Pre-Licensure Baccalaureate Degree Accelerated Second Degree Other (Please Specify): Advanced Practice Options: Nurse Practitioner Clinical Nurse Specialist Nurse Anesthetist Nurse Midwife Post-Master’s Certificate (Please Specify): Title IV Information The governing organization/institution may use ACEN accreditation to establish eligibility to participate in Title IV programs. ACEN accreditation may only be utilized for eligibility purposes if the governing organization is not accredited by another USDOE-recognized organization. When accreditation is achieved, the institution is interested in having the ACEN serve as the Title IV gatekeeper. Yes Not Applicable Nurse Administrator Signature Date Completed Candidacy Application (including signature) Copy of Current Governing Organization Accreditation or Candidacy Status Document Copy of Current State Regulatory Agency for Nursing Approval Status Document for Each Nursing Program (if applicable) Copy of Organizational Chart for the Governing Organization* Copy of Organizational Chart for the Nursing Education Unit* * Organizational charts should clearly delineate the relationship between the governing organization and the nursing education unit; additional organizational charts may be necessary to accurately illustrate this relationship.
Pre-Licensure Baccalaureate Degree Accelerated Second Degree Other (Please Specify): Advanced Practice Options: Nurse Practitioner Clinical Nurse Specialist Nurse Anesthetist Nurse Midwife Post-Master’s Certificate (Please Specify): Title IV Information The governing organization/institution may use ACEN accreditation to establish eligibility to participate in Title IV programs. ACEN accreditation may only be utilized for eligibility purposes if the governing organization is not accredited by another USDOE-recognized organization. When accreditation is achieved, the institution is interested in having the ACEN serve as the Title IV gatekeeper. Yes Not Applicable Nurse Administrator Signature Date Completed Candidacy Application (including signature) Copy of Current Governing Organization Accreditation or Candidacy Status Document Copy of Current State Regulatory Agency for Nursing Approval Status Document for Each Nursing Program (if applicable) Copy of Organizational Chart for the Governing Organization* Copy of Organizational Chart for the Nursing Education Unit* * Organizational charts should clearly delineate the relationship between the governing organization and the nursing education unit; additional organizational charts may be necessary to accurately illustrate this relationship.