1845-0012 E-App Application Fields Clean

Application for Approval to Participate in Federal Student Aid Programs

1845-0012 E-App Application Fields Clean

OMB: 1845-0012

Document [docx]
Download: docx | pdf

Application to Participate in Federal Student Financial Aid Programs


Section A: General Questions

The Application to Participate in Federal Student Financial Aid Programs serves as the starting point for Partner’s Participation in FSA Programs as well as the method of Participation maintenance. The eligibility application landing page will allow Partner to do the following:

  • Begin an Eligibility Application for the Purpose of:

    • Initial Certification

    • Recertification

    • Reinstatement

    • Structure Change and/or Change in Ownership

    • Merging of OPEIDs with the same Ownership

    • Designation of Eligible Nonparticipating Institution

    • Update/Report Information


Question #

Text

Field Type

Automations

Visibility


Tell us why you are submitting this application.  Select one reason below. 

 

Picklist, Multi-Select Picklist for Update Reason, Text Field for Reason: Other

Initial Certification

Recertification

Reinstatement

Structure Change and/or Change in Ownership

Merging of OPEIDs with the same Ownership

Designation as Eligible Nonparticipating Institution

Update/Report Information (Multi-Select Picklist)

Eligibility & Oversight Administrator

Name Change

Address Change – Main

Change Phone/Fax Number/Email or Website

Accrediting Agency

State Authorizing Agency

Official/Directors of Institution

Financial Aid Director

Officials/Directors of Ownership Entity

Board of Directors

Third-Party Servicer

Additional Location

Federal School Code

Redesignation of Main Location

Change Educational Measurement

Increase Level of Offering of Educational Programs

Degree Program

Nondegree/Vocational Program

Short-Term Training Program

Comprehensive Transition and Postsecondary Program

Add/Drop a Title IV, HEA Program (Pell, Direct Loan, SEOSG, TEACH Grant, etc)

Voluntary Withdrawal from All Title IV Programs

Foreign School – Postsecondary Legal Authorization
Foreign School - Degree Authorization
Foreign School- U.S. Administrative and/or Recruitment Offices
Foreign School - Facility at Which You Provide Graduate Medical Instruction
Foreign Graduate Medical School - Authorizing Entity
Foreign Graduate Veterinary School - Approval of Authorizing Entity
Foreign Graduate Medical School - Length of Program
Foreign Graduate Medical School – Clinical Sites

Foreign Schools Annual Medical Reporting

Other Purpose: (text field available)



1.

What is the name of your institution? 


Text

Autopopulated


1a.


If the official name of your institution is in a language other than English, provide an equivalent English language translation of the official name of your institution. 


Text

Autopopulated

Visible to Foreign Schools only

2.

Do you have another name such as a trade name or d/b/a name, under which you legally do business as a postsecondary educational institution?

Picklist (Yes, No)

Autopopulated



Enter Name: 


Text

Autopopulated

Visible if above answer = yes

3.

Your 8-digit OPEID is:


Number, Read-only

Autopopulated

Visible only to existing institutions

4.

Your Partner Connect ID is:

 

9 Digit Number, Read-only

Autopopulated


5.

What is your 9-digit Employee Identification Number (EIN)/Taxpayer Identification Number (TIN) given to you by the Internal Revenue Service (IRS)? 

Number

Autopopulated


6.

What is your 12-digit Alpha-Numeric Unique Entity Identifier (UEI)?


Number

Autopopulated


7.

What is the URL for your institution’s website? 


Website URL

Autopopulated


8.

What was your most recently completed award year? 

N/A

N/A



Beginning Date:  07/01/ 

Date (YYYY)

N/A



Ending Date:  06/30/ 

Date (YYYY)

N/A


9.

What is your current award year? 

N/A

N/A



Beginning Date:  07/01/ 

Date (YYYY)

N/A



Ending Date:  06/30/ 

Date (YYYY)

N/A



Additional Information


Text

N/A




Question #

Text

Field Type

Automations

Visibility


Before answering this question, please review the Guide to Structure Change and Change in Ownership – What You Need to Know

Display only



1.

What is the reason for your Structure Change and/or Change in Ownership?


Picklist: (multi-picklist)

CIO – Change in Control

CIO – Without Change in Control

CIO – This Main OPEID will become an additional location of another institution following a Change in Ownership

CIO – Request to change Title IV Participation Designation (Public, Private Non-Profit, Proprietary)

Other – The additional location(s) of this OPEID are being acquired by the owner of a different OPEID.

Other – This OPEID is acquiring an additional location (former OPEID that closed)

Other – This OPEID is acquiring an additional location (no former OPEID at this location)

Other – This OPEID is acquiring the programs and/or platform from another OPEID with different ownership.

Other – CIO inquiry

Other (Text box for other)


N/A

Visible when application purpose is Structure Changes and/or CIO

2.

Please provide a detailed written description of the structure change or change in ownership transaction you are requesting approval of and upload documentation to support this request.


Narrative Box and ability to upload documents.

N/A

Visible when application purpose is Structure Changes and/or CIO

3.

Change in Ownership Date


Date

N/A

Visible when application purpose is Structure Changes and/or CIO

4.

Are you submitting an application for a Pre-Acquisition Review?  

Picklist (Yes/No)

N/A 

Visible when application purpose is Structure Changes and/or CIO

5.

Are you requesting an Abbreviated Pre-Acquisition Review or Comprehensive Pre-Acquisition Review?


Radio Buttons:

(Pre-Acquisition Review,

Comprehensive Pre-Acquisition Review0

N/A

Visible when application purpose is Structure Changes and/or CIO

6.

Are you reporting an Excluded Change in Ownership?  


Picklist (Yes/No)

N/A

Visible when application purpose is Structure Changes and/or CIO

Document Table

Document Upload Component

File Uploader

N/A

N/A


Does this document contain PII data?


Picklist (Yes, No)

N/A

Visible when uploading a new file


Document Type

Picklist

This field will only show the remaining documents that are required to be uploaded

Visible when uploading a new file


Check here if you will be providing the URL to where this document type is located on your institution’s Web site in the document description below.

Checkbox

N/A

Visible when uploading a new file


Enter a description of the document

Text

N/A

Visible when uploading a new file



Question #

Text

Field Type

Automations

Visibility


You are requesting to merge one or more OPEIDs that share your ownership. 

 

If you are requesting to merge OPEIDs that do not share your ownership, the merging institution must first submit an application to report the Structure Change and/or Change in Ownership before you request to merge the institutions.


N/A

N/A

Visible when if purpose = merging of OPEIDs with the same ownership structure

1.

What is the anticipated date of this merger?


date


Visible when if purpose = merging of OPEIDs with the same ownership structure

2.

Provide the Main OPEID of the merging institution.

Number (lookup)

N/A

Visible when if purpose = merging of OPEIDs with the same ownership structure

Merger Adl. Location


Additional Location OPEIDs and Names

Text

Populates with data of approved locations

Visible when if purpose = merging of OPEIDs with the same ownership structure

3.

Merger Adl. Location

Select each location that is merging into this institution’s OPEID.




Checkbox for each location to select

N/A

Visible when if purpose = merging of OPEIDs with the same ownership structure

Table of Mergers

Enter an additional OPEID to merge additional locations with your institutions

N/A

N/A

N/A

Document Table

Document Upload Component

File Uploader

N/A

N/A


Does this document contain PII data?


Picklist (Yes, No)

N/A

Visible when uploading a new file


Document Type

Picklist

This field will only show the remaining documents that are required to be uploaded

Visible when uploading a new file


Check here if you will be providing the URL to where this document type is located on your institution’s Web site in the document description below.

Checkbox

N/A

Visible when uploading a new file


Enter a description of the document

Text

N/A

Visible when uploading a new file



Question #

Text

Field Type

Automations

Visibility

1.

Redesig. Adl Location Table

You are requesting to designate one of the additional locations of this OPEID as your Main Location.

Select the location that you are designating as your new Main Location.


table of additional locations – with a checkbox for each additional location

N/A 

Visible when application purpose = redesignation 



As a result of the requested Redesignation, this is the information about your new Main Location. Please confirm this information is correct. Select cancel if this is not the correct information.

N/A 

N/A 

Visible when application purpose = redesignation 



OPE ID, UEI, Location Name, Address  


Populated from Location Table

Visible when application purpose = redesignation 


Document Table

Document Upload Component

File Uploader

N/A

N/A


Does this document contain PII data?


Picklist (Yes, No)

N/A

Visible when uploading a new file


Document Type

Picklist

This field will only show the remaining documents that are required to be uploaded

Visible when uploading a new file


Check here if you will be providing the URL to where this document type is located on your institution’s Web site in the document description below.

Checkbox

N/A

Visible when uploading a new file


Enter a description of the document

Text

N/A

Visible when uploading a new file


Section B: Accreditation and State Authorization


Question #

Text

Field Type

Automation

Visibility


Accrediting Agency Table

Identify your accrediting agencies


Provide the following information for each agency that has the authority to accredit your institution’s programs.


N/A

N/A

Not Visible to Foreign Schools

1.

Select your accrediting agency


Accrediting Agency Lookup

Autopopulated – at least 1 required

Not Visible to Foreign Schools

1a.

What year did your accrediting agency last accredit you?

Date (YYYY)

Autopopulated

Not Visible to Foreign Schools

1b

For how many years is this accreditation granted?

Number

Autopopulated

Not Visible to Foreign Schools

1c.

Check here if this is your Primary Accreditor


Checkbox

Autopopulated

Not Visible to Foreign Schools

1d.

Select if this agency accredits your whole institution

Checkbox

Autopopulated

Not Visible to Foreign Schools

1e.

Select if this agency accredits individual programs offered by your institution


Checkbox

Autopopulated

Not Visible to Foreign Schools

1f.

Has this accreditor issued a decision letter, placed the institution/location on probation, placed the institution/location on warning, placed the institution/location on show cause, issued a loss/withdrawal of accreditation notice, mandated a reporting requirement or issued any other notification of non-compliance of accrediting standards since your last application was submitted?


Picklist (Yes, No)

N/A


Not Visible to Foreign Schools


Select action issued


You must upload a copy of the notification/action issued by your accreditor.


Picklist, Multi-Select Picklist:

Decision letter

Placed the institution/location on probation

Placed the institution/location on warning

Placed the institution/location on show cause

Issued a loss/withdrawal of accreditation notice

Mandated a reporting requirement 

Other notification of non-compliance of accrediting standards


N/A

Not Visible to Foreign Schools


Visible for Domestic Schools, when 1f.  = yes



Other notification of non-compliance of accrediting standards



Text


Visible if Selection Action issued = other adverse action

1g.

Provide the End Date of your Accreditation.


Only provide an end date if you are no longer accredited by the agency that you have entered above. Please contact FSA if you are providing an end date for your primary accreditor.


Date

Autopopulated if previously entered

Not Visible to Foreign Schools, only visible when editing


Enter the explanation as to why this is end date is more than 30 days in the future

Text

N/A

Visible when End Date is more than 30 days in the future


State

Authorizing Agency Table


Provide information for each state authorizing agency or entity that legally authorizes you as a postsecondary educational institution or exempts you from state authorization requirements as a religious institution.

N/A

N/A

Not Visible to Foreign Schools

2.

Select the State and the name of the state authorizing agency or other entity that legally authorizes you as a postsecondary educational institution or exempts you from state authorization requirements as a religious institution. If your state agency or other entity is not listed, contact Federal Student Aid for assistance.

N/A

N/A


2a.

Select State


Picklist

Autopopulated

Not Visible to Foreign Schools

2b.

Select Agency

Lookup

Autopopulated

Not Visible to Foreign Schools

2c.

Has this state licensing or authorizing agency issued a loss/withdrawal of state authorization notice, mandated a reporting requirement, or issued a notification/action of non-compliance of State requirements since your last application was submitted?  


Picklist (Yes, No)

N/A

Not Visible to Foreign Schools


Select action issued


You must upload a copy of the notification/action issued by your state licensing or authorizing agency.

Picklist, Multi-Select Picklist:

Mandated a reporting requirement,

Issued a loss/withdrawal of State recognition,

Notification of non-compliance of State requirements,

Other notification of non-compliance of authorization standards



Not Visible to Foreign Schools


Visible to Domestic Schools when 2c. = yes  


Other notification of non-compliance of authorization standards


Text


Visible if Selection Action issued = other adverse action

2d.

Provide the End Date of your State Authorization.


Only provide an end date if you are no longer authorized by the state agency or other entity that you entered above.

Date

Autopopulated if previously entered

Not Visible to Foreign Schools, only visible when editing


Enter the explanation as to why this is end date is more than 30 days in the future

Text

N/A

Visible when End Date is more than 30 days in the future

3.

Are you an institution that is authorized by name to offer educational programs beyond secondary education by the Federal Government; or, as defined in 25 U.S.C. 1801(a)(2), by an Indian tribe?


Picklist (Yes, No)

Autopopulated

Not Visible to Foreign Schools

4.


Are you exempted from State authorization as a religious institution under the State constitution or by State law?


Picklist (Yes, No)

Autopopulated

Not Visible to Foreign Schools

5.

Does the state agency that authorizes you, or exempts you, have a process to review and appropriately act on complaints concerning the institution including enforcing applicable State laws?


Picklist (Yes, No)

Autopopulated

Not Visible to Foreign Schools

5a.

Name of the State agency that reviews and acts on complaints concerning the institution including enforcing applicable State laws.


Text

Autopopulated

Not Visible to Foreign Schools


Additional Information

Use this area to provide information about any unusual circumstances or to provide additional explanations about questions you answered in this section.


Text

N/A


Document Table

Document Upload Component

File Uploader

N/A

N/A


Does this document contain PII data?


Picklist (Yes, No)

N/A

Visible when uploading a new file


Document Type

Picklist (See Submit eApp Section)

This field will only show the remaining documents that are required to be uploaded

Visible when uploading a new file


Check here if you will be providing the URL to where this document type is located on your institution’s Web site in the document description below.

Checkbox

N/A

Visible when uploading a new file


Enter a description of the document

Text

N/A

Visible when uploading a new file


Section C: Structure, Ownership and Control

Question #

Text

Field Type

Automation

Visibility

1.

Since you were last certified to participate in Federal Student Financial Aid Programs has your institution changed, or is your institution expecting to change (Pre-Acquisition), its structure or ownership in a manner that resulted, or will result, in a change in ownership with a change of control?


Picklist (Yes, No)

Blank or

Autopopulated depending on Application purpose



Your requested Title IV Participation Designation status is displayed.


OR


Your current Title IV Participation Designation status is displayed.

Text

Autopopulated


2.

Check here if you are requesting to change your Title IV Participation Designation status.



Checkbox



2a

Select your requested Title IV Participation Designation.







Picklist:

For domestic:

Public

Private Non-Profit

Proprietary

For foreign:

Foreign Public

Foreign Private Non-Profit

Foreign For-Profit


Autopopulated

Required when 2. = checked




Ownership Tree Table will display

Provide information for each entity or individual that directly or indirectly owns an interest in your institution. Starting with your Level 1 owner.

N/A

N/A


3.


Are you entering a person owner or an entity owner? Select Person if you are adding an individual owner (sole proprietor) or a shareholder/member/partner.

Picklist - Select

Person

Entity

Autopopulated


3a.

Select ownership type for this person owner from the choices below (select only one).



Picklist to:

Sole proprietorship (Individual Owner)

Shareholder/Member/Partner



Autopopulated

Visible when entering a person owner

3b.


Provide the information below for this owner. You must provide your home address, personal email, and personal telephone number.

N/A

N/A



Shareholder/Member/Partner of

Picklist of existing owners

Autopopulated



Visible when entering a person owner when Shareholder/Member/Partner is checked


Percentage of Ownership

Percentage

Autopopulated

Visible when entering a person owner, except defaults to 100% if sole proprietorship is checked


Percentage of Voting Rights

You must upload a copy of all voting agreements.

Percentage

Autopopulated

Visible when entering a person owner


Ownership Begin Date 

Date 

Autopopulated

Visible when entering a person owner


Ownership End Date


If this owner no longer has an ownership interest in the institution, enter the date the ownership ended.

Date

Autopopulated

Visible when editing a person owner


Check here if this is the same person as your: Chief Executive Officer

President/Chancellor

Chief Financial Officer

Financial Aid Director

Chief Information Officer

Chief Operating Officer


Checkbox



Autopopulated



Select position.

Picklist:

Chief Executive Officer - Name

President/Chancellor - Name

Chief Financial Officer - Name

Financial Aid Director - Name

Chief Information Officer - Name

Chief Operating Officer - Name

Autopopulated

Visible when, “Check here is the same person as ….” = checked.


Personal Information

Provide full legal name

N/A

N/A

Visible when entering a person owner


Prefix, First Name, Middle Name, Last Name, Suffix


Autopopulated

Visible when entering a person owner


E-mail Address

Text


Autopopulated

Visible when entering a person owner


Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated

Visible when entering a person owner


Telephone Number (include Area Code)

Phone

Autopopulated

Visible when USA is Chosen


International Telephone Number (include Country Code)

(Phone) Numeric & Special Characters

Autopopulated

Visible when Country Other than USA is Chosen


Telephone Number Extension

Number

Autopopulated

Visible when entering a person owner


Fax Number (include Area Code)

Phone

Autopopulated

Visible when USA is Chosen


International Fax Number (include Country Code)

(Fax) Numeric & Special Characters


Autopopulated

Visible when Country Other than USA is Chosen


Fax Number Extension

Number

Autopopulated

Visible when entering a person owner


Provide the following information.


N/A

N/A

Visible when entering a person owner


Home Address

Street Address, City, State/Province, Country, ZIP/Postal Code

Text

Autopopulated

Visible when entering a person owner


Personal E-mail Address

Email

Autopopulated

Visible when entering a person owner


Personal Telephone Number (include Area Code)

Number

Autopopulated

Visible when USA is Chosen


Personal International Telephone Number


Number

Autopopulated

Visible when Country Other than USA is Chosen

3c. Past Performance - Ownership

Has this owner or a member of the owner’s family ever had any ownership of another institution that is now participating in or has ever participated in federal student financial aid programs?


Picklist (Yes, No)

Autopopulated

Visible when entering a new person owner


Provide information for each institution that is or was owned.


School Search (Name, City, State)

Autopopulated

Visible when 3c. = yes


If Institution was not found, enter institution name here


Text

N/A

Visible when 3c. = yes


Provide the OPEID of the institution that is or was owned.

OPEID

Autopopulated

Visible when 3c. = yes


Is there any liability currently owed to the Department that is related to conduct of the institution during the period of ownership?

Picklist (Yes, No)

Autopopulated

Visible when 3c. = yes


Provide Explanation

Text


Visible when 3c. = yes

3d. Past Performance - Ownership (TPS)

Has this owner or a member of the owner’s family ever had any ownership of a Third-Party Servicer?

Picklist (Yes, No)

Autopopulated

Visible when entering a person owner


Provide the name of the Third-Party Servicer that is or was owned

Text

Autopopulated

Visible when 3d. = yes


If Third-Party Servicer was not found, enter Third Party Servicer here

Text

Autopopulated

Visible when Provide the name of the TPS that was owned = other


Is there any liability currently owed to the Department that is related to conduct of the third-party servicer during the period of ownership?

Picklist (Yes, No)

Autopopulated

Visible when 3d. = yes


Provide Explanation

Text


Visible when 3d. = yes

3e. Past Performance - Employment

Has this owner or a family member ever held a position at another institution?




Picklist (Yes, No)

Autopopulated



Provide information for each institution that this owner or a family member held a position at.

School Search (Name, City, State)

Autopopulated

Visible when 3e. = yes


If Institution was not found, provide the name of the institution

Text

N/A

Visible when 3e. = yes


Provide the OPEID of the Institution


OPEID

Autopopulated

Visible when 3e. = yes


Date(s) position held.


Begin Date

End Date

N/A

Visible when 3e. = yes


Is there any liability currently owed to the Department that is related to conduct of the institution during the period of ownership or position held?

Picklist (Yes, No)

Autopopulated

Visible when 3e. = yes


Provide Explanation

Text


Visible when 3e. = yes

Ownership Tree Table

Provide the following information for each level of ownership (Entity)

N/A

N/A


3a.

Select ownership type for this entity owner from the choices below (select only one).





Picklist to:

Corporation (Publicly-traded)

Corporation (closely held under provisions of state law)

Corporation (for profit, not publicly-traded or closely held under provisions of state law)

Corporation (for profit - Certified B)

Corporation (nonprofit)

Corporation (public benefit)

Limited liability company (for profit)

Limited liability company (nonprofit)

Limited liability partnership (for profit)

Limited liability partnership (nonprofit)

Limited liability limited partnership (for profit)

Limited liability limited partnership (nonprofit)

General partnership (for profit)

General partnership (nonprofit)

Trust (Irrevocable)

Trust (Irrevocable nonprofit)

Trust (Revocable)

Foreign Entity

Other


Autopopulated

Visible when entering an entity owner


If you selected Publicly Traded Corporation above, provide the stock exchange trading symbol.

Text

Autopopulated

Visible when entering an entity owner when ownership type = Publicly Traded Corporation


If you selected Trust (Irrevocable), Trust (Revocable), or Trust (Irrevocable nonprofit) Provide beneficiary (enter name of each person or entity)

Text

Autopopulated

Visible when entering an entity owner if Partner selected Trust (Irrevocable) or Trust (revocable), Optional if Trust (Irrevocable nonprofit)


If you selected Trust (Irrevocable), Trust (Revocable), or Trust (Irrevocable nonprofit) Provide Trustee (enter name of person or entity)

Text

Autopopulated

Visible when entering an entity owner if Partner selected Trust (Irrevocable) or Trust (revocable), Optional if Trust (Irrevocable nonprofit)


What is your tax status?

Picklist:

C Corporation

S Corporation

Other

Autopopulated

Visible when,

ownership type = “Corporation (closely held under provisions of state law)” or

Corporation (for profit, not publicly-traded or closely held under provisions of state law)” or

Corporation (for profit - Certified B)”



Identify the country in which this owner is incorporated/organized.

Picklist

Autopopulated



Date Incorporated/Organized: MM/DD/YYYY

Date

Autopopulated

Display when country is not USA


Identify the state in which this owner is incorporated/Organized.

Picklist

Autopopulated

Display when country is USA


Date Incorporated/Organized: MM/DD/YYYY

Date

Autopopulated

Display when country is USA


Provide date of first financial activity: MM/DD/YYYY


Date

Autopopulated


3b.

Owner Of

Picklist of existing owners or add new owner

Autopopulated with owner selected

Visible when entering an entity


Ownership Begin Date

Date

Autopopulated

Visible when entering an entity


Ownership End Date

Date

Autopopulated

Visible when editing an entity


Percentage of Ownership

Percentage

Autopopulated

Visible when entering an entity


Percentage of Voting Rights


You must upload a copy of all voting agreements.


Percentage

Autopopulated

Visible when entering an entity owner


Name of Entity

Picklist of existing owners or add new owner

Autopopulated

Visible when entering an entity


EIN/TIN

Number

Autopopulated

Visible when entering an entity owner


UEI

Number

Autopopulated

Visible when entering an entity owner


Provide the following information

N/A

N/A

Visible when entering an entity owner


Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated

Visible when entering an entity owner


Telephone Number (include Area Code)

Phone

Autopopulated

Visible when USA is Chosen


International Telephone Number (include Country Code)

(Phone) Numeric & Special Characters

Autopopulated

Visible when Country Other than USA is Chosen


Telephone Number Extension

Number

Autopopulated

Visible when entering an entity owner


Fax Number (include Area Code)

Phone

Autopopulated

Visible when USA is Chosen


International Fax Number (include Country Code)

(Fax) Numeric & Special Characters


Autopopulated

Visible when Country Other than USA is Chosen


Fax Number Extension

Number

Autopopulated

Visible when entering an entity owner

3c. Past Performance - Ownership

Has this owner or related entity ever had any ownership of another institution that is now participating in or has ever participated in federal student financial aid programs?


Picklist (Yes, No)

Autopopulated

Visible when entering an entity owner


Provide the name of each institution that is or was owned

School Search (Name, City, State)

Autopopulated

Visible when 3c. = Yes



If Institution was not found, enter institution name here

Text

N/A

Visible when 3c. = Yes



OPEID of Institution

OPEID

Autopopulated

Visible when 3c. = Yes



Is there any liability currently owed to the Department that is related to conduct of the institution during the period of ownership?


Picklist (Yes, No)

Autopopulated

Visible when 3c. = Yes



If yes, please provide explanation 


Text

Autopopulated

Visible when 3c. = Yes


3d. Past Performance - Ownership (TPS)

Has this owner or a related entity ever had any ownership of a Third-Party Servicer? 


Picklist (Yes, No)

Autopopulated

Visible when entering an entity owner


Provide the name of the Third-Party Servicer that is or was owned

Text

Autopopulated

Visible when 3d. = yes


If Third-Party Servicer was not found, enter Third-Party Servicer here

Text

Autopopulated

Visible when 3d. = yes


Is there any liability currently owed to the Department that is related to conduct of the third-party servicer during the period of ownership?


Picklist (Yes, No)

Autopopulated

Visible when 3d. = yes


If yes, please provide explanation 


Text

Autopopulated

Visible when 3d. = yes

3e.

Identify the officials that serve in the following positions for this Entity owner 

N/A

N/A

N/A


Entity Officials Table

Select the role(s) this individual holds for this Entity Owner. Select all that apply.

Picklist (multipicklist)

Chief Executive Officer

President

Chief Financial Officer

Chief Operation Officer

Other Executive Officer


Autopopulated

Visible when entering an Entity owner

Prefix, First Name, Middle Name, Last Name, Suffix, Job Title


Autopopulated

Visible when entering an Entity official


E-mail Address

Text


Autopopulated

Visible when entering an Entity official


Street Address, City, State/Province, Country, ZIP/Postal Code

Picklist

Autopopulated

Visible when entering an Entity official


Telephone Number (include Area Code)

Phone

Autopopulated

Visible when USA is Chosen


International Telephone Number (include Country Code)

(Phone) Numeric & Special Characters

Autopopulated

Visible when Country Other than USA is Chosen


Telephone Number Extension

Number

Autopopulated

Visible when entering an Entity official


Fax Number (include Area Code)

Phone

Autopopulated

Visible when USA is Chosen


International Fax Number (include Country Code)

(Fax) Numeric & Special Characters


Autopopulated

Visible when Country Other than USA is Chosen


Fax Number Extension

Number

Autopopulated

Visible when entering an Entity official


Provide the Home Address, Phone Number, and E-mail Address for this owner.

N/A

N/A

Visible when entering an Entity official


Home Address

Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated

Visible when entering an Entity official


Personal E-mail Address

Email

Autopopulated

Visible when entering an Entity official


Personal Telephone Number (include Area Code)

Number

Autopopulated

Visible when USA is Chosen


Personal International Telephone Number


Number

Autopopulated

Visible when Country Other than USA is Chosen


Effective Date

Date

Autopopulated

Visible when entering an Entity official


End Date

Date


Visible when editing an entity

3f. Past Performance - Ownership

Has this entity official or a member of the entity official’s family ever had any ownership of another institution that is now participating in or has ever participated in federal student financial aid programs?

Picklist (Yes, No)

Autopopulated

Visible when entering an Entity official


Provide the name of each institution that is or was owned


School Search (Name, City, State)


Autopopulated


Visible when 3f. = yes


If Institution was not found, enter institution name here


Text


N/A

Visible when 3f. = yes


OPEID of Institution that is or was owned.


OPEID


Autopopulated


Visible when “3f. = yes


Is there any liability currently owed to the Department that is related to conduct of the institution during the period of ownership?

Picklist (Yes, No)

Autopopulated

Visible when 3f. = yes


If yes, please provide explanation 

Text

Autopopulated 

Visible when 3f. = yes

3g. Past Performance - Ownership (TPS)

Has this entity official or a member of the entity official’s family ever had any ownership of a Third-Party Servicer?

Picklist (Yes, No)

Autopopulated

Visible when entering an Entity official


Provide the name of the Third-Party Servicer that is or was owned

Search

Autopopulated

Visible when 3g. = yes


If Third-Party Servicer was not found, enter Third Party Servicer name here


Text

N/A

Visible when 3g. = yes


Is there any liability currently owed to the Department that is related to conduct of the third-party during the period of ownership?

Picklist (Yes, No)

Autopopulated

Visible when 3g. = yes


If yes, please provide explanation 

Text

Autopopulated  

Visible when 3g. = yes

3h. Past Performance - Employment

Has this entity official or a family member ever held a position at another institution?

Picklist (Yes, No)

Autopopulated

Visible when entering an entity owner



Provide information for each institution that this entity official or a family member held a position at.


School Search (Name, City, State)


Autopopulated

Visible when 3h. = yes


If Institution was not found, enter institution name here


Text


N/A

Visible when 3h. = yes


OPEID of Institution Provided


OPEID


Autopopulated


Visible when3h. = yes


Date(s) position held.


Start Date

End Date

N/A

Visible when 3h. = yes


Is there any liability currently owed to the Department that is related to conduct of the institution during the period of ownership or position held?

Picklist (Yes, No)

Autopopulated

Visible when 3h. = yes


If yes, please provide explanation 

Text

Autopopulated 

Visible when 3h. = yes

3i.

Provide the legal name and Business Street Address of the contact person (sometimes known as the "registered agent") within the state or foreign country where you are incorporated.

N/A

Autopopulated

Visible when entering an entity owner


Prefix, First Name, Middle Name, Last Name, Suffix


Autopopulated

Visible when entering an entity official


E-mail Address

Text


Autopopulated

Visible when entering an entity official


Street Address, City, State/Province, Country, ZIP/Postal Code

Text

Autopopulated

Visible when entering an entity official


Telephone Number (include Area Code)

Phone

Autopopulated

Visible when USA is Chosen


International Telephone Number (include Country Code)

(Phone) Numeric & Special Characters

Autopopulated

Visible when Country Other than USA is Chosen


Telephone Number Extension

Number

Autopopulated

Visible when entering an entity official


Fax Number (include Area Code)

Phone

Autopopulated

Visible when USA is Chosen


International Fax Number (include Country Code)

(Fax) Numeric & Special Characters


Autopopulated

Visible when Country Other than USA is Chosen


Fax Number Extension

Number

Autopopulated

Visible when entering an entity official


Additional Information


Use this area to provide information about any unusual circumstances or to provide additional explanations about questions you answered in this section.


Text

N/A



Section D: Officials of the Institution

The Partner will be able to enter multiple official entries with the following fields, they will also be able to edit existing official details.


Question #

Text

Field Type

Automations

Visibility

Provide information below about each official at your institution.


You must identify individuals in the following roles : Chief Executive Officer; President/Chancellor; Chief Financial Officer, Financial Aid Director; Chief Information Officer; and Chief Operating Officer.

N/A

N/A

N/A

Institution Officials Table

Select the role(s) that this individual performs at your institution.

Picklist (multi-select)

Chief Executive Officer - Name

President/Chancellor

Chief Financial Officer- Name

Financial Aid Director- Name

Chief Information Officer- Name

Chief Operating Officer- Name

Autopopulated



Check here if the identity of this person has not changed, but you need to change his or her name (for example, due to marriage or another reason). Provide the reason for the name change in the additional information box and the end of this section.

If you need to add a new official, you must enter an end date for this official and select Edit Official to resturn to the officials table on the previous screen.

Do not add a new person on this screen.

Checkbox


Visible when Partner edits the name field


Prefix, First Name, Middle Name, Last Name, Suffix, Job Title


Autopopulated



E-mail Address

Text


Autopopulated



Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated



Telephone Number (include Area Code)

Phone

Autopopulated

Visible when USA is Chosen


International Telephone Number (include Country Code)

(Phone) Numeric & Special Characters

Autopopulated

Visible when Country Other than USA is Chosen


Telephone Number Extension

Number

Autopopulated



Fax Number (include Area Code)

Phone

Autopopulated

Visible when USA is Chosen


International Fax Number (include Country Code)

(Fax) Numeric & Special Characters


Autopopulated

Visible when Country Other than USA is Chosen


Fax Number Extension

Number

Autopopulated



Provide the following information for this Official.

N/A

N/A



Home Address

Street Address, City, State/Province, Country, ZIP/Postal Code

Text

Autopopulated



Personal E-mail Address

Email

Autopopulated



Personal Telephone Number (include Area Code)

Number

Autopopulated

Visible when USA is Chosen


Personal International Telephone Number


Number

Autopopulated

Visible when Country Other than USA is Chosen


Role Effective Date



Date

Autopopulated


Once the User completes the above questions, an entry is added Institution Officials Table

Role End Date

Date

Autopopulated

only visible when editing

Institution Board of Trustees Table

Does this institution have a Board of Trustees or Board of Directors? 



Picklist (Yes, No)

Autopopulated


2a.

Provide information for each member of the Board of Trustees or the Board of Directors. 

N/A

N/A

Visible when, “Does this entity have a Board of Trustees or Board of Directors?” = yes 



Check here if this is the same person as your:

Chief Executive Officer

President/Chancellor

Chief Financial Officer

Financial Aid Director

Chief Information Officer

Chief Operating Officer


Checkbox



Autopopulated



Select position.

Picklist

Chief Executive Officer - Name

President/Chancellor - Name

Chief Financial Officer - Name

Financial Aid Director - Name

Chief Information Officer - Name

Chief Operating Officer - Name


Autopopulated

Visible when, “Check here is the same person as ….” = checked.


Prefix, First Name, Middle Name, Last Name, Suffix


Autopopulated or Picklist selection



Email Address

Email

Autopopulated or Picklist selection

Visible when entering a member of the Board of Trustees or Board of Directors

2b. Past Perform. -Owner

Has this Board member ever had any ownership of another institution that is now participating in or has ever participated in federal student financial aid programs?

Picklist (Yes, No)

Autopopulated

Visible when entering a member of the Board of Trustees or Board of Directors


Provide the name of each institution that is or was owned


School Search (Name, City, State)


Autopopulated with production


Visible when 2b. = yes


If Institution was not found, enter institution name here


Text


N/A

Visible when 2b. = yes


OPEID of Institution Provided


OPEID


Autopopulated with Institution Selection or blank


Visible when 2b. = yes


Is there any liability currently owed to the Department that is related to conduct of the institution during the period of ownership?

Picklist (Yes, No)

Autopopulated

Visible when 2b. = yes


Provide Explanation

Text


Visible when 2b. = yes

2c. Past Perform. -Owner

(TPS)

Has this Board member ever had any ownership of a Third-Party Servicer?

Picklist (Yes, No)

Autopopulated

Visible when entering a member of the Board of Trustees or Board of Directors


Provide the name of the Third Party Servicer that is or was owned

Account Lookup or Text

Autopopulated

Visible when 2c. = yes


If Third Party Servicer was not found, enter Third Party Servicer name here


Text

N/A

Visible when 2c. = yes


Is there any liability currently owed to the Department that is related to conduct of the institution during the period of ownership?

Picklist (Yes, No)

Autopopulated

Visible when 2c. = yes


Provide Explanation

Text


Visible when 2c. = yes

2d. Past Perform - Employ

Has this Board member ever held a position or ever served as a board member at another institution?

Picklist (Yes, No)

Autopopulated

Visible when entering a member of the Board of Trustees or Board of Directors


Provide information for each institution that this Board member held a position at.



School Search (Name, City, State)



Visible when 2d. = yes


If Institution was not found, enter institution name here


Text



Visible when 2d. = yes


OPEID of Institution Provided


OPEID



Visible when 2d. = yes


Date(s) position held.

Start Date

End Date

N/A

Visible when 2d. = yes


Is there any liability currently owed to the Department that is related to conduct of the institution during the period of ownership or position held?

Picklist (Yes, No)

Autopopulated

Visible when 2d. = yes


Provide Explanation

Text


Visible when 2d. = yes


Effective Date

MM/DD/YYYY

Date

Autopopulated


Once the User completes the above questions, an entry is added Institution BOT Table

End Date

MM/DD/YYYY

Date

Autopopulated

only visible when editing

3.

Who is the appropriate person to contact for further information about your board (for example, the board's recording secretary). 


N/A

N/A



Check here if this is the same person as your: Chief Executive Officer

President/Chancellor

Chief Financial Officer

Financial Aid Director

Chief Information Officer

Chief Operating Officer


Checkbox



Autopopulated



Select position.

Picklist

Chief Executive Officer - Name

President/Chancellor - Name

Chief Financial Officer - Name

Financial Aid Director - Name

Chief Information Officer - Name

Chief Operating Officer - Name

Autopopulated

Visible when, “Check here is the same person as ….” = checked.


Prefix, First Name, Middle Name, Last Name, Suffix


Autopopulated

Visible when entering a BOT



E-mail Address

Text


Autopopulated

Visible when entering a BOT



Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated

Visible when entering a BOT



Telephone Number (include Area Code)

Phone

Autopopulated

Visible when entering a BOT


AND when USA is Chosen


International Telephone Number (include Country Code)

(Phone) Numeric & Special Characters

Autopopulated

Visible when entering a BOT


And when Country Other than USA is Chosen


Telephone Number Extension

Number

Autopopulated

Optional




Fax Number (include Area Code)

Phone

Autopopulated

Visible when entering a BOT

and when USA is Chosen


International Fax Number (include Country Code)

(Fax) Numeric & Special Characters


Autopopulated

Visible when entering a BOT


Visible when Country Other than USA is Chosen


Fax Number Extension

Number

Autopopulated

Visible when entering a BOT




Effective Date

MM/DD/YYYY

Date

Autopopulated

Visible when entering a BOT





End Date

MM/DD/YYYY

Date

Autopopulated

only visible when editing


Additional Information


Use this area to provide information about any unusual circumstances or to provide additional explanations about questions you answered in this section.


Text

N/A


Document Table

Document Upload Component

File Uploader

N/A

N/A


Does this document contain PII data?


Picklist (Yes, No)

N/A

Visible when uploading a new file


Document Type

Picklist (See Submit eApp Section)

This field will only show the remaining documents that are required to be uploaded

Visible when uploading a new file


Check here if you will be providing the URL to where this document type is located on your institution’s Web site in the document description below.

Checkbox

N/A

Visible when uploading a new file


Enter a description of the document

Text

N/A

Visible when uploading a new file


Section E: Eligibility & Oversight Admin


Question #

Text

Field Type

Automations

Visibility


Identify your Eligibility and Oversight Administrator

Display Only



1.

Who is your Eligibility and Oversight Administrator?

N/A

N/A



Check here if this is the same person as your:

Chief Executive Officer

President/Chancellor

Chief Financial Officer

Financial Aid Director

Chief Information Officer

Chief Operating Officer


Checkbox



Autopopulated



Select position.

Picklist

Chief Executive Officer

President/Chancellor

Chief Financial Officer

Financial Aid Director

Chief Information Officer

Chief Operating Officer

Autopopulated

Visible when, “Check here is the same person as ….” = checked.


Check here if the identity of this person has not changed, but you need to change his or her name (for example, due to marriage or other reason).

Checkbox


Visible when Partner edits the name field


Prefix, First Name, Middle Name, Last Name, Suffix


Autopopulated

Visible when entering an EOA


E-mail Address

Text


Autopopulated

Visible when entering an EOA



Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated

Visible when entering an EOA



Telephone Number (include Area Code)

Phone

Autopopulated

Visible when entering an EOA

when USA is Chosen


International Telephone Number (include Country Code)

(Phone) Numeric & Special Characters

Autopopulated

Visible when entering an EOA

when Country Other than USA is Chosen


Telephone Number Extension

Number

Autopopulated

Visible when entering an EOA



Fax Number (include Area Code)

Phone

Autopopulated

Visible when entering an EOA

when USA is Chosen


International Fax Number (include Country Code)

(Fax) Numeric & Special Characters


Autopopulated

Visible when entering an EOA

when Country Other than USA is Chosen


Fax Number Extension

Number

Autopopulated

Visible when entering an EOA



End Date

Date

Autopopulated

only visible when editing


Identify your alternate Eligibility and Oversight Administrator

Display Only



2.

Who is your alternate Eligibility and Oversight Administrator?


N/A

N/A



Check here if this is the same person as your:

Chief Executive Officer

President/Chancellor

Chief Financial Officer

Financial Aid Director

Chief Information Officer

Chief Operating Officer


Checkbox



Autopopulated



Select position.

Picklist

Chief Executive Officer

President/Chancellor

Chief Financial Officer

Financial Aid Director

Chief Information Officer

Chief Operating Officer

Autopopulated

Visible when, “Check here is the same person as ….” = checked.


Check here if the identity of this person has not changed, but you need to change his or her name (for example, due to marriage or other reason)

Checkbox




Prefix, First Name, Middle Name, Last Name, Suffix


Autopopulated



E-mail Address

Text


Autopopulated

Visible when entering an EOA alternate



Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated

Visible when entering an EOA alternate



Telephone Number (include Area Code)

Phone

Autopopulated

Visible when USA is Chosen


International Telephone Number (include Country Code)

(Phone) Numeric & Special Characters

Autopopulated

Visible when Country Other than USA is Chosen


Telephone Number Extension

Number

Autopopulated

Visible when entering an EOA alternate



Fax Number (include Area Code)

Phone

Autopopulated

Visible when entering an EOA alternate

when USA is Chosen


International Fax Number (include Country Code)

(Fax) Numeric & Special Characters


Autopopulated

Visible when entering an EOA alternate

when Country Other than USA is Chosen


Fax Number Extension

Number

Autopopulated

Visible when entering an EOA alternate



End Date

Date

Autopopulated

only visible when editing


Additional Information

Text

N/A


Document Table

Document Upload Component

File Uploader

N/A

N/A


Does this document contain PII data?


Picklist (Yes, No)

N/A

Visible when uploading a new file


Document Type

Picklist (See Submit eApp Section)

This field will only show the remaining documents that are required to be uploaded

Visible when uploading a new file


Check here if you will be providing the URL to where this document type is located on your institution’s Web site in the document description below.

Checkbox

N/A

Visible when uploading a new file


Enter a description of the document

Text

N/A

Visible when uploading a new file

Section F: Locations



Question #

Text

Field Type

Automations

Visibility


Main Location Information:


Institution Name

OPEID

Partner Connect ID



N/A

N/A



Institution Name


N/A

Autopopulated



OPEID

N/A

Pre-populated for existing institutions, not editable

Will not be present for initial eligibility or additional to freestanding




Partner Connect ID

N/A

Pre-populated, not editable


1.

Check here if you need to update the address of your main location and provide the following information.

checkbox




Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated



Telephone Number (include Area Code)

Phone

Autopopulated

Visible when USA is Chosen


International Telephone Number (include Country Code)

(Phone) Numeric & Special Characters

Autopopulated

Visible when Country Other than USA is Chosen

2.

Do students receive instruction at this physical location?

Select “yes” if students enrolled at your institution receive instruction at this physical location. Select “no” if this location is an administrative location where no students physically attend class or receive instruction.”

Picklist (Yes, No)

Autopopulated



Federal School Code Name

Display Only



3.

The information listed above will be this location’s Name for the Federal School Code listing. If you would like to change the Name used for this location for the Federal School Code listing, you may do so here.


Enter the Federal School Code Name you would like displayed in the Federal School Code listing.

Text

Autopopulated




Federal School Code

Number

Autopopulated

Only Visible when Application purpose is not initial, reinstatement, designated as eligible


FSC Contact

N/A

N/A



First Name, Last Name


Autopopulated



Email

Email

Autopopulated




Telephone Number (include Area Code)

Phone

Autopopulated

Visible when Country is USA


International Telephone Number (include Country Code)

(Phone) Numeric & Special Characters

Autopopulated

Visible when country is not USA


Telephone Number Extension

Number

Autopopulated



You must provide information for any additional location (other than your main location) at which you offer or will offer 50% or more of an educational program.

N/A

N/A


4.Additional Locations Table

Additional Location Name

Text

Autopopulated For existing Additional Locations



OPEID

N/A

Autopopulated



Partner Connect ID

N/A

Autopopulated



UEI

Text

Autopopulated



Provide the address for this Location

N/A

Autopopulated



Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated


5.

Is this location a prison or jail?


Picklist (Yes, No)

Autopopulated

Visible to Domestic Schools,

6.

Effective Date

Date

Autopopulated



End Date

Date

Autopopulated

only visible when editing


End Date Reason

Picklist

Location Closed

Loss of State/Tribal/Federal Authorization

Loss of Accreditation

Voluntary Withdrawal

Loss of Legal Authorization (Foreign School)

Other

Autopopulated



If you selected “Other” from the list of End Date Reasons above, enter the reason here.

Text

Autopopulated


7.

Do you want this location to have a Federal School Code?

Picklist (Yes, No)

N/A

Visible only when Partner is adding a new location


The following will be this location’s Name for the Federal School Code listing. If you would like to change the Name used for this location for the Federal School Code listing, you may do so here



Enter the Federal School Code Name you would like displayed in the Federal School Code listing.

N/A

N/A

Visible when 7. = Yes OR when Additional Location already exists and has a Federal School Code


Federal School Code Name

Text

Autopopulated

Visible when 7. = Yes OR when Additional Location already exists and has a Federal School Code


Federal School Code

Number

Autopopulated

Only visible to schools with a federal school code


Do you wish to deactivate the FSC Code that is currently assigned to this location?


Checkbox

N/A

Only visible to schools with a federal school code


FSC Contact

N/A

N/A

Visible when 7. = Yes OR when Additional Location already exists and has a Federal School Code OR when Additional Location already exists and has a Federal School Code


First Name

Name

Autopopulated

Visible when 7. = Yes OR when Additional Location already exists and has a Federal School Code


Last Name

Name

Autopopulated

Visible when 7. = Yes OR when Additional Location already exists and has a Federal School Code


Email

Email

Autopopulated


Visible when 7. = Yes OR when Additional Location already exists and has a Federal School Code


Telephone Number (include Area Code)

Phone

Autopopulated

Visible when 7. = Yes OR when Additional Location already exists and has a Federal School Code


Once User has entered the above details , an entry will populated on Additional Locations Table


International Telephone Number (include Country Code)

(Phone) Numeric & Special Characters

Autopopulated

Visible when 7. = Yes OR when Additional Location already exists and has a Federal School Code



Telephone Number Extension

Number

Autopopulated

Visible when 7. = Yes OR when Additional Location already exists and has a Federal School Code



Additional information



Use this area to provide information about any unusual circumstances or to provide additional explanations about questions you answered in this section.


Text


Additional information

Document Table

Document Upload Component

File Uploader

N/A

N/A


Does this document contain PII data?


Picklist (Yes, No)

N/A

Visible when uploading a new file


Document Type

Picklist (See Submit eApp Section)

This field will only show the remaining documents that are required to be uploaded

Visible when uploading a new file


Check here if you will be providing the URL to where this document type is located on your institution’s Web site in the document description below.

Checkbox

N/A

Visible when uploading a new file


Enter a description of the document

Text

N/A

Visible when uploading a new file


Section G: Educational Programs


Question #

Text

Field Type

Automations

Visibility

1.

Check each box below that describes the educational program(s) you provide as of the date you submit this application, or that you will provide during the current award year. Provide information only on the program(s) that you wish to be eligible for federal student financial aid. (You may check more than one box.)

Each Field below will be a checkbox

Autopopulated if populated

Visible to Domestic Schools



1a.

Associate Degree Programs

An educational program of at least two years of postsecondary education in an academic or occupational field culminating in the receipt of an Associate Degree. Associate degrees include, but are not limited to, the following:

  • Associate of Arts (AA)

  • Associate of Applied Science (AAS)

  • Associate of Occupational Science (AOS)

  • Associate of Science (AS)

Visible to Domestic Schools

1b.

Bachelor's Degree Programs

An educational program of at least four years of postsecondary education in an academic or occupational field culminating in the receipt of a Bachelor’s Degree. Bachelor’s degrees include, but are not limited to, the following:

  • Bachelor of Arts (BA)

  • Bachelor of Science (BS)


1c.

Master’s Degree Programs

An educational program of one or two years of postgraduate study in a graduate school or department culminating in the receipt of a Master’s Degree. Master’s degrees include, but are not limited to, the following:

  • Master of Arts (MA)

  • Master of Science (MS)

  • Master of Social Work (MSW)

  • Master of Business Administration (MBA)



Visible to Domestic Schools

1d.

Doctoral Degree Programs

An educational program of three or more years of postgraduate study for the completion of advanced graduate or professional studies in the humanities, the social sciences, the behavioral sciences, or the pure sciences beyond the master’s level, culminating in the receipt of a research Doctoral Degree. Doctoral degrees include, but are not limited to, the following:

  • Doctor of Philosophy (PhD)

  • Doctor of Theology (ThD)

  • Doctor of Engineering (EngD)

  • Doctor of Education (EdD)




1e.

Professional Degree Program

An educational program culminating in receipt of a degree awarded by an institution to an entry-level professional in certain occupational fields. Although sometimes called doctoral degrees, professional degrees differ from research doctorates in that they do not include a required component of original research or a demonstration of expertise in a field beyond what is required to qualify for basic licensing examinations. Professional degrees may be awarded in such fields as:

Chiropractic, dentistry, divinity/ministry, law, medicine, optometry, osteopathic medicine, pharmacy, podiatry, rabbinical and Talmudic studies, and veterinary medicine.

Visible to Domestic Schools

1f.

Graduate or Professional Non – Degree Programs

An educational program above the baccalaureate level that leads to a non-degree certificate or other recognized educational credential,

  • is at least 10 weeks,

  • provides at least 8 semester or trimester credit hours, 12 quarter credit hours, or 300 clock hours of instruction, and

  • prepares students for gainful employment in a recognized occupation


1g.

Graduate Admission Programs

An educational program that is acceptable for admission to a graduate or professional degree program, for which your institution awards a degree subject to review and approval by the Secretary.

Visible to Domestic Schools

1h.

Two-Year Transfer Program

An educational program that is acceptable for full credit toward a Bachelor’s Degree AND for which a degree, certificate, diploma, or other educational credential is not awarded by your institution.


1i.

Undergraduate Non-Degree Programs

An educational program that:

  • leads to a certificate or other recognized educational credential,

  • is at least 15 weeks,

  • provides at least 16 semester or trimester credit hours, 24 quarter credit hours, or 600 clock hours of instruction, and

  • prepares students for gainful employment in a recognized occupation

Visible to Domestic Schools

1j.

Undergraduate Non-Degree Programs (Requires enrolling students to have an Associate’s Degree or Higher)

An educational program that:

  • leads to a certificate or other recognized educational credential,

  • is at least 10 weeks,

  • provides at least 8 semester or trimester credit hours, 12 quarter credit hours, or 300 clock hours of instruction,

  • prepares students for gainful employment in a recognized occupation,

  • AND requires an enrolling regular student to have an associate’s degree or higher


1k.

Undergraduate Non-Degree (Short-Term) Programs

An educational program that:

  • leads to a certificate or other recognized educational credential,

  • is at least 10 weeks,

  • provides at least 300 but not more than 599 clock hours of instruction,

  • does not exceed by more than 50% the minimum number of clock hours established by the state for such training programs,

  • has been provided for at least one year,

  • prepare students for gainful employment in a recognized occupation.

Visible to Domestic Schools

1l.

Postbaccalaureate Teacher Certification Program

An educational program consisting of courses required by a state that are necessary to become a teacher in an elementary or secondary school in that state AND for which a degree, certificate, diploma, or other educational credential is not awarded by your institution. See 34 C.F.R. 690.6.



1m.

Comprehensive Transition and Postsecondary Program

A degree, certificate, nondegree, or noncertificate educational program designed to support students with intellectual disabilities seeking to prepare for gainful employment.


Visible to Domestic Schools

1n.

Does your institution have a flight program?

An educational program for which the school must receive FAA Certification. This program must be included when reporting Program types above, and in the Educational Program Summary.


Visible to Domestic Schools


FAA 141 Certification Number

Number

Autopopulated

Domestic Only


FAA Certificate Expiration Date

Date

Autopopulated

Domestic Only

1.

Check each box below that describes the educational program(s) you provide as of the date you submit this application, or that you will provide during the current award year. Provide information only on the program(s) that you wish to be eligible for federal student financial aid. (You may check more than one box.)


Each Field below will be a checkbox

Autopopulated if populated

Visible to Foreign Schools

1a.

Associate Degree Programs

An educational program of at least two years of academic study in an academic or occupational field culminating in the receipt of an Associate Degree. Associate degrees include, but are not limited to, the following:

  • Associate of Arts (AA)

  • Associate of Applied Science (AAS)

  • Associate of Occupational Science (AOS)

  • Associate of Science (AS)



Visible to Foreign Schools

1b.

Bachelor's Degree Programs

An educational program of at least four years of college-level work in an academic or occupational field culminating in the receipt of a Bachelor’s Degree. Bachelor’s degrees include, but are not limited to, the following:

  • Bachelor of Arts (BA)

  • Bachelor of Science (BS)

Visible to Foreign Schools

1c.

Master’s Degree Programs

An educational program of one or two years of postgraduate study in a graduate school or department culminating in the receipt of a Master’s Degree. Master’s degrees include, but are not limited to, the following:

  • Master of Arts (MA)

  • Master of Science (MS)

  • Master of Social Work (MSW)

Visible to Foreign Schools

1d.

Doctoral Degree Programs

An educational program of three or more years of postgraduate study for the completion of advanced graduate or professional studies in the humanities, the social sciences, the behavioral sciences, or the pure sciences beyond the master’s level, culminating in the receipt of a research Doctoral Degree. Doctoral degrees include, but are not limited to, the following:

  • Doctor of Philosophy (PhD)

  • Doctor of Theology (ThD)

  • Doctor of Engineering (EngD)

  • Doctor of Education (EdD)

Visible to Foreign Schools

1e.

Professional Degree Program

An educational program culminating in receipt of a degree awarded by an institution to an entry-level professional in certain occupational fields. Although sometimes called doctoral degrees, professional degrees differ from research doctorates in that they do not include a required component of original research or a demonstration of expertise in a field beyond what is required to qualify for basic licensing examinations. Professional degrees may be awarded in such fields as:

Chiropractic, dentistry, divinity/ministry, law, medicine, optometry, osteopathic medicine, pharmacy, podiatry, rabbinical and Talmudic studies, and veterinary medicine.

Visible to Foreign Schools

1f.

Graduate or Professional Non-degree Programs

An educational program above the baccalaureate level that

  • leads to a non-degree certificate or other recognized educational credential,

  • is at least 10 weeks,

  • provides at least 8 semester or trimester credit hours, 12 quarter credit hours, or 300 clock hours of instruction, and

  • prepares students for gainful employment in a recognized occupation

Visible to Foreign Schools

1g.

Two Year Transfer Program

An educational program that is acceptable for full credit toward a Bachelor’s Degree AND for which a degree, certificate, diploma, or other educational credential is not awarded by your institution.

Visible to Foreign Schools

1h.

Undergraduate Non-Degree Programs that:

  • Lead to a certificate or other recognized educational credential,  

  • Prepare students for gainful employment in a recognized occupation,

  • Are at least (1) academic year in length

Visible to Foreign Schools

2.

Provide information for each Associate Degree program for which you are requesting approval for federal student financial aid eligibility.


N/A

N/A



Name of Program

Text

Autopopulated



Classification of Instructional Programs (CIP) Code (searchable)

Lookup

Autopopulated



Standard Occupational Classification (SOC) Code



Institutions must enter at least 1 and may enter up to 10 SOC codes for each program.

Text

Autopopulated



Date First Provided

Date

Autopopulated



Number of Weeks

Number

Autopopulated



Clock Hours (number of hours) of instruction

Number

Autopopulated



Number of Credit Hours

Number (XXX.XX)

Autopopulated



Type of Credit Hours (select one)

Picklist

Semester

Trimester

Quarter

Autopopulated



How is this program delivered? (Check all that apply).



You must select “direct assessment” if student progress is measured, in whole or in part, in the program using direct assessment. If you check “direct assessment,” you must upload documentation that explains how a student's progress is measured in the program and documentation you have received from your accrediting agency indicating that it has evaluated and approved the program and your method of measuring student progress in the program.”


Multi-select Picklist

Classroom

Distance Education

Correspondence

Independent Study

Direct Assessment






Do you have a written agreement or contract with an ineligible institution of higher education or entity to provide any portion of this program?



You must upload a copy of any contract or written agreement with any entity or ineligible institution of higher education that provides any portion of this program and, for domestic institutions, provide a copy of the approval for the arrangement from your accrediting agency and State authorizing agency.






Picklist (Yes, No)

Autopopulated

Domestic and Foreign

Ineligible

Contract

Table

Provide the percentage of the program provided by the entity or ineligible institution of higher education.

Percentage

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Provide the name of each ineligible institution or entity that you contract with to provide any portion of this program.

N/A

N/A

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Name of ineligible institution or entity

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Corporation Name, if Applicable

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Former OPEID number of the ineligible institution, if applicable

Number

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated or opeid address

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Does any owner, person, or related entity of your institution own or control any portion or serve as a director or as an executive officer of this ineligible institution or entity?

Picklist, Yes/No

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

What is the name of this owner, person, or entity?

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Did this ineligible institution or entity withdraw from participating in federal student financial aid programs under a termination, show cause, suspension, or similar type of proceeding initiated by its state licensing agency, accrediting agency, guarantor, or the U.S. Secretary of Education?

Picklist, Yes/No

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Contract Effective Date

Date


Visible if “…Do you have a written agreement…with an ineligible institution …” = yes


Does any owner, person, or related entity of your institution own or control any portion or serve as a director or an executive officer




Once the user completes above questions, an entry will be added to the Educational Program Details Table for that degree program

Contract End Date

Date


only visible when editing


Program End Date

Date


only visible when editing


Enter the explanation as to why this is end date is more than 30 days in the future

Date

N/A

Visible when End Date is more than 30 days in the future

3. Educational Program Details Table

Provide information for each Bachelor’s Degree program for which you are requesting approval for federal student financial aid eligibility.








Name of Program

Text




Classification of Instructional Programs (CIP) Code (searchable)

Lookup




Standard Occupational Classification (SOC) Code



Institutions must enter at least 1 and may enter up to 10 SOC codes for each program.

Text




Date First Provided

Date




Number of Weeks

Number




Clock Hours (number of hours) of instruction

Number




Number of Credit Hours

Number




Type of Credit Hours (select one)

Picklist

Semester

Trimester

Quarter




How is this program delivered? (Check all that apply).



You must select “direct assessment” if student progress is measured, in whole or in part, in the program using direct assessment. If you check “direct assessment,” you must upload documentation that explains how a student's progress is measured in the program and documentation you have received from your accrediting agency indicating that it has evaluated and approved the program and your method of measuring student progress in the program.”


Multi-select Picklist

Classroom

Distance Education

Correspondence

Independent Study

Direct Assessment






Do you have a written agreement or contract with an ineligible institution of higher education or entity to provide any portion of this program?



You must upload a copy of any contract or written agreement with any entity or ineligible institution of higher education that provides any portion of this program and, for domestic institutions, provide a copy of the approval for the arrangement from your accrediting agency and State authorizing agency.


Picklist (Yes, No)

Autopopulated

Domestic and Foreign

Ineligible

Contract

Table

Provide the percentage of the program provided by the entity or ineligible institution of higher education.

Percentage

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Provide the name of each ineligible institution or entity that you contract with to provide any portion of this program.

N/A

N/A

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Name of ineligible institution or entity

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Corporation Name, if Applicable

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Former OPE ID number of the ineligible institution, if applicable

Number

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Contract Effective Date

Date


Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Once the user completes above questions, an entry will be added to the Educational Program Details Table for that degree program

Contract End Date

Date


only visible when editing


Program End Date

Date


only visible when editing


Enter the explanation as to why this is end date is more than 30 days in the future

Date

N/A

Visible when End Date is more than 30 days in the future

4. Educational Program Details Table

Provide information for each Master’s Degree program for which you are requesting approval for federal student financial aid eligibility.





Name of Program

Text




Classification of Instructional Programs (CIP) Code (searchable)

Lookup




Standard Occupational Classification (SOC) Code



Institutions must enter at least 1 and may enter up to 10 SOC codes for each program.

Text




Date First Provided

Date




Number of Weeks

Number




Clock Hours (number of hours) of instruction

Number




Number of Credit Hours

Number




Type of Credit Hours (select one)

Picklist

Semester

Trimester

Quarter




How is this program delivered? (Check all that apply).



You must select “direct assessment” if student progress is measured, in whole or in part, in the program using direct assessment. If you check “direct assessment,” you must upload documentation that explains how a student's progress is measured in the program and documentation you have received from your accrediting agency indicating that it has evaluated and approved the program and your method of measuring student progress in the program.”


Multi-select Picklist

Classroom

Distance Education

Correspondence

Independent Study

Direct Assessment






Do you have a written agreement or contract with an ineligible institution of higher education or entity to provide any portion of this program?



You must upload a copy of any contract or written agreement with any entity or ineligible institution of higher education that provides any portion of this program and, for domestic institutions, provide a copy of the approval for the arrangement from your accrediting agency and State authorizing agency.



Picklist (Yes, No)

Autopopulated

Domestic and Foreign

Ineligible

Contract

Table

Provide the percentage of the program provided by the entity or ineligible institution of higher education.

Percentage

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Provide the name of each ineligible institution or entity that you contract with to provide any portion of this program.

N/A

N/A

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Name of ineligible institution or entity

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Corporation Name, if Applicable

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Former OPE ID number of the ineligible institution, if applicable

Number

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated or opeid address

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Does any owner, person, or related entity of your institution own or control any portion or serve as a director or as an executive officer of this ineligible institution or entity?

Picklist, Yes/No

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

What is the name of this owner, person, or entity?

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Did this ineligible institution or entity withdraw from participating in federal student financial aid programs under a termination, show cause, suspension, or similar type of proceeding initiated by its state licensing agency, accrediting agency, guarantor, or the U.S. Secretary of Education?

Picklist, Yes/No

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Contract Effective Date

Date


Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Once the user completes above questions, an entry will be added to the Educational Program Details Table for that degree program

Contract End Date

Date


only visible when editing


Program End Date

Date


only visible when editing


Enter the explanation as to why this is end date is more than 30 days in the future

Date

N/A

Visible when End Date is more than 30 days in the future

5. Educational Program Details Table

Provide information for each Doctoral Degree program for which you are requesting approval for federal student financial aid eligibility.






Name of Program

Text




Classification of Instructional Programs (CIP) Code (searchable)

Lookup




Standard Occupational Classification (SOC) Code



Institutions must enter at least 1 and may enter up to 10 SOC codes for each program.

Text




Date First Provided

Date




Number of Weeks

Number




Clock Hours (number of hours) of instruction

Number




Number of Credit Hours

Number




Type of Credit Hours (select one)

Picklist

Semester

Trimester

Quarter




How is this program delivered?


You must select “direct assessment” if student progress is measured, in whole or in part, in the program using direct assessment. If you check “direct assessment,” you must upload documentation that explains how a student's progress is measured in the program and documentation you have received from your accrediting agency indicating that it has evaluated and approved the program and your method of measuring student progress in the program.”


Multi-select Picklist

Classroom

Distance Education

Correspondence

Independent Study

Direct Assessment






Do you have a written agreement or contract with an ineligible institution of higher education or entity to provide any portion of this program?



You must upload a copy of any contract or written agreement with any entity or ineligible institution of higher education that provides any portion of this program and, for domestic institutions, provide a copy of the approval for the arrangement from your accrediting agency and State authorizing agency.



Picklist (Yes, No)

Autopopulated

Domestic and Foreign

Ineligible

Contract

Table

Provide the percentage of the program provided by the entity or ineligible institution of higher education.

Percentage

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Provide the name of each ineligible institution or entity that you contract with to provide any portion of this program.

N/A

N/A

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes






Ineligible

Contract

Table

Name of ineligible institution or entity

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes






Ineligible

Contract

Table

Corporation Name, if Applicable

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Former OPE ID number of the ineligible institution, if applicable

Number

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated or opeid address

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Does any owner, person, or related entity of your institution own or control any portion or serve as a director or as an executive officer of this ineligible institution or entity?

Picklist, Yes/No

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

What is the name of this owner, person, or entity?

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Did this ineligible institution or entity withdraw from participating in federal student financial aid programs under a termination, show cause, suspension, or similar type of proceeding initiated by its state licensing agency, accrediting agency, guarantor, or the U.S. Secretary of Education?

Picklist, Yes/No

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible

Contract

Table

Contract Effective Date

Date


Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Once the user completes above questions, an entry will be added to the Educational Program Details Table for that degree program

Contract End Date

Date


only visible when editing


Program End Date

Date


only visible when editing


Enter the explanation as to why this is end date is more than 30 days in the future

Date

N/A

Visible when End Date is more than 30 days in the future

6. Educational Program Details Table

Provide information for each Professional Degree program for which you are requesting approval for federal student financial aid eligibility.





Name of Program

Text




Classification of Instructional Programs (CIP) Code (searchable)

Lookup




Standard Occupational Classification (SOC) Code



Institutions must enter at least 1 and may enter up to 10 SOC codes for each program.

Text




Date First Provided

Date




Number of Weeks

Number




Clock Hours (number of hours) of instruction

Number




Number of Credit Hours

Number




Type of Credit Hours (select one)

Picklist

Semester

Trimester

Quarter




How is this program delivered? (Check all that apply).

You must select “direct assessment” if student progress is measured, in whole or in part, in the program using direct assessment. If you check “direct assessment,” you must upload documentation that explains how a student's progress is measured in the program and documentation you have received from your accrediting agency indicating that it has evaluated and approved the program and your method of measuring student progress in the program.”


Multi-select Picklist

Classroom

Distance Education

Correspondence

Independent Study

Direct Assessment






Do you have a written agreement or contract with an ineligible institution of higher education or entity to provide any portion of this program?



You must upload a copy of any contract or written agreement with any entity or ineligible institution of higher education that provides any portion of this program and, for domestic institutions, provide a copy of the approval for the arrangement from your accrediting agency and State authorizing agency.



Picklist (Yes, No)

Autopopulated

Domestic and Foreign

Ineligible Contract Table

Provide the percentage of the program provided by the entity or ineligible institution of higher education.

Percentage

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Provide the name of each ineligible institution or entity that you contract with to provide any portion of this program.

N/A

N/A

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Name of ineligible institution or entity

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Corporation Name, if Applicable

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Former OPE ID number of the ineligible institution, if applicable

Number

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated or opeid address

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Does any owner, person, or related entity of your institution own or control any portion or serve as a director or as an executive officer of this ineligible institution or entity?

Picklist, Yes/No

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

What is the name of this owner, person, or entity?

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Did this ineligible institution or entity withdraw from participating in federal student financial aid programs under a termination, show cause, suspension, or similar type of proceeding initiated by its state licensing agency, accrediting agency, guarantor, or the U.S. Secretary of Education?

Picklist, Yes/No

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes






Ineligible Contract Table

Contract Effective Date

Date


Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Once the user completes above questions, an entry will be added to the Educational Program Details Table for that degree program

Contract End Date

Date


only visible when editing


Program End Date

Date


only visible when editing

7. Educational Program Details Table

Provide information for each Graduate or Professional Non-Degree program for which you are requesting approval for federal student financial aid.





Name of Program

Text




Classification of Instructional Programs (CIP) Code (searchable)

Lookup




Standard Occupational Classification (SOC) Code



Institutions must enter at least 1 and may enter up to 10 SOC codes for each program.

Text




Date First Provided

Date




Number of Weeks

Number




Clock Hours (number of hours) of instruction

Number




Number of Credit Hours

Number




Type of Credit Hours (select one)

Picklist

Semester

Trimester

Quarter




How is this program delivered? (Check all that apply).



You must select “direct assessment” if student progress is measured, in whole or in part, in the program using direct assessment. If you check “direct assessment,” you must upload documentation that explains how a student's progress is measured in the program and documentation you have received from your accrediting agency indicating that it has evaluated and approved the program and your method of measuring student progress in the program.”


Multi-select Picklist

Classroom

Distance Education

Correspondence

Independent Study

Direct Assessment






Do you have a written agreement or contract with an ineligible institution of higher education or entity to provide any portion of this program?



You must upload a copy of any contract or written agreement with any entity or ineligible institution of higher education that provides any portion of this program and, for domestic institutions, provide a copy of the approval for the arrangement from your accrediting agency and State authorizing agency.



Picklist (Yes, No)

Autopopulated

Domestic and Foreign

Ineligible Contract Table

Provide the percentage of the program provided by the entity or ineligible institution of higher education.

Percentage

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Provide the name of each ineligible institution or entity that you contract with to provide any portion of this program.

N/A

N/A

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Name of ineligible institution or entity

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Corporation Name, if Applicable

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Former OPE ID number of the ineligible institution, if applicable

Number

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated or opeid address

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Does any owner, person, or related entity of your institution own or control any portion or serve as a director or as an executive officer of this ineligible institution or entity?

Picklist, Yes/No

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

What is the name of this owner, person, or entity?

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Did this ineligible institution or entity withdraw from participating in federal student financial aid programs under a termination, show cause, suspension, or similar type of proceeding initiated by its state licensing agency, accrediting agency, guarantor, or the U.S. Secretary of Education?

Picklist, Yes/No

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Contract Effective Date

Date


Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Once the user completes above questions, an entry will be added to the Educational Program Details Table for that degree program

Contract End Date

Date


only visible when editing


Program End Date

Date


only visible when editing

8. Educational Program Details Table

Provide information for each Graduate Admission program for which you are requesting approval for federal student financial aid eligibility.

11




Name of Program

Text




Classification of Instructional Programs (CIP) Code (searchable)

Lookup




Standard Occupational Classification (SOC) Code



Institutions must enter at least 1 and may enter up to 10 SOC codes for each program.

Text




Date First Provided

Date




Number of Weeks

Number




Clock Hours (number of hours) of instruction

Number




Number of Credit Hours

Number




Type of Credit Hours (select one)

Picklist

Semester

Trimester

Quarter




How is this program delivered? (Check all that apply).



You must select “direct assessment” if student progress is measured, in whole or in part, in the program using direct assessment. If you check “direct assessment,” you must upload documentation that explains how a student's progress is measured in the program and documentation you have received from your accrediting agency indicating that it has evaluated and approved the program and your method of measuring student progress in the program.”


Multi-select Picklist

Classroom

Distance Education

Correspondence

Independent Study

Direct Assessment






Do you have a written agreement or contract with an ineligible institution of higher education or entity to provide any portion of this program?



You must upload a copy of any contract or written agreement with any entity or ineligible institution of higher education that provides any portion of this program and, for domestic institutions, provide a copy of the approval for the arrangement from your accrediting agency and State authorizing agency.



Picklist (Yes, No)

Autopopulated

Domestic and Foreign

Ineligible Contract Table

Provide the percentage of the program provided by the entity or ineligible institution of higher education.

Percentage

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Provide the name of each ineligible institution or entity that you contract with to provide any portion of this program.

N/A

N/A

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Name of ineligible institution or entity

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Corporation Name, if Applicable

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Former OPE ID number of the ineligible institution, if applicable

Number

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated or opeid address

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Does any owner, person, or related entity of your institution own or control any portion or serve as a director or as an executive officer of this ineligible institution or entity?

Picklist, Yes/No

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

What is the name of this owner, person, or entity?

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Did this ineligible institution or entity withdraw from participating in federal student financial aid programs under a termination, show cause, suspension, or similar type of proceeding initiated by its state licensing agency, accrediting agency, guarantor, or the U.S. Secretary of Education?

Picklist, Yes/No

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Contract Effective Date

Date


Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Once the user completes above questions, an entry will be added to the Educational Program Details Table for that degree program

Contract End Date

Date


only visible when editing


Program End Date

Date


only visible when editing

9. Educational Program Details Table

Provide information for each Two-Year Transfer program for which you are requesting approval for federal student aid eligibility.





Name of Program

Text




Classification of Instructional Programs (CIP) Code (searchable)

Lookup




Standard Occupational Classification (SOC) Code



Institutions must enter at least 1 and may enter up to 10 SOC codes for each program.

Text




Date First Provided

Date




Number of Weeks

Number




Clock Hours (number of hours) of instruction

Number




Number of Credit Hours

Number




Type of Credit Hours (select one)

Picklist

Semester

Trimester

Quarter




How is this program delivered? (Check all that apply).



You must select “direct assessment” if student progress is measured, in whole or in part, in the program using direct assessment. If you check “direct assessment,” you must upload documentation that explains how a student's progress is measured in the program and documentation you have received from your accrediting agency indicating that it has evaluated and approved the program and your method of measuring student progress in the program.”


Multi-select Picklist

Classroom

Distance Education

Correspondence

Independent Study

Direct Assessment






Do you have a written agreement or contract with an ineligible institution of higher education or entity to provide any portion of this program?



You must upload a copy of any contract or written agreement with any entity or ineligible institution of higher education that provides any portion of this program and, for domestic institutions, provide a copy of the approval for the arrangement from your accrediting agency and State authorizing agency.



Picklist (Yes, No)

Autopopulated

Domestic and Foreign

Ineligible Contract Table

Provide the percentage of the program provided by the entity or ineligible institution of higher education.

Percentage

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Provide the name of each ineligible institution or entity that you contract with to provide any portion of this program.

N/A

N/A

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Name of ineligible institution or entity

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Corporation Name, if Applicable

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Former OPE ID number of the ineligible institution, if applicable

Number

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated or opeid address

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Does any owner, person, or related entity of your institution own or control any portion or serve as a director or as an executive officer of this ineligible institution or entity?

Picklist, Yes/No

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

What is the name of this owner, person, or entity?

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Did this ineligible institution or entity withdraw from participating in federal student financial aid programs under a termination, show cause, suspension, or similar type of proceeding initiated by its state licensing agency, accrediting agency, guarantor, or the U.S. Secretary of Education?

Picklist, Yes/No

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Contract Effective Date

Date


Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Once the user completes above questions, an entry will be added to the Educational Program Details Table for that degree program

Contract End Date

Date


only visible when editing


Program End Date

Date


only visible when editing


Enter the explanation as to why this is end date is more than 30 days in the future

Date

N/A

Visible when End Date is more than 30 days in the future

10. Educational Program Details Table

Provide information for each Undergraduate Non-Degree program for which you are requesting approval for federal student financial aid eligibility.






Name of Program

Text




Classification of Instructional Programs (CIP) Code (searchable)

Lookup




Standard Occupational Classification (SOC) Code



Institutions must enter at least 1 and may enter up to 10 SOC codes for each program.

Text




Date First Provided

Date




Number of Weeks

Number




Clock Hours (number of hours) of instruction

Number




Number of Credit Hours

Number




Type of Credit Hours (select one)

Picklist

Semester

Trimester

Quarter




Is each course within the program acceptable for full credit toward your associate or higher degree?

Picklist (Yes/No)

Autopopulated

Visible to Domestic Schools Only


How is this program delivered? (Check all that apply).



You must select “direct assessment” if student progress is measured, in whole or in part, in the program using direct assessment. If you check “direct assessment,” you must upload documentation that explains how a student's progress is measured in the program and documentation you have received from your accrediting agency indicating that it has evaluated and approved the program and your method of measuring student progress in the program.”


Multi-select Picklist

Classroom

Distance Education

Correspondence

Independent Study

Direct Assessment



M




Do you have a written agreement or contract with an ineligible institution of higher education or entity to provide any portion of this program?



You must upload a copy of any contract or written agreement with any entity or ineligible institution of higher education that provides any portion of this program and, for domestic institutions, provide a copy of the approval for the arrangement from your accrediting agency and State authorizing agency.



Picklist (Yes, No)

Autopopulated

Domestic and Foreign

Ineligible Contract Table

Provide the percentage of the program provided by the entity or ineligible institution of higher education.

Percentage

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Provide the name of each ineligible institution or entity that you contract with to provide any portion of this program.

N/A

N/A

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Name of ineligible institution or entity

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Corporation Name, if Applicable

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Former OPE ID number of the ineligible institution, if applicable

Number

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated or opeid address

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Does any owner, person, or related entity of your institution own or control any portion or serve as a director or as an executive officer of this ineligible institution or entity?

Picklist, Yes/No

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

What is the name of this owner, person, or entity?

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Did this ineligible institution or entity withdraw from participating in federal student financial aid programs under a termination, show cause, suspension, or similar type of proceeding initiated by its state licensing agency, accrediting agency, guarantor, or the U.S. Secretary of Education?

Picklist, Yes/No

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes






Ineligible Contract Table

Contract Effective Date

Date


Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Once the user completes above questions, an entry will be added to the Educational Program Details Table for that degree program

Contract End Date

Date


only visible when editing


Program End Date

Date


only visible when editing

11. Educational Program Details Table

Provide information for each Undergraduate (Short-Term) Non-Degree program for which you are requesting approval for federal student financial aid eligibility.






Name of Program

Text




Classification of Instructional Programs (CIP) Code (searchable)

Lookup




Standard Occupational Classification (SOC) Code



Institutions must enter at least 1 and may enter up to 10 SOC codes for each program.

Text




Date First Provided

Date




Number of Weeks

Number




Clock Hours (number of hours) of instruction

Number




Maximum number of clock hours authorized by the state licensing agency

Number




Provide the completion rate and the placement rate for your most recently completed award year.



Help Text: The regulations regarding the calculation of completion and placement rates can be found at 34 C.F.R. § 668.8(f) and 34 C.F.R. § 668.8(g).

N/A

N/A

Visible for Domestic Only



Completion Rate


Percentage

Autopopulated

Visible for Domestic Only



Placement Rate

Percentage

Autopopulated

Visible for Domestic Only



How is this program delivered? (Check all that apply).



You must select “direct assessment” if student progress is measured, in whole or in part, in the program using direct assessment. If you check “direct assessment,” you must upload documentation that explains how a student's progress is measured in the program and documentation you have received from your accrediting agency indicating that it has evaluated and approved the program and your method of measuring student progress in the program.”


Multi-select Picklist

Classroom

Distance Education

Correspondence

Independent Study

Direct Assessment




Visible for Domestic Only



Do you have a written agreement or contract with an ineligible institution of higher education or entity to provide any portion of this program?



You must upload a copy of any contract or written agreement with any entity or ineligible institution of higher education that provides any portion of this program and, for domestic institutions, provide a copy of the approval for the arrangement from your accrediting agency and State authorizing agency.



Picklist (Yes, No)

Autopopulated

Domestic and Foreign

Ineligible Contract Table

Provide the percentage of the program provided by the entity or ineligible institution of higher education?

Percentage

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Provide the name of each ineligible institution or entity that you contract with to provide any portion of this program.

N/A

N/A

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Name of ineligible institution or entity

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes






Ineligible Contract Table

Corporation Name, if Applicable

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Former OPE ID number of the ineligible institution, if applicable

Number

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated or opeid address

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Does any owner, person, or related entity of your institution own or control any portion or serve as a director or as an executive officer of this ineligible institution or entity?

Picklist, Yes/No

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

What is the name of this owner, person, or entity?

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Did this ineligible institution or entity withdraw from participating in federal student financial aid programs under a termination, show cause, suspension, or similar type of proceeding initiated by its state licensing agency, accrediting agency, guarantor, or the U.S. Secretary of Education?

Picklist, Yes/No

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Contract Effective Date

Date


Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Once the user completes above questions, an entry will be added to the Educational Program Details Table for that degree program

Contract End Date

Date


only visible when editing


Program End Date

Date


only visible when editing


Enter the explanation as to why this is end date is more than 30 days in the future

Date

N/A

Visible when End Date is more than 30 days in the future

12. Educational Program Details Table

Provide information for each Postbaccalaureate Teacher Certification program that you would like to be eligible for federal student financial aid.





Name of Program

Text




Classification of Instructional Programs (CIP) Code (searchable)

Lookup




Standard Occupational Classification (SOC) Code



Institutions must enter at least 1 and may enter up to 10 SOC codes for each program.

Text




Date First Provided

Date




Number of Weeks

Number




Clock Hours (number of hours) of instruction

Number




Number of Credit Hours

Number




Type of Credit Hours (select one)

Picklist

Semester

Trimester

Quarter




How is this program delivered? (Check all that apply).



You must select “direct assessment” if student progress is measured, in whole or in part, in the program using direct assessment. If you check “direct assessment,” you must upload documentation that explains how a student's progress is measured in the program and documentation you have received from your accrediting agency indicating that it has evaluated and approved the program and your method of measuring student progress in the program.”


Multi-select Picklist

Classroom

Distance Education

Correspondence

Independent Study

Direct Assessment






Do you have a written agreement or contract with an ineligible institution of higher education or entity to provide any portion of this program?



You must upload a copy of any contract or written agreement with any entity or ineligible institution of higher education that provides any portion of this program and, for domestic institutions, provide a copy of the approval for the arrangement from your accrediting agency and State authorizing agency.



Picklist (Yes, No)

Autopopulated

Domestic and Foreign

Ineligible Contract Table

Provide the percentage of the program provided by the entity or ineligible institution of higher education?

Percentage

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Provide the name of each ineligible institution or entity that you contract with to provide any portion of this program.

N/A

N/A

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Name of ineligible institution or entity

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Corporation Name, if Applicable

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Former OPE ID number of the ineligible institution, if applicable

Number

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated or opeid address

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Does any owner, person, or related entity of your institution own or control any portion or serve as a director or as an executive officer of this ineligible institution or entity?

Picklist, Yes/No

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

What is the name of this owner, person, or entity?

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Did this ineligible institution or entity withdraw from participating in federal student financial aid programs under a termination, show cause, suspension, or similar type of proceeding initiated by its state licensing agency, accrediting agency, guarantor, or the U.S. Secretary of Education?

Picklist, Yes/No

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes






Ineligible Contract Table

Contract Effective Date

Date


Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Once the user completes above questions, an entry will be added to the Educational Program Details Table for that degree program

Contract End Date

Date


only visible when editing


Program End Date

Date


only visible when editing


Enter the explanation as to why this is end date is more than 30 days in the future

Date

N/A

Visible when End Date is more than 30 days in the future

13. Educational Program Details Table

Provide information for each Comprehensive Transition and Postsecondary Program for which you are requesting approval for federal student financial aid eligibility.


An institution that offers a comprehensive transition and postsecondary program must apply to the Secretary to have the program determined to be an eligible program. The institution applies under the provisions in 34 CFR 600.20 for adding an educational program, and must include in its application:

(a) A detailed description of the comprehensive transition and postsecondary program that addresses all of the components of the program, as defined in 34 CFR 668.231;

(b) The institution's policy for determining whether a student enrolled in the program is making satisfactory academic progress;

(c) The number of weeks of instructional time and the number of semester or quarter credit hours or clock hours in the program, including the equivalent credit or clock hours associated with noncredit or reduced credit courses or activities;

(d) A description of the educational credential offered (e.g., degree or certificate) or identified outcome or outcomes established by the institution for all students enrolled in the program;

(e) A copy of the letter or notice sent to the institution's accrediting agency informing the agency of its comprehensive transition and postsecondary program. The letter or notice must include a description of the items in paragraphs (a) through (d) above and any other information the Secretary may require.







Name of Program

Text




Classification of Instructional Programs (CIP) Code (searchable)

Lookup




Standard Occupational Classification (SOC) Code



Institutions must enter at least 1 and may enter up to 10 SOC codes for each program.

Text




Date First Provided

Date




Number of Weeks

Number




Clock Hours (number of hours) of instruction

Number




Number of Credit Hours

Number




Type of Credit Hours (select one)

Picklist

Semester

Trimester

Quarter




How is this program delivered? (Check all that apply).



You must select “direct assessment” if student progress is measured, in whole or in part, in the program using direct assessment. If you check “direct assessment,” you must upload documentation that explains how a student's progress is measured in the program and documentation you have received from your accrediting agency indicating that it has evaluated and approved the program and your method of measuring student progress in the program.”


Multi-select Picklist

Classroom

Distance Education

Correspondence

Independent Study

Direct Assessment

Visible to Domestic Schools Only


Do you have a written agreement or contract with an ineligible institution of higher education or entity to provide any portion of this program?



You must upload a copy of any contract or written agreement with any entity or ineligible institution of higher education that provides any portion of this program and, for domestic institutions, provide a copy of the approval for the arrangement from your accrediting agency and State authorizing agency.



Picklist (Yes, No)

Autopopulated

Domestic and Foreign

Ineligible Contract Table

Provide the percentage of the program provided by the entity or ineligible institution of higher education?

Percentage

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Provide the name of each ineligible institution or entity that you contract with to provide any portion of this program.

N/A

N/A

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Name of ineligible institution or entity

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Corporation Name, if Applicable

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Former OPE ID number of the ineligible institution, if applicable

Number

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated or opeid address

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Does any owner, person, or related entity of your institution own or control any portion or serve as a director or as an executive officer of this ineligible institution or entity?

Picklist, Yes/No

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

What is the name of this owner, person, or entity?

Text

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Ineligible Contract Table

Did this ineligible institution or entity withdraw from participating in federal student financial aid programs under a termination, show cause, suspension, or similar type of proceeding initiated by its state licensing agency, accrediting agency, guarantor, or the U.S. Secretary of Education?

Picklist, Yes/No

Autopopulated

Visible if “…Do you have a written agreement…with an ineligible institution …” = yes






Ineligible Contract Table

Contract Effective Date

Date


Visible if “…Do you have a written agreement…with an ineligible institution …” = yes

Once the user completes above questions, an entry will be added to the Educational Program Details Table for that degree program

Contract End Date

Date


only visible when editing


Program End Date

Date


only visible when editing


Enter the explanation as to why this is end date is more than 30 days in the future

Date

N/A

Visible when End Date is more than 30 days in the future

Document Table

Document Upload Component

File Uploader

N/A

N/A


Does this document contain PII data?


Picklist (Yes, No)

N/A

Visible when uploading a new file


Document Type

Picklist (See Submit eApp Section)

This field will only show the remaining documents that are required to be uploaded

Visible when uploading a new file


Check here if you will be providing the URL to where this document type is located on your institution’s Web site in the document description below.

Checkbox

N/A

Visible when uploading a new file


Enter a description of the document

Text

N/A

Visible when uploading a new file

Section H: Additional Factors & Details


Question #

Text

Field Type

Automation

Visibility

1.

Are any of your programs offered in whole or in part by distance education?

Picklist (Yes/No)

Autopopulated


2.

Are any of your programs offered in whole or in part by correspondence?


Picklist (Yes/No)

Autopopulated



The Title IV Award Year runs from July 1 through June 30.


The “Most Recently Completed Award Year” is the most recently completed 12-month period that began with July 1 and ended with the most recently past June 30.


N/A

N/A


2a.

For the most recently completed award year, were more than 50% of your courses taught by means of correspondence? (See C.F.R. 600.7 and 668.38)

Picklist (Yes/No)

Autopopulated


2b.

For the most recently completed award year, were 50% or more of your regular students enrolled in correspondence courses? (See C.F.R. 600.7 and 668.38)

Picklist (Yes/No)

Autopopulated


3.

For the most recently completed award year, were more than 50% of your regular students ability-to-benefit students? (See 34 C.F.R. 600.7 and 668.32(e)(2-3,5))


Picklist (Yes/No)

Autopopulated


4.

For the most recently completed award year, were more than 25% of your regular students incarcerated? (See 34 C.F.R. 600.7)

Picklist (Yes/No)

Autopopulated


5.

Tell us on what date you were both legally authorized to provide and began continuously providing the education or training program(s) for which you are seeking eligibility.


Date

Autopopulated

Visible when Application Purpose = Initial or Designated as Eligible

6.

How many full-time equivalent (FTE) financial aid staff members do you have?

N/A

N/A


6a.

Administrative, counselors, or other professionals

Number

N/A

Visible when if application purpose = Initial, Reinstatement, Structure Changes and/or Change in Ownership, Merging of OPEIDs with the same Ownership Structure

6b.

Clerical

Number

N/A

Visible when if application purpose = Initial, Reinstatement, Structure Changes and/or Change in Ownership, Merging of OPEIDs with the same Ownership Structure

7.

How many regular students do you estimate would be eligible to receive federal student financial aid for the remainder of the current award year and for each of the next two award years if you become eligible to participate in federal student financial aid programs?

N/A

N/A


7a.

Estimated number for the remainder of the current award year

Number

N/A


7b.

Estimated number for the next award year

Number

N/A


7c.

Estimated number for the award year following the next award year

Number

N/A


8.

Provide the following information about your regular students. (If a student drops out and then reenrolls, count the student each time.)

N/A

N/A

Visible only during required conditions

8a.

How many regular students were enrolled at your institution during the most recently completed award year?

Number

N/A

Visible when Application Purpose = Initial, Reinstatement, or Designated as Eligible Non-Participating Institution

8b.

How many of the regular students enrolled during your most recently completed award year (entered above) withdrew from, dropped out of, or were expelled from the institution during the 100% refund period and received the refund?

Number

N/A

Visible when Application Purpose = Initial, Reinstatement, or Designated as Eligible Non-Participating Institution

8c.

How many of the regular students enrolled during your most recently completed award year (entered above) withdrew from, dropped out of, or were expelled from the institution after the 100% refund period?

Number

N/A

Visible when Application Purpose = Initial, Reinstatement, or Designated as Eligible Non-Participating Institution

9.

For each program, check here if you have provided the program continuously for at least the most recent 24 months.

Checkbox

N/A

Visible if Partner indicated they have vocational (non-degree) programs







Additional Information


Use this area to provide information about any unusual circumstances or to provide additional explanations about questions you answered in this section.


Text

N/A


Document Table

Document Upload Component

File Uploader

N/A

N/A


Does this document contain PII data?


Picklist (Yes, No)

N/A

Visible when uploading a new file


Document Type

Picklist (See Submit eApp Section)

This field will only show the remaining documents that are required to be uploaded

Visible when uploading a new file


Check here if you will be providing the URL to where this document type is located on your institution’s Web site in the document description below.

Checkbox

N/A

Visible when uploading a new file


Enter a description of the document

Text

N/A

Visible when uploading a new file

Section J: Third-Party Servicer


Question #

Text

Field Type

Automations

Visibility

Third Party Servicer Table

Provide information for all Third-Party Servicer with whom you contract to perform any aspect of the institution’s responsibilities under the Title IV, HEA programs. Do not report independent auditors or ATB providers in this section.


N/A

N/A


1.

Before completing this section, make sure to contact your Third-Party Servicer first to verify the following information:

Third-Party Servicer’s Legal Name

Third-Party Servicer’s Address

Contact Information of the CEO/COO/President

Contracted Services

To search for your Third-Party Servicer, enter your servicer's name in the box below. If your Third-Party Servicer is not found, provide your servicer's name and contact information.


Servicer Lookup

Autopopulated



Here is the information concerning the TPS you have selected:

DJS Financial Aid Services, Inc.

123 Kellogg Drive

Wichita, KS 67213


Deborah Ann Smith, President

(800) 242-9999 • Fax: (316) 777-9999

E-mail: [email protected]


N/A

N/A

Visible once Partner has selected their Servicer – data cannot be edited


Third-Party Servicer Legal Name or Company’s Legal Name

Text

Autopopulated



Third Party Servicer Name d/b/a

Text

Autopopulated



TPS ID

Number

Autopopulated

Visible when School is editing an existing TPS relationship


Partner Connect ID

Number

Autopopulated



Provide the following information for your Third-Party Servicer's CEO/COO/President. Contact your Third-Party Servicer to obtain this information.

N/A

N/A



Prefix, First Name, Middle Name, Last Name, Suffix, Job Title


Autopopulated



Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated with Production account answer or preliminary account information



E-mail Address

Text


Autopopulated



Telephone Number (include Area Code)

Phone

Autopopulated

Visible when USA is Chosen


International Telephone Number (include Country Code)

(Phone) Numeric & Special Characters

Autopopulated

Visible when Country Other than USA is Chosen


Telephone Number Extension

Number

Autopopulated



Fax Number (include Area Code)

Phone

Autopopulated

Visible when USA is Chosen


International Fax Number (include Country Code)

(Fax) Numeric & Special Characters


Autopopulated

Visible when Country Other than USA is Chosen


Fax Number Extension

Number

Autopopulated



International Fax Number

Number

Autopopulated



Fax Number Extension

Number

Autopopulated


Services Provided Table

Select the service(s) performed by your Third-Party Servicer.

Select all of the primary and specific service(s) that apply. If you do not see a service in the list provided, select “Other” and provide an explanation of the functions or service(s) performed by your Third-Party Servicer.

Text Display

N/A


2.

Main Service

Picklist


Autopopulated


2a.

Specific Service

Picklist




Services Provided Table

If you chose “Other” above, please describe the services provided

Text

Autopopulated with Production

Answer


Services Provided Table

Effective Date

Date

Autopopulated with Production

Answer


Services Provided Table

End Date

Date




Enter the date this Third-Party Servicer began performing functions/services on behalf of your institution

N/A




Effective Date

Date

Autopopulated



If you no longer have a contract with this Third-Party Servicer, provide the date the contract ended or will end below.



Only enter an end date if the contract with this Third- Party Servicer has ended.

Do not enter an end date if the services provided have changed and/or your contact at the Third-Party Servicer has changed. In these instances, update the services provided. Contact the Third-Party Servicer Oversight Group if your contact person or the address of your Third-Party Servicer has changed.

N/A

Autopopulated


Once User completes above questions, a new TPS entry will be added to the Table

End Date

Date

Autopopulated

only visible when editing


Additional Information



Use this area to provide information about any unusual circumstances or to provide additional explanations about questions you answered in this section.


Text

N/A


Document Table

Document Upload Component

File Uploader

N/A

N/A


Does this document contain PII data?


Picklist (Yes, No)

N/A

Visible when uploading a new file


Document Type

Picklist (See Submit eApp Section)

This field will only show the remaining documents that are required to be uploaded

Visible when uploading a new file


Check here if you will be providing the URL to where this document type is located on your institution’s Web site in the document description below.

Checkbox

N/A

Visible when uploading a new file


Enter a description of the document

Text

N/A

Visible when uploading a new file




Section K: Ability to Benefit


Question #

Text

Field Type

Automations

Visibility

1.

Do you use an ability to benefit test for students who do not have a high school diploma or its recognized equivalent?

Picklist (Yes, No)

Autopopulated

Visible for Domestic Schools Only



1a.

Select the ability to benefit test(s) administered. Contact FSA if your ability to benefit test is not identified in this list.

Picklist (multi-select)

Wonderlic Basic Skills Test (WBST) Verbal Forms VS-1 and VS-2, Quantitative Forms QS-1 and QS-2. Paper Test


Wonderlic Basic Skills Test (WBST) Verbal Forms VS-1 and VS-2, Quantitative Forms QS-1 and QS-2. Online Test


Spanish Wonderlic Basic Skills Test (Spanish WBST) Verbal Forms VS-1 and VS-2, Quantitative Forms QS-1 and QS-2. Paper Test


Spanish Wonderlic Basic Skills Test (Spanish WBST) Verbal Forms VS-1 and VS-2, Quantitative Forms QS-1 and QS-2. Online Test


Combined English Language Skills Assessment (CELSA), Forms 1 and 2.


ACCUPLACER Computer-adaptive tests (Reading Test, Writing Test, and Arithmetic Test)


COMPANION ACCUPLACER Forms J and K (Reading Test, Writing Test, and Arithmetic Test)


Texas Success Initiative (TSI) Assessment Computer-adaptive tests (Reading Placement Test, Writing Placement Test, and Arithmetic Placement Test)


COMPANION TSI Forms T and V (Reading Placement Test, Writing Placement Test, and Arithmetic Placement Test)



Autopopulated

Visible for Domestic 1. = yes

1b.

Ability to Benefit Testers Table for each Test Selected

Provide the name and address of your ATB Test Administrator(s)

N/A

N/A

Visible for Domestic Schools Only

1. = yes


Name of Test Administrator

Text

Autopopulated

Visible for Domestic Schools Only

1. = yes


Prefix, First Name, Middle Name, Last Name, Suffix


Autopopulated

Visible when entering ATB Tester



E-mail Address

Text


Autopopulated

Visible when entering ATB Tester



Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated

Visible when entering ATB Tester



Telephone Number (include Area Code)

Phone

Autopopulated

Visible when entering ATB Tester and USA is Chosen



International Telephone Number (include Country Code)

(Phone) Numeric & Special Characters

Autopopulated

Visible when entering ATB Tester and Country Other than USA is Chosen



Telephone Number Extension

Number

Autopopulated

Visible when entering ATB Tester



Fax Number (include Area Code)

Phone

Autopopulated

Visible when entering ATB Tester and USA is Chosen


International Fax Number (include Country Code)

(Fax) Numeric & Special Characters


Autopopulated

Visible when entering ATB Tester and Country Other than USA is Chosen



Fax Number Extension

Number

Autopopulated

Visible when entering ATB Tester



Tester End date

date

Autopopulated

Visible when editing a tester entry

2.

Do you admit and enroll students through an eligible career pathway program?

Picklist (yes, no)


Visible for Domestic Schools Only

1. = yes


Additional Information


Use this area to provide information about any unusual circumstances or to provide additional explanations about questions you answered in this section.


Text

N/A


Document Table

Document Upload Component

File Uploader

N/A

N/A


Does this document contain PII data?


Picklist (Yes, No)

N/A

Visible when uploading a new file


Document Type

Picklist (See Submit eApp Section)

This field will only show the remaining documents that are required to be uploaded

Visible when uploading a new file


Check here if you will be providing the URL to where this document type is located on your institution’s Web site in the document description below.

Checkbox

N/A

Visible when uploading a new file


Enter a description of the document

Text

N/A

Visible when uploading a new file






Section L: Administrative Capability


Question #

Text

Field Type

Automations

Visibility

1.

Do you have a system of internal checks and balances for administering federal student financial aid that meets federal regulations? (See 34 CFR 668.16)

Picklist (Yes, No)

N/A



Please provide an explanation


Text

N/A


2.

Do you divide the functions of determining student awards and disbursing funds that result from those award decisions? (See 34 CFR 668.16).

Picklist (Yes, No)

N/A



Please provide an explanation


Text

N/A


3.

Do you have procedures that ensure frequent, periodic reconciliation of fiscal office and financial aid office award data? (See 34 CFR 668.14, 668.16, 668.24, 674.19, 675.19, 676.19, 685.300 and 690.81)

Picklist (Yes, No)

N/A



Please provide an explanation


Text

N/A


4.

Do you have a system to identify and resolve discrepancies in information you receive from various sources about a student's application for financial aid? (See 34 CFR 668.16).

Picklist (Yes, No)

N/A



Please provide an explanation


Text

N/A


5.

Do you have procedures that ensure that your requests for federal cash do not exceed the amount of funds you need immediately to make aid disbursements to students? (See 34 CFR 668.162)

Picklist (Yes, No)

N/A



Please provide an explanation


Text

N/A


6.

Do you have a policy that meets federal regulations for requiring satisfactory academic progress for recipients of federal student financial aid? (See 34 CFR 668.16 and 668.34).

Picklist (Yes, No)

N/A



Please provide an explanation


Text

N/A


7.

Do you have a policy that meets federal regulations for returning Title IV funds when a student withdraws from classes? (See 34 CFR 668.22).

Picklist (Yes, No)

N/A



Please provide an explanation


Text

N/A


8.

Have you submitted your required annual financial statement audits to us on time? (For initial applicants, have you established a process to ensure that you submit your required annual financial statement audit to us on time?) (See 34 CFR 668.23)

Picklist (Yes, No)

N/A



Please provide an explanation


Text

N/A


9.

Have you submitted your required annual federal student financial aid compliance audits to us on time? (For initial applicants, have you established a process to ensure that you submit your required annual federal student financial aid compliance audit to us on time?) (See 34 CFR 668.23)

Picklist (Yes, No)

N/A



Please provide an explanation


Text

N/A


10.

Do you have a process to ensure you obtain the necessary approvals from the Department for expanding or re-establishing your institutional eligibility, (such as changes of ownership resulting in a change of control, excluded changes in ownership, or adding new locations in certain circumstances), and that you notify us within 10 days about other important changes (such as changing your name, address or official)? (See 34 CFR 600.10, 600.20, and 600.21).

Picklist (Yes, No)

N/A



Please provide an explanation


Text

N/A


11.

Do you use the electronic processes required by the Secretary? (See 34 CFR 668.16).

Picklist (Yes, No)

N/A



Please provide an explanation


Text

N/A



Additional Information


Use this area to provide information about any unusual circumstances or to provide additional explanations about questions you answered in this section.


Text

N/A


Document Table

Document Upload Component

File Uploader

N/A

N/A


Does this document contain PII data?


Picklist (Yes, No)

N/A

Visible when uploading a new file


Document Type

Picklist (See Submit eApp Section)

This field will only show the remaining documents that are required to be uploaded

Visible when uploading a new file


Check here if you will be providing the URL to where this document type is located on your institution’s Web site in the document description below.

Checkbox

N/A

Visible when uploading a new file


Enter a description of the document

Text

N/A

Visible when uploading a new file

Section M: Title IV Programs

Question #

Text

Field Type

Automations

Visibility

1.

Indicate all of the federal student financial aid programs in which you are seeking approval to participate.


Federal Pell Grant Program

Federal Supplemental Educational Opportunity Grant (FSEOG) Program

Teacher Education Assistance for College and Higher Education (TEACH) Grant Program

Federal Work-Study (FWS) Program


Checkboxes for the following:


Autopopulated



William D. Ford Federal Direct Loan Program (Direct Loan Program)


  • Federal Direct Loan Program (Subsidized and Unsubsidized)


  • Federal Direct PLUS Loan Program


No Picklist


Picklist for

Federal Direct Loan Program (Subsidized and Unsubsidized)


Federal Direct PLUS Loan Program


Autopopulated



Teacher Education Assistance for College and Higher Education (TEACH) Grant Program

 

Check all of the following conditions that apply to your institution.


N/A

N/A

N/A


Offer a high-quality teacher preparation program at either the baccalaureate or masters level that is accredited by a specialized accrediting agency recognized by the Secretary for the accreditation of professional teacher education programs, and the program provides or assists in providing supervision and support services to teachers

 

Identify the accreditor for this program:


Checkboxes for the following:

No Accreditor Available at this time

 


Autopopulated

Visible to Domestic Schools


Offer a high-quality teacher preparation program at either the baccalaureate or master’s level that is approved by a state and includes a minimum of 10 weeks of full time pre-service clinical experience or its equivalent and the program provides or assists in providing supervision and support services to teachers.

Checkbox

Autopopulated

Visible to Domestic Schools


Offer a high-quality teacher preparation program at either the baccalaureate or masters level that is approved by a state and includes a minimum of 10 weeks of full-time pre-service clinical experience, or its equivalent and the program provides or assists in providing supervision and support services to teacher.

Checkbox

Autopopulated

Visible to Domestic Schools


Provide a two-year program of study that is acceptable for full credit to a baccalaureate teacher preparation program. If selected, you must identify the name of at least one and no more than three other institutions which accepts all the credits from your two-year program towards their baccalaureate teacher preparation program.

Checkbox

Autopopulated

Visible to Domestic Schools


Offer a baccalaureate degree that will prepare a student to teach in a high-need field and have an agreement with another institution that offers a teacher preparation program or a post-baccalaureate program. If selected, you must identify the name of at least one and no more than three other institutions with which your institution has such an agreement.


Checkbox

Autopopulated

Visible to Domestic Schools


Offer a postbaccalaureate degree program.



Checkbox

Autopopulated

Visible to Domestic Schools


Institution Name

Text

Autopopulated

IF the Partner indicates that they selected a TEACH criteria that uses a partnership


Partnership End Date

Date (DD/MM/YYYY)

Autopopulated



Institution Name

Text

Autopopulated

IF the Partner indicates that they selected a TEACH criteria that uses a partnership


Partnership End Date

Date (DD/MM/YYYY)

Autopopulated



Institution Name

Text

Autopopulated

IF the Partner indicates that they selected a TEACH criteria that uses a partnership


Partnership End Date

Date (DD/MM/YYYY)

Autopopulated



TEACH Program End Date

Date (DD/MM/YYYY)

Autopopulated



Additional Information


Use this area to provide information about any unusual circumstances or to provide additional explanations about questions you answered in this section.


Text

N/A


Document Table

Document Upload Component

File Uploader

N/A



Does this document contain PII data?


Picklist (Yes, No)

N/A

Visible when uploading a new file


Document Type

Picklist (See Submit eApp Section)

This field will only show the remaining documents that are required to be uploaded

Visible when uploading a new file


Check here if you will be providing the URL to where this document type is located on your institution’s Web site in the document description below.

Checkbox

N/A

Visible when uploading a new file


Enter a description of the document

Text

N/A

Visible when uploading a new file


Section N: Additional Contacts

Question #

Text

Field Type

Automations

Visibility

1 Additional Contacts Table

Would you like Federal Student Aid to contact someone not at your institution about this application?

Picklist (yes/no)

If select yes, then display the rest of the questions below.

If yes, the table of additional contacts is displayed


Please provide contact information for the individual(s) that are not at your institution that you would like Federal Student Aid to speak to about this application.

N/A

N/A



Contact Type

Picklist

Application Contact

Additional Contact

Autopopulated



Prefix, First Name, Middle Name, Last Name, Suffix, Job Title


Autopopulated



Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated



E-mail Address

Text


Autopopulated



Telephone Number (include Area Code)

Phone

Autopopulated

Visible when USA is Chosen


International Telephone Number (include Country Code)

(Phone) Numeric & Special Characters

Autopopulated

Visible when Country Other than USA is Chosen


Telephone Number Extension

Number

Autopopulated



Fax Number (include Area Code)

Phone

Autopopulated

Visible when USA is Chosen


International Fax Number (include Country Code)

(Fax) Numeric & Special Characters


Autopopulated

Visible when Country Other than USA is Chosen


Fax Number Extension

Number

Autopopulated



End Date

Date




Additional Information


Use this area to provide information about any unusual circumstances or to provide additional explanations about questions you answered in this section.

Text

N/A


Document Table

Document Upload Component

File Uploader

N/A

N/A


Does this document contain PII data?


Picklist (Yes, No)

N/A

Visible when uploading a new file


Document Type

Picklist (See Submit eApp Section)

This field will only show the remaining documents that are required to be uploaded

Visible when uploading a new file


Check here if you will be providing the URL to where this document type is located on your institution’s Web site in the document description below.

Checkbox

N/A

Visible when uploading a new file


Enter a description of the document

Text

N/A

Visible when uploading a new file


Section O: Additional Information

Question #

Text

Field Type

Automations

Visibility

1.

Use this area to provide information about any unusual circumstances or to provide additional explanations about questions you answered in this application.


Longform Text

N/A



Section P: Upload Documents


Question #

Text

Field Type

Automations

Visibility


You must upload the documents listed below to successfully submit your application or provide an explanation for why the document is missing. Please select the document you are uploading from the list of required documents displayed. If the document you need to upload is not displayed, select ‘other’ and provide a description of the document. Once the document is uploaded, the document will display in the table below. If you uploaded a document that contains PII, please indicate that you are doing so in the file upload component. Please contact Federal Student Aid if you have any issues uploading documents.



N/A

N/A



Select the Document Type you are uploading from the dropdown and then select upload files button. If this document is available on your website, you must also provide the URL for the this document. Please provide a description of the document and indicate if the document contains PII or Proprietary Information.





Document Type

Picklist

This Document Type will only show the remaining documents that are required to be uploaded as appropriate based on the Document Matrix



Select Document

Document Upload

N/A



Document Web Link

Text




Description

Text

N/A



If you do not upload the documents required, you must enter an explanation for each document you are not including in your submission.

Text

N/A



Contains Personally Identifiable Information (PII)

Checkbox

N/A



Contains Proprietary Information

Checkbox

N/A




Section Q: Send eApp for Signature eApp



Text

Field Type

Automation

Visibility


Who is your authorized signature authority?

Your authorized signature authority is the person that has the power and authority to act on behalf of the institution with connection to all legal and other matters of the institution.


N/A

N/A



Check here if this is the same person as your:

Chief Executive Officer

President/Chancellor

Chief Operating Officer

Checkbox



Autopopulated



Select position.

Picklist

Chief Executive Officer - New

President/Chancellor - New

Chief Operating Officer - New

Autopopulated

Visible when, “Check here is the same person as ….” = checked.


Check here if this person is an owner of the institution

Checkbox



Autopopulated



Select Owner

Picklist of Person Owners

Autopopulated

Visible when, “Check here is the same person as ….” = checked.


Prefix, First Name, Middle Name, Last Name, Suffix


Autopopulated



E-mail Address

Email Address

Autopopulated



Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated



Telephone Number

Number

Autopopulated

Visible for Domestic Schools, Optional For Foreign Schools


International Telephone Number

Number

Autopopulated

Visible for Foreign Schools only


Telephone Number Extension

Number

Autopopulated



Fax Number

Number

Autopopulated



International Fax Number

Number

Autopopulated

Visible for Foreign Schools only


Fax Number Extension

Number

Autopopulated



Provide the Home Address, Phone Number, and E-mail Address for this Authorized Signer.

N/A

N/A



Home Address

Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated



Personal E-mail Address

Email

Autopopulated



Personal Telephone Number (include Area Code)

Number

Autopopulated



Effective Date

Date

Autopopulated



End Date

Date

Autopopulated

only visible when editing


Please check here, if your authorized signature authority is not available to sign this application and provide an explanation below.


You must provide contact information and upload a copy of the written delegation of authority for the person that has the power and authority to act on behalf of the institution with connection to all legal and other matters in the absence of the authorized signature authority identified above. This delegation of authority must be on school letterhead.



Checkbox




You must provide contact information and upload a copy of the written delegation of authority for the person that has the power and authority to act on behalf of the institution with connection to all legal and other matters in the absence of the authorized signature authority identified above. This delegation of authority must be on school letterhead.


Text


If “Please check here…” = yes , this field displays


Add contact information for the delegated authority to sign on behalf of the authorized signature authority.





Prefix, First Name, Middle Name, Last Name, Suffix, Job Title


Autopopulated



E-mail Address

Text


Autopopulated



Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated



Telephone Number (include Area Code)

Phone

Autopopulated

Visible when USA is Chosen


International Telephone Number (include Country Code)

(Phone) Numeric & Special Characters

Autopopulated

Visible when Country Other than USA is Chosen


Telephone Number Extension

Number

Autopopulated



Fax Number (include Area Code)

Phone

Autopopulated

Visible when USA is Chosen


International Fax Number (include Country Code)

(Fax) Numeric & Special Characters


Autopopulated

Visible when Country Other than USA is Chosen


Fax Number Extension

Number

Autopopulated



Provide the Home Address, Phone Number, and E-mail Address for this person.

N/A

N/A



Home Address

Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated



Personal E-mail Address

Email

Autopopulated



Personal Telephone Number (include Area Code)

Number

Autopopulated



Personal International Telephone Number


Number

Autopopulated



Effective Date

Date




End Date

Date




I hereby certify that, to the best of my knowledge and belief, all information in this document is true and correct. I understand that if my institution provides false or misleading information, (a) the U.S. Department of Education may deny the institution’s request for eligibility to participate in federal student financial aid programs and/or revoke eligibility once it has been granted and (b) the institution may be liable for all federal student financial aid funds it or its students received. I also understand that providing false or misleading information on this application is a violation of the United States Criminal Code, Title 18, Section 1001 and may result in a fine of up to $250,000 for an individual or $500,000 for an organization, and/or imprisonment for up to five years, or both, for misinformation that is material to receipt and stewardship of federal student financial aid funds.


Checkbox

None



Section I: Foreign Schools

Question #

Text

Field Type

Automation

Visibility

1.

Do you admit as regular students only people who have a credential of secondary school completion or its recognized equivalent?



Picklist (Yes, No)

Autopopulated

Visible to Foreign Schools

2.

Do you admit students on the basis of a "mature student" admission policy?


Help Text:

A policy to admit adult students who have not completed a secondary school or high school education based on the applicant’s age.

Picklist (Yes, No)

Autopopulated

Visible to Foreign Schools

3.

In the country where you are located, are you legally authorized by the education ministry, council, or equivalent agency to provide an educational program beyond the secondary school level?


Picklist (Yes, No)

Autopopulated

Visible to Foreign Schools

4.

Does your institution award degrees, certificates, or other recognized education credentials that are officially recognized by the country in which your institution is located?


Picklist (Yes, No)

Autopopulated

Visible to Foreign Schools

5.

Identify from the list the legal authorizing agency/ministry/educational council within the country where your institution is located that granted legal authorization to your institution to provide an educational program beyond the secondary school level.

Picklist



Autopopulated

Visible to Foreign Schools

6.

Add any additional information regarding your institution’s legal authorization to provide an educational program beyond the secondary school level, such as reference to Royal Charter, law, or regulation.

Text

Autocompleted

Visible to Foreign Schools


If the legal authorizing agency is not included in this list, insert the name and address of the legal authorizing agency in the spaces provided.

N/A


Visible to Foreign Schools


Legal Authorization Agency Name

Text

Autopopulated

Visible to Foreign Schools


Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated

Visible USA is Chosen


Telephone Number (include Area Code)

Phone

Autopopulated

Visible when USA is Chosen


International Telephone Number (include Country Code)

(Phone) Numeric & Special Characters

Autopopulated

Visible when Country Other than USA is Chosen


Telephone Number Extension

Number

Autopopulated



Fax Number (include Area Code)

Phone

Autopopulated

Visible when USA is Chosen


International Fax Number (include Country Code)

(Fax) Numeric & Special Characters


Autopopulated

Visible when Country Other than USA is Chosen


Fax Number Extension

Number

Autopopulated



End Date


Date



7.

Does another postsecondary education institution validate programs offered by your institution?


Picklist (Yes, No)

Autopopulated

Visible to Foreign Schools


Provide the details for each validation agreement and upload a copy of all validation agreement(s).

N/A

N/A

Visible to Foreign Schools when Does another postsecondary education institution validate programs offered by your institution? = yes


Institution Name

Institution Search (Smart Search with Name, City, State)

Autopopulated

Visible to Foreign Schools when Does another postsecondary education institution validate programs offered by your institution? = yes


Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated

Visible to Foreign Schools when Does another postsecondary education institution validate programs offered by your institution? = yes


Telephone Number (include Area Code)

Phone

Autopopulated

Visible to Foreign Schools when Does another postsecondary education institution validate programs offered by your institution? = yes Visible when USA is Chosen


International Telephone Number (include Country Code)

(Phone) Numeric & Special Characters

Autopopulated

Visible to Foreign Schools when Does another postsecondary education institution validate programs offered by your institution? = yes Visible when Country Other than USA is Chosen


Telephone Number Extension

Number

Autopopulated

Visible to Foreign Schools when Does another postsecondary education institution validate programs offered by your institution? = yes


Fax Number (include Area Code)

Phone

Autopopulated

Visible to Foreign Schools when Does another postsecondary education institution validate programs offered by your institution? = yes Visible when USA is Chosen


International Fax Number (include Country Code)

(Fax) Numeric & Special Characters


Autopopulated

Visible to Foreign Schools when Does another postsecondary education institution validate programs offered by your institution? = yes Visible when Country Other than USA is Chosen


Fax Number Extension

Number

Autopopulated

Visible to Foreign Schools when Does another postsecondary education institution validate programs offered by your institution? = yes


End Date


Date

Autopopulated, autopopulated with account lookup selected result

Visible to Foreign Schools when Does another postsecondary education institution validate programs offered by your institution? = yes

8.

Are you legally authorized to award a degree that is equivalent to an associate, baccalaureate, graduate, or professional degree awarded in the United States?

Picklist (Yes, No)

Autopopulated

Visible to Foreign Schools

9.

Do you provide an educational program that is at least a two-academic-year program acceptable for full credit toward the equivalent of a baccalaureate degree awarded in the United States?

Picklist (Yes, No)

Autopopulated

Visible to Foreign Schools

10.

Do you provide any educational programs that meet all three of these criteria?


  • The program is equivalent to at least a one-academic-year training program in the United States, and

  • The program leads to a certificate, degree, or other educational credential that is equivalent to one offered in the United States, and

  • The program prepares students for gainful employment in an occupation that is equivalent to one in the United States.


Picklist (Yes, No)

Autopopulated

Visible to Foreign Schools

11.

Are any of your programs offered in whole or in part by means of correspondence?

Picklist (Yes, No)

Autopopulated

Visible to Foreign Schools

12.

Do you offer any programs that uses telecommunications to provide instruction to U.S. students?


Picklist (Yes, No)

Autopopulated

Visible to Foreign Schools


13.

Do you have administrative offices and/or recruiting offices in the United States that represent you?


Provide the following information and upload a description of the functions of the U.S. administrative office.

Picklist (Yes, No)

Autopopulated

Visible to when entering a US administrative office

IF they answer no, no Admin Office Location table will display

13a.

U.S. Administrative/Recruiting Office Name

Text

Autopopulated

Visible to when entering a US administrative office



Street Address, City, State, Country, ZIP


Autopopulated

Visible to when entering a US administrative office



Telephone Number (include Area Code)

Phone

Autopopulated

Visible to when entering a US administrative office

Visible when USA is Chosen


International Telephone Number (include Country Code)

(Phone) Numeric & Special Characters

Autopopulated

Visible to when entering a US administrative office

Visible when Country Other than USA is Chosen


Telephone Number Extension

Number

Autopopulated

Visible to when entering a US administrative office



Fax Number (include Area Code)

Phone

Autopopulated

Visible to when entering a US administrative office

Visible when USA is Chosen


International Fax Number (include Country Code)

(Fax) Numeric & Special Characters


Autopopulated

Visible to when entering a US administrative office

Visible when Country Other than USA is Chosen


Fax Number Extension

Number

Autopopulated

Visible to when entering a US administrative office


13b.

U.S. Administrative/Recruiting Office Contact Name

Name

Autopopulated

Visible to when entering a US administrative office



Prefix, First Name, Middle Name, Last Name, Suffix, Job Title


Autopopulated

Visible to when entering a US administrative office



U.S. Administrative /Recruiting Office Contact E-Mail

Email

Autopopulated

Visible to when entering a US administrative office



End Date

Date

Autopopulated

Visible to when entering a US administrative office


14.

Are you accredited by an accrediting agency in the United States?


Picklist (Yes, No)

Autopopulated

Visible to Foreign Schools


14a.

Choose your accrediting agency

Accrediting Agency Lookup

Autopopulated

Visible to Foreign Schools

14b.

What year did this accrediting agency last accredit you?

Date YYYY

Autopopulated

Visible to Foreign Schools

14c.

For how many years is this accreditation granted?

Number

Autopopulated

Visible to Foreign Schools

14d.

Check here if this is your Primary Accreditor

Checkbox

Autopopulated

Visible to Foreign Schools

14e.

Select if this agency accredits your whole institution

Checkbox

Autopopulated

Visible to Foreign Schools

14f.

Select if this agency accredits individual programs offered by your institution


Checkbox

Autopopulated

Not Visible to Foreign Schools

14g.

Has this accreditor issued a decision letter, placed the institution/location on probation, placed the institution/location on warning, placed the institution/location on show cause, issued a loss/withdrawal of accreditation notice, mandated a reporting requirement or issued any other notification of non-compliance of accrediting standards since your last application was submitted?  


Picklist (Yes, No)

Autopopulated

Visible to Foreign Schools


Select action issued

Picklist, Multi-Select Picklist

Decision letter

Placed the institution/location on probation

Placed the institution/location on warning

Placed the institution/location on show cause

Issued a loss/withdrawal of accreditation notice

Mandated a reporting requirement 

Other notification of non-compliance of accrediting standards


Autopopulated

Visible to Foreign Schools


Other Adverse Action

Text

Autopopulated

Visible to Foreign Schools

14h.

Upon user completion of above questions, an entry will be added and displayed to the US Accrediting Agency Table

Provide the End Date of your Accreditation


Date

Autopopulated

Visible to Foreign Schools


Enter the explanation as to why this is end date is more than 30 days in the future

Date

N/A

Visible when End Date is more than 30 days in the future

15.

Indicate below whether your institution offers a degree of medical doctor, doctor of osteopathic medicine, or the equivalent; a veterinary program; or a nursing program.  Then indicate whether your institution seeks Title IV, HEA program eligibility for a medical program, a veterinary program, or a nursing program.

N/A

N/A

Visible to Foreign Schools


Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program

N/A

N/A

Visible to Foreign Schools


Program Offered

Picklist (Yes, No)

Autopopulated

Visible if Program Offered = Yes


Seeking Title IV

Picklist (Yes, No)

Autopopulated

Visible to Foreign Schools


Veterinary Program

N/A

N/A

Visible to Foreign Schools


Program Offered

Picklist (Yes, No)

Autopopulated

Visible to Foreign Schools


Seeking Title IV

Picklist (Yes, No)

Autopopulated

Visible to Foreign Schools


Nursing Program

N/A

N/A

Visible to Foreign Schools


Program Offered

Picklist (Yes, No)

Autopopulated

Visible to Foreign Schools


Seeking Title IV

Picklist (Yes, No)

Autopopulated

Visible to Foreign Schools


Additional Information


Use this area to provide information about any unusual circumstances or to provide additional explanations about questions you answered in this section.

Text

N/A


Document Table

Document Upload Component

File Uploader

N/A

N/A


Does this document contain PII data?


Picklist (Yes, No)

N/A

Visible when uploading a new file


Document Type

Picklist (See Submit eApp Section)

This field will only show the remaining documents that are required to be uploaded

Visible when uploading a new file


Check here if you will be providing the URL to where this document type is located on your institution’s Web site in the document description below.

Checkbox

N/A

Visible when uploading a new file


Enter a description of the document

Text

N/A

Visible when uploading a new file


Foreign Medical Schools


Question #

Text

Field Type

Automation

Visibility


1.

Are you seeking approval for a Post baccalaureate/equivalent medical program?



Picklist (Yes, No)

Autopopulated

Visible to Foreign Schools, Visible to Foreign For – Profits


2.

Is your medical program offered as a joint degree program with another institution?


Picklist (Yes, No)

Autopopulated

Visible to Foreign Schools, Visible to Foreign For – Profits


3.

Medical Program Name

Text

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.


4.

Program Length in Months

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.

5.

Is the medical school listed in the World Directory of Medical Schools?

Picklist, Yes or No

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.

6.

Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.


Picklist, Yes or No

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.


Identify the medical accreditor within the country where your institution is located that is legally authorized to evaluate the quality of medical education programs in your country.

N/A

N/A

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.

7.

Medical Accrediting Agency or Ministry

Picklist (multi)


(see email medical accrediting)

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


If you chose "Other" from the list of medical accreditors provide the name and address of the evaluating agency that is legally authorized to approve, accredit or recognize medical schools in your country.



N/A

N/A

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV. And when and when “Medical Accrediting Agency or Ministry” = other


Medical Accrediting Agency Name


Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV. And when and when “Medical Accrediting Agency or Ministry” = other


Street Address, City, State/Province, Country, Postal Code



Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV. And when and when “Medical Accrediting Agency or Ministry” = other


International Telephone Number (include Country Code)


Phone (note, international, requires all characters and more than 10 digits)

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV. And when and when “Medical Accrediting Agency or Ministry” = other


Telephone Number Extension

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV. And when and when “Medical Accrediting Agency or Ministry” = other


International Fax Number (include Country Code)


Phone (note, international, requires all characters and more than 10 digits)

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV. And when and when “Medical Accrediting Agency or Ministry” = other


Fax Number Extension

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV. And when and when “Medical Accrediting Agency or Ministry” = other


Medical Accreditor Contact Name

Display Text

N/A

N/A


Prefix, First Name, Middle Name, Last Name, Suffix, Job Title


Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV. And when and when “Medical Accrediting Agency or Ministry” = other


Medical Accreditor Contact Email

Text

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV. And when and when “Medical Accrediting Agency or Ministry” = other

8.

Is your medical school currently approved by this medical accrediting agency?




Picklist (Yes, No)

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.

8a.

What month/year did the medical accrediting agency last approve the medical school?


Date

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Is your medical school currently approved by this medical accrediting agency?” = yes


8b.

For how many years did the evaluating agency extend its approval?

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Is your medical school currently approved by this medical accrediting agency?” = yes



Provide the date this accreditation ended.


Date

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Is your medical school currently approved by this medical accrediting agency?” = yes


9.

Confirm that your medical accreditor is recognized by the World Federation for Medical Education (WFME).


Picklist (Yes, No)

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes

10.

Where is the facility at which you provide graduate medical educational program instruction in your country? Also include Contact person information at this facility.

.


N/A

N/A

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Name of Facility

Text

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Street Address, City, State/Province, Country, Postal Code


Autopopulated


Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes




Telephone Number (include Area Code)

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes And Country = USA



International Telephone Number (include Country Code)


Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes and country is not USA


Telephone Number Extension

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Fax Number (include Area Code)

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes And Country = USA


International Fax Number (include Country Code)


Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes and country is not USA


Fax Number Extension

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Name of contact at the facility

N/A

N/A



Prefix, First Name, Middle Name, Last Name, Suffix, Job Title


Autopopulated



Facility Contact Email





End Date



Only provide an end date if you no longer provide graduate medical educational program instruction at this facility.




11.


Identify all clinical instruction locations where your medical students receive clinical training from home country; other locations that are Liaison Committee on Medical Education (LCME) or American Osteopathic Association (AOA) approved; or a National Committee on Foreign Medical Education and Accreditation (NCFMEA) approved comparable foreign country.






N/A

N/A

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes

11a.

Instruction Type



Identify the type(s) of clinical training instruction provided at this location. Select all that apply:

Picklist

Core Clinical

Elective Clinical


Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes

11b.

Indicate the date that instruction was first offered to your medical students at this location.

Date

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Enter the name and address of this clinical site.

N/A

N/A

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes

11c

Name of Non-U.S. Training Facility

Text

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Street Address, City, State/Province, Country, Postal Code


Autopopulated


Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Telephone Number (include Area Code)

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


International Telephone Number (include Country Code)


Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Telephone Number Extension

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Fax Number (include Area Code)

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


International Fax Number (include Country Code)


Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Fax Number Extension

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Name of contact at this clinical site

N/A

N/A



Prefix, First Name, Middle Name, Last Name, Suffix, Job Title


Autopopulated



Clinical Site Contact Email

Text

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


End Date



Only provide an end date if you no longer provide graduate medical educational program instruction at this clinical site.

Date

N/A

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes

12

Has the medical accrediting agency in your home country conducted an on-site evaluation and specifically approved this clinical training site?



Picklist (Yes, No)

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes

13

Does your medical school have a formal affiliation agreement or other written arrangement to provide clinical training instruction to your students at this location?

Picklist, Y/N

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.

13a

Is Agreement current?

Picklist (Yes, No)

Autopopulated

Visible when Does your medical school have a formal affiliation agreement or other written arrangement to provide clinical training instruction to your students at this location?= yes

13b

Briefly describe the agreement’s terms of renewal

Text

Autopopulated

Visible when “Is Agreement Current” = no


Agreement End Date

Date

Autopopulated

Visible when “Is Agreement Current” = no

13c

Identify where in the clinical affiliation agreement the following 6 elements can be found, for example, the page number and section number


N/A

N/A

Visible when Does your medical school have a formal affiliation agreement or other written arrangement to provide clinical training instruction to your students at this location? = yes


Regulatory Elements

N/A

N/A

Visible when Does your medical school have a formal affiliation agreement or other written arrangement to provide clinical training instruction to your students at this location?= yes and when Is Agreement Current” = yes


Element 1: Maintenance of the School’s Standards

Text

Autopopulated

Visible when Does your medical school have a formal affiliation agreement or other written arrangement to provide clinical training instruction to your students at this location?= yes and when Is Agreement Current” = yes


Element 2: Appointment of Faculty to the Medical School Staff

Text

Autopopulated

Visible when Does your medical school have a formal affiliation agreement or other written arrangement to provide clinical training instruction to your students at this location?= yes and when Is Agreement Current” = yes


Element 3: Design of the Curriculum

Text

Autopopulated

Visible when Does your medical school have a formal affiliation agreement or other written arrangement to provide clinical training instruction to your students at this location?= yes and when Is Agreement Current” = yes


Element 4: Supervision of Students

Text

Autopopulated

Visible when Does your medical school have a formal affiliation agreement or other written arrangement to provide clinical training instruction to your students at this location?= yes and when Is Agreement Current” = yes


Element 5: Evaluation of Student Performance

Text

Autopopulated

Visible when Does your medical school have a formal affiliation agreement or other written arrangement to provide clinical training instruction to your students at this location?= yes and when Is Agreement Current” = yes


Element 6: Provision of Liability Insurance

Text

Autopopulated

Visible when Does your medical school have a formal affiliation agreement or other written arrangement to provide clinical training instruction to your students at this location?= yes and when Is Agreement Current” = yes

14

Is this clinical training location approved by the agency authorized to evaluate medical schools in your country?


Picklist (Yes, No)

Autopopulated

Visible when school indicates they have a foreign medical school

15

Is this clinical training location included in the accreditation of a medical program accredited by the Liaison Committee on Medical Education (LCME) or the American Osteopathic Association (AOA)?

Picklist (Yes, No)

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.

16

Is clinical instruction that is provided to your students at this site also offered in conjunction with a medical education program that is offered to students enrolled in another medical school(s) that is accredited by the medical accreditor that is legally authorized to evaluate medical education in that country located in an NCFMEA approved comparable foreign country?


Picklist (Yes/No)

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.

17

Name of the accredited medical school

Text

Autopopulated

Visible when “Check here if clinical instruction that is provided to your students at this site is also offered in conjunction with a medical education program that is offered to students enrolled in another medical school(s) that is accredited by the medical accreditor that is legally authorized to evaluate medical education in that country = checked.


Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated

Visible when “Check here if clinical instruction that is provided to your students at this site is also offered in conjunction with a medical education program that is offered to students enrolled in another medical school(s) that is accredited by the medical accreditor that is legally authorized to evaluate medical education in that country = checked.


Telephone Number (include Area Code)

Number

Autopopulated

Visible when “Check here if clinical instruction that is provided to your students at this site is also offered in conjunction with a medical education program that is offered to students enrolled in another medical school(s) that is accredited by the medical accreditor that is legally authorized to evaluate medical education in that country = checked


International Telephone Number (include Country Code)

Number

Autopopulated

Visible when “Check here if clinical instruction that is provided to your students at this site is also offered in conjunction with a medical education program that is offered to students enrolled in another medical school(s) that is accredited by the medical accreditor that is legally authorized to evaluate medical education in that country = checked.


Telephone Number Extension

Number

Autopopulated

Visible when “Check here if clinical instruction that is provided to your students at this site is also offered in conjunction with a medical education program that is offered to students enrolled in another medical school(s) that is accredited by the medical accreditor that is legally authorized to evaluate medical education in that country = checked.


Fax Number (include Area Code)

Number

Autopopulated

Visible when “Check here if clinical instruction that is provided to your students at this site is also offered in conjunction with a medical education program that is offered to students enrolled in another medical school(s) that is accredited by the medical accreditor that is legally authorized to evaluate medical education in that country = checked.


International Fax Number (include Country Code)

Number

Autopopulated

Visible when “Check here if clinical instruction that is provided to your students at this site is also offered in conjunction with a medical education program that is offered to students enrolled in another medical school(s) that is accredited by the medical accreditor that is legally authorized to evaluate medical education in that country = checked.


Fax Number Extension

Number

Autopopulated

Visible when “Check here if clinical instruction that is provided to your students at this site is also offered in conjunction with a medical education program that is offered to students enrolled in another medical school(s) that is accredited by the medical accreditor that is legally authorized to evaluate medical education in that country = checked.


Identify all clinical instruction locations that are U.S. training facilities

N/A

N/A

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes

18

Instruction Type



Identify the type(s) of clinical training instruction provided at this location. Select all that apply:

Picklist

Core Clinical

Elective Clinical


Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes

19.

Name of U.S. training facility

Text

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Telephone Number (include Area Code)

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.


International Telephone Number (include Country Code)

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Telephone Number Extension

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Fax Number (include Area Code)

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


International Fax Number (include Country Code)

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Fax Number Extension

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Name of contact at this U.S. Training Facility

N/A

N/A



Prefix, First Name, Middle Name, Last Name, Suffix, Job Title


Autopopulated



U.S. Training Facility Email

Text

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes

20.

Identify the U.S medical licensing boards and evaluating bodies that approve your clinical training.


Display Only

N/A

N/A


Name of evaluating body/medical licensing board


Text

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Telephone Number (include Area Code)

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


International Telephone Number (include Country Code)

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Telephone Number Extension

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Fax Number (include Area Code)

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


International Fax Number (include Country Code)

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Fax Number Extension

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Medical Licensing Board/Evaluating body Contact Information

N/A

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Prefix, First Name, Middle Name, Last Name, Suffix, Job Title


Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Email

Text

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Is your clinical training still approved by this medical licensing board/evaluation body

Picklist (yes, no)

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


If you are no longer approved by this medical licensing board/evaluation body, enter the date this approval ended

Date

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes


Indicate the date that instruction was first offered to your medical students at this location.

Date

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes

21.

Does your medical school have a formal affiliation agreement or other written arrangement to provide clinical training instruction to your students at this location?



Picklist, Y/N

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.

21a.

Is Agreement current?

Help Text if partner answers “no” to this question: “If the school does not have a valid formal affiliation agreement or other agreement with the clinical site or hospital, it is not an approved, eligible site.”

Picklist (Yes, No)

Autopopulated

Visible when Does your medical school have a formal affiliation agreement or other written arrangement to provide clinical training instruction to your students at this location?= yes

21b.

Briefly describe the agreement’s terms of renewal

Text

Autopopulated

Visible when “Is Agreement Current” = no


Agreement End Date

Date

Autopopulated

Visible when “Is Agreement Current” = no

21c.

Identify where in the clinical affiliation agreement the following 6 elements can be found, for example, the page number and section number


N/A

N/A

Visible when Does your medical school have a formal affiliation agreement or other written arrangement to provide clinical training instruction to your students at this location? = yes


Regulatory Elements

N/A

N/A

Visible when Does your medical school have a formal affiliation agreement or other written arrangement to provide clinical training instruction to your students at this location?= yes and when Is Agreement Current” = yes


Element 1: Maintenance of the School’s Standards

Text

Autopopulated

Visible when Does your medical school have a formal affiliation agreement or other written arrangement to provide clinical training instruction to your students at this location?= yes and when Is Agreement Current” = yes


Element 2: Appointment of Faculty to the Medical School Staff

Text

Autopopulated

Visible when Does your medical school have a formal affiliation agreement or other written arrangement to provide clinical training instruction to your students at this location?= yes and when Is Agreement Current” = yes


Element 3: Design of the Curriculum

Text

Autopopulated

Visible when Does your medical school have a formal affiliation agreement or other written arrangement to provide clinical training instruction to your students at this location?= yes and when Is Agreement Current” = yes


Element 4: Supervision of Students

Text

Autopopulated

Visible when Does your medical school have a formal affiliation agreement or other written arrangement to provide clinical training instruction to your students at this location?= yes and when Is Agreement Current” = yes


Element 5: Evaluation of Student Performance

Text

Autopopulated

Visible when Does your medical school have a formal affiliation agreement or other written arrangement to provide clinical training instruction to your students at this location?= yes and when Is Agreement Current” = yes


Element 6: Provision of Liability Insurance

Text

Autopopulated

Visible when Does your medical school have a formal affiliation agreement or other written arrangement to provide clinical training instruction to your students at this location?= yes and when Is Agreement Current” = yes

22.

Does your institution have a clinical training program that was approved by a state on or before January 1, 1992 and has it continuously operated a clinical training program in at least one state that approves the program?


Picklist (Yes, No)

Autopopulated


23.

Does your institution have a clinical training program that was approved by a state prior to January 1, 2008 and has it continuously operated a clinical training program in at least one state that approves the program?


Picklist (Yes, No)

Autopopulated


24.

Is your institution approved to offer clinical instruction by a State at this location?



Picklist (Yes, No)

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes

24a.

State Agency Name

Text

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes = yes and when “Is your institution approved to offer clinical instruction by a State at this location?” = yes

24b.

State Approval Start Date


Date

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes = yes and when “Is your institution approved to offer clinical instruction by a State at this location?” = yes

24e

State Approval End Date

Date

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes = yes and when “Is your institution approved to offer clinical instruction by a State at this location?” = yes

24c.

Check here if your institution ceased to offer a clinical training program at this clinical site or it is no longer approved to offer the clinical training program.

Checkbox

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.

24d

Last Date of Instruction

Date

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.

24e

State Approval End Date

Date

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and when “Please confirm that your MD program is in a country other than the United States that the National Committee on Foreign Medical Education and Accreditation (NCFMEA) has determined uses comparable medical accrediting agency approval standards.” = yes = yes and when “Is your institution approved to offer clinical instruction by a State at this location?” = yes

25.

Enter the date of medical school graduations within the past three twelve-month periods.


N/A

N/A

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.


Enter the graduation date

Date

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.


Identify the number of medical school graduates in the graduating class






Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.


Enter the graduation date

Date

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.


Identify the number of medical school graduates in the graduating class

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.


Enter the graduation date

Date

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.


Identify the number of medical school graduates in the graduating class

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.

26.

What is the beginning and ending dates of your institution's most recently completed academic year?

Display Only

N/A

N/A


Beginning Date:

Date

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.


Ending Date:

Date

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.

27.

How many full-time regular students were enrolled during the most recently completed academic year? 

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.

28.

How many of the regular students in the most recently completed academic year were not U.S. citizens or residents eligible for U.S. federal financial aid programs?

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.

29.

During the most recently completed year, how many of your regular students and graduates from the three preceding years took any "step" of the examinations administered by the Educational Commission for Foreign Medical Graduates?

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.

30.

How many of these students received passing scores on any "step" of the examinations?

Number

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.


Does your foreign graduate medical school provide any of the following types of medical educational programs? (check each type of program that is offered)

N/A

N/A

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and Institution Type = Foreign For Profit


Post baccalaureate/equivalent medical programs


Checkbox

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and Institution Type = Foreign For Profit


Other types of programs that lead to employment as a doctor of osteopathic medicine, or doctor of medicine or equivalent?

Checkbox

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV and Institution Type = Foreign For Profit


Review and respond to the following questions concerning data collection and reporting.

N/A

N/A

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.


Do you require U.S. citizens, U.S. nationals and U.S. lawful permanent residents accepted for admission into a post-baccalaureate/ equivalent medical program to take the Medical College Admission Test (MCAT)?


Picklist (Yes, No)

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.


Explanation:

Text

Autopopulated

Visible when “Do you require U.S. citizens, U.S. nationals and U.S. lawful permanent residents accepted for admission into a post-baccalaureate/ equivalent medical program to take the Medical College Admission Test (MCAT)?” = Yes


Do you require U.S. citizens, U.S. nationals and U.S. lawful permanent residents to report their MCAT scores to you?

Picklist (Yes, No)

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.


Do you report the MCAT scores achieved by U.S. citizens, U.S. nationals and U.S. lawful permanent residents and a statement of the number of times each U.S. citizen, U.S. national or U.S. lawful permanent resident took the MCAT examination in the preceding calendar year to the medical school's accrediting authority?

Picklist (Yes, No)

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.


Has your institution determined the consent requirements for and require the necessary consent of ALL students accepted for admission for whom the institution must report to comply with data collection and submission requirements for all of the following:


N/A

N/A

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.


MCAT Scores

Picklist (Yes, No)

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.


USMLE Performance Data


Picklist (Yes, No)

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.


U.S. Medical Residency Programs Placement Rate Data

Picklist (Yes, No)

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.


U.S. Citizenship Rate Data

Picklist (Yes, No)

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.


Does your institution have a data collection and reporting system that allows you to report all required information to the U.S. Department of Education and your medical school accrediting agency?


Picklist (Yes, No)

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.


Do you have a privacy law or a data protection law in your country prevents you from providing MCAT scores, USMLE scores, placement rates in U.S. medical residency programs, or citizenship/residency data for your medical students or graduates to the U.S. Department of Education or to your medical school’s accrediting agency?

Picklist (Yes, No)

Autopopulated

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.


Additional Information


Use this area to provide information about any unusual circumstances or to provide additional explanations about questions you answered in this section.


Text

N/A

Visible when School indicates they have a foreign Medical Doctor/Doctor of Osteopathic Medicine/Equivalent Program and answer “yes” to seeking Title IV.


Document Table

Document Upload Component

File Uploader

N/A

N/A


Does this document contain PII data?


Picklist (Yes, No)

N/A

Visible when uploading a new file


Document Type

Picklist (See Submit eApp Section)

This field will only show the remaining documents that are required to be uploaded

Visible when uploading a new file


Check here if you will be providing the URL to where this document type is located on your institution’s Web site in the document description below.

Checkbox

N/A

Visible when uploading a new file


Enter a description of the document

Text

N/A

Visible when uploading a new file

Annual Reporting for Foreign Medical School


Question #

Text

Field Type

Automation

Visibility

1.

Click below to upload your medical school’s Individual USMLE Test-Taker Performance Data, USMLE Pass Rates, Citizenship Rates and Consumer Information for the most recently completed calendar year.


Display Only

N/A

N/A


Upload Individual USMLE Test-Taker Performance Data


Document Upload

N/A

Visible when Application Update Purpose ‘Annual Reporting for Foreign Medical School’


Upload USMLE Pass Rates


Document Upload

N/A

Visible when Application Update Purpose ‘Annual Reporting for Foreign Medical School’


Upload Medical Citizenship Rate


Document Upload

N/A

Visible when Application Update Purpose ‘Annual Reporting for Foreign Medical School’


Upload Medical Consumer Information


Document Upload

N/A

Visible when Application Update Purpose ‘Annual Reporting for Foreign Medical School’

Foreign Veterinary Schools



Question #

Text

Field Type

Automation

Visibility

1.

Are you seeking approval for a Post baccalaureate/equivalent veterinary program?


Picklist (Yes, No)

Autopopulated

Visible when School indicates they have a foreign Veterinary School Program and answer “yes” to seeking Title IV and Institution Type = Foreign For Profit

2.

Is your Veterinary program offered as a joint degree program with another institution?

Picklist (Yes, No)

Autopopulated

Visible when School indicates they have a foreign Veterinary School Program and answer “yes” to seeking Title IV and Institution Type = Foreign For Profit

3.

Do you have an entity in your country that is legally authorized to evaluate the quality of your program of classroom and clinical veterinary instruction?


Picklist (Yes, No)

Autopopulated

Visible when school indicates they have a foreign vet school and answer “yes” to seeking Title IV.

3a.

Select the name and address of the entity in your country that is legally authorized to evaluate veterinary instruction offered in your country.

N/A

N/A

Visible when school indicates they have a foreign vet school and answer “yes” to seeking Title IV and “Do you have an entity in your country that is legally authorized to evaluate the quality of your program of classroom and clinical veterinary instruction?” = yes


Name of Veterinary Accreditor

Picklist




Autopopulated

Visible when school indicates they have a foreign vet school and answer “yes” to seeking Title IV and “Do you have an entity in your country that is legally authorized to evaluate the quality of your program of classroom and clinical veterinary instruction?” = yes


Here is the information concerning the Veterinary Program Accreditor you have selected:

Name, Address, Contact displays

Display only



3b.

Is your veterinary school approved, accredited, or recognized by this entity? If Yes, upload your most current approval documents in the Upload Documents section of this application?


Picklist (Yes, No)

Autopopulated

Visible when school indicates they have a foreign vet school and answer “yes” to seeking Title IV and “Do you have an entity in your country that is legally authorized to evaluate the quality of your program of classroom and clinical veterinary instruction?” = yes

3c

What month/year did the evaluating agency last approve the veterinary school?

Date

Autopopulated

Visible when school indicates they have a foreign vet school and answer “yes” to seeking Title IV and “Do you have an entity in your country that is legally authorized to evaluate the quality of your program of classroom and clinical veterinary instruction?” = yes

3d.

For how many years did the evaluating agency extend its approval?

Number

Autopopulated

Visible when school indicates they have a foreign vet school and answer “yes” to seeking Title IV and “Do you have an entity in your country that is legally authorized to evaluate the quality of your program of classroom and clinical veterinary instruction?” = yes


If you are no longer approved by this entity, enter the date this approval ended.




Date

Autopopulated

Visible when school indicates they have a foreign vet school and answer “yes” to seeking Title IV and “Do you have an entity in your country that is legally authorized to evaluate the quality of your program of classroom and clinical veterinary instruction?” = yes



Identify all locations where your veterinary students receive classroom and clinical instruction.



Note: Do not report veterinary clinical training locations that are not used regularly, but instead are chosen by individual students who take no more than two electives at the clinical training locations for no more than a total of eight weeks.


N/A

N/A

Visible when school indicates they have a foreign vet school

4,.

Enter the name and address of your foreign veterinary school location

Display only



4a.

Name of Veterinary School

Text

Autopopulated

Visible when entering a foreign veterinary school location



4b.

Instruction Type

Picklist (multi)

Classroom Instruction

Clinical Instruction

Autopopulated

Visible when entering a foreign veterinary school location



4c

Address information

Display only




Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated with Production Answer

Visible when entering a foreign veterinary school location



End Date

Date


Visible when entering a foreign veterinary school location


5.

Do you have a written agreement under which clinical instruction is provided at this veterinary school?

If yes, upload a copy of your written agreement as a supporting document to this application.

Picklist (Yes, No)

Autopopulated

Visible when entering a foreign veterinary school location


5a.

Identify the date that instruction was first offered to your veterinary students at this

veterinary school.

Date

Autopopulated

Visible when entering a foreign veterinary school location


5b.

Do you require your students to complete their clinical training at this U.S. veterinary school?

Picklist (Yes, No)

Autopopulated

Visible if a Partner is a foreign for-profit institution and identifies the clinical site location’s country as the “United States."

5c.

Do you have a written agreement under which instruction is provided at this U.S. location?

Note: If yes, upload your written agreement

Picklist (Yes, No)

Autopopulated

Visible when school indicates they have a foreign vet school and the country is US

5d.

Check all statements that apply

Display only




Check here if you have an affiliation agreement or other written arrangement to provide clinical instruction to your students at this veterinary school.

Upload a copy of this agreement as a supporting document for this application.

Checkbox

Autopopulated

Visible when school indicates they have a foreign vet school


Check here if this clinical location is specifically approved by the agency authorized to evaluate veterinary schools in your country.


Checkbox

Autopopulated

Visible when school indicates they have a foreign vet school


Check here if this facility is an approved veterinary school located within the United States.

Checkbox

Autopopulated

The question is visible for Foreign non profit and Foreign public schools that report a location that is not in U.S. and not in the country of the institution’s principal location.


Check here if this clinical training location is included in the accreditation of a veterinary program accredited by the American Veterinary Medical Association (AVMA) or a veterinary accreditor that has been approved by the Secretary of the U.S. Department of Education.

Checkbox

Autopopulated

The question is visible for Foreign non profit and Foreign public schools that report a location that is not in U.S. and not in the country of the institution’s principal location.

5e.

Provide information about a contact at this facility.

N/A

N/A

Visible when school indicates they have a foreign vet school


Prefix, First Name, Middle Name, Last Name, Suffix, Job Title


Autopopulated

Visible when school indicates they have a foreign vet school


E-mail Address

Email

Autopopulated

Visible when school indicates they have a foreign vet school


Location End Date

Date

Autopopulated

Visible when school indicates they have a foreign vet school


Additional Information


Use this area to provide information about any unusual circumstances or to provide additional explanations about questions you answered in this section.


Text

N/A


Document Table

Document Upload Component

File Uploader

N/A

N/A


Does this document contain PII data?


Picklist (Yes, No)

N/A

Visible when uploading a new file


Document Type

Picklist (See Submit eApp Section)

This field will only show the remaining documents that are required to be uploaded

Visible when uploading a new file


Check here if you will be providing the URL to where this document type is located on your institution’s Web site in the document description below.

Checkbox

N/A

Visible when uploading a new file


Enter a description of the document

Text

N/A

Visible when uploading a new file



Foreign Nursing

Question #

Text

Field Type

Automation

Visibility

1.

Are you seeking approval for a Post baccalaureate/equivalent nursing program?


Picklist (Yes, No)

Autopopulated

Visible when Foreign For Profit Partner indicates they are seeking title iv for their foreign nursing program

2.

Is your nursing program offered as a joint degree program with another institution?

Picklist (Yes, No)

Autopopulated

Visible when Foreign For Profit Partner indicates they are seeking title iv for their foreign nursing program


Identify all locations where your nursing students receive clinical instruction.

N/A

N/A


3.

Enter the name and address of your U.S. Hospital/Accredited Nursing School Location

N/A

N/A



School/Facility Name

Text

Autopopulated

Visible when entering Nursing Location


Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated


Visible when entering Nursing Location



Telephone Number (Include Area Code)

Number

Autopopulated

Visible when entering Nursing Location

When country = USA



International Phone Number (include Country Code)


Number

Autopopulated

Visible when entering Nursing Location When Country is not USA




Telephone Number Extension

Number

Autopopulated

Visible when entering Nursing Location


International Fax Number (include Country Code)

Number

Autopopulated

Visible when entering Nursing Location When Country is not USA




Fax Number Extension

Number

Autopopulated

Visible when entering Nursing Location



3a.

Provide the name of a contact at the facility

N/A

N/A

Visible when entering Nursing Location



Prefix, First Name, Middle Name, Last Name, Suffix, Job Title


Autopopulated

Visible when entering Nursing Location



Facility Contact E-Mail Address

Text

Autopopulated

Visible when entering Nursing Location


4.

Identify each type of nursing instruction offered at this location.

Picklist:

Classroom Instruction

Clinical Instruction

Autopopulated

Visible when entering Nursing Location


4a.

If clinical training is provided to your students at this location, is this facility a U.S. hospital or an accredited school of nursing in the U.S.? (Check all that apply)

Picklist

U.S. hospital

Accredited school of nursing in U.S.

Other facility

Autopopulated

Visible when entering Nursing Location


4b.

Check here if this is a location where your student completes nursing clinical training.

Checkbox

Autopopulated

Visible when entering Nursing Location


4c.

Check here if your foreign nursing school has an Affiliation agreement with this facility to ensure proper oversight of the nursing program.



Note: At time of application submission, a copy of the provider Affiliation agreement with this provider and its certified English translation will be required to be uploaded.

Checkbox

Autopopulated

Visible when entering Nursing Location


4d.

Check here if faculty members of the foreign school are based at this facility to ensure proper educational oversight.

Checkbox

Autopopulated

Visible when entering Nursing Location


5.

Do students graduating from your nursing school also receive a degree from the accredited school of nursing located in the United States?

Picklist (Yes, No)

Autopopulated

Visible when entering Nursing Location



At time of application submission, a copy of the joint degree program agreement with the U.S. accredited nursing school will be required to be uploaded.

Identify below the nurse licensing boards and evaluating bodies which have approved the nursing program, and the dates of their approval.

N/A

N/A



End Date

Date


Visible when editing Nursing Location


6.

Identify below the U.S. nurse licensing boards and evaluating bodies which have approved the nursing program and the dates of their approval





Nurse Licensing Board or Evaluating Body

Text

Autopopulated

Visible when entering a Nurse Licensing Board or Evaluating Body


Street Address, City, State/Province, Country, ZIP/Postal Code


Autopopulated


Visible when entering a Nurse Licensing Board or Evaluating Body


Telephone Number (Include Area Code)

Number

Autopopulated

Visible when entering a Nurse Licensing Board or Evaluating Body And Country = USA


International Phone Number (include Country Code)


Number

Autopopulated

Visible when entering a Nurse Licensing Board or Evaluating Body When Country is not USA



Telephone Number Extension

Number

Autopopulated

Visible when entering Nursing Location


International Fax Number (include Country Code)

Number

Autopopulated

Visible when entering a Nurse Licensing Board or Evaluating Body When Country is not USA






Fax Number Extension

Number

Autopopulated

Visible when entering Nursing Location




Is your nursing school approved by this nursing licensing entity or evaluating body? If Yes, upload your most current approval documents in the Upload Documents section of this application.

Picklist (Yes, No)

Autopopulated

Visible when entering a Nurse Licensing Board or Evaluating Body


Provide the following information for a contact at this entity.

N/A

N/A

Visible when entering a Nurse Licensing Board or Evaluating Body



Prefix, First Name, Middle Name, Last Name, Suffix, Job Title


Autopopulated

Visible when entering a Nurse Licensing Board or Evaluating Body



Entity Contact E-mail Address

Email

Autopopulated

Visible when entering a Nurse Licensing Board or Evaluating Body


For how many years did the licensing/evaluating entity extend its approval?

Number

Autopopulated

Visible when entering a Nurse Licensing Board or Evaluating Body


If you are no longer approved by this licensing/evaluating entity, enter the date this approval ended.

Date

Autopopulated

Visible when entering a Nurse Licensing Board or Evaluating Body


7.

Identify below the accrediting agencies that approved the joint degree program between your nursing school and your U.S. nursing school.

N/A

N/A



Choose your accrediting agency

Lookup

Autopopulated

Visible when entering an Accrediting Agency

7a.

Is your nursing program approved by this accrediting agency? If Yes, upload your most current approval documents in the Upload Documents section of this application.

Email

Autopopulated

Visible when entering an Accrediting Agency

7b.

What month/year did the accrediting agency last approve the nursing program?

Date

Autopopulated


7c.

For how many years did the accrediting agency extend its approval?


Autopopulated


7d.

Provide the following information for a contact at this accrediting agency.

N/A

N/A



Prefix, First Name, Middle Name, Last Name, Suffix, Job Title


Autopopulated

Visible when entering an Accrediting Agency


Accrediting Agency Contact E-mail Address

Email

Autopopulated

Visible when entering an Accrediting Agency



If your nursing program is no longer approved by this accrediting agency, enter the date this approval ended.

Date

Autopopulated


8.

Select the foreign nursing school programs that your institution offers.

Check each that applies:

Multi Select Picklist:

  • Associate Degree School of Nursing

  • Collegiate School of Nursing

  • Diploma School of Nursing

Autopopulated


9.

Identify the graduation dates and the number of Nursing students who graduated from your Nursing school within the last two 12 month periods.

N/A

N/A



Enter date of Nursing school graduation.

Date

Autopopulated



Enter the number of nursing school graduates in this graduating class.

Number

Autopopulated



Enter date of Nursing school graduation.

Date

Autopopulated



Enter the number of nursing school graduates in this graduating class.

Number

Autopopulated


10.

Identify the number of students and graduates of the Nursing school who took the NCLEX-RN

Number

Autopopulated


11.

Identify the number of students and graduates who passed the NCLEX-RN

Number

Autopopulated


12.

Identify the % of students and graduates passing NCLEX.

Percentage

Autopopulated


13.

Does your nursing school employ only those faculty members whose academic credentials are the equivalent of credentials required of faculty members teaching the same or similar course at nursing schools in the U.S.?

Picklist (Yes, No)

Autopopulated


14.

Check here if your foreign nursing school agrees to reimburse the Secretary of Education for the costs of defaulted student loans for students attending your foreign nursing program.

Checkbox

Autopopulated


15.

Check here if your institution has determined the consent requirements for and requires the consents of all Nursing students accepted for admission who are U.S. citizens, nationals or eligible noncitizens.

Checkbox

Autopopulated


16.

Check here if a privacy law or a data protection law in your country prevents you from providing NCLEX-RN results or other data to the U.S. Department of Education.

Checkbox

Autopopulated



End Date

Date

Autopopulated



Additional Information


Use this area to provide information about any unusual circumstances or to provide additional explanations about questions you answered in this section.


Text

N/A


Document Table

Document Upload Component

File Uploader

N/A

N/A


Does this document contain PII data?


Picklist (Yes, No)

N/A

Visible when uploading a new file


Document Type

Picklist (See Submit eApp Section)

This field will only show the remaining documents that are required to be uploaded

Visible when uploading a new file


Check here if you will be providing the URL to where this document type is located on your institution’s Web site in the document description below.

Checkbox

N/A

Visible when uploading a new file


Enter a description of the document

Text

N/A

Visible when uploading a new file




File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitlePartner Participation Oversight Eligibility Application (eApp)
AuthorRider, Andrew
File Modified0000-00-00
File Created2023-09-02

© 2024 OMB.report | Privacy Policy