Missouri Nonpublic School Accrediting Association

Missouri Nonpublic School Accrediting Association

ANNUAL REPORT FORM

Elementary

SCHOOL DATA

CURRENT SCHOOL YEAR 2016-2017

YEAR OF LAST SCHOOL IMPROVEMENT PLAN

SCHOOL

ENROLLMENT (Grades through ) TOTAL (Current Year)

ADDRESS

ZIP

ADMINISTRATOR

PHONE NUMBER ( )

Please respond yes/no: Is this a Special Education School or Program? YesNo

Does the school offer a: Pre-school Program? YesNo Before or After School Care Program? NoYes

STATUS OF SCHOOL IN PREVIOUS YEAR: AccreditedAccredited with violationAccredited with First WarningAccredited with Second Warning

INDICATORS OF MEMBERSHIP

Please write YES for all the indicators that the school fulfills. If the indicator is only partially fulfilled or not fulfilled at all, write NO. An explanation of the circumstances preventing the fulfillment of particular indicator(s) and the steps that will be taken to address these indicators must be included on page 5 of this form.

Mission and Philosophy

YesNo 1A

YesNo 1B

YesNo 1C

YesNo 1D

YesNo 1E

YesNo 1F

Climate

YesNo 2A

YesNo 2B

YesNo 2C

YesNo 2D

YesNo 2E

YesNo 2F

YesNo 2G

YesNo 2H

YesNo 2I

Leadership

YesNo 3A

YesNo 3B

YesNo 3C

YesNo 3D

YesNo 3E

YesNo 3F

YesNo 3G

YesNo 3H

YesNo 3I

YesNo 3J

YesNo 3K

YesNo 3L

YesNo 3M

YesNo 3N

YesNo 3O

YesNo 3P

Personnel

YesNo 4A

YesNo 4B

YesNo 4C

YesNo 4D

YesNo 4E

YesNo 4F

YesNo 4G

YesNo 4H

YesNo 4I

YesNo 4J

YesNo 4K

YesNo 4L

Page 2

Curriculum

YesNo 5A

YesNo 5B

YesNo 5C

YesNo 5D

YesNo 5E

YesNo 5F

YesNo 5G

YesNo 5H

YesNo 5I

Instruction

YesNo 6A

YesNo 6B

YesNo 6C

YesNo 6D

YesNo 6E

YesNo 6F

YesNo 6G

YesNo 6H

YesNo 6I

YesNo 6J

Services

YesNo 7A

YesNo 7B

YesNo 7C

YesNo 7D

YesNo 7E

YesNo 7F

YesNo 7G

YesNo 7H

YesNo 7I

YesNo 7J

YesNo 7K

YesNo 7L

YesNo 7M

YesNo 7N

Facilities

YesNo 8A

YesNo 8B

YesNo 8C

YesNo 8D

YesNo 8E

YesNo 8F

YesNo 8G

YesNo 8H

YesNo 8I

YesNo 8J

YesNo 8K

YesNo 8L

YesNo 8M

YesNo 8N

Finance and Planning

YesNo 9A

YesNo 9B

YesNo 9C

YesNo 9D

YesNo 9E

YesNo 9F

YesNo 9G

YesNo 9H

YesNo 9I

OPTIONAL PROGRAM INDICATORS OF MEMBERSHIP

Early Childhood Program

YesNo 10A

YesNo 10B

YesNo 10C

YesNo 10D

YesNo 10E

YesNo 10F

YesNo 10G

Before and After School Care Programs

YesNo 11A

YesNo 11B

YesNo 11C

YesNo 11D

YesNo 11E

YesNo 11F

Exceptional Learning Needs School or Program

YesNo 12A

YesNo 12B

YesNo 12C

YesNo 12D

YesNo 12E

YesNo 12F

YesNo 12G

YesNo 10H

YesNo 10I

YesNo 10J

YesNo 10K

YesNo 10L

YesNo 10M

YesNo 10N

YesNo 10O

YesNo 10P

YesNo 10Q

YesNo 10R

YesNo 10S

YesNo 12H

YesNo 12I

Page 3

PLAN FOR IMPROVEMENT

Please list activities/strategies implemented in the 2016-17 school year.

Page 4

PLAN FOR IMPROVEMENT

Please list activities/strategies to be implemented in the 2017-18 year.

Page 5

CURRENT DEVIATIONS IN INDICATORS

Give a brief explanation of circumstances that prevent the fulfillment of any of the indicators to which a "no" was given on pages 1-2. Also include the steps that will be taken to address this indicator. (Include a separate sheet if necessary.)

MEMBERSHIP INDICATOR NUMBER EXPLANATION OF DEVIATION IN INDICATORS

Page 6

CITED VIOLATIONS FROM PREVIOUS YEAR

List below the violations cited by the Association in the previous year's report. Explain progress made. (Use a separate sheet if necessary.)

INDICATOR NUMBER: EXPLANATION OF PROGRESS MADE

All material included on this Annual Form is accurate and complete.

______

Signature of Administrator

Please return this form to your Sponsoring Agency with annual dues payable to your Sponsoring Agency.

FOR USE OF SPONSORING AGENCY:

It is the opinion of the Sponsoring Agency of this school that all policies and procedures of said agency are adequately followed and that the school’s Plan for Improvement demonstrates a viable plan for school improvement.

______

Signature of Sponsoring Agency Director

Revised 2015