NEW MEXICO HIGHER EDUCATION DEPARTMENT/PRIVATE POSTSECONDARY SCHOOLS DIVISION
2048 GALISTEO STREET/SANTA FE, NM 87505-2100/505-476-8442/FAX: 505-476-8454/PRIVATE.SCHOOLS@STATE.NM.US
INITIAL LICENSE APPLICATION for THE PROVISIONAL APPROVAL TO OPERATE (PAO)
SECTION I: INSTITUTIONAL INFORMATION: 5.100.1.11 (A); (B) NMAC.
Date of Application
Degree Granting Institution Fee: $4,000. Non-Degree Granting Fee: $1000. Amount Enclosed
Name of Institution
Physical Address of Institution
Institution’s Telephone:
City_____________ State
Fax:
Local Primary Point of Contact
Local Telephone:
Zip
Website
Title
Local Fax:
Email Address:
Mailing Address if different from above
Address of Main Institution (if applicable)
City
City
State
State
Zip
Zip
Application Fees 5.100.2.32 (A) Please initial and check the appropriate line.
1.
$4,000.00 fee to establish a new degree-granting institution, move an existing institution or establish a branch campus.
2.
$1,000.00 fee to establish a new non-degree granting institution.
Name of Institution
SECTION II: APPLICATION CHECKLIST
Please initial the appropriate blank line next to the item number and attach the appropriate documentation; identify the corresponding
number in the upper right hand corner of your attachment. (Example Attachment #3, Attachment #4, etc.) If an item is not applicable,
indicate with an N/A.
Institution Ownership 5.100.2.12(A.) NMAC.
3.
Sole Proprietorship/Partnership:
Attach Name(s) and Resume(s)
4.
Corporation: For Profit:
Attach Evidence of Incorporation
5.
Corporation: For Non-Profit:
Attach Evidence of Non-Profit Status
6.
Current on NM Gross Receipts Taxes
Attach Evidence from the NM Taxation & Revenue Department
Institution Administration 5.100.2.12(H.); Student Support Services 5.100.2.17(A. – F.) NMAC.
7.
Attach a summary list and resumes for the institutions management including the chief executive officer, senior business or
finance officer, senior financial aid administrator (if relevant), student services advisor and senior academic officer.
Institution Accreditation/Other Approvals Including Approvals from other States 5.100.2.14(A.) NMAC.
8.
9.
List all your institution’s accreditors and provide the most recent notice of your primary institutional accreditation, including the
most recent summary findings by the accrediting agency regarding your institution.
List states from which the institution holds approval(s) including home state approval.
Institution Financial Stability 5.100.2.13(B.) NMAC.
10.
Demonstrate liquid assets sufficient to operate the institution for a period of one year exclusive of anticipated revenue from
tuition and fees. These assets shall be sufficient to pay all projected salary and benefits of employees and the rent, utilities,
insurance and other costs of operating the institution’s facilities for a period of one year. In no case shall these assets be less than
$50,000.
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Name of Institution
Evidence of Surety Bond 5.100.2.15(C.) NMAC.
11.
Provide evidence of a surety bond (not less than $25,000 and not to exceed 20% of anticipated or actual gross annual tuition.) If the
institution is part of a corporation the bond should include both the name of the institution and the corporation.
Institution Liability Insurance 5.100.2.13(G.) NMAC.
12.
Licensed institutions by the Department shall maintain standard, commercial liability insurance, worker’s compensation insurance
and property insurance, worker’s compensation insurance, property insurance sufficient to protect students, employees, and other
citizens from hazards in the institution’s facilities.
Institution Fire Department Inspection 5.100.2.16(G.) NMAC.
13.
Please include appropriate documentation indicating institution has recent fire department inspection.
Advisory Council/Committees 5.100.2.15(A.) NMAC.
14.
Provide a list of the institution’s advisory committee members, may not be employees of the institution, which include their names
and titles, addresses and telephone numbers for each program.
Enrollment Agreement/Student Transcript 5.100.2.17(G.) NMAC.
14.
Attach copies of both the enrollment agreement and student transcript.
Evaluation/Appraisal 5.100.2.14(A.); 5.100.2.16(E.); 5.100.2.17(B.) (C.) (E.) (F.) NMAC.
15.
Provide your institution’s plan for assessing the satisfaction of your graduates.
16.
Provide your institution’s plan for ensuring that courses are current.
17.
Provide your institution’s plan for faculty improvement in terms of content knowledge and relevant instructional technologies to
support instruction.
18.
Provide your institution’s plan for using new and appropriate technologies to support instruction.
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Name of Institution:
Catalog 5.002.19(A); 5.100.2.20(F.); 5.100.2.22(A. – D.) NMAC
Please highlight the following policies in your catalog and also make reference to the page number and attach an additional sheet(s) describing
each policy and using the code number on the right hand corner of your page.
19.
Provide a copy of your institution’s most recent catalog(s) and additional publications that are routinely provide to students
describing the institution and its programs and policies. If you are not yet operating and don’t have a completed catalog, please
provide a draft.
20.
Tuition Policy. It should include the tuition and fees charged for each program. Page(s
21.
Refund Policy. Provide the tuition refund policies) of your institution. Page(s)
22.
Satisfactory academic progress of students. Identify the time limits imposed for program completion. Page(s)
23.
Complaint Policy: Provide your institution’s policy regarding handling of complaints from students and other persons. Page(s)
24.
Admissions Policy. Provide a clear and detailed statement of describing your procedure for assessing the qualifications of student
applicants for admission to your institution. In particular, students without a high school diploma. Page(s)
Main Institution
Branch
Non-Degree Institutional Programs:
Degree Granting Institution:
Levels of Education (check all that apply):
Non-credit Short Term Modules
Certificate
Diploma
Associate of Science
Associate of Arts
Bachelor of Science
Bachelor of Arts
Master of Science
Master of Arts
Juris Doctorate
Doctorate of Education (Ed.D.)
Doctorate of Philosophy (Ph.D.)
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Name of Institution
Section III Programs: Educational Programs Offered by the Institution.
5.100.2.27 (A) Additional Standards for Degree-Granting Institutions Program Requirements (Initial box as you provide item):
25.
Associate Degree Programs must include both technical/vocational and general education instruction.
26.
27.
Associate of Applied Science Degree: The recipient is prepared for immediate employment in a specified career field.
Associate of Arts or Associate of Science Degree: The recipient is prepared for immediate employment in a specified career field
and transfer to another institution for more advanced study.
Baccalaureate Degree Programs: At a minimum, issuance of a baccalaureate degree shall require at least 120 semester hours of
academic credits or the equivalent; the degree programs must include at least 33 semesters hours of general education core
requirements.
Master Degree Programs: Shall require at least 30 semester hours of academic credit or the equivalent beyond a Baccalaureate
Degree.
Doctoral Degree: Shall require at least 90 semester hours of academic credit or the equivalent beyond a baccalaureate degree or at
least 60 hours beyond the master’s degree or equivalent and a defense of a major independent project, involving original research
or application of knowledge.
A detailed description of the policy and procedure followed in awarding credit for life experience or experience gained through
employment related to the program of study.
A description of the process followed to achieve periodic review and approval of programs by teaching faculty at the institution.
An agreement that you have signed with accredited institutions to facilitate transfer of credit between institutions.
Samples of course outlines and syllabi.
Copies of all degree programs/requirements.
If your institution is non-traditional, including use of distance learning; provide a description of the instructional techniques used.
Attach your plan for meeting the accreditation requirement.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
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Name of Institution
Pursuant to 5.100.2.16. (C.) NMAC. A new application for a license will be approved to offer no more than six (6) degree programs during its
first two years of operation under a Provisional Approval to Operate (PAO). Please complete the following:
Program
Program Accreditor
CIP Code*
Level of
Education**
Delivery
Method***
Internship
Clinical
Externship
Semester/
Quarter
Credit Hours
Clock
Hours
Program
Cost
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Program
Program Accreditor
CIP Code*
Level of
Education**
Delivery
Method***
Internship
Clinical
Externship
Semester/
Quarter
Credit Hours
Clock
Hours
Program
Cost
*CIP Code: Classification of Instructional Program issued by an accreditor agency. Indicate if credit college hours are semester or quarter.
**Level of Education: Non-degree: 1-Module; 2-Certificate 3-Diploma – Degree: AS, AA, BS, BA, MS, MA, JD, EDd., PhD.
**DELIVERY METHOD: Online/Residential; Hybrid: Online/Classroom Participation; Distance Education; Correspondence; Classroom Instruction.
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Name of Institution
5.100.2.26 (A., B., C.) Evaluation and Appraisal of Programs and the Institution
In addition to providing PPSD with the information in the previous table, please respond to the following items:
Number of students enrolled in each Program, number of graduates for the past three years and employment of graduates anticipated during
each of the next three (5) years. If this is a new institution, please write non-applicable.
Program
Number of students enrolled
each program
Number of graduates for the past
three (3) three years
Anticipated number of
employment of graduates for the
next three (3) years
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Name of Institution
Section IV: Certification
As an authorized representative of the applicant institution, I hereby certify that the information provided in this application is accurate and
complete. I agree that the Department of Higher Education, Private Postsecondary Schools Division may conduct inspection visits at any or all
instructional sites of the institution to gather additional information pertinent to their evaluation of eligibility of licensure.
I certify that this institution has not filed bankruptcy during the past five years nor has it been under the control of, nor is it managed by a
person who has filed bankruptcy associated with the operations of an educational institution during the past five years.
I certify that at such time as the management of the institution believes that it may be necessary to close the institution, the Department of
Higher Education, Private and Postsecondary Division, will be informed. I understand that such notification must be provided as less than thirty
calendar days prior to closure. I further certify that the institution will provide the Department of Higher Education, Division of Private and
Postsecondary Division, with a plan that provides for:
1. Completion of programs by all currently active students,
2. Preservation of student records, and
3. Identification of a responsible agent for the school following closure, consistent to the requirements set forth in 5 NMAC.100.2.
I hereby certify that I have read in its entirety 5 NMAC. 100.2 New Mexico Higher Education Department and I hereby commit the institution to
abide by the conditions for licensure as a private postsecondary institution in New Mexico, consistent with applicable state law and 5 NMAC
100.2.
I certify that the information provided herein and attached is accurate and truthful.
Name
(Owner, President of Organization)
Signature ______________________________
Title
__
Date________________________________
RETURN THIS DOCUMENT TO:
NEW MEXICO HIGHER EDUCATION DEPARTMENT/PRIVATE POSTSECONDARY SCHOOLS DIVISION
2048 GALISTEO STREET/ SANTA FE, NM 87505-2100/ (505) 476-8442/FAX: (505) 476-8454/ PRIVATE.SCHOOLS@STATE.NM.US
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