Full name of the program: 
Full name of the institution and faculty to which the program is affiliated: 
(If applicable) Date of prior accreditation of the program: 
Application Date: Self-Assessment Report Date:

1. EVALUATION CHART

2. Additional information requested from the Pre-Visit Program

PRELIMINARY EVALUATION RESULT 
In this section, a general assessment of the Self-Assessment Report, the sections of the report that are missing or the items that are missing in the report, where additional information is needed, there is a lack of expression, are listed here and one of the following items is marked.

Admission 
( ) The Self-Assessment Report has been adopted, the Institution Visiting Calendar must be issued. 
( ) The Self-Assessment Report has been accepted, the Institution Visits Calendar must be issued, but additional information is requested from the Program to be completed until the visit. 

Correction 
( ) As the Self-Assessment Report is incomplete, additional information is requested to be forwarded to MIAK-MAK. 

Rejection 
( ) Self-Assessment Report found inadequate and/or unacceptable. The relevant Program must prepare a new Self-Assessment Report by the end of December of the application year or complete the deficiencies in the Report.