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Peterson's - CCAMembership App (Page 1)

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Peterson's - CCAMembership App
(Dues year: July 1 ­June 30)
It is the policy of the Board of Directors that new institutional members be accredited, or are in
the application process for accreditation, by a national or regional accreditation agency.
Please indicate which agency(s) accredits your institution.
National Accrediting Agencies
Accrediting Bureau of Health Education Schools (ABHES)
Accrediting Council for Independent Colleges & Schools (ACICS)
Accrediting Council for Continuing Education & Training (ACCET)
Accrediting Commission of Career Schools & Colleges of Technology (ACCSCT)
Council on Occupational Education (COE)
Distance Education and Training Council (DETC)
National Accrediting Commission of Cosmetology Arts & Science (NACCAS)
Regional Accrediting Agencies
Middle States Association of Colleges and Schools (MSACS)
New England Association of Schools and Colleges (NEASC)
North Central Association of Colleges and Schools (NCACS)
Northwest Association of Schools and Colleges (NASC)
Southern Association of Colleges and Schools (SACS)
Western Association of Schools and Colleges (WASC)
Other _______________________________________________________
CCA Member dues are based on the total gross tuition revenue of all campuses as reported to the U.S.
Department of Education. Please calculate your institution's dues by using the Dues Calculation Table inside.
If you have any questions about completing the application forms, please contact the CCA Membership
Department, at (202) 336-6834 or the Accounting Department, at (202) 336-6740.
IMPORTANT: CCA bylaws require that all institutions under common ownership control must become
members if one of the institutions joins.
Please complete the following for your primary business office.
(Mr. Ms. Mrs. Miss) _______ First Name ________________________ Last Name ____________________________
Title ______________________________________________ Nickname ___________________________________
Institution _____________________________________________________________________________________
Address _______________________________________________________________________________________
City ______________________________________________________ State ____________ Zip _______________
Phone ___________________________________________ Fax _________________________________________
Email ___________________________________________ Website ______________________________________
Primary Contact _________________________________________________________________________________
(this individual will receive all CCA mailings)
Designated Delegate _____________________________________________________________________________
(authorized person to vote for the institution during official CCA activities)
I hereby certify that all schools under my common ownership have been included in these membership forms
and that the above information is true and correct to the best of my knowledge.
Authorized Signature __________________________________________________________________________________
If your combined gross tuition revenue is more than $3,000,000, complete section I, page 2.
If your combined gross tuition revenue is less than $3,000,000, complete section II, page 2.
(Do not complete both.)

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