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. Page 2 of 9 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. Page 3 of 9 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.) Page 4 of 9 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. Page 5 of 9 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 Page 6 of 9 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. Page 7 of 9 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 Page 8 of 9 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 Page 9 of 9