A Subsidiary of the National Association of Private Special Education Centers
N♦C♦A♦S♦E♦S
The National Commission for the Accreditation of Special Education Services
NCASES Application Form
NCASES application fee for accreditation is $250 and is non-refundable
Date: _______________________
Agency:_______________________________________________________________
Address:_______________________________________________________________
Telephone
Number: __________________ Fax Number:
__________________________
President/ CEO of Corporate/ Parent Agency (if
applicable):_________________________
CEO/ Executive Director of Applying Agency:
___________________________________
Contact Person if not CEO/ Executive
Director:___________________________________
Email of Contact
Person: ___________________ Year Agency
Established:___________
Does Your Agency have State Licensure /State Approval? Yes _____
No_____
Special Needs
Served:______________________________________________________
Other Approvals or
Accreditations: ___________________________________________
Age of Population
Served: __________________________________________________
Number of Students
Served:_________________________________________________
How Many Staff are
Employed by Your Agency?:_________________________________
___ Check if requesting an integrated accreditation – NCASES & Council on Accreditation.
Accreditation
Services Offered:
A. Special Education in Residential Settings
$4,000
B.
Special Education Programs not in Residential Settings
$2,500
Applying For – please circle selection: A. B.
Signature: _________________________________________________
Date: _________________
When applying for NCASES-COA Integrated Accreditation, you will need to contact COA directly. NCASES does send a memo stating that you requested an integrated accreditation, but you will need to make accreditation arrangements directly through them. Then NCASES and COA will coordinate your joint visit schedule.
COA Contact Information
120 Wall Street. 11th Floor
New York, NY 10005
866-COA-8088 Toll Free
212-797-1428 Fax
www.coanet.org Web Site