Application for Joint CPSE - PDF PDF Document (24 KB)

Pursuant to section 4410.3(b) of Education Law and in accordance with section 200.16 of the Regulations of the Commissioner of Education, two or more Boards of Education may, subject to the approval of the Commissioner of Education, establish a joint Committee on Preschool Special Education (CPSE).

Instructions:  Submit one copy of the application to your Regional Associate prior to establishing a joint CPSE.

School District #1________________________  BEDS Code _______________________

School Superintendent ______________________________________________________

Application Contact ________________________________________________________

Address _________________________________________________________________

Phone __________________________ Fax ______________________

E-mail __________________________________________________

School District #2 ______________________BEDS Code ________________________

School Superintendent _________________________________________________________

Application Contact ___________________________________________________________

Address ____________________________________________________________________

Phone ____________________________ Fax _________________________

E-mail _________________________________________________

 

Effective Start Date of Joint CPSE:  _________________________________________________

Effective End Date of Joint CPSE:  __________________________________________________

Narrative:  Provide a typed narrative explaining the reason for the joint CPSE and a plan for holding meetings at a mutually agreed upon time and place in accordance with section 200.5(d) of the Regulations of the Commissioner of Education, for ensuring confidentiality of student records and for ensuring required CPSE membership.

Approval Process:  The Boards of Education may not establish the joint CPSE until receipt of written notification of approval by the State Education Department.  This approval will be granted if the application is consistent with applicable laws and regulations.

 

School Superintendent

We hereby certify that the application for a joint CPSE in our school districts is necessary for the functioning of the Committee on Preschool Special Education and that our Boards of Education participated in the development of this application.

 Date: ________________  Signature: ____________________________________

 Date: _________________ Signature:  ___________________________________

 

 

 

For Department Use Only

Application Approved:o   Date:  ________________

Application Denied: o   Date:  ________________

 Reasons for Denial: _________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________