ACCREDITATION REPORTING FORM

Institution:	Choose an item.	Reporting Period:	July 1,	Click or tap to enter a date.	through June 30,	Click or tap to enter a date.
Area	Accreditation Agency	Date of Visit or Notification of Status Change	Reason for Visit or Status Change	Institutional Action	Accreditation Agency Action
List all Accreditation visits, status changes, and/or reporting activity that has occurred at the Institution, College, School, Unit, and/or Degree Program levels from July 1 through June 30.	National Organization; State Department; etc.	Month, Year	Initial Accreditation; Continuing accreditation; Continuing State Department of Education Approval; etc.	Rejoinder; Progress Report; Substantive Change Form; Prospectus; etc.	Accreditation for __ years (20__); Continuing accreditation for ___ years (20__); Results pending; Report accepted; No additional reporting required before next affirmation; etc.
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Chief Academic Officer Signature – Date	Institutional Executive Officer Signature – Date