Student Admission Form Step 1 of 2 50% Student Full Name* First Middle Last Suffix Home Phone Home Address*Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Country of Birth*AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabweSex* Male Female Citizenship* If the student has multiple citizenships, please add them as needed.Date of Intended Entry to ANS*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Former Applicant* New Student Previously Applied to / Attended ANS Please indicate whether your child is a new student or has previously applied to or attended ANSPreviously Attended GradesK3K4Kindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradePlease mark the grades your child has previously attended to at ANS. Mark all that apply.Applying Grade*K3K4Kindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeLanguage ProficiencyFirst Language* First Language Proficiency* Understands Speaks Reads Writes Second Language Second Language Proficiency Understands Speaks Reads Writes Third Language Third Language Proficiency Understands Speaks Reads Writes Language Spoken at Home* Father's First Language* Mother's First Language* Learning SupportAdditional Learning Support Needs Speech Reading Writing Behavior Autism Math Sensory Processing Students with additional learning support needs, please check the areas that apply.Previous Documented Plan* Yes No Has any previous education provider prepared a documented plan to support the student's additional learning needs?Educational InformationPrevious Schooling* Yes No Please indicate if your child has received previous schooling.Name of Previous School Location of Previous School Early Learning Students Washing Hands Dressing Bathroom Use Demonstrates independence in personal care, such as:Nicaraguan Diploma for Secondary School Applicants Yes No In addition to the American Nicaraguan School High School Diploma, my child will opt to earn the Diploma de Bachiller en Ciencias y Letras granted by the Nicaraguan Ministry of Education, which is required for higher education in Nicaragua, by countries in Latin America, and some countries in Europe and Asia. Family InformationSiblings at ANSNameAt ANSApplying to ANSGrade Siblings studying at ANS or applying to enter ANSStudent Lives With* Both parents Mother Father Guardian Please specify whether student lives with both parents or mark the option that applies.Child Custody TermsIf parents are separated, divorced or either one has re-married, please specify child custody terms. Legal documentation may be required to support this information.Parent or Guardian InformationMale Parental FigureRelationship* Father Male Guardian Name* First Middle Last Suffix Citizenship* ID Type* Nicaraguan ID Nicaraguan Residency Passport Nicaraguan ID Mobile Phone Email Work Place Work Phone ANS Alumnus* Yes No Has this person studied at ANS?Attended ANS ForPlease enter a number from 0 to 13.Please enter the amount of years this person studied at ANSClass ofPlease enter a number from 1944 to 2021.Please enter the class generation this person belongs toFemale Parental FigureRelationship* Mother Female Guardian Name* First Middle Last Suffix Citizenship* ID Type* Nicaraguan ID Nicaraguan Residency Passport Nicaraguan ID Mobile Phone Email Work Place Work Phone ANS Alumna* Yes No Has this person studied at ANS?Attended ANS ForPlease enter a number from 0 to 13.Please enter the amount of years this person studied at ANSClass ofPlease enter a number from 1944 to 2021.Please enter the class generation this person belongs toEmergency ContactsEmergency Contacts*Full NameRelationship with StudentMobile PhoneHome PhoneWork Phone Please provide up to a maximum of 3 emergency contacts.Billing InformationTuition Payed By* Father Mother Other ANS Faculty Scholarship Person Responsible of Tuition Please indicate who will be paying for the tuitionPrimary Household Contact Name* Priamry Email Address This email address will be taken as a primary source of contact for the student's household. In addition to billing purposes, it will be used for ANS community communications and during Board of Directors elections.Student DocumentationPlease provide the required and additional documentation for the student in the drop box below.Student Documentation Upload Drop files here or Select files Accepted file types: doc, docx, pdf, jpg, jpeg, png, bmp, gif, tiff, Max. file size: 64 MB. Please note that, for security reasons, we only accept Word documents, PDF documents, and image files. Maximum file size is 64 MiB.Acceptance* I accept I certify that all information provided on this application is complete and accurate to the best of my knowledge. I understand that providing false information may interfere with my child's possibility of admission or continued enrollment.