Verification Report 9
Provider Report of School Age Students
Receiving Special Education Services as of December 3, 2007
As Reported by School Districts with CSE Responsibility

Below is a report of the number of school age students with disabilities (aged 4-21) who were receiving special education services in your program according to the least restrictive environment setting in which they were provided special education services as of December 3, 2007. These data were reported by the school districts that had CSE responsibility for these students as of December 3, 2007.

Directions: Please review your program’s record of the number of school age students with disabilities provided special education services from each school district against the numbers reported below by school districts.  If there are discrepancies between your records and the school district’s records, please contact the special education office of each school district to resolve the discrepancy. If the school district’s record is inaccurate, they will need to resubmit their district files with the necessary corrections to the Regional Information Center (or the data warehouse for large cities) during the verification time period. These data should be consistent with the data provided by the approved special education programs to school districts on the SEDCAR-1 forms by March 3, 2008 for school age students to request a vendor per-pupil funding amount of IDEA funds.

School District {Code} {Name}

Table1:  In regular school-programs in buildings attended by disabled and nondisabled students
  A B C D E F
Line Number Time INSIDE Regular Classroom Age Group  
4-5 6-11 12-13 14-17 18-21 Total

01

80% or more            

02

40% to 79%            

03

Less than 40%            

04

Total            


Table 2:  In Separate Settings Outside of regular school facilities, in buildings that are attended by students with disabilities only.  Line 4 includes students who are placed on home instruction by the CSE.  Students who are home-schooled by parent choice are reported in Table 3.
  A B C D E F
Line Number Type of Setting Age Group  
4-5 6-11 12-13 14-17 18-21 Total

01

Separate School            

02

Residential Facility            

03

Hospital (In-patient)            

04

Home Placement by CSE            

05

Total            


Table 3: In Other Specific Settings.  School districts do not place students in these settings.  Instead, students are in these settings because of court decisions or parental choice.
  A B C D E F
Line Number Type of Setting Age Group  
4-5 6-11 12-13 14-17 18-21 Total

01

Incarcerated in County Correctional Facilities            

02

Home Schooled at Parental Choice            

03

Parentally Placed in Nonpublic School-Receiving Special Education            

04

Parentally Placed in Nonpublic School-Not Receiving Special Education Services            

05

Total