Faneyåkan Sinipok Application Form SY 2021-2022 for Kinder
Håfa Adai!

Si Yu'os Ma'åse' for choosing the Faneyåkan Sinipok (CHamoru Immersion)
SY 21-22 Program for your kindergarten student. Please fill out this application form and make sure to answer all the questions.

We will contact you to schedule an interview upon receipt and review of this application,
This application does not guarantee your child's enrollment to the Faneyåkan Sinipok.


Sen Dångkolo na Si Yu'os Ma'åse'.
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Email *
CHILD'S INFORMATION
Last Name *
First Name, M.I. *
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Current Address/Physical Address *
Mailing Address (If different from the physical address) *
Citizenship *
Are you a: *
Ethnicity *
If  you chose  Mixed Ethnicity or Other  please specify
Child's Primary  Language *
Family's Primary Language *
FAMILY / PARENT  INFORMATION
I am the  (Mother or Guardian) please choose one: *
Last Name *
First Name, M.I. *
Date of Birth *
MM
/
DD
/
YYYY
Ethnicity *
If  you chose Mixed Ethnicity  or Other  please specify
Occupation *
Employment Status *
Contact Information
What is the best way to contact you.
Phone Number *
Email Address *
Current Address/Physical Address   (Write SAME if your address is the same as above) *
Mailing Address     (Write SAME if your address is the same as above) *
I am the  (Father or Guardian) please choose one: *
Last Name *
First Name, M.I *
Date of Birth *
MM
/
DD
/
YYYY
Ethnicity *
If you chose Mixed Ethnicity or Other please specify
Occupation *
Employment Status *
Current Address/Physical Address    (Write SAME if your address is the same as above) *
Mailing Address   (Write SAME if your address is the same as above) *
Please read before submitting.
I certify that the above information is true and correct. I understand that this information will be used to determine the eligibility of my child for the CHamoru Immersion (Faneyakan) Program. I understand that the deliberate misrepresentation of the information may result in the dismissal of my child’s participating in the Program. This program does not discriminate based on disability in accordance with the Americans with Disabilities Act.
I have read the above statement and certify that the above information is true and correct. (Please indicate your name) *
Date *
MM
/
DD
/
YYYY
Submit
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