| Charter Schools Program |
| Office of Innovation and Improvement |
| U.S. Department of Education |
| Data Collection Form |
| Instructions |
| Purpose of Data Collection: |
The new data collection will collect CSP grant award information from grantees (state agencies and some schools) to create a new database of current CSP-funded charter schools and award amounts. Once complete, the data contained in the database will be merged with student demographic and performance information extracted from the EDEN database. Together, these data will allow the U.S Department of Education and the CSP to monitor CSP grant performance and analyze data related to accountability for academic performance and financial integrity. This project satisfies Title V, Part B, Section 5205 of the ESEA, which calls for national activities related to the collection of information, technical assistance, and information dissemination regarding charter schools and the CSP. |
| For SEAs: |
SEAs reporting CSP subgrant award information are asked to complete the form entitled "Data Collection Form: SEAs." This form has two parts. Part A asks for CSP SEA award information. The state name, the state contact person, and the department in which the contact person works has already been entered in the form. If this information is incorrect, please contact the data collection administrators (see "Contact Information" below). In the gray box, please enter the number of CSP subgrants awarded during the 2006 fiscal year. |
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Part B asks for CSP subgrant award information. For each subgrant awarded by your state, please identify: 1) the charter school (and the subgrantee, if different than the charter school); 2) the amount, type, and date of each subgrant; and 3) the charter school operation information. Part B should be completed separately for each subgrant awarded during the 2006 fiscal year. |
| For Direct Grant Recipients: |
Charter schools (or other organizations) receiving CSP grants directly from the U.S. Department of Education are asked to complete the form entitled "Data Collection Form: Direct Grant Recipients." In the gray spaces, please provide the following grant award information: 1) the charter school (and the grantee, if different than the charter school); 2) the amount, type, and date of each subgrant; and 3) the charter school operation information. |
| Form Submission: |
Completed forms should be sent electronically to [email protected]. In the subject heading please include "CSP Data Collection" followed by your state or school name. Please be sure to save a copy of the completed form for your own records. |
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If an electronic copy cannot be sent, please send a paper copy of the completed data collection form to the following address: |
| Attn: John Flaherty |
| 4665 Lampson Ave. |
| Los Alamitos, CA 90720 |
| Please be sure to make a copy of the completed form for your own records. |
| Contact Information: |
If you have any questions or concerns regarding the completion of the data collection form, please contact Peter Cooper ([email protected]; 510.302.4308) or John Flaherty ([email protected]; 562.799.5114). |
| OMB Number: xxxx-xxxx Approval Expires xx/xx/xxxx |
| Charter Schools Program |
| Office of Innovation and Improvement |
| U.S. Department of Education |
| Data Collection Form: SEAs |
| Part A: CSP SEA Award Information |
| State Name |
California |
| State Contact Person |
Jane Doe |
| Office/Department of Contact Person |
Charter School Office |
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| Dollar amount of CSP Grant Award from Federal Fiscal year 2002 |
$1 |
| Dollar amount of CSP Grant Award from Federal Fiscal year 2003 |
$1 |
| Dollar amount of CSP Grant Award from Federal Fiscal year 2004 |
$1 |
| Dollar amount of CSP Grant Award from Federal Fiscal year 2005 |
$1 |
| Number of subgrant awards issued in 2006: |
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| Please turn to Part B and complete a separateworksheet for each subgrantee. |
| OMB Number: xxxx-xxxx Approval Expires xx/xx/xxxx |
| Data Collection Form: SEAs (continued) |
| Please complete a separatePart Bworksheet for each subgrantee. |
| Part B: CSP Subgrant Award Information |
| Please provide the following information for each 2006 subgrant award. In many cases, the subgrant is awarded to a charter school. In some cases however, a charter school developer serves as the subgrantee. For each subgrant awarded by your state, please identify: 1) the charter school (and the subgrantee, if different than the charter school); 2) the amount, type, and date of each subgrant; and 3) the charter school operation information. |
| 1) Charter School Information |
| Charter School Information |
Subgrantee Identification (if different than charter school) |
| Charter school name |
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Subgrantee name |
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| School DUNS number |
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Subgrantee DUNS number |
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| School NCES ID |
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Subgrantee state ID |
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| School mailing address |
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Subgrantee mailing address |
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| LEA name |
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| LEA DUNS number |
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| LEA NCES ID |
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| LEA mailing address |
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| Is it an LEA with only charter schools? (Yes/No) |
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| Does the charter school act as its own LEA? (Yes/No) |
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| Is it an LEA with only charter schools? (Yes/No) |
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| Does the charter school act as its own LEA? (Yes/No) |
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| 2) Subgrant Information |
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2006 |
2005 |
2004 |
2003 |
2002 |
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| Dollar amount of subgrant award |
$ |
$ |
$ |
$ |
$ |
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| Month and year of subgrant award |
mm/yyyy |
mm/yyyy |
mm/yyyy |
mm/yyyy |
mm/yyyy |
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| Type of subgrant |
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| 3) Charter School Operation |
| School year first enrolled students |
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| Did the school enroll students for school year 2005-2006? |
(Yes/No) |
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| If yes, what was the total enrollment? |
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| Did the school enroll students for school year 2006-2007? |
(Yes/No) |
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| If yes, what was the total enrollment? |
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| Thank you very much for your cooperation. |
| OMB Number: xxxx-xxxx Approval Expires xx/xx/xxxx |
| Charter Schools Program |
| Office of Innovation and Improvement |
| U.S. Department of Education |
| Data Collection Form: Direct Grant Recipients |
| The following form is to be used to document CSP grant award information . Please provide grantee information in the spaces below. In particular, please identify: 1) the charter school (and the grantee, if different than the charter school); 2) the amount, type, and date of each subgrant; and 3) the charter school operation information. |
| 1) Charter School Information |
| Charter School Information |
Subgrantee Identification (if different than charter school) |
| Charter school name |
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Subgrantee name |
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| School DUNS number |
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Subgrantee DUNS number |
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| School NCES ID |
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Subgrantee state ID |
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| School mailing address |
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Subgrantee mailing address |
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| LEA name |
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| LEA DUNS number |
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| LEA NCES ID |
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| LEA mailing address |
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| Is it an LEA with only charter schools? (Yes/No) |
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| Does the charter school act as its own LEA? (Yes/No) |
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| Is it an LEA with only charter schools? (Yes/No) |
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| Does the charter school act as its own LEA? (Yes/No) |
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| 2) Subgrant Information |
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2006 |
2005 |
2004 |
2003 |
2002 |
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| Dollar amount of subgrant award |
$ |
$ |
$ |
$ |
$ |
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| Month and year of subgrant award |
mm/yyyy |
mm/yyyy |
mm/yyyy |
mm/yyyy |
mm/yyyy |
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| Type of subgrant |
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| 3) Charter School Operation |
| School year first enrolled students |
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| Did the school enroll students for school year 2005-2006? |
(Yes/No) |
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| If yes, what was the total enrollment? |
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| Did the school enroll students for school year 2006-2007? |
(Yes/No) |
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| If yes, what was the total enrollment? |
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| Thank you very much for your cooperation. |
| OMB Number: xxxx-xxxx Approval Expires xx/xx/xxxx |