DISTRICT OF COLUMBIA PUBLIC CHARTER SCHOOL BOARD
SUBMITTED BY:
School Representative – School Name
SUBJECT:
Request to [Consolidate Campuses, Change Grade Levels
Served, and/or Convert from a Single Campus to MultiCampus Status]
DATE:
Month ##, 201#
______________________________________________________________________
REQUEST
School Name Public Charter School submits to the District of Columbia Public Charter
School Board this request to reconfigure grade levels and/or campuses and/or change the
grade levels served from ## to ## for the 201#-201# school year.
BACKGROUND
Please address all questions and requests for information in narrative form. This
information provides helpful background to the PCSB Board as it reviews these
notifications.
Overview of School Performance
1. Provide the following information about your school: (1) number of years in
operation; (2) grade levels served; (3) and the expiration date of the school’s
charter agreement.
2. Summarize the school’s academic performance history, including PMF scores
and/or accountability plan results for the past three years.
3. List all notices of concerns, charter warnings, or corrective actions issued to the
school by PCSB in the past five years, as well as how the school responded to
such notices and warnings.
4. Summarize the school’s enrollment history for the previous five years, including
(a) the school’s current enrollment; (b) the school’s current enrollment ceiling; (c)
the school’s reenrollment rates; and (d) the number of students on the school’s
waiting list each year.
Proposed change to grade levels and/or campuses
1. Explain the school’s rationale for this proposal.
2. How will the proposed change impact the school’s operations and finances?
Provide a proposed budget and budget narrative.
3. Will the new grade levels and/or campuses pursue the same goals and student
academic achievement expectations (“expectations”) that are detailed in the
school’s charter? If no, please detail proposed new goals and expectations.
4. If this request is for an additional campus, please describe all funds (including
public and private) the school has earmarked for this new campus.
5. Has the school informed stakeholders (including staff, parents, and advisory
neighborhood commissioners) of the proposed new campus? If so, how were
stakeholders notified? Please describe any concerns raised by stakeholders.
[Insert School Name] Public Charter School
Enrollment Matrix – All Campuses
Although PCSB requests that schools detail their proposed enrollment through 2018-19, note that schools
may only seek approval for an enrollment increase for the school years remaining before the school’s next
scheduled high-stakes review or renewal. If the school is requesting an enrollment increase at more than
one campus, it should complete a separate enrollment matrix for each such campus.
Grade
Pre-School
PreKindergarten
(Pre-K)
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Ungraded ES
Grade 6
Grade 7
Grade 8
Ungraded MS/
JHS
Grade 9
Grade 10
Grade 11
Grade 12
Ungraded SHS
Alternative
Special Ed
Schools
Adult
LEA Total
Projected % Special Needs
Projected % ELL
# Campuses*
Academic
Year 2014-15
Academic Year
2015-16
Academic
Year 2016-17
Academic
Year 201718
Academic
Year 201819