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Association of Accredited Bible Schools and Teachers

Member School Information Report

Please complete the entire form.

School Name _______________________________________________________ Year Founded _____________

Mailing Address ___________________________________________________

Email __________________________________________________________

Web Site _________________________________________________________

School Phone __________________________________________

City ____________________________________ State _______________ ZIP ___________________

Street Address (if different from above) _________________________________________________

Sponsoring Church (if any) _______________________________________________________________

Church Phone ___________________________ Pastor _________________________________________

Pastor E-mail Address ___________________________________________________________

Administrator/Principal ______________________________________________________________

Administrator/Principal E-mail Address _________________________________________________

Administrator’s Home Phone ______________________________

Elementary Principal ____________________________________________

High School Principal ______________________________________________

Preschool/Child Care Director ______________________________________________

School Secretary ______________________________________________________

Was your school a member during the 2002-2003 school year? (Circle one) Yes No

List the number of students in your school or Home School in each age or grade and totals as indicated below.

Preschool (PS) Junior High (JH) Senior High (SH)

    1. yr. ________ 1-2 yr. ___________ 2-3 yr. ___________ K4 __________ Total ___________

Elementary (EL)

K5 ___________ 1st __________ 2nd ____________ 3rd ____________ 4th ____________

5th ______________ 6th ______________ Total _______________________

Junior High (JH)

7th _________________ 8th _________________ Total _________________

Senior High (SH)

9th ______________ 10th _____________ 11th _____________ 12th ______________ Total _________

PS Total ____________ EL Total ____________ JH Total ___________ SH Total ___________

Total Student Enrollment (PS-12) ................................................................. __________________

Total Home School Division Student Enrollment (PS-12) .................. ....... __________________

Total Faculty (full- and part-time teachers, administrators, coaches, etc.) ..... __________________

Grand Total (student enrollment plus faculty) .................................................. __________________

What best describes your school?

_____ Individualized (ACE, Alpha Omega, etc.) _____ Traditional (BJU Press, A Beka Book, etc.)

_____ Video: A Beka _____ Other ____________________ _____ Satellite: BJ LINC _____

Other _______________________ Combination:_________________________________

Does your school offer: Legislative Information:

Special education program? _____ Yes _____ No U.S. Congressional district number _____________

Home school division? _____ Yes _____ No

U.S. Congressman’s name ____________________________________________

Boarding school? _____ Yes _____ No

We are in complete agreement with the above ODB, Statement of Faith and the Membership Statement.

Signed _________________________________________

Title _________________________________________

Date _________________________________________

Schools should complete this entire form and return it with their dues ($2.50 per student and faculty member) to the ODB, National Office.

Our Daily Bread, Missions

Association of Accredited Bible Schools and Teachers

P.O. Box 1934, Redmond, OR 97756

Phone: (541) 383-4840

E-mail:  Contact Us