P-12 ›› Elementary, Middle, Secondary & Continuing Education

EMSC

Data Collection Forms

No Child Left Behind - Consolidated Application Update 2009-2010
Program Information Report, 2008-09

When you have completed this form and are ready to submit it to the Department, be sure to print a copy for your records and then click on the "SUBMIT" button at the bottom of the page.

LEA:
Did you offer any Title I-funded AIS during the summer?

Yes

No
Contact Email:

General Instructions: 

  • Include all pupils served in academic intervention services (AIS)/Title I supplementary (compensatory) instructional programs.
  • Include students served in regular school day, before school, after school, and/or board-approved extended day programs
  • Only count students with disabilities for AIS/Title I instructional services received, NOT for services listed on their IEPs.
  • Only count limited English proficient (LEP) students for AIS/Title I instructional services received, NOT for Part 154 services.
  • In non-graded situations, include participants in the grade designation appropriate to their age level.
  • You will need to enter a pupil in as many service areas as necessary. In most cases, this will result in numbers that exceed the unduplicated count in column 1. (See instructions for guidance.)

A. 4/5  AIS/Title I Instructional Programs - Student Participation Summary for TAS and SWP - Public School Students ONLY

  • In column 1, enter the total number of (unduplicated) students participating in any Title I-funded instructional program (English language arts, mathematics, social studies, and/or science) by grade level, in a Targeted Assistance school. Count each pupil only once in this column .

  • In column 2, enter the total number of (unduplicated) students participating in any Title I-funded instructional program (English language arts, mathematics, social studies, and/or science) by grade level, in a Schoolwide Program school. Count each pupil only once in this column.

Grade
Level		 1.
Total Pupils (Unduplicated) in Targeted Assistance Programs		 2.
Total Pupils (Unduplicated) in Schoolwide Programs
Ages 0 - 2

Ages 3 - 5
NOTE:  Data for Grades K -12 will be automatically extracted from the Data Warehouse
Ungraded
 

A. 4  AIS/Title I Instructional Programs - Student Participation Summary for TAS ONLY

  • In column 1, enter the total number of (unduplicated) students participating in any AIS/Title I instructional program (English language arts, mathematics, social studies, and/or science) .

  • In columns 2 - 7, enter the number of students served in AIS/Title I instructional program by each core subject area.
 
  1.
Total Pupils (Unduplicated)		 2.
English Language Arts		 3.
Mathematics		 4.
Social Studies		 5.
Science		 6.

Career/Vocational Services

 7.

Other
Total
 
B. 5  AIS/Title I Instructional Programs - Student Participation Summary for Nonpublic School Students and Students in a Facility for the Neglected

  • In column 1, enter the total number of (unduplicated) nonpublic school students participating in any AIS/Title I instructional program (English language arts, mathematics, social studies, and/or science) by grade level . Count each pupil only once in this column .

  • In column 2, enter the total number of (unduplicated) Neglected students participating in any AIS/Title I instructional program (English language arts, mathematics, social studies, science, career/vocational, and/or other) by grade level. Count each pupil only once in this column .
Grade
Level		 1.
Total Nonpublic School Pupils (Unduplicated)		 2.
Total Neglected  Pupils (Unduplicated)
Ages 0-2    
Ages 3-5    
K

 

  
1    
2    
3    
4    
5    
6    
7    
8    
9    
10    
11    
12
Total    
AIS/Title I Student Support Services - Student Participation Summary for Both TAS and SWP
  • In column 1, enter the total number (unduplicated) of students by grade level receiving student support services under AIS/Title I, including both TAS and SWP.  Count each pupil only once in this column.
  • In columns 2 - 5, enter the number of students served in AIS/Title I student support programs by type of service.
  • In column 6, only report the number of students who received additional services not included in columns 2 - 6.
  1.
Total Pupils (Unduplicated)		 2.
Guidance Counseling		 3.
Psychological Services		 4.
Social Worker Services		 5.
Health, Dental
& Eye		 6.
Other
Total  
   
A. 7(a) AIS/Title I Instructional Program Staffing
  Enter the full time equivalent (FTE) number of staff funded wholly or in part by Title I for AIS/Title I instructional programs in the regular school day, plus any additional staff funded wholly or in part by Title I in before school, after school, and/or Board-approved extended day programs.

Note: Non-instructional staff funded wholly or in part by Title I should be included in the OTHER STAFF category.
 

Teachers Delivering AIS Services Funded in Whole or Part by Title I

Other Staff Funded in Whole or Part by Title I
  AIS Admin. or Coord. Teaching Assistants Teacher Aides Other
  Total FTE        
TAS
SWP    

 

 

 
A. 7(b) Qualified Teaching Assistants (Paraprofessionals) - Both TAS and SWP
  Enter the full time equivalent (FTE) number of Teaching Assistants (paraprofessionals) who are "qualified".
TAS
SWP
   
A. 8 AIS/Title I Student Support Service Staffing - TAS Only
  Enter the full time equivalent number of staff (FTE) funded wholly or in part by Title I for AIS student support services.
           
  Guidance
Counselors		 Psychologists Social Workers Health/Dental Other
TAS
       
A. 9 AIS/Title I Ancillary Staffing - TAS Only
  Enter the full time equivalent (FTE) number of staff funded by Title I for ancillary AIS/Title I services.
       
  Clerical Project Evaluators Other  
TAS  
Comments:(400 character limit)

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If you have any questions, please contact the Title I School & Community Services office at emscpir@mail.nysed.gov or (518) 473-0295.

Last Updated: November 3, 2009