Form Website Overseas School Application

SURVEY YEAR: 2025

DEPARTMENT OF STATE

PRINTED AS OF:

OVERSEAS SCHOOL QUESTIONAIRE

02/14/2025

The Office of Overseas Schools (A/OPR/OS)
GRANT APPLICATION FOR ASSISTED
OVERSEAS SCHOOLS

SCHOOL APPLICATION NUMBER: SCH0004081

STATUS: Draft

SCHOOL NAME:

DATE SUBMITTED:

POST COUNTRY:

OVERSEAS SCHOOLS REGION:

POST:

SCHOOL INFORMATION
SCHOOL LEGAL NAME:
SCHOOL EMAIL:
SCHOOL LOCAL PHONE:
SCHOOL U.S. PHONE:
SCHOOL STREET:

SCHOOL ZIP CODE:

SCHOOL CITY:

SCHOOL COUNTRY:

SCHOOL PERSONNEL
PERSON PREPARING REPORT:
TITLE OF PERSON PREPARING REPORT:
HEAD OF SCHOOL/SUPERINTENDENT NAME:
HEAD OF SCHOOL/SUPERINTENDENT TITLE:

HEAD OF SCHOOL/SUPERINTENDENT PERSONAL
EMAIL:

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DEPARTMENT OF STATE

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OVERSEAS SCHOOL QUESTIONAIRE

HEAD OF SCHOOL/SUPERINTENDENT PHONE:

02/14/2025

HEAD OF SCHOOL/SUPERINTENDENT
PROFESSIONAL EMAIL:

GRADE STRUCTURE
GRADES OFFERED:
PRE-KINDERGARTEN:
ELEMENTARY:
DOES YOUR SCHOOL HAVE A PRIMARY SCHOOL LEVEL?:
MIDDLE SCHOOL:
HIGH SCHOOL:
OTHER GRADE STRUCTURE NAMES:

ONLINE COURSES OFFERED:

BOARDING FACILITIES:

BOARDING FACILITIES DESCRIPTION:

ACADEMIC CALENDAR
TOTAL DAYS OF INSTRUCTION:
CALENDAR HEMISPHERE ALIGNMENT:
ACADEMIC CALENDAR STRUCTURE:
There are no Academic Calendar records.

There are no Documents attached for the School's Academic Calendar.

ACCREDITATION
ACCREDITED BY AN AMERICAN AGENCY:
STEPS TAKEN TOWARD AN AMERICAN AGENCY ACCREDITATION:

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DEPARTMENT OF STATE

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OVERSEAS SCHOOL QUESTIONAIRE

ACCREDITED BY:

02/14/2025

ACCREDITATION APPROVED ON:
ACCREDITATION RENEWAL DATE:

LICENSED OR AUTHORIZED BY LOCAL AUTHORITIES:
LICENSE OR AUTHORIZATION APPROVED BY:

NATURE OF APPROVAL:
APPROVAL DESCRIPTION:

DATE OF MOST RECENTLY UPDATED SCHOOL CHARTER AND BY-LAWS:
There are no Documents attached for the most recent Charter and By-laws.

There are no Documents attached for the Child Protection Policy.

GOVERNING BOARD OF THE SCHOOL
OFFICIAL NAME OF GOVERNING BOARD:

HOW LONG IS THE TERM OF OFFICE FOR A
BOARD MEMBER?:

TITLE OF GOVERNING BOARD MEMBERS:

REPRESENTATIVE OF THE U.S. AMBASSADOR ON
THE BOARD?:

List the number of members on the Board from each employment sector. If the Board Member is a dependent
with no work affiliation in their own right, please use 'Other' from each employment sector.
U.S GOVERNMENT - U.S.:

U.S. GOVERNMENT - THIRD

U.S. GOVERNMENT - HOST

COUNTRY:

COUNTRY:

CORPORATE - U.S.:

CORPORATE - THIRD
COUNTRY:

CORPORATE - HOST COUNTRY:

NON-PROFIT ORGANIZATION -

NON-PROFIT ORGANIZATION -

NON-PROFIT ORGANIZATION -

U.S.:

THIRD COUNTRY:

HOST COUNTRY:

OTHER - U.S.:

OTHER - THIRD COUNTRY:

OTHER - HOST COUNTRY:

TOTAL NUMBER OF BOARD MEMBERS:

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DEPARTMENT OF STATE

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OVERSEAS SCHOOL QUESTIONAIRE

02/14/2025

NUMBER OF ELECTED BOARD MEMBERS:
NUMBER OF APPOINTED BOARD MEMBERS:

COMPOSITION OF THE STUDENT BODY
Provide Number of Students enrolled in each education level by citizenship as of October 1.
U.S. STUDENTS IN PRE-K:

THIRD COUNTRY STUDENTS IN
PRE-K:

HOST COUNTRY STUDENTS IN
PRE-K:

U.S. STUDENTS IN

THIRD COUNTRY STUDENTS IN

HOST COUNTRY STUDENTS IN

ELEMENTARY:

ELEMENTARY:

ELEMENTARY:

U.S. STUDENTS IN MIDDLE
SCHOOL:

THIRD COUNTRY STUDENTS IN
MIDDLE SCHOOL:

HOST COUNTRY STUDENTS IN
MIDDLE SCHOOL:

U.S. STUDENTS IN HIGH

THIRD COUNTRY STUDENTS IN

HOST COUNTRY STUDENTS IN

SCHOOL:

HIGH SCHOOL:

HIGH SCHOOL:

TOTAL U.S. STUDENTS:

TOTAL THIRD COUNTRY
STUDENTS:

TOTAL HOST COUNTRY
STUDENTS:

TOTAL OF STUDENTS
ENROLLED:
PRE-KINDERGARTEN ENROLLMENT:

MIDDLE SCHOOL ENROLLMENT:

ELEMENTARY ENROLLMENT:

HIGH SCHOOL ENROLLMENT:

TOTAL U.S. GOVERNMENT EMPLOYEES'
STUDENTS ENROLLED:
Provide the list of the top 10 nationalities represented by Students and the number of students from each
country.

Rank

Nationality Represented

Number of People

1
2

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DEPARTMENT OF STATE

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OVERSEAS SCHOOL QUESTIONAIRE

Rank

Nationality Represented

02/14/2025

Number of People

3
4
5
6
7
8
9
10

FACULTY AND STAFF
Provide Number of Administrative Staff as of October 1.
PRINCIPALS:

SPECIAL NEEDS
COORDINATORS:

CURRICULUM
COORDINATORS:

ASSISTANT PRINCIPALS:

ATHLETIC DIRECTORS:

ADMISSIONS DIRECTORS:

ADVANCEMENT DIRECTORS:

OPERATIONS:

ADMINISTRATIVE STAFF
TOTAL:
Provide Number of Faculty as of October 1. Do not include Administrative Staff.
CLASSROOM TEACHERS:

TEACHER'S AIDES:

SPECIAL NEEDS:

SCHOOL COUNSELORS:

COLLEGE COUNSELORS:

LIBRARIANS:

INSTRUCTIONAL
TECHNOLOGY/MAKER
SPACE/DESIGN CENTER:

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DEPARTMENT OF STATE

PRINTED AS OF:

OVERSEAS SCHOOL QUESTIONAIRE

02/14/2025

FACULTY TOTAL:
Provide Number of Faculty who have been hired locally versus recruited from overseas by citizenship as of
October 1.
UNITED STATES CITIZENS
OVERSEAS HIRES:

THIRD COUNTRY NATIONALS
OVERSEAS HIRES:

HOST COUNTRY NATIONALS
OVERSEAS HIRES:

UNITED STATES CITIZENS

THIRD COUNTRY NATIONALS

HOST COUNTRY NATIONALS

LOCAL HIRES:

LOCAL HIRES:

LOCAL HIRES:

TOTAL U.S. CITIZENS ON
FACULTY:

TOTAL THIRD COUNTRY
NATIONALS ON FACULTY:

TOTAL HOST COUNTRY
NATIONALS ON FACULTY:

Provide the list of the top 5 nationalitites represended by Administrative Staff and the number of
administrators from each country.

Rank

Nationality Represented

Number of People

1
2
3
4
5

Provide the list of the top 5 nationalities represented by Faculty and the number of faculty from each country.

Rank

Nationality Represented

Number of People

1
2
3
4

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DEPARTMENT OF STATE

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OVERSEAS SCHOOL QUESTIONAIRE

Rank

Nationality Represented

02/14/2025

Number of People

5

Provide number of Administrators and Faculty members who were trained in the United States.
TEACHERS TRAINED IN THE U.S.:

ADMINISTRATORS TRAINED IN THE U.S.:

Provide number of teachers by highest education level achieved.
BACHELOR'S DEGREE (BA OR
BS):

MASTER'S DEGREE (MA OR
MS):

DOCTORATE (PHD):

Provide the salary range for teachers in $(USD) equivalent.
LOWEST SALARY: $(USD)0.00

HIGHEST SALARY: $(USD)0.00

AVERAGE SALARY: $(USD)0.00

Provide average Salary Step increases for Bachelor’s and Master’s Degree holders. A salary step is an increase
in salary based on previous qualifying professional experience.
SALARY STEP FOR
BACHELOR'S DEGREE HOLDER

SALARY STEP FOR MASTER'S
DEGREE HOLDER +5 YEARS

+2 YEARS
EXPERIENCE: $(USD)0.00

EXPERIENCE: $(USD)0.00

SCHOOL FINANCES
Provide tuition information for the current fiscal year in $(USD) equivalent.
PRE-KINDERGARTEN TUITION: $(USD)0.00
ELEMENTARY TUITION: $(USD)0.00
MIDDLE SCHOOL TUITION: $(USD)0.00
HIGH SCHOOL TUITION: $(USD)0.00
BOARDING FEE: $(USD)0.00
MAY TUITION BE PAID IN U.S DOLLARS?:

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DEPARTMENT OF STATE

PRINTED AS OF:

OVERSEAS SCHOOL QUESTIONAIRE

02/14/2025

DOES THE SCHOOL ASSESS A CAPITAL LEVY
FEE?:
ANNUAL CAPITAL LEVY FEE: $(USD)0.00

ONE TIME CAPITAL LEVY FEE: $(USD)0.00

OTHER FEES:
There are no documents attached for Schedule of Fees.

PROJECTED
REVENUE: $(USD)0.00

PROJECTED
EXPENDITURES: $(USD)0.00

CONTINGENCY

EMERGENCY OPERATIONAL

FUNDS: $(USD)0.00

RESERVE: $(USD)0.00

CAPITAL RESERVE: $(USD)0.00

OTHER RESERVE
FUNDS: $(USD)0.00

PROJECTED BUDGET
BALANCE: $(USD)0.00

There are no documents attached for Budget Summary.

AFFILIATED COMPANIES
Provide information of the top 10 U.S. Affiliated Business Firms which employ parents of enrolled students.

Rank

Parent
Company

Local
Affiliate

Number of U.S.
Citizen Students

Number of Host
Country National

Number of Third
Country National

Students

Students

1
2
3
4
5
6

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DEPARTMENT OF STATE

PRINTED AS OF:

OVERSEAS SCHOOL QUESTIONAIRE

Rank

Parent
Company

Local
Affiliate

Number of U.S.
Citizen Students

02/14/2025

Number of Host
Country National

Number of Third
Country National

Students

Students

7
8
9
10

REQUEST FOR GRANT ASSISTANCE
The Request for Grant Assistance section should be prepared by the chief administrative official of the school
in consultation with the school board. In order to provide proper information on this form, please note that
funds being requested in November of any given year are from current U.S. Government Fiscal Year funds. If
granted, the funds would be spent by the school during the next school year. NOTE: The fields in this section
allow a maximum of 4000 characters. Please do not type or paste special characters into these fields, including
accented characters(ex: Ç, ñ, etc.), symbols in Word (ex: •, –, etc.), or any other non-alphanumeric or nonpunctuation characters (ex: "tab", etc.).
FISCAL YEAR: 2025
Section I. SCHOOL NARRATIVE - A summary statement describing the extent to which the school now meets
the seven categories of the overseas schools program and how the school demonstrates U.S. education
excellence abroad.
SCHOOL NARRATIVE:
Section II. SCHOOL OBJECTIVES - A brief general statement of the school’s long-range strategic objectives
and development plans for continuous involvement and innovation.
STRATEGIC OBJECTIVES:
Section III. TYPES AND ESTIMATED COST OF NEW ASSISTANCE REQUESTED - The table below should
be used to summarize the types and estimated costs in dollars of new assistance requested by the school
according to the seven categories shown. Include the US dollar equivalent of all costs (which can be expended
in local currency) in the Requested Amount field.

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DEPARTMENT OF STATE

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OVERSEAS SCHOOL QUESTIONAIRE

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Section IV. THE JUSTIFICATION - In the Justification field, describe the essential details (number,
quantities, types, duration, etc.) of the project to be financed under each of the categories of assistance listed
in the table below and state how each item of requested assistance fits into the school’s development plans and
advances the objectives of the overseas schools program. In the Anticipated Impact field, provide a brief
reference to any previous grants made for the same purpose and to future grants which may be requested for
the same purpose. Following the discussion of each item of requested assistance, use the Priority field to
designate the rating it should be accorded in terms of the school’s development program by designating it
Priority 1 - 7, with 1 being the highest and 7 the lowest.
Provide requested amounts for each Assistance Type in $(USD) equivalent. Please note: the information
provided in this section should reflect your best estimate of the next school year, the year for which assistance
is being requested. This should not repeat information concerning the current school year.

Assistance Type

Requested
Amount

Special Needs Program Expansion

$(USD)0.00

Social Emotional Well-Being/Child Protection

$(USD)0.00

Leadership Development and School
Governance

$(USD)0.00

Salaries for U. S. Citizen Professional Staff

$(USD)0.00

Professional Development

$(USD)0.00

Gifted and Talented Education Programs

$(USD)0.00

Special Projects and Innovation

$(USD)0.00

Justification

Anticipated
Impact

PROGRAM SURVEY
CURRICULUM PROGRAMS:
LANGUAGES:
OTHER LANGUAGES OFFERED:
EXTERNAL ASSESSMENTS:

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DEPARTMENT OF STATE

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02/14/2025

OTHER EXTERNAL ASSESSMENTS OFFERED:

SPECIAL NEEDS SURVEY
DOES THE SCHOOL OFFER A PROGRAM AND/OR SERVICES FOR CHILDREN WITH SPECIAL NEEDS?:
DOES THE SCHOOL ADMIT AND PROVIDE SUPPORT FOR SPECIAL NEEDS PRESCHOOL STUDENTS?:
SCHOOL'S ADMISSION CRITERIA:
IN GENERAL, THE SCHOOL CAN SUPPORT STUDENTS WHOSE LEARNING SUPPORT NEEDS ARE:
THE SCHOOL HAS THE EXPERTISE AND CAPABILITY TO SERVE THE FOLLOWING DISABILITIES:
DOES THE SCHOOL PROVIDE AN IEP, ILP, OR SSP?:
SPECIAL NEEDS SUPPORT SERVICES:
PUSH IN FOR LEARNING SUPPORT TEACHER:

PUSH OUT FOR LEARNING SUPPORT TEACHER:

MAXIMUM PUSH IN HOURS PER WEEK PER
STUDENT:

MAXIMUM PUSH OUT HOURS PER WEEK PER
STUDENT:

SELF-CONTAINED CLASSROOMS:
Indicate number of staff available. Provide information in decimals for staff who work part-time in general or
at a particular level. Ex: If one Nurse covers all grades, it should be listed as Elementary - 0.33, Middle
School - 0.33, and High School - 0.34.

Staff

Elementary

Middle School

High School

Total

Special Needs Teacher
ESL Teacher
School Counselor
Psychologist
Social Worker

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DEPARTMENT OF STATE

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Staff

Elementary

Middle School

02/14/2025

High School

Total

Nurse
Special Needs Coordinator

Select all additional support services available in English
SUPPORT SERVICES PROVIDED BY THE SCHOOL:
OTHER SUPPORT SERVICES PROVIDED AT THE SCHOOL:
SUPPORT SERVICES PROVIDED IN THE COMMUNITY:
Select all Literacy or Mathematics support available for students
LITERACY OR MATHEMATICS SUPPORT PROVIDED BY THE SCHOOL:
LITERACY OR MATHEMATICS SUPPORT PROVIDED AT THE SCHOOL OR IN THE COMMUNITY:
SPECIALIZED SUPPORT SERVICES:
SPECIAL NEEDS WEBSITE WHERE SPECIAL NEEDS INFORMATION IS PUBLISHED::
NUMBER OF USG STUDENTS RECEIVING LEARNING SUPPORT:

SIGNATURES
The person preparing this application, the chief administrative official of the school and the chairman of the
school’s governing board should sign the request in the respective fields below the table.
PERSON PREPARING REPORT SIGNATURE:

PERSON PREPARING REPORT SIGNED DATE:

HEAD OF SCHOOL SIGNATURE:

HEAD OF SCHOOL SIGNED DATE:

BOARD CHAIR SIGNATURE:

BOARD CHAIR SIGNED DATE:

POST RECOMMENDATION
Section V. POST RECOMMENDATION - Pursuant to 2 FAM 613 and 622, the principal officer responsible
for coordinating school activities at the Foreign Service Post should ensure that the request for assistance is

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DEPARTMENT OF STATE
OVERSEAS SCHOOL QUESTIONAIRE

PRINTED AS OF:
02/14/2025

carefully reviewed in light of the policies and criteria for granting assistance set forth in 2 FAM 600 and is
justifiable in terms of these policies and criteria. The appropriate officer should prepare and sign the
recommendation at the place indicated. No request for assistance will be considered unless this section is
properly completed.
POST RECOMMENDATION:
SIGNED BY:

SIGNED DATE:

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