LLC (Limited Liability Company) Name: Attach a list of the name, home address, phone number and title of each corporate officer/member. Also, attach a list showing the same information on any stockholder(s) having controlling interest in the school. Attach a copy of the Articles of Incorporation and Certificate of Good Standing from the Office of the Secretary of State If an out-of-state corporation, include Statement of Foreign Entity Authority to transact business in Colorado. M. IS YOUR SCHOOL A No FRANCHISE? Yes, if yes you must attach a copy of the Franchise Agreement N. DO YOU PROVIDE No TRAINING AT ANY LOCATION OTHER THAN Yes, If yes provide the following: THAT LISTED ABOVE? Location Name: Location Address: Attach additional sheets Location Phone Number: if necessary Section Two Information (fee required) – In addition to the information requested below, you must also attach a completed and notarized , and fee (see on DPOS website), for each individual who will be acting as an agent for the school, specifically those who will be in the business of selling private occupational education services for your school. The application form can be found on the Division’s website under Resources/Forms”. “School A. TOTAL NUMBER OF AGENTS RENEWING OR ADDING WITH THIS APPLICATION B. AGENT Name: INFORMATION Address: Phone Number: C. INFORMATION Name: Address: Phone Number: For additional Agents, please attach a list of their names, addresses and phone numbers along with the attached In-State Agent Permit Applications. Section Surety Information – At the time of application for approval as a new school under the jurisdiction of the Division of Private Occupational Schools, you submitted a proposal in the form of a letter showing in detail the calculations made pursuant to Section 12-59-115, C.R.S. explaining the method used for computing the amount of the bond or alternative.
LLC (Limited Liability Company) Name: Attach a list of the name, home address, phone number and title of each corporate officer/member. Also, attach a list showing the same information on any stockholder(s) having controlling interest in the school. Attach a copy of the Articles of Incorporation and Certificate of Good Standing from the Office of the Secretary of State If an out-of-state corporation, include Statement of Foreign Entity Authority to transact business in Colorado. M. IS YOUR SCHOOL A FRANCHISE? No Yes, if yes you must attach a copy of the Franchise Agreement N. DO YOU PROVIDE TRAINING AT ANY LOCATION OTHER THAN THAT LISTED ABOVE? Attach additional sheets if necessary No Yes, If yes provide the following: Location Name: Location Address: Location Phone Number: Section Two – Information (fee required) In addition to the information requested below, you must also attach a completed and notarized , and fee (see on DPOS website), for each individual who will be acting as an agent for the school, specifically those who will be in the business of selling private occupational education services for your school. The application form can be found on the Division’s website under “School Resources/Forms”. A. TOTAL NUMBER OF AGENTS RENEWING OR ADDING WITH THIS APPLICATION B. AGENT INFORMATION Name: Address: Phone Number: C. INFORMATION Name: Address: Phone Number: For additional Agents, please attach a list of their names, addresses and phone numbers along with the attached In-State Agent Permit Applications. Section – Surety Information At the time of application for approval as a new school under the jurisdiction of the Division of Private Occupational Schools, you submitted a proposal in the form of a letter showing in detail the calculations made pursuant to Section 12-59-115, C.R.S. explaining the method used for computing the amount of the bond or alternative.
renewalapplication_2016fillable.docx