NECPA Verification Visit Request Form

Request Your Visit

The purpose of this form is to notify the NECPA Commission that your program has completed the self-study portion of the NECPA accreditation process and that you are ready to begin scheduling your verification visit. PLEASE SUBMIT THIS FORM TO SCHEDULE A VERIFICATION VISIT. You will also have the option to expedite your scheduling and results with your initial visit request below.

PLEASE NOTE: If you have an ACTIVE visit request, you may choose to EXPEDITE SCHEDULING and RESULTS here. Please do not submit an additional visit request.

Required Reading to Submit a Visit Request: Verification Visit Scheduling Process

Program Name*

NECPA Site Number (8-Digits)*

Program Director Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Email Address*

State License or Registration Number*

Licensed Capacity*

Number of Classrooms*

Number of Buildings*

Please select all ages served at the program:*

Select All
6 weeks to 15 months
16 months to 23 months
24 months to 35 months
3 years to 5 years
School-Age (Before & After Care)

The visit must reflect a typical day of enrollment at your program, with children present in all age groups served as checked above. In order to receive accreditation, each age group served by the program must be observed.

Would your program be willing to allow the NECPA to use your verification visit as a training opportunity for NECPA Verifiers?*

Yes
No

Days of Operation*

Select All
Monday
Tuesday
Wednesday
Thursday
Friday

Check all that apply

Hours of Operation*

Is your program enrolled with Paths to QUALITY?*

Yes
No

By participating in accreditation, you MAY be eligible for Accreditation Financial Assistance through the Indiana Accreditation Project (IAP). You must be enrolled with Paths to QUALITY to be eligible to apply for IAP support. Learn more about Paths to Quality here https://indianaspark.com/paths-to-quality.

Is your program enrolled with the Indiana Accreditation Project (IAP)?*

Yes
No

Learn more about the IAP program here: https://inaeyc.org/indiana-accreditation-project.

Verification Visit Request Fee*

Five Block Out Dates

*Block out dates are any days that your program would not be available for a verification visit. You may have five block out days. Days must be listed above in order of preference. The NECPA Office is closed on all federal holidays and will not conduct verification visits on these days.

Would You Like to Purchase Additional Block Out Dates?

Yes
No

Additional Block Out Date Fee

Price:

Pricing is per EACH additional block out date.

How Many Block Out Dates Would You Like to Purchase?

Please List Your Additional Block Dates Requested:

Would You Like to Expedite Scheduling to Reduce Scheduling Window?

Yes
No

Expediting this process will shorten your scheduling window from 120 days to 60 days.

Expedited Scheduling Fee

Price:

Expediting this process will shorten your scheduling window from 120 days to 60 days.

Would you like to expedite your program's results?

Yes
No

Expediting this process will shorten your Council Review and Result timeline to two weeks from the day your visit materials are received at the NECPA Office. Results are issued 8 weeks from the day of the visit if not expedited.

Expedited Results Fee

Price:

Receive your results within 2 weeks of your visit materials arriving at the NECPA Office.

Please Note: Fees are non-refundable and subject to change without prior notice. All returned checks will incur a $35 fee. As of June 1, 2012 program cancellations, changes to block out dates, requests to place program on hold, and/or refusal of dates are subject to additional fees.

NECPA Process Understandings and Agreements

1) I have answered ALL questions in the yellow AND blue sections of the Self Assessment Instrument and have collected surveys from at least 70% of my full and part time staff and 50% of the families we serve.
2) I understand that the visit must reflect a typical day of enrollment at our program, with children present in all age groups served as checked above. I understand that in order to receive accreditation, each age group served must be observed.
3) In the event that I place my program’s verification status on hold, any changes to NECPA standards and fees will be applicable to the program at the time of reactivation of the verification visit request.
4) I understand that my visit will be scheduled within 120 days (or 60 days if expedited) once the NECPA office receives this form and payment in full.
5) I understand that program cancellations, changes to block out dates, requests to place program on hold, and/or refusal of visit dates are subject to additional fees.
6) I have read the Verification Visit Scheduling Process document provided at the top of this form prior to submitting this request.

Please print your full name to agree to the above NECPA Process Understandings*

Indiana Accreditation Financial Assistance Understandings

I understand that in order to apply for Accreditation Financial Assistance with the INAEYC Indiana Accreditation Project (IAP), I must:
1) Be enrolled and in good standing with Paths to QUALITY™ at any level,
2) Submit to IAP through their online application, an open enrollment invoice from NECPA,
3) Submit my IAP scholarship application within 30 days of my NECPA enrollment submission.

I also understand that if my application for Accreditation Financial Assistance is denied for any reason, I will be responsible for the NECPA accreditation fees. Additionally, I understand that I am responsible to pay for any supplemental fees, such as additional block out dates and expedite fees, as these are not covered by the IAP scholarship program.

Please print your full name to agree to the Indiana Accreditation Financial Assistance Understandings*

Payment Details

Fees are non-refundable and subject to change without prior notice.

Total Amount:

$0.00

Credit Card

American Express

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MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name