PART I - INSTITUTION AND STATE AGENCY
Enter the names of the institution and State agency. A separate form must be completed for each institution.
PART II - BASIS FOR ELIGIBILITY
Respond "yes" or "no" to each of the three questions. If the answer is no to any one of these questions, the institution or community day program does not qualify.
PART III - TYPE OF INSTITUTION AND ENROLLMENT
Check the category that fits the definition of the institution. Do not report institutions that do not meet any of the four definitions.
For the category of institution checked, furnish the number of children under 21, through age 20, enrolled in a State-funded regular program of instruction on a date in calendar year 1998 specified by the State agency. The date specified by the State agency must be consistent for all institutions or community day programs operated by the Sate agency, and the date must represent a school day within calendar year 1998.
In order to be counted as enrolled, a child must be enrolled in a State-funded regular program of instruction for at least:
PART IV - ADJUSTED ENROLLMENT TO REFLECT THE RELATIVE LENGTH OF THE STATE AGENCY'S ANNUAL PROGRAM
Multiply the enrollment determined in Part III by the number of days in the year that the educational program operates. Divide that number by 180 to determine the adjusted enrollment.
PART V - CERTIFICATION
The appropriate institution and State agency official should sign certifying that the information provided meets the requirements of Title I, Part D, Subpart 1, and is complete and accurate. (Note, because these data will generate Federal funds, they are subject to audit and must be supportable from documented records.)
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This page last modified November 11, 1998 [gkp]