Accreditation Application

Type of School:*

ApprenticeshipCorrectionalPost-SecondarySecondary

Public, Not-for-Profit, or Profit:*

PublicNot-for-ProfitProfit

Accreditation Applying For:*

Building Automation SystemsGreen Mechanical SystemsHVACR Technologies

Accreditation Type:*

InitialRe-Accreditation

Name of School*

Physical Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Is the mailing address different from above?*

YesNo

Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Website*

Telephone Number*

Fax Number

Campus Director*

Title*

Email*

Telephone*

Cellphone

Self-Study Contact*

Title*

Email*

Telephone*

Cellphone

Annual Report Contact*

Title*

Email*

Telephone*

Cellphone

Billing Contact*

Title*

Email*

Telephone*

Cellphone

Name*

Telephone*

Cellphone

Email*

Building Automation SystemsGreen Mechanical SystemsHVACR Technologies

Full-time or Adjunct?*

Full-TimeAdjunct

Add Instructor?*

YesNo

Name*

Telephone*

Cellphone

Email*

Building Automation SystemsGreen Mechanical SystemsHVACR Technologies

Full-time or Adjunct?*

Full-TimeAdjunct

Add Instructor?*

YesNo

Name*

Telephone*

Cellphone

Email*

Building Automation SystemsGreen Mechanical SystemsHVACR Technologies

Full-time or Adjunct?*

Full-TimeAdjunct

Add Instructor?*

YesNo

Name*

Telephone*

Cellphone

Email*

Building Automation SystemsGreen Mechanical SystemsHVACR Technologies

Full-time or Adjunct?*

Full-TimeAdjunct

Add Instructor?*

YesNo

Name*

Telephone*

Cellphone

Email*

Building Automation SystemsGreen Mechanical SystemsHVACR Technologies

Full-time or Adjunct?*

Full-TimeAdjunct

Add Instructor?*

YesNo

Name*

Telephone*

Cellphone

Email*

Building Automation SystemsGreen Mechanical SystemsHVACR Technologies

Full-time or Adjunct?*

Full-TimeAdjunct

Add Instructor?*

YesNo

Name*

Telephone*

Cellphone

Email*

Building Automation SystemsGreen Mechanical SystemsHVACR Technologies

Full-time or Adjunct?*

Full-TimeAdjunct

Add Instructor?*

YesNo

Name*

Telephone*

Cellphone

Email*

Building Automation SystemsGreen Mechanical SystemsHVACR Technologies

Full-time or Adjunct?*

Full-TimeAdjunct

Add Instructor?*

YesNo

Name*

Telephone*

Cellphone

Email*

Building Automation SystemsGreen Mechanical SystemsHVACR Technologies

Full-time or Adjunct?*

Full-TimeAdjunct

Add Instructor?*

YesNo

Name*

Telephone*

Cellphone

Email*

Building Automation SystemsGreen Mechanical SystemsHVACR Technologies

Full-time or Adjunct?*

Full-TimeAdjunct

Program Information

	Building Automation Systems	Green Mechanical Systems	HVACR Technologies
Number of Full-time Instructors
Number of Adjunct Instructors
Number of Laboratories
Square Feet of Laboratories
Students Enrolled
Recent Completers
General Education Hours
Course Hours
Total Hours

The school has been training HVACR students continuously since:*

Under what legal authority is the school operating?*

The school is currently licensed/approved to operate as a school by the state of:*

Licensure or approval became effective on and expire on:

Effective:*

Expire:*

The school is institutionally accredited by:*

Has the school been:*

Denied AccreditationRemoved from AccreditationVoluntarily withdrawn its AccreditationNone of the above

Are there any pending adverse actions against the school?*

YesNo

Please attach a detailed explanation of the circumstances involved in the action:*

The Director/Administrator of the school submits this application for HVAC Excellence Programmatic Accreditation and hereby attests to the following:

The school is seeking accreditation by HVAC Excellence voluntarily.
School officials have thoroughly reviewed the Standards of Accreditation and supporting materials.
School officials wholeheartedly endorse and support the concept of Programmatic Accreditation as a voluntary, nongovernmental process of third-party vailidation involving peer review.
School officials understand that, in applying for programmatic accreditation, the school:
- Willingly subjects itself to a periodic review and a fair judgement by HVAC Excellence regarding the program's qualifications.
- Has the opportunity, as part of the accrediting process, to present itself in the best poossible light and to address any concerns.
- Are committed to providing complete and accurate information to, and answering questions from, members of the HVAC Excellence accrediting board.
- Voluntarily accepts responsibility for adhering to the Programmatic Accreditation Standards of HVAC Excellence.
- A non-member school will refrain from using its application for Programmatic Accreditation for promotional purposes before receiving accreditation.

1) Has any individual connected with the school been directly or indirectly employed or affiliated with any school which has lost or been denied accreditation by any accrediting agency during that individuals period of employment of affiliation?*

YesNo

Please attach a statement to this application that details the facts and circumstances surrounding the school's loss or denial of accreditation.*

2) Has any individual connected with the school been directly or indirectly employed or affiliated with any school which has closed or entered bankruptcy during that individuals period of employment of affiliation?*

YesNo

Please attach a statement to this application that details the facts and circumstances surrounding the bankruptcy or school closure.*

3) Has any adverse final action been taken by any court or administrative body (e.g. federal or state court, grand jury, U.S. Department of Education, or any state agency) as to any individual connected with the school, in a civil or criminal proceeding?*

YesNo

4) Is there now a proceeding or investigation pending in any court or administrative body (e.g. federal or state court, grand jury, U.S. Department of Education, or any state agency) involving any individual connected with the school, which relates to the matters in item 3?*

YesNo

If the answer to item 3 or 4 is yes, please attach a statement to this application, which gives full disclosure concerning the persons and matters involved, including an identification of the court or administrative body and the proceeding. If applicable, detail the facts and circumstances surrounding any investigation involving any individual connected with the school. Also, include a statement of the facts upon which the proceeding or investigation is or was based, a statement detailing the nature of the offense alleged or committed, and a description of the status or disposition of the matter. If the proceeding or investigation has been resolved, please describe the resolution and circumstances that let to the resolution.*

I certify that the information herein and attached hereto is correct and that the school has consistently described itself in identical terms to each accrediting agency (where more than one accrediting body is concerned) regarding identity, purpose, governance, programs, degrees, diplomas, certificates, personnel, finances, consituents served, and keeps each accrediting agency apprised of any change in its status with one or another accrediting body.

I grant permission for the HVAC Excellence accreditation board to contact the appropriate state agencies, the State and U.S. Department of Education, other accrediting agencies, or any other organizations appropriate for review of this application.

Name*

Title*

Date*

Date

How would you like to pay?*

Credit/Debit CardPurchase OrderCheck

HVAC Excellence Accreditation Application Fee: $500.00

Purchase Order Number*

I will send a check made out to HVAC Excellence in the amount of $500.00 to PO Box 521, Mt. Prospect, IL 60056*

Yes

Payment Information*

HVAC Excellence Accreditation Application Fee

$500.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Accreditation Application

Staff

Instructors

Disclosures

Certification