OFFICE OF SUPERINTENDENT OF PUBLIC INSTRUCTION ESD CO DIST School Apportionment and Financial Services Old Capitol Building PO Box 47200 OLYMPIA WA 98504-7200 360-725-6300 TTY 360-664-3631 MONTHLY REPORT OF SPECIAL EDUCATION ENROLLMENT (See reverse side for instructions) SERVING LOCAL EDUCATION AGENCY (LEA) NAME COUNTY NAME SERVING LEA NO. ESD NO. REPORT MONTH YEAR 2018–19 SPECIAL EDUCATION ENROLLMENT Headcount Resident District Age Age 3–5 Not Yet Kindergarten Resident District Name County Name No. Birth–2 Enrolled in Kindergarten to Age 21 Total Special Education Enrollment Served CERTIFICATION I hereby certify that all students reflected in this report are properly Acknowledged: enrolled and properly identified students in accordance with instructions and that student records and other pertinent documents are readily available for audit. Original Signature of LEA Superintendent or Authorized Official Date Original Signature of EDS Superintendent or Authorized Official Date FORM SPI P-223H (Rev. 7/2018)
OFFICE OF SUPERINTENDENT OF PUBLIC INSTRUCTION School Apportionment and Financial Services Old Capitol Building PO Box 47200 OLYMPIA WA 98504-7200 360-725-6300 TTY 360-664-3631 ESD CO DIST MONTHLY REPORT OF SPECIAL EDUCATION ENROLLMENT (See reverse side for instructions) SERVING LOCAL EDUCATION AGENCY (LEA) NAME COUNTY NAME SERVING LEA NO. ESD NO. REPORT MONTH YEAR 2018–19 SPECIAL EDUCATION ENROLLMENT Headcount Resident District Name County Name Resident District No. Age Birth–2 Age 3–5 Not Yet Enrolled in Kindergarten Kindergarten to Age 21 Total Special Education Enrollment Served CERTIFICATION I hereby certify that all students reflected in this report are properly enrolled and properly identified students in accordance with instructions and that student records and other pertinent documents are readily available for audit. Acknowledged: Original Signature of LEA Superintendent or Authorized Official Date Original Signature of EDS Superintendent or Authorized Official Date FORM SPI P-223H (Rev. 7/2018)
EnrollmentHandbook2018-19.docx