NWCCU REPORTS | BASIC INSTITUTIONAL DATA FORM
I
nformation and data provided in the institutional self-evaluation are usually for the academic and fiscal year preceding the year of the evaluation
committee visit. The purpose of this form is to provide Commissioners and evaluators with current data for the year of the visit. After the self-
evaluation report has been finalized, complete this form to ensure the information is current for the time of the evaluation committee visit. Please
provide a completed copy of this form with each copy of the self-evaluation report sent to the Commission office and to each evaluator. This form
should be inserted into the appendix of the self-evaluation report (see the guidelines).
Institutional Information
Name of Institution:
Mailing Address:
Address 2:
City:
State/Province:
Zip/Postal Code:
Main Phone Number:
Country:
Chief Executive Officer
Title (Dr., Mr., Ms., etc.):
First Name:
Last Name:
Position (President, etc.):
Phone:
Fax:
Email:
Accreditation Liaison Officer
Title (Dr., Mr., Ms., etc.):
First Name:
Last Name:
Position (President, etc.):
Phone:
Fax:
Email:
Chief Financial Officer
Title (Dr., Mr., Ms., etc.):
First Name:
Last Name:
Position (President, etc.):
Phone:
Fax:
Email:
