must occur no later than 18 months after final approval is granted. Denial of approval for a change of ownership or control by the Commission effectively drops the instruction the institution from status with the Commission.

(b) Not-For-Profit Corporation and Organizations Other Than Corporations—A change of control occurs when 50% or more of the members of the governing board change or 50% or more of the controlling parties change. The membership of record with the Council for the board or controlling parties is the membership at the time candidacy is granted or reinstatement of accreditation is granted following a change of control. A change from not-for-profit to for-profit constitutes a change of control.

The procedures defined by the Commission for approving a change of ownership or control of an institution are described below.

A. Change of Legal Ownership or Control of Total Institution

Accreditation does not transfer with a change of ownership or control of an institution. The institution must notify the Commission in a letter sent by certified mail or other signature-required delivery service at least seven days prior to a change of ownership or control. Following the legal change of ownership or control, if the institution desires to maintain COE accreditation, a completed Application for a Change of Ownership or Control and cashier’s check for the application fee must be received in the Council office by the Executive Director within fourteen days. The application must include the institution’s audited financial statements prepared by an independent certified public accountant for the two most recent fiscal years. It must also include the purchaser’s audited financial statements prepared by an independent certified public accountant for the two most recent fiscal years. In addition, the purchaser must submit an audited balance sheet prepared by an independent certified public accountant for the institution as of the date of purchase to be received in the Council office within 30 days after the closing date. Financial statements shall adhere to Generally Accepted Accounting Principles (GAAP) and shall be prepared in accordance with Generally Accepted Government Auditing Standards (GAGAS).

At the time of the receipt of the Application for a Change of Ownership or Control, the Commission considers the change in ownership or control to be final. In the event that, for any reason, the ownership or control reverts back to the previous owner(s) or non-profit board/controlling parties, a new application for candidate for accreditation must be filed.

Upon receipt of the Application for a Change of Ownership or Control, the Executive Director shall review the application and may request additional documentation. The Commission must grant initial approval of the application. The Commission reserves the right to require a preliminary visit to any institution prior to granting initial approval.

An on-site visit will be conducted within 180 days after initial approval of the change of ownership. A team (which may include a Commission representative) will visit the institution to ensure that the institution continues to comply with the standards, criteria, conditions, policies, and procedures of the Commission. The visiting team will submit

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a written report to the Executive Director within 30 days after completing the site visit. A copy of the visiting team report will be transmitted to the institution. The institution must submit a response to all findings of non-compliance to be received in the Council office by the Executive Director within 30 days of the date that the report was transmitted to the institution. The institution’s response report, if required, must provide documentation that deficiencies or violations of standards, criteria, and/or conditions of accreditation have been corrected. Cost of the on-site visit will be borne by the institution. The Executive Director will determine the amount of the deposit for the team site visit that must be conducted.

The Commission will review the application, financial statements, team report, and the institution’s response report, if required, and will make a final decision on the change of ownership or control at the next Commission meeting. Should the Change of Ownership or Control application be denied, the institution may appeal the decision in accordance with procedures specified by the Commission. If the final decision of the Commission is to approve the Change of Ownership or Control application, the Commission may require the new owner(s) and/or chief administrative officer to attend the next accreditation workshop held by the Council.

B. Change of Ownership or Control of a Branch or Extension

If an institution sells or otherwise disposes of a branch or extension, the accreditation of the branch or extension will be discontinued simultaneously with the sale or disposal action that results in a change of ownership or control. If an accredited institution acquires a branch or extension and wishes to continue to operate it as a branch or extension, the procedures required to establish a new branch or extension shall be followed. Should the new owner or non-profit board wish to make the branch or extension an accredited main campus, it must make application for candidate for accreditation.

C. Change of Ownership or Control of Candidate for Accreditation

Institutions in candidate status with the Commission are not permitted to change ownership during this status. If a candidate institution changes ownership or control, candidate status with the Commission is terminated as of the date of acquisition or change of control. The new owner of the institution must wait at least one year after the date of acquisition or change of control before applying for candidacy with the Commission.

D. Partial Change of Ownership or Control

If a partial change of ownership or control (i.e., less than 50%) occurs for a candidate or accredited institution, the Commission must be informed within the time periods prescribed below:

(i) If less than 50% of the assets of a for-profit corporation are transferred to another person, notification of the transfer must be received in the Commission office at least 30 calendar days before the date that the transfer occurs.

(ii) If fewer than 50% of the members of the governing board or 50% of the controlling parties of a not-for-profit organization or organization other than a corporation change, notification of the change must be received in the Commission office within 14 calendar days after the date that the change occurs.

Institutional Ethics and Integrity

The Commission must be assured that any institution which seeks candidate status, accreditation, reaffirmation of accreditation, or a change of ownership or control conducts its affairs with acceptable standards of honesty and integrity. When the Commission has any cause to believe that a candidate or accredited institution has acted in an unethical or untruthful manner, it will evaluate the matter and take appropriate action as described in the policies governing statuses (Section IV.E.1. Possible Commission Decisions).

If an institution misrepresents itself in documents filed with the Commission for purposes of candidate status, accreditation, reaffirmation, or a change of ownership or control, the Commission will immediately sever its relationship with the institution and may publish the decision.

Institutions must meet all lawful obligations, including those obligations arising from participation in federal student financial aid programs. Failure of an institution to conform to legal obligations imposed by governments and their agencies shall be cause for the Commission to remove the institution’s candidate or accredited status. The Commission may publish an action taken for such cause.

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The Commission may bar an individual from being an owner, an administrator, or a governing-board member of a COE-accredited institution if the individual has been debarred by a government agency or another accrediting agency or was an owner, an administrator, or a governing-board member of a COE-affiliated institution that was denied accreditation, was dropped from accreditation, or closed without providing a teach-out or refunds to currently enrolled students. The decision of the Commission to debar one or more individuals affiliated with an institution will be made at the time when action is taken against the institution and will be communicated to the individual concurrently with the notice of action taken against the institution. The debarment shall contain such conditions and length of time as the Commission may determine. A person who is debarred will have the right to appeal the decision of the Commission. The Commission is responsible for establishing procedures used in appealing debarment to ensure fairness to all affected parties.

U.S. Department of Education Considerations

The U.S. Department of Education requires that an institution’s accrediting agency must approve a change of ownership or control no later than the last day of the month following the month in which the transaction occurred. For example, if the sale of the institution occurs on April 20, the deadline for accreditation approval is May 31. Like all accrediting agencies, the Council on Occupational Education has timelines for its Commission meetings. A representative of the buyer should contact the Council office at (800) 917-2081, ext. 202 to discuss the timeless for the anticipated purchase of a COE-accredited institution. Failure to adhere to the Council’s deadlines could jeopardize the institution’s Program Participation Agreement with the ED.

Use of Consultants

A consultant may be used to assist in the self-study, but clear indications must exist that the faculty and staff were primarily responsible for preparing, revising, and editing any documents required in the accreditation process. Within seven days after employing a consultant for the purpose of assisting in the accreditation process, an institution must submit a copy of the consultant’s resume to the Council. A consultant should not represent the institution in communication with the Council. During COE site visits to the institution the school’s consultant should not be present at the institution. A consultant may provide assistance to the institution by providing on-site consultation for one or more of the following purposes:

1. Acquainting the administration and staff with the application process.

2. Providing an explanation of the content of the accreditation standards and criteria.

3. Lending assistance in organizing the application and supporting documents.

4. Identifying the types of exhibits or other documentation needed for the on-site visit.

Official Communications

Only written communication from the Commission will be considered official. All official communications from the Commission to candidate or accredited institutions shall be transmitted to the main campus chief administrator or, if applicable, to the institution’s accreditation liaison officer. All official communications from candidate or accredited institutions must be from the main campus chief administrator or, if applicable, from the institution’s accreditation liaison officer and in written form.

Institution’s Accreditation Liaison Officer

The accreditation liaison officer must be a permanent staff member at the main campus of the institution. This is the person with whom the Commission staff will discuss accreditation matters concerning the institution when the chief administrator is not available.

After an official notification of a change of ownership or control is received from an institution, no substantive change approvals will be granted for pending applications, nor will new applications for substantive changes be accepted prior to final approval of the change of ownership or control application.

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APPLICATION CERTIFICATION AND DISCLOSURE

The administration ofName of Institution

1. Is willing to invest the time, effort, and funds required to carry out a successful self-study, and a dedication to make any improvements which the study shows to be needed for strengthening the institution’s existence and services;

2. Demonstrates its commitment to the highest standards of ethical conduct reflected in the standards, criteria, and conditions of the Commission of the Council on Occupational Education (COE), either current or as they may be revised in the future by action of the membership, and to continued lawful and ethical performance;

3. Agrees to supply to the Commission any and all such information as the Commission may require pertaining to standards, criteria, and conditions of the Commission;

4. Agrees that the Commission may make known to state or federal agencies, other accrediting bodies, the general public, other institutions, organizations, or agencies, all information regarding the institution’s status as specified by the COE Handbook of Accreditation in section V.A.4. Confidentiality of Materials, and V.A.6. Publication of Institutional Status;

5. Certifies that the ownership and management have read and understand the standards, criteria, and conditions of the Commission

6. Certifies that the ownership and management have read the last COE Annual Report, Self-Study Report, and Visiting Team Report (If copies of these documents are not available from the previous owner, they will be made available from the COE office upon written permission from the previous owner.);

7. Assumes the responsibility for meeting all pending and future obligations of the institution with COE, including but not limited to fees, annual reports, and completion of accreditation processes; and,

8. Certifies that the information submitted in this application and supporting documents is accurate and complete.9. Agrees to comply with all requirements of the Council.

Signature of Chief Administrator Date

This is the on-site administrative head of the institution to whom has been delegated major responsibility for the direction, operation, and coordination of the institution’s programs and activities.

Type or Print Name and Title of Chief Administrator

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OTHER CAMPUSES BRANCHES

List all branch campuses (make additional copies of this page if necessary). See the Handbook of Accreditation for “Branch” definition.

Name of Branch “A”

Street Address

City State Zip

Telephone

Name and Title of On-Site Administrator

Name of Branch “B”

Street Address

City State Zip

Telephone

Name and Title of On-Site Administrator

Name of Branch “C”

Street Address

City State Zip

Telephone

Name and Title of On-Site Administrator

Name of Branch “D”

Street Address

City State Zip

Telephone

Name and Title of On-Site Administrator

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EXTENSIONS

List all extension facilities (make additional copies of this page if necessary). See the Handbook of Accreditation for “Extension” definition.

Name of Extension “A”

Street Address

City State Zip

Telephone Distance From Main Campus

Name and Title of On-Site Administrator

Name of Extension “B”

Street Address

City State Zip

Telephone Distance From Main Campus

Name and Title of On-Site Administrator

EXTENDED CLASSROOMS

List all extended classrooms (make additional copies of this page if necessary). See the Handbook of Accreditation for “Extended Classroom” definition.

Name of Extended Classroom “A”

Street Address

City State Zip

Telephone Distance From Main Campus

Name and Title of On-Site Administrator

Name of Extended Classroom “B”

Street Address

City State Zip

Telephone Distance From Main Campus

Name and Title of On-Site Administrator

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INSTRUCTIONAL SERVICE CENTERS

List all instructional service centers (make additional copies of this page if necessary). See the Handbook of Accreditation for “Instructional Service Center” definition.

Name of Instructional Service Center “A”

Street Address

City State Zip

Telephone

Name and Title of On-Site Administrator

Name of Instructional Service Center “B”

Street Address

City State Zip

Telephone

Name and Title of On-Site Administrator

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GENERAL CHARACTERISTICS

1. Date the institution was initially accredited with COE

2. Date of last COE reaffirmation

3. Previous owner(s)

New owner(s)

Address of new owner(s) if different from institution’s address:

Street Address

City State Zip Code

4. Date of acquisition by new owner(s)

5. Form of Ownership:

Check the appropriate box, complete the related section of the form, and provide any requested documentation.

NON-PROFIT CORPORATION

Has the corporation been officially recognized by the Internal Revenue Service as an exempt organization under Section 501(c)(3), or other Section, of the IRS Code?

YES NO If “YES”, attach a copy of the determination letter from the IRS. If “NO”, explain.

Provide a copy of the corporate charter.

Corporate Name

Street Address

City State Zip

Telephone Email Address

Registered Agent

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Non-Profit Corporation (continued)

List names and titles of all officers:

NAME TITLE% OF TIME

DEVOTED TO THIS INSTITUTION

Provide a roster of all members of the board of directors listed by name, title, professional/business affiliation, and address.

PRIVATELY HELD BUSINESS CORPORATION

If the institution is a unit or subsidiary of a corporation or corporate division whose stock is privately held,list the appropriate corporate officer or operating division head.

Provide a copy of the corporate charter.

Corporate Officer/Operating Division Head

Corporate Name

Street Address

City State Zip

Telephone Email Address

List names and titles of all owners and officers (including minority stock holders):

NAME TITLE% OF

OWNERSHIP

% OF TIME DEVOTED TO

THE INSTITUTION

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PUBLICLY HELD BUSINESS CORPORATION

If the institution is a unit or subsidiary of a corporation or corporate division whose stock is publicly held,list the appropriate corporate officer or operating division head.

Provide a copy of the corporate charter.

Corporate Officer/Operating Division Head

Name of Parent Corporation

Name of Operating Division

Street Address

City State Zip

Telephone Email Address

Is the stock traded: NYSE AMEX NASDAQ OTC Reg. Exchange

Name of the corporate official to whom the chief on-site administrator of the school reports:

Name / Title

Street Address

City State Zip

PARTNERSHIP

Name of Partnership

Street Address

City State Zip

Telephone FAX Email Address

List names and titles of all owners and officers (including minority stock holders):

NAME TITLE% OF

OWNERSHIP

% OF TIME DEVOTED TO

THE INSTITUTION

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PROPRIETORSHIP

Name of Proprietor

Street Address

City State Zip

Telephone FAX Email Address

6. Provide a chart of the organizational structure showing names of all officers and administrators. If appropriate, show the structure and control from the corporate body or bodies to students.

7. Who appoints the chief administrator of the institution?

8. Has any new owner, officer, or administrator of this institution held any ownership interest in another postsecondary institution?

9. Has any new owner, officer, or administrator of this institution served as an officer or administrator at another postsecondary institution?

YES NO If “YES”, please provide details.

10. Check if any of the following items apply to the new ownership within the last ten years, including the corporation, major stockholders, administrators, proprietors, or partners. If any items are checked, please provide an explanation as a separate attachment to this application.

a) School closingsb) Bankruptcy, liquidation, or receivershipc) Liensd) Criminal or civil suitse) Claimsf) Felony convictionsg) Loss of accreditation by any accrediting agency

11. Have any owners, administrators, or governing board members of the institution been debarred by a government agency or other accrediting agency recognized by the U.S. Secretary of Education?

YES NO If “YES”, see the current edition of the Handbook of Accreditation, B.1.a. Institutional Ethics and Integrity.

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YES NO If “YES”, please provide details.

12. a) Complete the attached Roster of Instructional Staff and Roster of Administrative and Supervisory Staff.

b) Complete the attached New Personnel Form for each NEW person employed in an instructional, supervisory, or administrative capacity as a result of the change of ownership or control.

c) List persons, by title, who handle money within the institution and provide evidence of bonding.

13. Attach copies of appropriate legal documents authorizing the institution to function. Check those attached:

a) State and local licenses showing approval of the change of ownership/controlb) Sales agreementc) Proof of ownershipd) Corporate chartere) Partnership agreementf) Certificate of authority for the new owner to do business within the stateg) Management agreement

14. a) Is the institution currently processing Title IV loans for students? YES NO

If “YES”, what is the institution’s cohort default rate for the previous three years?

b) At the time of purchase, is there a student refund liability? YES NO x

If “YES”, who will assume the liability?

15. At the time of purchase, is there any legal action pending against the institution? YES NO

If “YES, who will assume the liability?

16. Provide the previous owner’s audited financial statements prepared by an independent certified public accountant for the two most recent fiscal years. Financial statements shall adhere to Generally Accepted Accounting Principles (GAAP), shall be prepared in accordance with Generally Accepted Government Auditing Standards (GAGAS), and must include a Composite Score.

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Year: = Year: = Year: =

17. Provide the purchaser’s audited financial statements prepared by an independent certified public accountant for the two most recent fiscal years. In addition, the purchaser must submit an audited balance sheet prepared by an independent certified public accountant for the institution as of the date of purchase to be received in the Council office within 30 days after the closing date of the sale. Financial statements shall adhere to Generally Accepted Accounting Principles (GAAP), shall be prepared in accordance with Generally Accepted Government Auditing Standards (GAGAS), and must include a Composite Score. If the purchaser is a new company formed expressly for the purpose of acquiring the institution, provide a copy of an opening balance sheet as of the inception of the company audited and prepared by a certified public accountant.

18. Will the current name of the institution remain the same? YES NO If “NO”, attach a copy of the state license or other approval agency documents to certify the name change.

19. Will the same program offerings be continued? YES NO

If “NO”, describe briefly the anticipated changes and complete a Change in Existing Program application for each program that will be revised or a New Program application for each new program that will be offered.

20. Complete the attached Postsecondary Educational Programs chart for each campus.

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APPLICATION FEE AND DUES

Change of Ownership Application Fee: $3,000.00

Site Visit Deposit for Non-Public Institutions: $3,000.00(A larger deposit may be required in special cases)

TOTAL AMOUNT OF CHECK INCLUDEDWITH THIS APPLICATION

Make the check payable toCouncil on Occupational Education

and attach it to the front page of the hard-copy application.

Mail your completed (typed) application to:

Council on Occupational Education7840 Roswell Road, Bldg. 300, Suite 325

Atlanta, GA 30350ATTN: Dr. Alex Wittig

Email a PDF copy of the application, including all attachments, as one file to:

alex.wittig@council.org

Alternately, you may include a digital copy of the application on a flash-drive and mail it to the Council with the hard copy of the application.

THIS APPLICATION WILL NOT BE PROCESSED UNTIL THE FEE HAS BEEN RECEIVED

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$

Directions for Preparing and Submitting a Substantive Change Application

1. Be sure you have contacted the Council (alex.wittig@council.org) to notify COE in advance of the substantive change; the staff will inform the school of application deadlines and Commission approval dates and assure that you have the correct application. Application deadlines may be found in the FAQ section under the Accreditation tab at the Council’s website (www.council.org). Application due-dates for 2019 are: APR 18 (for a vote in June 2019), JUL 18 (for a vote in September 2019), SEP 19 (for a vote in November 2019), and DEC 12 (for a vote in February 2020).

2. All applications are to be completed in English and typed using a one-side-only format (not front-and-back, since the staff frequently needs to scan sections of the application).

3. Keep the application in correct page order; attachments (clearly labeled) should be placed after the last page of the application.

4. If the application asks for documentation of the need for the new branch, program, etc. (including other institutions, demographic analysis, and occupational surveys), please provide a brief written summary of this information; do not include pages from Chamber of Commerce, Dept. of Labor, or other government documents where raw data may be found.

5. If the application asks for documentation of planning for the change, you may include excerpts from the institution’s Strategic Plan that mention the change; please do not include the entire Strategic Plan document.

6. Some applications request a copy of a lease agreement, which these days can be many pages long; the Commission wants to see the front page (where the property and parties are listed) and the signature page that all the parties have signed. These two pages are sufficient to include in the application.

7. If Advisory Committee meeting minutes are included in the application, please highlight the sections of the minutes where there is a discussion of the planned change.

8. Applications for a new campus or location may ask for a copy of the school catalog to document that the new sites are listed; you need only include the cover page or other pages where campus names and addresses are listed, or a short excerpt from the catalog that describes a new campus and its programs. The Commission does not need to see the entire catalog.

9. Public schools: if a budget is requested, please do not submit a multi-page district budget or state agency budget. You may simply attest that the district or agency has allocated funds for the new campus, program, etc.

10. Personnel information may be requested in new campus or new program applications, in which case the school should send just the completed COE Personnel Form and a copy of any license or certificate that is required by a state or federal agency as a pre-requisite to teaching in the program. Do not include résumés, continuing education certificates, letters of recommendation, or unrequested transcripts.

11. The Postsecondary Educational Program Chart should list programs by name and hours exactly as they are approved by the institution’s oversight agency.

12. The Clock Hour/Credit Hour Chart should have all rows and columns completed and totaled. 13. No pages should be stapled or paper-clipped in any part of the application, including any attachments, and all

pages should be standard letter size (8 ½ ” x 11”).14. Pages should not be placed in plastic sheet protectors.15. The application should not be bound, nor placed in a 3-ring binder. This means that even the copy of the audited

financial report, which usually appears as a bound document, should be loose-leaf and in correct page order when included in the application packet.

16. The application may be held together by a large metal jumbo clip, or even rubber bands; it is easier for the staff and Commission to review and scan if applications are submitted this way.

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17. The payment check should be placed in a separate envelope on top of the application cover sheet; please be sure to scan the payment check as part of the digital application.

18. To generate a PDF digital copy of the application, scan the application in correct page order, followed by the attachments, as one document. Name the document “(School Name) (APPLICATION NAME) (Day-Month-Year)”, for example “Piedmont Academy NEW BRANCH CAMPUS 24Feb2019.”

19. The hard-copy application should be mailed to Council on Occupational Education, 7840 Roswell Road, Bldg. 300, Suite 325, Atlanta, GA 30350, Attn: Dr. Alexander Wittig.

20. The flash drive containing the digital copy of the application should be included in the hard-copy packet mailed to the Council.

21. Applications must be received by the due-date (see #1 above) in order to be on the next Commission agenda for a vote of initial approval; initial approval must be granted by the Commission before students may be enrolled at a new site or in a new program.

22. You will be notified by Council staff if there are any problems or concerns with the application submitted to COE. The Council does not return non-compliant applications.

If you have any questions, please call (800) 917-2081, ext. 202 or email alex.wittig@council.org

Revised: 15 MAR 2019

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ROSTER OF INSTRUCTIONAL STAFF

Complete this roster for all (full and part-time) instructional staff currently employed and on site. Indicate which instructors teach courses within Associate Degree Programs with an asterisk (*). Complete one chart per location.

LOCATION::

NAMENote: Group by program

YEAROF

EMPLOYMENT

MOSTADVANCED

DEGREE

EXPERIENCEIN FIELD AND/ORIN CLASSROOM

COURSESTAUGHT

CURRENTINSTRUCTIONAL

LOAD – IN HOURSPart-Time Full-Time

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ROSTER OF ADMINISTRATIVE AND SUPERVISORY STAFF

Complete this roster for all (full and part-time) administrative and supervisory staff currently employed and on site. Complete one chart per location.

LOCATION::

NAMEYEAR

OFEMPLOYMENT

EDUCATION EXPERIENCENUMBER OF

HOURS EMPLOYED PER WEEK

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NEW PERSONNEL FORM

Complete this form for each NEW person employed in an instructional, supervisory, or administrative capacity, full- or part-time, who will be involved in the new program. Include descriptions of experience with and/or training for distance education administration and instruction, if applicable.

Full name:

School: City: State:

Date of initial employment: Full-Time: Part-Time:

Present title: How long in position?

Describe primary responsibilities, including subjects taught:

Describe current instructional/supervisory/administrative licenses and/or credentials and ATTACH COPIES to this form:

Educational Background: (Attach additional sheets if necessary)

Institution Name & AddressAttendance

Major StudiesAward

Diploma/DegreeFrom To

Related Work Experience:

Company Name & AddressDates

Job Title & DutiesFrom To

How do you maintain up-to-date professional knowledge? (Organization activities, self-study, publications, etc.)

CERTIFICATION STATEMENT

I certify that the information contained on this form and attached hereto is correct and complete.

Employee’s Signature Date(June 2012)

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INSTRUCTIONS FOR COMPLETING THE POSTSECONDARY EDUCATIONAL PROGRAMS CHART

GENERAL INSTRUCTIONS1. Complete one chart for each campus of the institution (main campus, branch, extension, instructional service center).2. Indicate the manner in which the length of the program is measured (clock hours/semester credit hours/quarter credit

hours). More than one option may be indicated.3. One Clock Hour/Credit Hour Chart must be completed for each program measured in credit hours and must accompany

the Postsecondary Educational Programs chart.4. All documentation submitted to the Commission must be TYPED and provided in English.

IMPORTANT DEFINITIONS (From the Handbook of Accreditation)Program - A combination of courses and related activities (e.g. laboratory activities and/or work-based activities) that leads to a credential and is offered by an institution to develop competencies required for a specific occupation.

Distance Education - As defined for the purposes of accreditation review, education that uses one or more of the technologies to deliver instruction to students who are separated from the instructor; and support regular and substantive instruction between students and the instructor, synchronously or asynchronously. Technologies used may include the internet, print-based media, e-mail, one-way and two-way transmissions through open broadcast, closed circuit, cable, microwave, broadband lines, fiber optics, satellite, or wireless communications devices; audio conferencing; or video cassettes, DVDs, and CD-ROMs, if the cassettes, DVDs, or CD-ROMs are used in a course in conjunction with any of the technologies listed.

A Credit Hour is equivalent to a minimum of each of the following: one semester credit for 15 clock hours of lecture, 30 clock hours of laboratory, or 45 clock hours of work-based activities; or one quarter credit for 10 clock hours of lecture, 20 clock hours of laboratory, or 30 clock hours of work-based activities.

LISTING PROGRAMS1. List all programs offered by the institution as of the date the chart is completed. 2. List only those programs that educate students for the purpose of job entry or job advancement.3. List only those programs that are actively enrolling students or those that have enrolled students within 12

months prior to the date of the chart. All programs must be listed no matter the length of the program.4. Include Vocational English-As-A-Second-Language programs offered at any campus.5. Indicate the name of each program as it appears in the institution’s catalog. (Program names must be consistent with the

names printed in institutional publications AND state approval documentation.)6. Be sure to indicate what percentage of the program’s total length is available through distance education delivery

methods. If a program is available entirely through classroom delivery AND entirely through distance education methods, list the program TWICE on the form. Indicate the appropriate percentages, delivery method(s), number of enrolled students, and instructors for each program.

EXAMPLE:

PROGRAM NAME /CIP Code

(Use One Line For Each Program)

PROGRAMLENGTH

% o

f Pro

gram

’s

Tota

l Len

gth

Ava

ilabl

e Th

roug

h D

istan

ce E

duca

tion

INSTRUCTIONALDELIVERYMETHOD

(Check One or Both)

CREDENTIAL PROGRAMSTARTDATE

STUDENTS INSTRUCTORS

ClockHours

CreditHours

Trad

ition

al

Hyb

rid

Dist

ance

Ed

C

ertif

icat

e

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Accounting / 52.0302 1190 70 0 X X 2/15/90 59 243 4 6

Accounting / 52.0302 1190 70 100 X X 4/30/03 72 12Computer Aided Drafting / 15.1302 1400 84 50 X X X 6/4/2001 24 201 3 7

Traditional Program – Program that requires all instructional hours to be completed on campus.Hybrid Program – Program in which less than 50% of the required instructional hours are available via distance education delivery methods.

Distance Education Program – Program in which 50% or more of the required instructional hours are available via distance education delivery methods.(June 2012)

21

POSTSECONDARY EDUCATIONAL PROGRAMSDATA COMPILED AS OF (date):

Programs listed beloware those of the: Main Campus Other Campus Location:

Check appropriate box to indicate method of measuring program length: Clock Hours Semester Credit Hours Quarter Credit HoursComplete Clock Hour/ Complete Clock Hour/Credit Hour Chart Credit Hour Chart

PROGRAM NAME /CIP Code

(Use One Line For Each Program)

PROGRAMLENGTH

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INSTRUCTIONALDELIVERYMETHOD

(Check One or Both)

CREDENTIAL PROGRAMSTARTDATE

STUDENTS INSTRUCTORS

ClockHours

CreditHours

Trad

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al

Hyb

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Dist

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Traditional Program – Program that requires all instructional hours to be completed on campus.Hybrid Program – Program in which less than 50% of the required instructional hours are available via distance education delivery methods.

Distance Education Program – Program in which 50% or more of the required instructional hours are available via distance education delivery methods. (June 2012)

22