REQUEST FOR RECOGNITION OF INSTITUTION AND/OR PROGRAMME

Section 1: Personal Data

First Name

Middle Name(s)

Last Name

Title (please indicate)

Other Title (Please specify)

City

Country

Address

Postal code

Section 1: Personal Data

Gender

Male

Female

ID #

ID Type

Email *

Phone #

By providing my phone number, I agree to receive text messages from the business.

Section 2: Type of Request (please indicate whether institution AND/OR programme)

Type of Request

Recognition Status of Institution

Recognition Status of Programme

Details of the Institution

Name of Institution
Address of Instutition

Details of the Programme

Enrollment

Learning Modalities

Have you previously requested an evaluation from the Barbados Accreditation Council?

Yes

Date

Please provide any additional information which may assist the Council with facilitating your request.

Section 3: Statement on Recognition

Number of copies

Section 4: Mailing Instructions

Mail statement to the mailing address in Section 1

Customer will collect

Mail the statement to the address(es) below

Supporting Documents

Upload supporting documents here:

Affirmations:

I hereby certify that the information provided on this application form is true, accurate and correct.
I certify that I have read the instructions and conditions (see Guidelines attached) and agree to the terms
stated therein.
I enclose the required information and request for recognition and hereby authorise the release of this
information to the party/parties listed in Section 4 above.

Signature