Fillable Form 1: 2016 Standards Application for Accreditation

Fill Online, Printable, Fillable, Blank Form 1: 2016 Standards Application for Accreditation Form

Use Fill to complete blank online OTHERS pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Form 1: 2016 Standards Application for Accreditation

On average this form takes 25 minutes to complete

The Form 1: 2016 Standards Application for Accreditation form is 6 pages long and contains:

  • 0 signatures
  • 71 check-boxes
  • 67 other fields

Country of origin: OTHERS
File type: PDF

BROWSE OTHERS FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
1
Rev 3.2020
Application for Accreditation
2016 Standards
Eligibility Requirements
The following three items must be met before any application can to be submitted to CACREP.
☐ Students are enrolled in each specialty area applying for accreditation.
☐ The institution holds regional accreditation.
☐ Specialty area and doctoral programs meet the relevant minimum semester/quarter hour
requirements as outlined in Standard 1.J and Standard 6.A.1.
Instructions for Electronically Submitting Application and Documentation
1. This Application document includes the ability to provide electronic signature.
2. Review our guide to electronic preparation of Self-Study materials and visit the Reports
Submission page on our website to initial the transfer of documents.
3. Also See Policy 1.m Electronic Submission of Accreditation Documents for formatting
guidelines. NOTE: The requirement to submit documents via CDs/USBs has been
waived.
4. Mail a check payable to CACREP for the application fee of $2500.
Mailing address:
Council for Accreditation of Counseling and Related Educational Programs
500 Montgomery Street, Suite 350
Alexandria, Virginia 22314
2
Rev 3.2020
Section 1
Application for Accreditation
Date: __________
I
nstitution: _________________________________________________________________
Department/Academic Unit: _____________________________________________________
M
ailing Address: ____________________________________________________________
I
nstitution Website: ____________________________________________________________
CA
CREP Liaison: ____________________________________________________________
T
elephone: _____________________ Fax: _____________________
E-ma
il: ___________________________________________________________________
This institution is: (check all that apply):
☐HBCU ☐HSI ☐Tribal College
☐For-profit ☐Public ☐Private
☐Online ☐Faith-based ☐Other ___________________________________
Specialty Areas Offered
Place an "X" on the left next to the specialty area(s) for which accreditation is sought. We need three answers for
each specialty area under review: 1) indicate by the ‘X” which specialty area standards the program is addressing
(e.g., Clinical Mental Health Counseling); 2) what your department calls the program on your website and in other
media (e.g., Professional Counseling, Clinical Counseling); and 3) what the title of the program is on the student’s
transcript (e.g., Professional Counseling – Clinical Mental Health Counseling Specialization).
En
try-level
☐ Addiction Counseli
ng ☐
M.Ed. ☐M.A. ☐M.S. ☐Other ______________________________
Title of degree/program: ____________________________________________________________________
Transcript title: ___________________________________________________________________________
☐ C
areer Counseling ☐M.Ed. ☐M.A. ☐M.S. ☐Other ______________________________
Title of degree/program: ____________________________________________________________________
Transcript title: ___________________________________________________________________________
3
Rev 3.2020
☐Clinical Mental Health Counseling ☐M.Ed. ☐M.A. ☐M.S. ☐Other _________________________
Title of degree/program: ______________________________________________________________________
Transcript title: _____________________________________________________________________________
☐
Clinical Rehabilitation Counseling ☐M.Ed. ☐M.A. ☐M.S. ☐Other __________________________
Title of degree/program: ______________________________________________________________________
Transcript title: _____________________________________________________________________________
☐ C
ollege Counseling and Student Affairs ☐M.Ed. ☐M.A. ☐M.S. ☐Other _____________________
Title of degree/program: ______________________________________________________________________
Transcript title: _____________________________________________________________________________
☐ M
arriage, Couple, and Family Counseling ☐M.Ed. ☐M.A. ☐M.S. ☐Other ________________
Title of degree/program: ______________________________________________________________________
Transcript title: ______________________________________________________________________________
☐ School Counseling ☐M.Ed. ☐M.A. ☐M.S. ☐Other ________________________________
Title of degree/program: _______________________________________________________________________
Transcript title: ______________________________________________________________________________
☐ Rehabilitation Counseli
ng
☐M.Ed. ☐M.A. ☐M.S. ☐Other ________________________________
T
itle of degree/program: _______________________________________________________________________
T
ranscript title: ______________________________________________________________________________
Doctoral-level
☐Counselor Education and Supervision ☐Ph.D. ☐Ed.D. ☐Other ___________________
Title of degree/program: _______________________________________________________________________
Transcript title: _______________________________________________________________________________
4
Rev 3.2020
Section 2
Signature Pages
B
y signing and submitting this application, you agree to the following:
• T
o ensure the integrity of this process, it is imperative that professional conduct be exemplified in the
application and self-study materials submitted to CACREP, as well as in the accreditation review
procedures followed by the accrediting organization. For the process to be effective and fair, it mus
t
f
ollow the established review procedures and the information submitted during the review process must be
based on clear statements and documentation describing how the program operates. The self-st
udy
n
arrative and supporting evidence must not misrepresent the program by implying resources or any level
of strengths that exceed the program’s level of operation. Constructive, reciprocal feedback can only be
based on an open and honest documentation that follows the prescribed review process.
• N
o feedback will be provided to the program until all current fees that have been paid.
• T
he accreditation process is voluntary. CACREP will issue an invoice (or W-9 as applicable) for payment
of fees, but unless expressly required by law or regulation, CACREP will not sign a procurement or vendor
contract with the institution.
• The institution agrees to adhere to all CACREP policies.
President/CEO
of the Institution Name: _________________________________________________________
Signature: ______________________________________________________
Mailing Address: ________________________________________________
E-mail: ________________________________________________________
Addressed in correspondence as: ☐Dr. ☐Mr./Ms. ☐Other _________
D
ean of
the College or School Name: ________________________________________________________
Signature: ______________________________________________________
College/School: _________________________________________________
Mailing Address: ________________________________________________
E-mail: ________________________________________________________
Addressed in correspondence as: ☐Dr. ☐Mr./Ms. ☐Other _________
5
Rev 3.2020
Department
Chair Name: _________________________________________________________
Signature: ______________________________________________________
Department: ____________________________________________________
Mailing Address: ________________________________________________
E-mail: ________________________________________________________
Addressed in correspondence as: ☐Dr. ☐Mr./Ms. ☐Other _________
CACREP Liaison Name: ________________________________________________________
Signature: ______________________________________________________
Mailing Address: ________________________________________________
E-mail: _________________________________________________________
A
ddressed in correspondence as: ☐Dr. ☐Mr./Ms ☐Other __________
O
ther Official to Receive Correspondence (optional)
Title:
Name: _________________________________________________________
Signature: ______________________________________________________
Mailing Address: ________________________________________________
E-mail: ________________________________________________________
A
ddressed in correspondence as: ☐Dr. ☐Mr./Ms. ☐Other _________
6
Rev 3.2020
Section 3
Required Supplemental Documentation
1. Please list each site and delivery method where the specialty area(s) is offered:
Specialty Area(s)
Site(s) and/or Delivery
Method(s)
Can a student take over
50% of coursework
here?*
________________ __________________ _____________________
*If the answer is yes at any site or if an alternative online or distance education version of the
specialty area(s) is offered, provide summary responses to the conditions in the Multiple
Sites Policy (1.o) and/or the Multiple Delivery Methods Policy (1.q).
2. Please provide a current program of study for each specialty area that includes all required
courses and indicates the total number of hours required to obtain the degree. This
information should also include the number of clinical hours required in practicum and
internship courses.
3. Please create tables or charts with the following information. If the specialty area(s) is
offered at multiple sites and/or by different delivery methods, please provide information for
each site or delivery method and for the overall program.
a) Table 1 – Faculty Who Currently Teach in the Program
1. List all core faculty by name and include each person’s credit hours taught in last 12 months,
t
erminal degree and major, primary teaching focus, professional memberships, licenses/
certifications, and nature of involvement in the program(s) (e.g., academic unit leader).
2. L
ist all non-core faculty by name and include each person’s credit hours taught in last 1
2
m
onths, terminal degree and major, primary teaching focus, professional memberships
,
l
icenses/certifications, and nature of involvement in the program(s) (e.g., clinical faculty
,
adjunct).
b) T
able 2 – Current Students
1. For each applicant specialty area (e.g., School Counseling), please indicate the number of
full-time, part-time, and full time equivalent (FTE) students at each campus site and/or
delivery method.
2. Please indicate any other counseling specialty areas in the academic unit that are not applying
for accreditation, the number of full-time, part-time, and full time equivalent (FTE) students
at each campus site and/or delivery method.
c) Tabl
e 3 – Graduates for the Past Three (3) Years
For each applicant specialty area (e.g., School Counseling), please indicate the number of
graduates at each campus site and/or delivery method.
7
Rev 3.2020
4. Please provide evidence of institutional accreditation by a regional accreditor recognized by
the US Department of Education or the Council for Higher Education Accreditation (CHEA).
See Policy 8.b.
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Form 1: 2016 Standards Application for Accreditation

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 18 January 2022

Message

View Audit Log
Print With Audit Log
Duplicate Document