First name

Last name

Organization

Position

Address

Telephone

Fax

Email

Name of program

Type of program
Academic (college-based)
Non-Academic

Number of hours of program

(taught hours only, exclude study or practicum hours)

URL of program

Statement from candidate: We have reviewed our program and we believe that we meet 100% of the Core Standards and at least 70% of the non-core Standards.
Yes
No

Applying for Distinguished Status?
Yes
No

If Yes for "Applying for Distinguished Status", Statement from candidate: We have reviewed our program and we believe that we meet the accreditation standards and at least 70% of the recommended standards.
Yes
No

Please designate if your program is language-neutral or language specific:
Language-neutral
Language-specific

If Language-specific, please specify language(s):

Do you offer a practicum?
Yes
No

Please describe delivery of your program:
Online
Has own teaching site
Trainers go to different sites

When will you be ready for an audit?
(use mm/dd/yyyy)

Notes

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Verification Code

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