Program Participation Agreement - Alaska Comission Of Postsecondary Education

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Program Participation Agreement
Alaska Performance Scholarship
The Program Participation Agreement is required for all institutions requesting to administer Alaska Performance Scholarship funds.
A complete application must be received by ACPE no later than June 30th of the year preceding the academic program period for
which eligibility is requested.
In addition to this form, all non-accredited, non-authorized schools must submit copies of the following with this form:
Audited Financial statements for the most recently completed fiscal year, OR
Educational Institution Surety Bond (contact ACPE Institutional Authorization staff to determine amount)
Institutional Information
Name of Institution:
Address of Institution:
Phone Number:
Web Address:
Contact information for primary and secondary points of contact for APS program participation administration:
Secondary Contact Name:
Primary Contact Name:
Address:
Address:
City:
State:
Zip:
City:
State:
Zip:
Phone Number:
Phone Number:
Email Address:
Email Address:
Accreditation and Authorization
Name of institutional accrediting authority (if applicable):
Authorized
Exempt
No established status
Current institutional status with ACPE:
Complete list of all program credentials, program accreditations and other third-party approvals or endorsements (attach additional
pages as needed):
APS PPA Application and Certification (Rev. 12/13)
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