Part A: Institutional Directory Information
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Name of Institution:
Name of campus if more than one:
Address:
President (or Campus Director)
For proprietary institutions: present
corporate ownership (name and corporate address):
Also provide a corporate organizational
chart for all components of the corporation related to this
institution, showing lines of responsibility and accountability.
Accreditation contact name:
Title:
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Telephone: |
( ) _______
- ___________ |
Fax: ( ) _______ -
___________ |
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E-mail: |
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Part B: Student Information
Fall enrollment (most recent fall
semester): |
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Undergraduate |
1st Professional |
Graduate |
| Full-time |
| (a) Preceding Year |
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| (b) Current Year |
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| Part-time |
| (a) Preceding Year |
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| (b) Current Year |
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| Average class size |
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Preceding Year |
Current Year |
| Undergraduate admissions
(first-time freshmen; fall term) |
| # of completed applications |
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| # of acceptances |
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| # of freshman enrollees |
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| Graduate admissions (all
programs; fall term) |
| # of completed applications |
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| # of acceptances |
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| # of enrollees |
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| First-professional degree student
admissions (all programs; fall term) |
| # of completed applications |
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| # of acceptances |
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| # of enrollees |
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Admissions Test Scores for most
recent two years available (e.g., SAT/ACT, CPAt, ESL, GRE, GMAT,
LSAT, etc.)
For scores, report middle 50 percent range, or mean or median (cite
which one).
For each test provide key to scores or benchmarks (grade,
equivalency, percentile, etc.). |
| Test Name: |
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| Year |
Scores |
Key for Scores |
| (1) |
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| (2) |
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| Test Name: |
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| Year |
Scores |
Key for Scores |
| (1) |
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| (2) |
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| Test Name: |
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| Year |
Scores |
Key for Scores |
| (1) |
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| (2) |
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| Freshman persistence rate
(full-time, first-time, first term to second term) in the preceding
two years |
| Year |
Entering Number |
Continuing Number |
Persistence Rate |
| (1) |
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| (2) |
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PART C: Educational Program Information
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| Courses (most recent fall term) |
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| Total # of course titles offered |
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| Total # of course sections offered |
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| % of sections taught by full-time faculty |
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| Total # of courses for credit provided by a
non-accredited* entity through one or more contractual relationships |
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| *Non-accredited means not accredited by an agency
nationally recognized as an accrediting agency by the U.S. Secretary
of Education. Describe contracts, courses, clientele and enrollments
on separate sheet. |
| Distance education for fall term
only (i.e., teacher and student not in the same place) |
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Preceding Year |
Current Year |
| # of students taking distance
education courses |
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| # of courses offered through
distance education |
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| List on a separate sheet all
programs for which 50 percent or more of credits may be earned
through distance education. Asterisk programs that can be completed
entirely through distance education |
PART D: Faculty Information
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| Number of Faculty (all faculty
teaching at location in the fall semester) |
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Preceding Year |
Current Year |
| Full-time |
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| Part-time |
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PART E: HEA TITLE IV Responsibilities Information
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| Federal loan default data (most
recent two years available) |
| Year |
Number in Default |
Rate of Default |
| (1) |
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| (2) |
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PART F: Student Outcomes Information
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| Number of degrees awarded for
preceding academic year |
| Associate |
Baccalaureate |
Master’s |
Doctorate |
1st Professional |
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Undergraduate cohort graduation
rates for FT undergraduate for two most recent cohorts reported:
(3 years for associate degree, 6 years for baccalaureate degree) |
| Degree level: |
| Year |
Entering Number |
Completing Number |
Completion Rate |
| (1) |
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| (2) |
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| Provide on separate sheet job
placement data by field, as reported to other data systems (VTEA,
ACICS or other organizations), or as collected if not reported, for
each of the two most recent years available. |
| Exit examination scores: Provide
results of licensure (teaching, nursing, law, etc.) or equivalent
proficiency outcomes of enrollees and graduates for each of the last
two years (percent passing/score distribution) |
| Test |
Year |
Number |
Percent Passing |
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PART G: MAJOR INSTITUTIONAL CHANGES INFORMATION
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Summary of recent major changes. Include those changes made in the
13 months preceding the due date of this form. Also include changes
planned for the next six months after the due date.
Senior administrative officers and trustees
Ownership/control (if proprietary) with date of change
Additional branch campuses as defined in § 4.2 (f) of the Regents Rules. Document any State approvals connected with addition of one or more branch campuses as federally defined.
Substantial change in mode of instructional delivery (including distance learning and alliances/collaborative relationships with other colleges and non-collegiate organizations)
Major changes in scope of educational program, including new degree level and expansions/contractions by 50 percent or more in fall enrollment (at one-degree level for program having one or more full- and part-time students). Document any State approvals (i.e., program registrations, master plan amendments, charter amendments) granted or in application that are related to each change cited
Significant capital investments related to the educational program
Major changes in revenue (greater than 20 percent) from any one source (including Federal or State student aid). Other significant changes in financial resources or their allocation.
Major changes in current or prospective expenses and/or liabilities (including student aid disallowance)
- List of formal student complaints and their outcomes.
Complete one form for the institution as a whole, and if multi-campus, for the main campus and each branch campus defined as in § 4-1.2 of the Rules of the Board of Regents. Please complete the form for the preceding academic year defined as July 1 through June 30.
Please also provide:
1. Two copies of the institution’s current catalog(s) and one comprehensive printed list of courses/sections offered in the most recent fall term (all locations, times, and formats).
2. Copy of any reports of other accrediting agencies and the agency accreditation action letter dated with the 13 months preceding the due date of this form.
3. List of any other nationally recognized accrediting agencies that preaccredit or accredit your institution or any specific programs.
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