Fillable Application for Programmatic Review (Alabama Commission on Higher Education)

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Application for Programmatic Review (Alabama Commission on Higher Education)

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Application for Programmatic Review
Complete the following application and submit the original application by mail to the Alabama
Commission on Higher Education along with --
An electronic copy on flash drive, SD card, CD, or similar device or emailed to nri@ache.edu;
The current Articles of Organization of your institution’s parent corporation if applicable;
If the institution is private, a copy of your institution’s private school license as issued by the
state where your institution or its parent corporation is headquartered and domiciled; and
A copy of the most recent, official institutional catalog preferably in an electronic medium; e.g.,
CD, Flash Drive, etc.
PART I: INSTITUTION NAME AND ORGANIZATIONAL STRUCTURE
1.
Main Campus Name
2.
Mailing Address
3.
Institution OPE ID#
1
4. GOVERNANCE:
(a) Name of institution’s parent corporation, if applicable; Board of Regents; Board of Trustees;
etc.):
(b) Location/Address of Headquarters/Domicile:
(c) Name and Title of Chief Executive Officer:
(d) State(s) of Incorporation or Legal Authority to operate, e.g., State Charter:
1
The OPE ID number is a unique 8-digit number assigned to postsecondary educational institutions that are
currently/formerly participating in federal Title IV programs or that want to apply for participation.
5. ADMINISTRATION:
(a) Name/Title of the institution’s President, Chancellor, or Chief Executive Officer.
(b) Name of the institution’s Chief Academic Officer. Include mailing address, email address, and
telephone number.
Name:
Title:
Address:
Email:
Phone:
6. DATE OF ESTABLISHMENT: Date institution was established.
7. DATE OF LICENSURE: Year the institution was first licensed by its state of record, if applicable. ______
8. ACCREDITATION (if applicable): Name, address, and year of last accreditation. [Note: Unaccredited
institutions or those accredited by an agency not recognized by the United States Department of
Education or Council on Higher Education Accreditation must undergo an external review of its programs
by one or more outside consultants chosen by ACHE. (ACHE Administrative Code: Chapter 300-2-1 (3))]
Accreditor:
Address:
Year of Last Accreditation:
9. ENROLLMENT:
(a) Total Institutional Enrollment: __________
(b) Total Onsite Enrollment in Alabama: __________
(c) Total Online Enrollment in Alabama: __________
10. BRANCH OR OFF CAMPUS OPERATIONS:
(a) State(s) within the United States other than Alabama where branch or off campus
operation(s) are located:
(b) Countries outside the United States where branch or campus operations are located:
PART II: ALABAMA OPERATIONS – PROGRAMS OF INSTRUCTION
11. PROGRAMS PROPOSED: On the chart below list the programs requested to be approved for
Alabama students. Attach additional sheets if needed.
Name of Program
CIP Code
Specialized Programmatic
Accreditation
Tuition
On-site
Online
12. PROGRAM INFORMATION: For each proposed program listed in the chart above, provide the page
number or direct link in the official institutional catalog where the following information is published.
(a) Objectives of the Program: Page ______
(b) Curriculum Outline: Page ______
(c) Description of Externships or Clinical Experiences, if applicable: Page ______
13. SITE LOCATION(s): List the location(s) in Alabama with the address of the site(s) where the program(s)
of instruction will be taught or Clinical Rotations/Internships will be conducted.
14. CONTACT INFORMATION: Provide name(s), title(s), mailing address(es), email address(es), and
telephone number(s) of the authorized Contact(s) for the Site(s) where program(s) of instruction will be
taught or Clinical Rotations/Internships will be conducted. List additional entries as needed.
Name:
Title:
Address:
Email:
Phone:
Name:
Title:
Address:
Email:
Phone:
15. REGIONAL COORDINATOR: Provide the name, title, mailing address, email address, and telephone
number(s) of Regional Coordinator, if applicable.
Name:
Title:
Address:
Email:
Phone:
16. PROCTORING EXAMINATIONS: If the program is online, describe the method(s) used for Proctoring
Examinations.
17. LIBRARY/RESEARCH RESOURCES: Describe Library, Reference, and Other Resources available to
Alabama students.
PART III: FACULTY QUALIFICATIONS
18. FACULTY: Total number of faculty supporting the programs proposed ____________. Provide
information via spreadsheet or electronic storage device. See sample template below. Copy the chart as
needed for additional entries.
Last Name
First Name
Highest Degree Earned and
Institution
19. FACULTY SELECTION PROCESS: Describe the Faculty Selection Process for this institution.
PART IV: STUDENT SUPPORT SERVICES
20. OFFICE OF STUDENT AFFAIRS: Name of the institution’s Senior Officer for Student Affairs. Include
mailing address, email address, and telephone number.
Name
Title:
Address:
Email:
Phone:
21. STUDENT RECORDS: Location where permanent Student Records are maintained.
22. STUDENT ADVISORS: Name(s), title(s), mailing address(es), email address(es), and telephone
number(s) of the person(s) authorized to act as advisor(s) to Alabama students.
Name
Title:
Address:
Email:
Phone:
Name
Title:
Address:
Email:
Phone:
23. COMPLIANCE WITH FEDERAL INTEGRITY RULE: (34 CFR §668.43)
a. Where is the Institutional Grievance Procedure published? Give the specific location or
provide a direct link.
b. Where is state official or other relevant agency Information published? Give the specific
location or provide a direct link.
PART V: CERTIFICATION OF APPLICATION
In submitting this application, the state agency or governing authority certifies that the programs
proposed comply with the U.S. Department of Education Program Integrity Rule, 34 CFR Part 668.
[https://ifap.ed.gov/fregisters/attachments/FR103015FinalRuleProgramIntegrityandImprovement.pdf]
AUTHORIZED PREPARER: Institutional or corporate officer authorized to prepare and submit this
application.
Name
Title:
Address:
Email:
Phone:
PRIMARY CONTACT: The institution’s primary contact to the Commission for this application if different
from the person named above.
Name
Title:
Address:
Email:
Phone:
PART VI: AFFIDAVIT
I, _______________________________________, being duly sworn, depose and state that each of the
statements in this application and all items attached to this application are true and correct to the best of
my knowledge and belief.
_______________________________________________
Signature: Date:
Subscribed and sworn before me this _______ day of ________________________, 20 _____.
______________________________________ Notary Public
______________________________________ County and State
______________________________________ My Commission Expires
Send this application to:
UPS or FedEx:
Alabama Commission on Higher Education
Office of Non-Resident Institutions
100 North Union Street, Suite 782
Montgomery, AL 36104-3758
Mailing Address:
Alabama Commission on Higher Education
Office of Non-Resident Institutions
P.O. Box 302000
Montgomery, AL 36130-2000
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Application for Programmatic Review (Alabama Commission on Higher Education)

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Completed 29 July 2020

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