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ACPE ACCREDITATION COMMISSION

PROPOSED CHANGES IN CENTERS AND PROGRAMS:
REPORT OF REGIONAL ACTIONS

Note: attach Changes in Centers and Programs Form and associated documentation submitted by the center.

Submission Date: _______________
Accredited Member: ___________________________________________________________
Address: ____________________________________________________________
Supervisors: ____________________________________________________________
Region: ____________________________________________________________

PROVISIONAL ACTION BY THE REGION: (Regional Accreditation Chair communicates change to ACPE within 30 days.)

Date of action _______________

Provisional action(s):

REGIONAL COMMITTEE DISCUSSION, ACTION/RECOMMENDATIONS: (Regional Accreditation Chair will present change to Commission for action at its next meeting)

Date of action: ______________

Discussion/Action(s)/Recommendation(s):

ACCREDITATION COMMISSION DISCUSSION, ACTION AND VOTE: (Regional Chair will complete this form and provide it, along with all documentation, to the national office)

Date of action _______________

Discussion, action(s), vote: