PROGRAM DATA FORM PLEASE REPORT ANY PERSONNEL CHANGES BY COMPLETING THE APPROPRIATE FIELDS BELOW. SUBMIT THE COMPLETED FORM TO: 1. Chief Executive Officer of Sponsoring Institution Salutation (e.g., Dr., Ms., Mr.): Name and Credentials (e.g., PhD, EdD): Administrative Title: Institution: Address: City, State, & Zip: Telephone: E-mail: Former Chief Executive Officer of Sponsoring Institution If applicable, please indicate the name of the CEO being replaced: Name: Please indicate if the the should be disabled: above individual’s access to program’s record in ACOTE Online () Yes, please disable access to ACOTE Online No, this individual still needs access to ACOTE Online 2. Dean or administrator to whom the program director reports Salutation (e.g., Dr., Ms., Mr.): Name and Credentials (e.g., PhD, EdD): Administrative Title: Institution: Address: City, State, & Zip: Telephone: E-mail: Former Dean or Administrator to whom the program director reported: If applicable, please indicate the name of the Dean/Administrator being replaced: Name: Please indicate if the access to the ACOTE Online () should be disabled: above individual’s program’s record in Yes, please disable access to ACOTE Online No, this individual still needs access to ACOTE Online
PROGRAM DATA FORM PLEASE REPORT ANY PERSONNEL CHANGES BY COMPLETING THE APPROPRIATE FIELDS BELOW. SUBMIT THE COMPLETED FORM TO: 1. Chief Executive Officer of Sponsoring Institution Salutation (e.g., Dr., Ms., Mr.): Name and Credentials (e.g., PhD, EdD): Administrative Title: Institution: Address: City, State, & Zip: Telephone: E-mail: Former Chief Executive Officer of Sponsoring Institution If applicable, please indicate the name of the CEO being replaced: Name: Please indicate if the above individual’s access to the program’s record in ACOTE Online () should be disabled: Yes, please disable access to ACOTE Online No, this individual still needs access to ACOTE Online 2. Dean or administrator to whom the program director reports Salutation (e.g., Dr., Ms., Mr.): Name and Credentials (e.g., PhD, EdD): Administrative Title: Institution: Address: City, State, & Zip: Telephone: E-mail: Former Dean or Administrator to whom the program director reported: If applicable, please indicate the name of the Dean/Administrator being replaced: Name: Please indicate if the above individual’s access to the program’s record in ACOTE Online () should be disabled: Yes, please disable access to ACOTE Online No, this individual still needs access to ACOTE Online