Council for Accreditation of Counseling and Related Educational Programs

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1 Page 1 of 5 Council for Accreditation of Counseling and Related Educational Programs Instructions for Completion 1. Submit a hard copy of Pages 2 and 3 with original signatures. 2. Include a copy of the complete application, including all accompanying documents and tables, in an electronic format on the self-study disk. 3. Submit a check or money order payable to CACREP for the application fee. The current fee may be obtained by calling the CACREP office or checking 4. Submit four (4) copies of the self-study in read-only format on disks. See Accreditation Process Policy #17 in the current Policy Document for formatting guidelines. Mail the signature pages, application fee, and four (4) copies of the self-study to: Council for Accreditation of Counseling and Related Educational Programs 1001 North Fairfax Street, Suite 510 Alexandria, Virginia 22314

2 Page 2 of 5 Date Institution Department/Academic Unit Mailing Address Program Website CACREP Liaison Telephone ( ) Fax ( ) Place an "X" on the left next to the program area(s) for which accreditation is sought and indicate the degree(s) offered. Entry-Level Addictions Counseling M.Ed. M.A. M.S. Other Career Counseling M.Ed. M.A. M.S. Other Clinical Mental Health Counseling M.Ed. M.A. M.S. Other Marriage, Couple, and Family Counseling M.Ed. M.A. M.S. Other School Counseling M.Ed. M.A. M.S. Other Student Affairs and College Counseling M.Ed. M.A. M.S. Other Doctoral-Level Counselor Education and Supervision Ph.D. Ed.D.

3 Page 3 of 5 President/CEO of the Institution Dean of the College Department Chair

4 Page 4 of 5 1. Please list each site where the program(s) is offered and the percentage of the degree requirements that can be completed at each site. Note: If over 50% of a program s required curriculum is offered at more than one location, the conditions specified in the Multiple Sites Policy (rev. 7.11) must be met for each site and the program as a whole in order for the program to be viewed as a single program offered at multiple locations. If the conditions are not met, then a separate application, self-study, and fee are required for each location. Please provide summary responses to the conditions in the multiple sites policy, if applicable. 2. Please provide a sample transcript (with blacked out identifying information) for each program area for which accreditation is sought. 3. Please provide a current program of study for each program area that includes all required courses and indicates the total number of hours to obtain the degree. This information should also include the number of clinical hours required in practicum and internship courses. 4. Please create tables or charts with the following information. If the program(s) is offered at multiple sites, please provide information for each site as well as for the overall program. a) Table 1 Faculty Who Currently Teach in the Program 1. List all core faculty by name and include each person s credit hours generated in last 12 months, terminal degree and major, primary teaching focus, professional memberships, licenses/ certifications and nature of involvement in the program(s) (e.g., Academic Unit Leader) 2. List all noncore faculty by name and include each person s credit hours generated in last 12 months, terminal degree and major, primary teaching focus, professional memberships, licenses/ certifications and nature of involvement in the program(s) (e.g., clinical faculty, adjunct) b) Table 2 Current Students 1. Please indicate for each applicant program (e.g., School Counseling), the number of full-time, part-time, and full time equivalent (FTE) students at each campus site. 2. Please indicate any other counseling program(s) in the academic unit that are not applying for accreditation, the number of full-time, part-time, and full time equivalent (FTE) students at each campus site. (continues on next page)

5 Page 5 of 5 c) Table 3 Graduates for the past Three (3) Years 1. Please indicate for each applicant program (e.g., School Counseling), the number graduates at each campus site. 2. Please indicate for any other counseling program in the academic unit, the number of graduates at each campus site. 5. Please provide evidence of institutional accreditation by an accreditor recognized by the US Department of Education or the Council for Higher Education Accreditation (CHEA). 6. Clearly label and submit as part of the response for Standard I.AA in the selfstudy a comprehensive assessment plan that satisfies the conditions specified in Transition Policy #5 in the current Policy Document..

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