National Independent Study Accreditation Council

(Print out the following form, fill in, and mail to NISAC

with accompanying documents - see "Application Process" page.)

 

 

Application for: ___ Candidacy  ___ Accreditation ___ Renewal

                                                             

Name of School :__________________________________________________Date:__________  

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___Administrator ___ Principal:_____________________________________________________

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School Phone: ________________________ Admin Home Phone: _______________________

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Admin Cell:___________________________School Fax: ________________________________

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School Address:__________________________________________________________

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City:_____________________________________State:______________Zip:_________________

                

Mailing Address (if different):_______________________________________________________

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Website:_____________________________________Email:_______________________________    

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Year Established:___________ For Profit:____________ Non-profit:__________

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Geography of enrollment: ___ Local ___ State ___ National ___ International 

 

Current # of Students:______________Grades Served:___________________

 

Number of Staff: ____ Full Time  ___ Part Time  ___ Volunteer    

 

 

                                                           Accreditation Information

 

List Other Accreditations, if any (Include proof of current membership):

 

 

 

 

                                                                           

Have you ever been denied, terminated, or resigned from accreditation:

 

___Yes ___No            If yes, please provide details: