Private College & University Qualifications

To apply for the to the Private Colleges and Universities Authority Bond, you must provide documentation for the following:

Not-for-profit Organization
Must be a not-for-profit organization whose predominant function is education
501(c)(3) Documentation
Must be described as a Section 501(c)(3) of the Internal Revenue Code.
Education Programs
Must be authorized by law to provide a program of education beyond the high school level
Is Not Controlled by the State of Georgia
Must not be owned or controlled by the State of Georgia or any political subdivision, agency, instrumentality, district or municipality of the State of Georgia

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1. Identification of the Applicant

a) Name of College or University (Applicant) *

b) Address *

c) Person to Contact (give name and title) *

d) Telephone Number *

2. Qualification of the Applicant to Borrow from the Authority.

a) Is the applicant a not-for-profit organization whose predominant function is educational?

Yes No

(If the Applicant is a corporation, attach a copy of the articles of incorporation, or charter, which has been certified by the Secretary of State of Georgia.)

b) Is the Applicant an organization described in Section 501(c)(3) of the Internal Revenue Code and is it exempt from tax under Section 501(a) of the Internal Revenue Code?

Yes No

Attach a copy of the Internal Revenue Service Determination Letter or other proof of the Applicant's qualification for Section 501(c)(3) status.

c) Is the Applicant authorized by law to provide a program of education beyond the high school level?

Yes No

Please make specific reference to the statute or other law which authorizes the Applicant to provide such a program.

d) Is the Applicant owned or controlled by the State of Georgia or any political subdivision, agency, instrumentality, district or municipality of the State of Georgia?

Yes No

If "yes", please explain.

e) Does the Applicant admit as regular students only individuals having a certificate of graduation from a high school, or the recognized equivalent of such a certificate?

Yes No

If "no", please explain.

f) Does the Applicant provide:

1) Not less than a two-year program which is acceptable for full credit toward a bachelor's degree?

Yes No

2) An educational program for which it awards a bachelor's degree?

Yes No

3) An educational program, admission into which is conditioned upon prior attainment of a bachelor's degree or its equivalent, for which it awards a post graduate degree?

Yes No

g) Is the Applicant accredited by a nationally recognized accrediting agency or association?

Yes No

If "yes", attach a certified copy of the most recent certificate or other acknowledgement of accreditation.

h) If the Applicant is not accredited as provided in "g" above, state whether the Applicant's credits are accepted on transfer by the University System of Georgia and its educational units for credit on the same basis as if transferred from an institution so accredited.

i) Is the Applicant a school of divinity, a seminary or a department of divinity?

Yes No

j) To what extent is the Applicant's educational program based upon religious teachings or materials?

k) Is study of religious teachings or materials part of the required curriculum?

Yes No

If "yes", please explain.

l) Do the Applicant's admissions procedures or policies limit the student body to members of a particular religion, denomination or sect?

Yes No

m) Do the Applicant's admission procedures or policies discriminate in favor of a particular religion, denomination or sect?

Yes No

3. Information Concerning the Project to be Financed.

a) Describe the Project, paying particular attention to

1) The use to which the Project will be put:

2) The size of the Project:

3) The type of construction:

4) The percentage of construction which has been completed (if the Project has been completed, state when the Project was first put in service):

5) The estimated cost of the Project (actual cost if already incurred) broken down in the following categories

5.1) Cost of construction:

5.2) Cost of land:

5.3) Cost of equipment:

5.4) Cost of architectural, engineering, legal and other costs related to the planning and construction of the Project:

5.5) Interest on amounts borrowed to finance the Project during construction:

5.6) Costs of issuing the bonds, including underwriting fees or discounts, accountant's fees, bond counsel's fees, fees for legal counsel to the Authority and to the Applicant:

5.7) Any other costs incurred in connection with the Project which are not customarily deemed to result in a current operating charge:

*If any of the costs listed above have already been incurred, please so indicate by use of an asterisk (*) next to the dollar amount.

b) If the Project has been completed and the purpose of the proposed bond issue is to refinance obligations incurred to finance the Project,

1) Describe the obligations to be refinanced including

1.1) The original principal amount:

1.2) The presently outstanding principal amount:

1.3) The interest rate or rates:

1.4) The terms of repayment:

2) Explain whether any portion of the obligations to be refinanced were incurred for any purpose other than the financing of the Project:

c) Will the Project, or any part of the Project, be used (or has it, or any part thereof, ever been used) for sectarian instruction or as a place of religious worship?

Yes No

If "yes", please provide historic detail.

d) Will the Project, or any part of the Project, be used (or has it or any part thereof ever been used) primarily in connection with any part of the program of a school or department of divinity for any religion, denomination or sect?

Yes No

If "yes", please explain.

e) Will the Project generate revenues?

Yes No

If "yes", will the revenues be sufficient to amortize the principal and interest payments of the proposed bond issue?

Yes No

If "yes", please attach a copy of the projections on which the answer is based.

f) If the proposed bonds are to be sold publicly, will they be rated by Moody's, Standard and Poor's or otherwise?

Yes No

f.1) If "no", what rating(s) is/are expected?

g) Has a construction contractor been named?

Yes No

If "yes", please provide the name and address of the contractor.

h) By what process was the construction contractor chosen, or by what process will the construction contractor be chosen?

i) Has an architect been named for the Project?

Yes No

If "yes", please provide the name and address of the architect.

j) By what process was the architect chosen, or by what process will the architect be chosen?

k) Have plans and/or specifications been prepared for the Project?

Yes No

If "yes", by whom were they prepared?

l) If plans and specifications are not available, are there schematic drawings or other preliminary design papers?

Yes No

m) If the Project is to be a newly constructed facility, have soil tests been performed?

Yes No

n) Please describe the budget and/or capital improvement approval process by which the Project has been approved by the appropriate officials of the Applicant. Upload file here:

o) Please list any and all amounts expended to date on or in connection with the Project.

Upload list here

Date of project

Amount of project

Date of project

Amount of project

Date of project

Amount of project

4. Information Concerning the Proposed Bond Issue.

a) What is the aggregate principal amount of the proposed bond issue?

b) If known, describe the

b.1) Terms of repayment:

b.2) The interest rate or rates:

b.3) The security, if any, for the bonds. If security is to be provided, state the value thereof and the method of determining the value.

c) If known, state how the bonds are proposed to be sold

c.1) Direct sale to one or more institutions:

c.2) Limited institutional placement by an underwriter:

c.3) Public distribution by an underwriter:

d) If the bonds are to be underwritten, name the underwriter.

5. Information Concerning the Applicant's Ability to Pay the Bonds.

a) Attach copies of the Applicant's audited financial statements for the last five fiscal years, including appropriate treatment for the applicant's endowment fund or funds.

a.1) Upload file here

b) In which of Applicant's last 5 fiscal years has Applicant had a surplus of gross revenues (that is, unrestricted revenues exclusive of loan proceeds plus unused restricted revenues which could be used to pay the principal of and interest on the bonds) over expenses (excluding expenses paid with restricted revenues)?

b.1) What was the amount of any such surplus?

b.2) Please give analogous information for any year during Applicant's last five fiscal years in which there was a deficit of gross revenues.

c) Does Applicant have any source of revenues which could be used to pay the bonds other than the gross revenues described in "b" above?

Yes No

If "yes", please describe.

d) Has the Applicant during the last five years failed to pay any of its financial obligations or any installment thereon when such obligations or installment was due?

Yes No

If "yes", please describe.

e) Has the Applicant prepared or does it have access to a study showing whether it is feasible for the Applicant to repay the bonds as they become due?

Yes No

If "yes", please attach a copy of such study.

6. Information Regarding Potential Conflicts of Interest.

a) Is any member of the Authority affiliated with the Applicant in any way?

Yes No

If "yes", please provide the name of such member and describe such affiliation.

b) Is any member of the Authority affiliated with the proposed underwriter for the bonds?

Yes No

If "yes", please provide the name of such member and describe such affiliation.

c) Is any member of the Authority affiliated with any person or entity which has a substantial interest in the Project such as

c.1) The Seller of the land on which the Project is to be built?

Yes No

c.2) The institution holding the obligations to be refinanced with the bond proceeds?

Yes No

c.3) The general contractor, major subcontractor or supplier?

Yes No

c.4) The proposed underwriter or institutional purchaser of the bonds?

Yes No

Signature

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Title

Date

PCUA Application Form

Private College & University Qualifications

1. Identification of the Applicant