Accrediting Commission for Schools 533 Airport Boulevard, Suite 200Burlingame, California 94010 (650) 696-1060  Fax (650) 696-1867 [email protected]  www.acswasc.org

DATA SHEET New Member Updated Information

Mr. Ms. Miss Mrs. Dr. Br. Sr. Other: Name: Gender Male Female Job Title: Ethnicity African American, Not of Hispanic Origin Date of Birth: American Indian, Alaskan Native Employment (School): Asian Department: Filipino Address: Hispanic or Latino City, State ZIP: Pacific Islander White, Not of Hispanic Origin Home Address: Other: City, State ZIP: Religious Affiliation (Optional) Direct Phone: (utilized when assignment might relate to a religious institution) Fax: Armenian Apostolic Jewish (Conservative) Home Phone: Cell: Atheist-Agnostic Jewish (Orthodox) Email: Baptist Jewish (Reform) Buddhist Lutheran Preferred Mailing Address Catholic Methodist Employment Home Other Christian Mormon/LDS Christian Scientist Muslim Years of Experience Congregationalist Other/Non-Denom. years teaching years admin Episcopalian Presbyterian Other (please explain): Greek Orthodox Protestant Jewish Seventh-day Adventist

Experience Curricular Areas of Expertise Preschool English/Language Arts Alternative Education Elementary School ESL At-Risk Students Junior High/Middle School Bilingual Education Career Education Comprehensive High School Computer/Technology Counseling Charter School History/Social Science Culturally Diverse Students Continuation High School Math Curricular Development Independent Study Physical Education Instructional Leadership Postsecondary Institution Science Library Services Correctional Adult School Visual and Performing Arts Management/Organization Court/Community School Vocational Technical Education Program Quality Review Online/Distance Learning Int’l Baccalaureate (PYP) Restructuring Regional Occupational Ctr/Pgm Int’l Baccalaureate (MYP) School Culture Int’l Baccalaureate (Diploma Program) School Planning Urban Other Curricular Experience: School Services/Facilities Rural Special Education Suburban Foreign Language(s) Special Needs Public School Chinese Staff Development Private/Independent School French Student Assessment CAIS HAIS German Student Services Religious School Japanese Other Areas of Expertise: ACSI SDA WCEA Korean Boarding School Spanish NPS Tagalog Other Experience: Thai Other:

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