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["Print this form and mail it to the ANSAA office by September 15 along with all fee payments. The form must include  the Head Administrator's original signature.  This same form must also  be submitted electronically with the entire report.  The original signature is not required on the electronic submission."]
["Mail to:  ANSAA/ Kristine Grelle, Executive Director / 2209 South 18th Place  / Rogers, AR  72758"]
[]
["School Name"]
["Mailing Address"]
["Physical Address, if different from above"]
["City / Zip / County"]
["Telephone & Fax Numbers"]
["E-mail Address (will be listed in the ANSAA Directory)"]
["Website Address"]
["Chief Administrator Name & Title"]
["Chief Administrator E-mail Address"]
["Chief Administrator Cell Number (ANSAA office use only)"]
["Other Administrators’ E-mail Addresses (Included in ANSAA mass emails)"]
["Grade levels included in your elementary enrollment"]
["Grade levels included in your secondary enrollment"]
["Year school was founded"]
["Church affiliation (if applicable)"]
["School accreditation other than ANSAA"]
["Member of Arkansas Activities Association                           ",{"$nulls":7},"Yes / No"]
["(Enrollment for grades 9,10,11 will be sent to the AAA office with a cut-off date of Oct. 1)"]
[]
["Number of Employees",{"$nulls":4},"Total Employees in Each Category (PreK4-Grade 12)"]
["Administration"]
["Office Personnel"]
["Teachers (Not including Teacher's Aides)"]
["Media/Library"]
["Technology"]
["Counselors"]
["Support Staff (Custodians, Cafeteria)"]
[]
["Preschool Enrollment / Current Year",{"$nulls":4},"Total K4 Students = "]
["Enrollment Per Grade (K5-12) Including Part Time Students / Current Year"]
["K5 ",null,1,null,2,null,3]
[4,null,5,null,6,null,7]
[8,null,9,null,10,null,11]
[12,null,"Elementary + Secondary Enrollment (Do not include K4)  =  ",{"$nulls":5},{"$f":"SUM(B34,D34,F34,H34,B35,D35,F35,H35,B36,D36,F36,H36,B37)","v":0}]
[]
["Enrollment Fee (Total  Number of Students in Grades K5-12) x $3 per/student",{"$nulls":7},{"$f":"I37*3","v":0}]
["Base Fee Elementary & Secondary Associate School",{"$nulls":6},300,"$"]
["Late Fee, if applicable",{"$nulls":6},100,"$"]
["Donation / Gift to ANSAA to Assist in Promoting Private School Advocacy (Optional)",{"$nulls":7},"$"]
["All Fees  / *Enclose check payable to ANSAA                           ",{"$nulls":6},"Total Fees",{"$f":"SUM(I39,I40, I141, I42)","v":0}]
[" I hereby certify that all the information contained in the full ANSAA report that was submitted electronically is verified by written documents and evidence which are on file in the school office.  "]
["Authorized by  ORIGINAL SIGNATURE OF ADMINISTRATOR IS REQUIRED",null,null,null,"Title ",null,null,"Date"]

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["Verification of ANSAA Mandatory (*)Standards "]
["Refer to the ANSAA Policy Manual 2023  Edition when filling out this section."]
["The purpose of this report is to enable the school’s Chief Administrator and ANSAA Executive Director to determine the school’s readiness for “Candidate Status” and initial accreditation. This annual tracking system of ANSAA Mandatory Standards will assist the school in determining its progress in reaching “Candidate Status” for accreditation.\n\nMark YES with an (x) if the school is in full compliance with the standard; if the standard is only partially fulfilled mark NO with an (x) and explain the circumstances preventing the fulfillment of the standard(s) at the end of the report. Some of the standards may only apply to elementary and/or secondary schools. If the standard does not apply to your school level, mark N/A in the NO box.\n"]
[{"$nulls":7},"YES","NO"]
["*1.0  The school has written mission and philosophy statements that reflect the beliefs and values of the governing board and school constituents. "]
["*1.1  The mission and philosophy statements are approved by the governing board, annually reviewed and evaluated, and published in handbooks, policy manuals, and other materials distributed by the school."]
["*2.0  The school has a responsible governing board or legal authority to which the chief executive officer or educational administrator is responsible."]
["*2.1  The governing board or legal authority has a published policy statement that leaves the daily management and supervision of the school to the chief executive officer or educational administrator."]
["*2.2  In-service programs dealing with the roles, responsibilities, and duties of the governing board or legal authority are provided for new members and reviewed with current members on an annual basis. "]
["*2.3  The chief executive officer, not serving as the school’s educational administrator, has an advanced degree or its equivalent in accordance with the job description of the school’s governing board."]
["*2.4  The school system has a chief executive officer who supervises the educational aspects of the school and oversees the educational administrator/s. The chief executive officer can have a dual role and also serve as the educational administrator. A school system is defined as more than one building site and includes a combination of elementary, middle, and secondary levels."]
["*2.5  School units such as K-4, K-5, K-6, K-8, K-12, 7-9, 7-12, 9-12 must have an educational administrator with a master’s degree in school administration or a school administrator certification and a minimum of three (3) years teaching experience. Accredited schools may apply for a Professional Deficiency Plan to meet this standard. A maximum of two years is granted for completion of an approved degree plan or certification requirements."]
["*2.6\t  The educational administrator devotes at least one-half (1/2) of the school day to the administration and supervision of the school while the remaining one-half (1/2) of the school day may be devoted to another role within the school. Schools with an enrollment of 300 or more students must have a full-time administrator."]
[{"$nulls":7},"YES","NO"]
["*2.7    The school adheres to local, state, and federal laws with special attention given to the following (Check ANSAA.com for annual updates): \n*a) student supervision when using potentially hazardous materials \n*b) policies for inclement weather and early dismissal \n*c) legal requirements for bus driver certification and bus equipment  \n*d) background checks and I-9 Employment Eligibility Verification forms on school personnel "]
["*2.8\t  The school has a written and published policy concerning nondiscrimination in school admissions \tand employment of faculty and staff."]
["*2.9\t  The school has a written policy pertaining to child custody arrangements which includes release of student’s records, filing of court orders, and procedures for checking students out of school during the day. "]
["*2.10    The school is incorporated as a non-profit organization and has been granted a 501-(C) (3) or an equivalent form of tax-exempt status by the Internal Revenue Service."]
["*2.11  The school operates by means of a carefully planned and regularly monitored annual budget to ensure adequate financial resources and effective management. The chief executive officer or educational administrator is given sufficient authority to monitor and regulate the expenditures of the annual budget. "]
["*2.12\t  All school accounts, including auxiliary groups (i.e., parent organization, Booster Club), must have a recognized accounting system which includes a sound check and balance structure and delineation of duties. Checks and balances will include reconciliation of bank accounts, posting, check writing, signing and depositing funds. "]
["*2.13\t  Accountability to the governing body or legal authority is ensured through a system of periodic financial reporting that includes the ANSAA Annual Financial Review and an external review or audit at least once every seven years, preferably the year prior to the ANSAA site visit.  \n"]
["*3.0\t  All teachers, including those teaching specialty classes (i.e., Art, Music, Spanish, P.E., Library), have a minimum of a bachelor’s degree from an accredited four-year institution of higher education and typically teach in their major or minor field of study. Teachers of religion are not required to have a bachelor’s degree as long as they hold a certificate of training in the school’s doctrine.  "]
["*3.1\t  The school maintains a current professional file for each teacher that includes annual contracts, college transcripts, teaching certificates, annual evaluations, I-9 Employment Eligibility Verification, and background checks on teachers who do not have an AR teaching license."]
["*3.2\t  The curriculum reflects the mission, philosophy, and goals of the school and encompasses the fundamental principles of student growth and development as well as specific learning theories.\n\t"]
["*3.3  The school has a written curriculum that incorporates both vertical and horizontal alignment, takes into consideration state guidelines and national standards, and is developed and evaluated with input from the administration and faculty. "]
[{"$nulls":7},"YES","NO"]
["*3.4   Check the ANSAA Policy Manual Edition 2023 for curriculum requirements for grades kindergarten through six. "]
["*3.5 \tCheck ANSAA Policy Manual Edition 2023 for curriculum requirements for grades seven and eight. "]
["*3.6\t  High School Curriculum - Minimum Course Offerings / Grades 9-12: The secondary school must have a master curriculum schedule that offers a minimum of 28 units (listed below), 24 of which are offered at least every other year. Check ANSAA Policy Manual Edition 2023 for specific requirements. "]
["*3.7  High School Graduation Requirements / Grades Nine through Twelve: A minimum of twenty-two (22) units earned in grades nine through twelve is required for high school graduation, (16) of which are mandatory. Check ANSAA Policy Manual Edition 2023 for specific requirements. \n"]
["*3.8 \tA unit of credit is defined as the credit given for a course which meets for a minimum of 120 hours per year. \n"]
["*3.9\t  The school maintains permanent academic records (attendance, test scores, grades) for each student which are stored in a secure location within the school facilities.           "]
["*3.10\t  A standardized testing program is provided annually for grades 1-8 that includes diagnostic and prescriptive services utilized to direct student learning and evaluate curriculum. \n"]
["*3.11 \tThe minimum length of the school year is in accordance with the length designed by the Arkansas Legislature. The on-campus planned instructional time is a minimum of 178 days or equivalent of 1068 hours annually for grades 1-12. Up to forty minutes of recess may count towards the planned instructional time for elementary students (grades K-6). Nothing less than three (3) hours will be counted as one-half (1/2) day of instruction. A full day kindergarten program shall not be less than five (5) and one-half (½) hours per day. Evidence of compliance is submitted yearly with the school’s ANSAA Annual Report. "]
["*4.0\t  Residents new to the school community are oriented to the mission, philosophy, objectives, processes, and procedures of the school. \n"]
["*4.1\t  Methods of annually evaluating the school’s climate are established."]
["*4.2\t  The school conducts an annual orientation for all coaches and activity sponsors who are members of the Arkansas Activities Association. AAA member schools must adhere to all the guidelines and by-laws in accordance with the current Arkansas Activities Association Handbook. (Only applies to schools with sports programs that are members of AAA.)"]
["*5.0\t  The school shall annually budget and expend sufficient resources to purchase and maintain an appropriate balance of print, non-print, and electronic media that is adequate in quality and quantity to meet the academic standards for all students. "]
["*5.1\t  The collection of instructional, learning, and media materials are catalogued according to a recognized and accepted system of classification. "]
["*5.2 \tThe school has accessible, adequate, and appropriate space for the library, media equipment, and resource materials."]
[{"$nulls":7},"YES","NO"]
["*5.3\t  The school has a technology acceptable use policy for the faculty, staff, and students that is annually reviewed, signed, and conveyed to parents in a written format."]
["*5.4\t  Firewalls and filters are used on all computers to safeguard the use of restricted internet sites and comply with federal regulations. "]
["*5.5\t  The school maintains health records for each student including immunization and health screening requirements (scoliosis, vision, hearing) established by state law.  \n"]
["*5.6   \tThe role of the counselor is clearly defined and communicated to the school community, and the counselor’s credentials match the school’s job description. The requirements for the guidance program for grades 9-12 are as follows.                                                \n*a) Secondary school has a guidance program to aid students in educational, personal,                                                                                                                                                                           social and career development.                                                                                 *b) Secondary school provides the necessary facilities, support, and personnel for counseling. \n*c) Guidance services are provided by qualified personnel. \n*d) A ratio of one counselor for each 450 students is recommended.\n*e) Secondary school has at least a part-time counselor. "]
["*5.7\t  The school has clearly defined written guidelines regarding the manner in which coaches and sponsors conduct extra-curricular activities. These guidelines are communicated annually and indicate the school’s intent to conduct all sports and activities with a sense of fair play. (Only applies to schools with sports programs.)"]
["*6.0\t  The school has clearly defined guidelines for student behavior which are aligned with the school’s mission, philosophy, and objectives."]
["*6.1\t  The physical facilities and school grounds are designed to ensure the health and safety of the total school community.  "]
["*6.2 \tInspections of the facilities, property, playground and athletic equipment are conducted and documented monthly to identify safety hazards and correct deficiencies."]
["*6.3\t  The school adheres to local, state, and federal laws concerning safety and health of the school community with special attention given to the following (check ANSAA.com for annual updates):\n*a.)  fire extinguishers are placed throughout the facilities and inspected annually\n*b.)  emergency evacuation routes are posted in all classrooms \n*c.)  warning systems for emergency drills and other crisis situations are in place\n*d.)  safety drills are practiced and results are recorded – including required monthly fire drills \n*e.)  legal requirements for fire safety and annual inspections are met \n*f.)   the school is in compliance with asbestos regulations\n*g.)  school parking lot requirements, including designated spaces for handicap parking, are met \n*h.)  cafeteria and kitchen state health and safety requirements are met\n"]
["*6.4\t  The school has a published crisis plan and written procedures for accidents, emergencies, and disasters that are practiced and reviewed annually, with emergency numbers readily available.  "]
[{"$nulls":7},"YES","NO"]
["*7.0\t  The school has the responsibility of developing a Strategic Plan to strengthen all aspects of the school’s operation (i.e., academic progress, enrollments, finances, staffing, facilities, marketing, and public relations); the plan must be updated annually and include the finances, personnel, resources, and timelines needed to achieve the action plans and goals.  "]
[]
["Attendance Report for 2022-2023  School Year (Indicates compliance with ANSAA Standard *3.11)"]
["Total Number of On-Campus, Instructional Days in Attendance"]
["Total Number of Off-Campus \"Cyber Days\" / Alternative Methods of Instruction (AMI)"]
[]
["On-Campus Daily Secondary School Hours for 2022-2023 School Year (Indicates compliance with ANSAA Standard *3.11)"]
["Starting Time",null,null,null,"Dismissal Time"]
["Total Daily Instruction Time (excludes lunch and more than 40 minutes of recess)"]
[]
["Justification Statements for ANSAA Standard / Non-Compliance"]
["Write an explanation for any ANSAA Standard(s) that was marked “no” in the survey. Name the ANSAA Standard, and/or Curriculum Area in question and give a written explanation why the school is not in compliance with the named standard.   Add cells as needed."]
["Standard #","Reason for Non-compliance"]
[]
[]
["VERIFICATION"]
["The current policy manual (Edition 2023) has been reviewed and this school is still maintaining ANSAA Standards as marked on the proceeding page. I hereby certify that all the information contained herein is verified by transcripts, certified copies of academic records, and teaching certificates issued by a sponsoring organization. These documents are on file in the school office.  The space below is provided for any comments or questions.\n\nI understand that in using the ANSAA name in relation to the school’s membership, the term Non-Accredited Associate Member will be used in all school publications (e.g., website, advertisements). "]
["Include electronic signature of the chief administrator below that has verified all the information. Typed names are acceptable."]
["Administrator  ",{"$nulls":6},"Date"]