Name of School:
Physical Street Address:
City:
State:
Zip/Postal Code:
County:
Country:
Mailing Street Address:
Mailing City:
Mailing State:
Mailing Country:
Mailing Zip/Postal Code:
School Phone:
School Email:
Website Address:
Year the School Opened:
Is the school part of a larger organization (i.e. district, (arch) diocese, corporation)? Yes No
Please specify the name of the larger organization.
School Head Title
School Head First Name
School Head Last Name
School Head Cell
School Head Email
Primary Contact Title
Primary Contact First Name
Primary Contact Last Name
Primary Contact Cell
Primary Contact Email
YesNo
12345678910
Branch Campus 1 Address (Street, City, State Zip)
Branch Campus 2 Address (Street, City, State Zip)
Branch Campus 3 Address (Street, City, State Zip)
Branch Campus 4 Address (Street, City, State Zip)
Branch Campus 5 Address (Street, City, State Zip)
Branch Campus 6 Address (Street, City, State Zip)
Branch Campus 7 Address (Street, City, State Zip)
Branch Campus 8 Address (Street, City, State Zip)
Branch Campus 9 Address (Street, City, State Zip)
Branch Campus 10 Address (Street, City, State Zip)
Is the school incorporated? YesNo
If yes, name of corporation:
Is the school licensed to operate as an educational institution? YesNo
If yes…In what state(s) is the school licensed to operate?
In what country(ies) is the school licensed to operate?
If no, explain the school's authority to operate:
Is the school licensed to grant diplomas or certificates? YesNo
If yes…In what state(s)/country(ies) is the school licensed to grant diplomas or certificates?
Type(s) of diplomas or certificates offered:
If no, explain the school's authority to grant diplomas or certificates: