State Authorization

Application Type

Exemption to NC-SARA Membership Physical Presence in ND

Type of Application

Please select whether this is a new application or a application renewal.

New Application Application Renewal

Type of Application

First Exemption Renewal Exemption

INSTITUTION INFORMATION

Institution Name

Name of institution

Institution Website

Institution Type:

Public/State Non-Profit For Profit/LLC

Institution Street Address

Institution City

Institution State

Institution Zip Code

Is the institution owned by another entity?

No

Yes

List the official name and address of the corporate parent.

CONTACT INFORMATION

Contact Name

Contact Email

Contact Phone Number

Would you like to list an alternate contact?

Alternate Contact Name

Alternate Contact Email

Alternate Contact Phone Number

NC-SARA Membership

Provide rationale(s) for your institution's ineligibility for NC-SARA membership.

Please provide a letter from SARA State Portal Entity or a letter from NC-SARA via the attachment field.

FINANCIAL AID INFORMATION

Is your institution eligible for student financial aid programs under title IV of the Higher Education Act of 1965?

Please provide financial aid eligibility documentation via the attachment field.

Is your institution on a heightened cash monitoring payment method?

Please provide the reasoning for the heightened cash monitoring.

FEDERAL RESPONSIBILITY COMPOSITE SCORE INFORMATION

What is the institution's most recent federal responsibility composite score?

Please provide the institution’s most recent federal responsibility composite score documentation via the attachment field.

If the institution is owned by a corporate parent, what is the corporate parent's most recent federal responsibility composite score?

Please provide the corporate parent’s most recent federal responsibility composite score documentation via the attachment field.

ACCREDITATION INFORMATION

Accrediting Agency

Accreditation Expiration Date

Please provide the most recent Accreditation Letter via the attachment field.

Has your institution been subject to any formal sanctions or received any warnings from accrediting or regulatory bodies in the past or present?

Please describe the sanctions and/or warnings.

Please provide any relevant documentation in the attachment field.

DISCLOSURE INFORMATION

Does your institution offer programs that are designed to lead to professional licensure or certification?

Please provide a list of programs that lead to professional licensure or certification.

Please provide a link to your institution's professional licensure public disclosure website.

How are the following items provided to the student prior to enrollment:

a. A physical or electronic copy of the institution's catalog and any other supporting document that details the services to be provided by the institution.

b. The title of the program or each course in which the student is enrolling, as identified in the catalog.

c. The number of credit or clock hours and the number of weeks or months required for completion of the program or each course in which the student is enrolling.

d. Identification of the type of diploma, certificate, associate, bachelor, master, or doctorate to be received by the student upon successful completion of the program or course.

e. The total amount of tuition required for the program or each course in which the student is enrolling. If the total number of credit or clock hours required for completion of the program will span more than one enrollment period, the disclosures shall include a statement that tuition is subject to change.

f. The cost of any required books and supplies, which may be estimated if necessary.

g. Any other costs and charges to be paid by the student.

h. The scheduled start and end dates of the program or each course and a description of the class schedule.

i. The method by which the student can cancel or voluntarily terminate enrollment.

j. The institution's refund policy for cancellations and terminations.

Please describe how the items listed above are met.

SURETY BOND

Please attach the Surety Bond form via the attachment field.

DATA INFORMATION

Please attach Institution Information spreadsheet via the attachment field.

FEE INFORMATION

Enrolled FTE	Annual Fee
Less than 2,500	$2,200
2,500-9,999	$4,400
10,000-29,999	$6,600
30,000 or more	$8,800

How would you like to pay for your institution's state authorization fees?

Please click on the link below to complete a credit card payment:

Please click on link to open a new browser and be sent to our TouchNet e-payment system to complete your payment via credit card.

Use link provided below to complete your payment via credit card. (NOTE: You may need to turn off your pop-up blocker on your browser to allow a new window to open.)

https://nduso-ndus.nbsstore.net/

Acknowledgement

Submission of this application indicates the following:
• The application has been reviewed by an authorized representative of the institution with authority to make binding commitment.
• Pertains to on-site institution delivery only: The institution does not qualify for an exemption from the authorization requirement under North Dakota Century Code 15-18.1-02.
• Appropriate officials have read and understand the laws and policies regarding authorization to operate a post-secondary institution in North Dakota.
• The material in this form is accurate. Inaccuracies may be considered misrepresentation that results in the revocation of authorization.
• Any institution offering programs that lead to professional certification or registration (e.g. Nursing, Education) is required to comply with North Dakota Century Code 15-18.1-17. By statute the institution is required to give written notification to the student whether their programs meet the requirements of the appropriate professional board in North Dakota, including notification upon any change in this status.

By clicking yes, you verify the above information to be true and correct to the best of your knowledge.

Attachment(s)

Please provide any requested documentation throughout the form here.

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Your name

Your email address

Verification Code