Missouri Coordinating Board for Higher Education



Missouri Coordinating Board for Higher Education

NOTICE OF CHANGE OF OWNERSHIP OF PROPRIETARY SCHOOL

AND APPLICATION FOR TEMPORARY CERTIFICATION TO OPERATE

This form must be submitted to the Missouri Department of Higher Education & Workforce Development within thirty (30) days of the effective date of a transfer of ownership of a proprietary school. Transfer of ownership means a change in the sole proprietor of a school, a change in the majority interest of general partners of a partnership owning a school, or a change in the majority of stock ownership of a school. The form is to be submitted by the new owner.

School Information

Name:      

Address:      

City, State, Zip:      

New Owner Information

Name:      

Address:      

City, State, Zip:      

Current/Previous Owner Information

Name:      

Address:      

City, State, Zip:      

Effective Date of New Ownership:      

The undersigned, in behalf of the new ownership, hereby applies for temporary certification to operate the above referenced school for a period not to exceed sixty (60) days from the effective date of the change of ownership. The undersigned asserts that any and all operations of the school under the new owner will comply with the criteria and standards set forth in 6 CSR 105.010, which are those governing certification to operate under the previous owner. The undersigned understands that the temporary status of certification will become regular certification through the end of the current certification year (June 30) upon submission by the new owner of: a certification fee in the same amount as the last required of and paid by the previous owner; a security deposit in the same amount as last required of and submitted by the previous owner; a copy of the signed and executed agreement providing for the change of ownership and terms of sale/purchase; a statement of assets committed to the school by the new owner; and additional conditions as specified.

     

Name and Title of Applicant (if different than new owner)

Signature of Applicant Date

(MDHEWD use only)

The above Notice of Change of Ownership is acknowledged. Temporary certification is granted and the expiration date of the temporary certification is ___________________________ . Regular certification through the end of the current certification year (June 30) will be granted upon submission of the required certification fee, the required security deposit, a copy of the executed sale/purchase agreement, a statement of assets committed to the school, and compliance with the following additional conditions:

The required certification fee is $ ___________ and the required security deposit is $ ________________. There are three options for a security deposit and MDHEWD forms, which must be used, are enclosed for each option.

_______________________________________________________

For the Coordinating Board for Higher Education Date

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