APPLICATION FOR CHANGE IN



APPLICATION FOR CHANGE IN LEGAL STATUS, OWNERSHIP OR CONTROL PART iInstitutionalInstitutions must receive prior approval from ABHES when the institution or a majority of its interest is sold or when there is a change in legal status or form of control. Accreditation does not automatically transfer to an institution when the institution or a majority of its interest is sold or when there is a change in legal status or form of control. Failure to secure prior ABHES approval of the change causes the institution’s accreditation to be withdrawn effective the date of the change in ownership, control, or legal status. Completion and submission of this Application is required at least 45 days prior to the planned date of change.1. GENERAL INFORMATION:NAME OF INSTITUTION:Click or tap here to enter text.ABHES ID #: Click or tap here to enter text.STREET ADDRESS:Click or tap here to enter text.CITY, STATE, ZIP:Click or tap here to enter text.NAME OF CEO:(SPECIFY DR., MR., MS., MRS.)Click or tap here to enter text.TITLE:Click or tap here to enter text.EMAIL ADDRESS:Click or tap here to enter text.DIRECT PHONE #: Click or tap here to enter text.NAME OF ON-SITE ADMINISTRATOR:(SPECIFY DR., MR., MS., MRS.)Click or tap here to enter text.TITLE:Click or tap here to enter text.EMAIL ADDRESS:Click or tap here to enter text.DIRECT PHONE #:Click or tap here to enter text.2. Change of Ownership InformationComplete the following information:Proposed Date of Change:Click or tap here to enter text.Total Purchase Price:Click or tap here to enter text.Current Student Enrollment:Click or tap here to enter text.Past 3 Years Default Rates:Reporting Year: Default Rate %Reporting Year: Default Rate %Reporting Year: Default Rate %Identify the ownership structure:?Sole Proprietorship Business?Non-Profit Organization?Privately Held Business Corporation?Limited Liability Partnership Company ?Publicly Held Business Corporation?Limited Partnership Company?Other, explain:3. Proposed Owner InformationComplete applicable sections below for proposed new owner:Sole Proprietorship BusinessIf sole proprietorship business, provide legal name and address:Name of OwnershipAddressClick or tap here to enter text.Click or tap here to enter text.List name, title, and address of individual responsible for operations of the sole proprietorship business that owns the institution. NameTitleAddressClick or tap here to enter text.Click or tap here to enter text.Click or tap here to enter text.Privately Held Business CorporationIf Privately Held Business Corporation, list the exact ownership structure, including all levels of subsidiaries under the parent corporation and any subsidiary corporations operating as non-main campuses:Provide the ownership percentage breakdown of each entity in the chain of ownership, up to and including the individual(s) who control the ultimate ownership entity in the chain of ownership.Provide descriptions for each level that include all individuals, partnerships, LLCs, corporations, trusts, or other forms of ownership stock.)Ownership Name and DescriptionPercentage of OwnershipList all corporate officers:NameTitlePublicly Held Business CorporationIf Publicly Held Business Corporation, list the exact ownership structure, including all levels of subsidiaries under the parent corporation and any subsidiary corporations operating as non-main campuses:Provide the ownership percentage breakdown of each entity in the chain of ownership, up to and including the individual(s) who control the ultimate ownership entity in the chain of ownership.Provide descriptions for each level that include all individuals, partnerships, LLCs, corporations, trusts, or other forms of ownership (for publicly traded corporations, this includes shareholders that directly own 10% of the stock.)Ownership Name and DescriptionPercentage of OwnershipList all corporate officers:NameTitleIf publicly held business corporation, the stock is traded on the (specify):NASDAQ; NYSE; ASE; OTC; Regional Exchange: ?Non-Profit OrganizationIf Non-Profit Organization, list the all members and officers of the board of directors/trustees:NameTitleTerm of OfficeVoting Member?End Date YesNoIf non-profit organization, attach a copy of the Governance Policy (Exhibit 12).If non-profit organization, has this organization been officially recognized by the Internal Revenue Service as an exempt organization under Section 501 ? (3), 501 ? (4), 501? (5) or 501? (6) of the IRS Code? Yes?No?Provide the name, title and contact information for the individual whom ABHES should contact regarding the Non-Profit Organization:Name and TitleEmail AddressTelephone NumberLimited Liability CompanyIf Limited Liability Company, list all members:Member NamePercentage of Membership (Ownership Interest)Provide the name, title and contact information for the individual whom ABHES should contact regarding the Limited Liability Company: Name and TitleEmail AddressTelephone NumberLimited Liability Partnership Company; Limited Partnership CompanyIf Limited Liability Partnership Company, Limited Partnership Company, list all partners:Names of General PartnersPercentage of Partnership (Ownership Interest)Names of Limited PartnersPercentage of Partnership (Ownership Interest)Provide the name, title and contact information for the individual whom ABHES should contact regarding the Limited Liability Partnership Company; Limited Partnership Company:Name and TitleEmail AddressTelephone Number4. Contact information for PROPOSED new owner:NAME:(SPECIFY DR., MR., MS., MRS.)TITLE:Address:EMAIL ADDRESS:DIRECT PHONE #: 5. Other Institutions:Does the proposed new owner(s) own other ABHES-accredited institutions?? Yes? NoIf yes, please identify the name, address and ID code of other institutions:NameAddressABHES ID #6. Key personnel List the expected Key Personnel (e.g., managers, department heads, and program directors) to be at the institution following the change in ownership/control:NameTitlePositionYears in PositionYears at the Institution7. Additional Information:A.Has any designated proposed new owner or manager been directly or indirectly employed or affiliated with any school which has lost or been denied accreditation by any accrediting organization during that individual’s period of employment or affiliation?Yes?No?If yes, please attach a statement to this form which details the facts and circumstances surrounding that school’s loss or denial of accreditation.B.Has any designated owner or manager been directly or indirectly employed or affiliated with any school that has closed without appropriately completing the education or training program for all enrolled students (e.g., an orderly teach-out plan/agreement) or entered into bankruptcy during that individual’s period of employment or affiliation?Yes?No?If yes, please attach a statement to this form which details the facts and circumstances surrounding that school’s closure, bankruptcy or both as applicable.C.Has any designated owner or manager been directly or indirectly employed or affiliated with any school that has lost or been denied eligibility to participate in Federal Student Financial Aid programs, including those under Title IV of the Higher Education Act?Yes?No?If yes, please attach a statement to this form which details the facts and circumstances surrounding the loss or denial of Title IV eligibility.D.Is any action pending (e.g. court action, audit, inquiry, review, administrative action), or has action been taken, by any court or administrative body (e.g. federal or state court, grand jury, special investigator, U.S. Department of Education, or any state agency), as to any designated proposed new owner or proposed new manager?Yes?No?If yes, please attach a statement to this form which gives full disclosure of the person(s) and the matters involved. Include a statement of the facts and circumstances surrounding the action identifying the matter (i.e., still under investigation, preliminary decision under appeal, etc.) and the position taken by the owner involved. If the matter is final, provide a copy of the final action documentation.E.Has any designated proposed new owner or manager served in a similar capacity in any other school where either that individual or the school has been charged or indicted in a civil or criminal forum or proceeding alleging fraud, misappropriation, or any criminal act?Yes?No?If yes, please attach a statement to this form which gives full disclosure of the person(s) and the matters involved. Include a statement of the facts and circumstances surrounding the action identifying the owner and the school which is involved. If the matter is not yet final, please describe the procedural status of the matter (i.e., still under investigation, preliminary decision under appeal, etc.) and the position taken by the owner involved. If the matter is final, provide a copy of the final action documentation.8. Required EXHIBITSThe following documents must be included in the application submission. Exhibit 1The most recent audited financial statements of the proposed new owner(s).Exhibit 2A true and complete copy of the contract of sale or purchase agreement. If there is no contract, submit a description of the terms of the agreement that is signed by both parties. In instances where the governing entity is a board, provide a copy of the by-laws, including a description of the terms of service of board members and the process to elect and replace board members.Exhibit 3Curriculum vitae of designated proposed new owner(s) including information on post-secondary institutional affiliations during the past ten (10) years.Exhibit 4A detailed description of the proposed ownership structure that includes:The current form of ownership (e.g., sole proprietorship, partnership, corporation, etc.); andAn ownership diagram that sets forth a precise breakdown of the proposed new ownership structure including a percentage ownership breakdown/delineation of each entity in the chain of ownership, up to and including the individual(s) who will own the ultimate ownership entity in the chain of ownership. The ownership descriptions must include all individuals, partnerships, LLCs, corporations, trusts, or other forms of ownership (for publically traded corporations, this includes shareholders that will directly own 10% of the stock as of the date of the change). Please submit with this form the ownership disclosure submitted in your application to participate in federal student aid programs.Exhibit 5A list of all board members, managers, and/or partners affiliated with each entity disclosed in the organization structure that is proposed to acquire the school that includes a description as to how each individual’s experience and background prepares them to oversee the operation of an accredited school and assures the likelihood that the school will remain in compliance with accreditation standards after the change. Exhibit 6A properly executed, notarized statement of proposed new owner (buyer) and current owner (seller) assuring ABHES that appropriate provisions have been made for all tuition refunds now due, or which may become due, to all students to whom the institution has an obligation (see Attachment A- Statement of Responsibility for Refund Liability).Exhibit 7Documentation of state approval to operate the institution under the proposed new ownership. Exhibit 8Description of any planned changes for the school by the proposed new owner, including changes to program(s), refund policy, tuition, facility and staff. Exhibit 9The name and curriculum vitae of the designated new on-site administrator, if applicable, including information on post-secondary institutional affiliations during the past ten (10) years.Exhibit 10A properly executed, notarized statement of purchaser assuring ABHES that it will guarantee student training should the institution cease operation (See Attachment B - Guarantee of Student Training).Exhibit 11Documentation to evidence that the institution has begun or completed the pre-acquisition process with the U.S. Department of Education if the institution participates in any federal student financial aid program. If the process is completed, provide the corresponding notice from the U.S. Department of Education. If the process is not completed, provide a copy of the institution’s pre-acquisition application and all correspondence between the institution/proposed and the U.S. Department of Education.Exhibit 12If a non-profit organization, a copy of the Governance Policy. Exhibit 13The application fee in accordance with Appendix G, Fees, of the Accreditation Manual. The Application fee is not refundable.9. certification:I certify that to the best of my knowledge and belief, the information herein and attached hereto is accurate and correct.I certify that I understand that it is the school’s responsibility to demonstrate compliance with the Standards of Accreditation and that the Commission’s deliberations and decisions are made on the basis of the written record and are therefore dependent on the forthrightness of the applicant in disclosing all information that the Commission has requested on this application. I certify that the proposed owner, governing entity (i.e., board), and management have reviewed the ABHES Accreditation Manual and supporting materials of the Commission and that under the proposed new owner, governing entity (i.e., board), and management, the school will continue to operate in accordance with the standards published by the Commission.I certify that the proposed owner, governing entity (i.e., board), and management have reviewed the current Annual Report, the list of programs approved with the school’s scope of accreditation, the last Self-Evaluation Report, and the most recent Commission action pertaining to the school and understand the information contained within those documents.I certify that the proposed owner, governing entity (i.e., board), and management will assume all responsibility and liability for contractual and refund obligations to all students, past and present, unless otherwise provided by the contract of sale.I understand that the Commission may seek assistance from external resources such as legal counsel to review the structure of the proposed transaction and that the school will be financially responsible for the expenses incurred in such review. The Commission will invoice the school for such expenses and the school must pay these expenses before the Commission will approve the application.PROPOSED NEW OWNER:Name:Title:Signature:Date:ATTACHMENT AStatement of Responsibility for Refund Liabilityas purchaser andPurchaser Nameas seller ofSeller Namelocated inName of InstitutionCityStateHEREBY assure the Accrediting Bureau of Health Education Schools (ABHES) and any interested parties such as students, financial institutions, and government agencies that appropriate provisions have been made for the payment of all tuition refunds now due or which may become due for all students to whom the institution has an obligation. If a previous owner is contractually liable for a refund but fails to fulfill the obligation, the new owner must satisfy the claim of the student or government agency and look to relief from the former owner in a separate action.FURTHER, I (we) understand that copies of this statement are available to students, financial institutions, federal and state agencies, and other interested persons, and hereby authorize such distribution and release of information.Current Owner’s Signature:Name:Title:Signature:Date:Proposed New Owner’s Signature:Name:Title:Signature:Date:NOTARY PUBLICState ofCounty of Subscribed and sworn to before me, a notary public, thisDayMonthYear My Commission expires:Click or tap to enter a date.ATTACHMENT BGUARANTEE OF STUDENT TRAININGas purchaser ofPurchaser NameName of Institutioncertify that the aforementioned institution, in which I (we) am to be new owner is subject to my (our) leadership, guidance, control, and responsibility. As an assurance of performance, I (we) guarantee that the training for which students enroll at the above named facility will be made available to them, by me (us), or by the transfer of the students to a facility offering a similar curriculum, without additional payment by the student other than that agreed upon in the original contract. If this arrangement is not acceptable to the student, the student shall have the option of a refund within 30 days of any interruption of service in accordance with the Statement of Responsibility for Refund Liability. Proposed New Owner’s Signature:Name:Title:Signature:Date:NOTARY PUBLICState ofCounty of Subscribed and sworn to before me, a notary public, thisofDayMonthYearName and title of new owner: Visit for additional information on ABHES policies, procedures or standards, and to view the Accreditation Manual. Note: The approval of a change in ownership or control expires if the transaction is not completed within 90 days from the date disclosed in the Application for Change in Ownership or Control Part 1. APPLICATION SUBMISSION INSTRUCTIONSThe completed application must be submitted as one seamless Portable Document Format (.pdf) file to ABHES online via DropBox Applications. The application may not be submitted to the Commission via e-mail.? It is imperative that the pdf is correctly named with ABHES ID#, Change in Ownership Part 1, and date of submission (ex: I‐100_ Change_in_Ownership- Part 1_072020).The application will not be processed until the fee is received. See the fees appendix in the Accreditation Manual. Payment of any fees can be remitted electronically via bank transfer in lieu of a hardcopy check, or by credit card where a 2.9% convenience fee is to be applied. Please contact the Accounting Department at accounting@ or (571) 282-0076 to obtain your invoice.If you have any questions regarding the application, please contact ABHES at 703-917-9503. ................
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