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P-12

Data Collection Forms

Annual Survey of Charter School Enrollments and Poverty Status for FY 2013-2014

PRELIMINARY
DUE: April 1, 2013

In order to determine the 2013-2014 Title I final allocations, each Charter School LEA is required to submit enrollment data to the New York State Education Department (NYSED), Office of Education Finance. We require the total number of enrolled students ages 5-17, the total number of enrolled students ages 5-17 that are eligible for free or reduced lunch (FRPL) and the public school district in which those students reside. If your Charter School is not listed in the drop-down section below, please contact Tina Santiago.

Name of Charter School:
Contact Information:
Name:
Title:
E-Mail:
Telephone:
Fax:

Instructions:
(A) Identify each public school district of residence from which your students originate
(NYC: select borough/county - i.e., BRONX (TOTAL), BROOKLYN (TOTAL), etc. - it is not necessary to use the geographical location)
(B) Identify the total number of enrolled students ages 5-17 from the selected district
(C) Identify the total number of enrolled students ages 5-17 eligible for free or reduced price lunch (FRPL) from the selected district

(A) Public School District of Residence (B) Enrolled Students (C) FRPL Students
  • Be sure to print out this form before clicking on "Submit". This will be your only record of transmittal.
  • If you need additional lines, please submit a second form.
  • If you have any questions, please contact Tina Santiago (518.408.1823) or Robert Lutringer (518.473.0295).

Certification by Chief Administration Official of Institution

I CERTIFY that the information provided on this survey is, to the best of my knowledge, complete and accurate. A knowingly false claim on this report is a criminal offense under U.S. Code, Title 18, Section 1001 or Section 387.

Last Updated: March 5, 2013