P-16 ›› PRE-K THROUGH COLLEGE

EMSC

Data Collection Forms

2009 - 2010 UPK Projected Data

* Denotes a required Field



Enter the number of UPK students the district anticipates enrolling in classes
where the instruction will be provided by each of the following.
Category Half Day Full day
Public School (PS)
Day Care Center (DCC)
Head Start (HS)
BOCES (B)
Nursery School (NS)
Nonpublic School (NPS)
Approved Pre-School Special Education Provider (4410)
Library (L)
Family/Group Family Day Care (F/GFDC)
Museum (M)
Other specify:
Total Number of Students halfday / fullday: * *
Total Number of Students Enrolled *

Fully implemented: If yes please check, . Also complete the "Notice of Fully Implemented UPK" form in the paper application.

Teachers (Enter the Number of UPK teachers and certifications - use only whole numbers.
(ex/ 2.5 FTE = 3 Teachers)
N-6 or B-Gr.2 Cert. Spec. Ed. Cert. Bachelor's w/ 5 Year Plan Other w/ 5 Year Plan Total # of Teachers
# of UPK Teachers in Classrooms operated by Public Schools: n/a n/a
# of UPK Teachers in Classrooms operated by Agencies
Total Number of Teachers        
VARIANCES - Request for Variance (Select Yes or No)
Class Size: Section 3602-e allows for a variance to class size based upon the unique characteristics of the program at the UPK site or to promote inclusion of preschool children with disabilities or who are homeless

If yes, provide the justification in the space provided. Describe the unique characteristics of the site, the desired class size and why the variance is needed. Describe how the district will ensure appropriate child/staff ratios and meet program requirements.
(Provide documentation as needed to support your request via hard copy)
Justification:
Collaboration: Section 3602-e allows for a variance from the collaboration requirement based on documented evidence that the district has been unable to develop a collaborative arrangement for reasons that are outside the control of the district. NYC Community School Districts may not apply for this variance If yes, provide the justification in the space provided. Describe the district's efforts to identify and recruit eligible agencies and the reasons for not collaborating. Allowable reasons include: no eligible agencies; existing agencies not interested or able; or there is good cause for not collaborating. SED reserves the right to deny the request for this variance if justification is missing or inadequate.
(Provide documentation as needed to support your request via hard copy)
Justification:
Summer-Only Program: Section 3602-e allows for a variance from the 180-day requirement for the operation of UPK program during the months of July/August for the following reasons only: there is no space available in public school buildings; there is no space available in eligible agencies in which to operate UPK classrooms If yes, provide the justification in the space provided. Describe the absence of space in any public school building and in any eligible agency during the school year in which to operate UPK classrooms.
(Provide documentation as needed to support your request via hard copy)
Justification:
Last Updated: June 23, 2009-->