Cobb County School District
Form IBB-3
Empowering Dreams for the Future
CONVERSION CHARTER SCHOOL
PETITION REVIEW INSTRUMENT
Petitioner:
Y=Yes; N=No; NI=Needs Improvement
A
Y
Statement of Intent
N
NI
Does the petition include a Statement of Intent?
________________________________
Date of Submission
Page
Comments:
B
Y
Overview of School
N
NI
Did the petitioner adhere to the 100 page application limit? If not, the application
will not be accepted and/or reviewed.
NI
Does the petition provide the name, address and telephone number of the
petitioner’s primary local contact?
NI
Does the petition describe how parents, members of the community and other
interested parties were directly and substantially involved in developing the
petition?
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Comments:
Y
N
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Comments:
Y
N
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Y
N
NI
Does the petition describe how parents, members of the community and other
interested parties will be involved in the school?
NI
Does the petition include the school’s mission?
NI
Does the petitioner state the term of the charter?
NI
Does the petition list the ages and grades to be included in the school?
NI
Does the petition include targeted class size?
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Comments:
Y
N
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Comments:
Y
N
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Comments:
Y
N
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Comments:
Y
N
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Y
N
NI
Does the petition state what the anticipated teacher-to-student ratio and the
rationale for maintaining such ratio?
NI
Does the petition include the length of the school year and the school day?
NI
Does the petition list the school’s proposed annual calendar and a draft daily school
schedule?
NI
Does the petition state that prior to submission of the petition to the Cobb County
Board of Education:
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Comments:
Y
N
Page
Comments:
Y
N
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Comments:
Y
N
A public meeting of the faculty and instructional staff members of the petitioning
school was held with two weeks advance notice and that at or within three business
days after the meeting, two-thirds of the faculty and instructional staff members of
the petitioning school voted by secret ballot to submit the petition to the Board for
its approval?
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Comments:
Y
N
NI
Does the petition state that a public meeting of the parents or guardians of students
enrolled in the petitioning school was held with two weeks advance notice and that at
or within three business days after the meeting, two-thirds of the parents or
guardians of students enrolled in the petitioning school voted by secret ballot to
submit the petition to the Board for its approval?
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Comments:
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C
Y
Accountability and Evaluation
N
NI
Does the petition list the school’s performance-based goals and measurable
objectives?
NI
Does the petition designate the performance to be improved and how it will be
improved through the waiver, in whole or in part, of specifically identified state and
local rules, regulations, policies, procedures, or provisions of Title 20 of the Official
Code of Georgia, other than the provisions of the Charter School Act of 1998 and all
other non-waivable federal and state laws?
NI
Does the petition state how the performance-based goals and objectives shall result
in improvement of student achievement and school performance yet comply with the
Single Statewide Accountability System in accordance with O.C.G.A. §20-2-2063?
NI
Does the petition include a) a description of what baseline data will be used to
establish student achievement for the proposed term of the charter school b) when
and how baseline data will be used to establish the targets for student achievement
and for which groups of students?
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Comments:
Y
N
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Comments:
Y
N
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Comments:
Y
N
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Y
N
NI
Does the petition indicate the performance-based criteria that will be used during
the term of the charter to measure progress of student achievement and school
performance (overall and for each program and ethnic group based on projected
enrollments)? Note: Results must be submitted to CCSD at both mid-year point and
at the end of each school year.
The petition must specifically include:
1) Overall academic targets for each year of the proposed charter for each grade
level (or high school course)
2) Academic targets for each program group (ELL, SWD, ED)
3) Academic targets for each ethnic group
4) School performance targets
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Comments:
Y
N
NI
Does the petition describe how the charter school will measure improvement in
student and school performance and over what period of time, provided that such
requirement shall not waive the accountability provisions of O.C.G.A. §20-14-30
through §20-14-41?
NI
Does the petition state that the school will participate in all student assessments
mandated by state law? In addition to state mandated assessments, the charter
school assessment program must include any additional standardized tests used by
the CCSD. If assessments are used that are beyond the scope of the district testing
plan, the school is responsible for any associated costs incurred with such testing.
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Comments:
Y
N
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Y
N
NI
Does the petition state that the school will participate in any student and stakeholder
satisfaction surveys mandated by the Cobb County School District?
NI
Is there a statement that the petitioner agrees to work with the CCSD to develop an
Annual Evaluation Plan that will establish the precise levels of achievement that the
charter school will meet or exceed on the state and District student assessments,
student and stakeholder surveys, student and staff retention, and unique charterbased objectives?
NI
Does the petition list the school’s performance-based goals and measurable
objectives?
NI
Does the petitioner acknowledge that accreditation from the Southern Association
for Colleges and Schools (SACS) is a requirement for approval of this charter
petition? Does the petitioner further acknowledge that continued SACS
accreditation must be maintained throughout the term of the charter?
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Comments:
Y
N
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Comments:
Y
N
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Comments:
Y
N
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D
Y
Admission of Students
N
NI
Does the petition state that the charter school shall enroll any eligible student who
resides in the charter school attendance zone as specific in the charter and who
submits a timely application, as specific in the charter, unless the number of
applicants exceeds the capacity of a program, class, grade level or building? In such
case, the petition must state that the school will employ a random selection process
that gives all applicants an equal chance of being admitted (unless otherwise
prohibited by law). The charter school may give enrollment preferences to
applicants in any one or more of the following categories in order of priority
specified in the charter: a sibling of a student enrolled in the start-up charter school;
a sibling of a student enrolled in another local school designated in the charter; a
student whose parent/guardian is a member of the governing board of the charter
school or is a full-time teacher, professional, or other employee of the charter school;
students matriculating from a local school designated in the charter; and students
who reside in the charter attendance zone as specified in the charter.
NI
Does the petition state whether enrollment preference will be given to siblings of
students already enrolled in the charter school?
NI
Does the petition state that the charter school will not accept students who reside
outside the CCSD?
NI
Does the petitioner agree that, in order to provide the CCSD with necessary data for
state funding reporting and enrollment monitoring, the petitioner will agree to use
the CCSD’s student information system in accordance with CCSD specifications?
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Comments:
Y
N
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Comments:
Y
N
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Comments:
Y
N
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E
Y
Credits and Units
N
NI
For a proposed charter high school, the petition must specify what credits or units
will (high school only) be earned and what completion credential will be awarded.
Page
Comments:
F
Y
Curriculum and Instruction
N
NI
Does the petition include a description of curriculum?
NI
Does the petition include a description of instructional methods?
NI
Does the petition include any academic focus to be incorporated into the academic
program?
NI
Does the petition describe how the school will meet the needs of the gifted and
talented students in compliance with State Rule 160-4-2-.38?
NI
Does the petition describe how the charter school plans to provide state and
federally mandated services to English Learners (EL)?
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Comments:
Y
N
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Comments:
Y
N
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Comments:
Y
N
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Comments:
Y
N
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Y
N
NI
Does the petition state that the charter school will implement the same identification,
evaluation, placement, reporting, and due process procedures and use the same
ESOL forms as other schools in the CCSD?
NI
Does the petition state what extracurricular and supplemental educational services
(SBOE Rule 160-4-5-.03 and NCLB) are planned to be offered at the school,
including any partnerships with the local board or community agencies regarding
charter school students utilizing extracurricular activities at the traditional public
school that the student would otherwise attend?
NI
Does the petition state how the charter school will provide remediation in required
cases pursuant to SBOE Rule 160-4-5-.03 and NCLB?
NI
Does the petition state the distinctive and/or unique instructional techniques that
will be utilized in the educational programs?
NI
Does the petition include documentation showing that the curriculum is aligned with
the State and/or the Cobb County curriculum?
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Comments:
Y
N
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Comments:
Y
N
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Comments:
Y
N
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Comments:
Y
N
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Comments:
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G
Y
Facility Plan
N
NI
Does the petition list the school’s emergency safety plan, which may constitute a
statement that the petitioner has, or will prepare an emergency safety plan in
accordance with O.C.G.A § 20-2-1185 and submit and obtain approval from the
Georgia Emergency Management Agency by a specified date?
Page
Comments:
H
Y
Financial Plan
N
NI
Does the petition state whether the charter school will utilize the local school board
for fiscal management and if so, specify the autonomy the school shall have over
budgets and expenditures?
NI
Does the petition describe the charter school’s plans for securing other sources of
funding, including funding from corporations, individuals, foundations,
philanthropic groups, or any other sources?
NI
Does the petition state that CCSD’s Internal Audit Department will be permitted to
audit the charter school as the CCSD deems appropriate?
NI
Does the petition describe the financial policies and procedures that the charter
school will implement to assure sound fiscal management?
Page
Comments:
Y
N
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Comments:
Y
N
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Comments:
Y
N
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Comments:
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I
Food Service
Y
N
NI
Does the petition state whether food service will be provided for students? If so, the
petition must state whether the charter school intends to ask the Cobb County
School Nutrition Program to provide breakfast, lunch and/or afternoon snacks.
NI
Does the petition state that if the charter school elects to participate in the National
School Breakfast and Lunch Program, the school will submit its own application to
the State Department of Education and that the charter school will be responsible
for accurately counting meals and submitting financial reimbursement claims to the
State Department of Education for meals meeting specified nutrient standards?
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Comments:
Y
N
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Comments:
J
Governance Plan
Y
N
NI
Does the petition state whether the charter school will be under the governance of a
local school council, as provided for in O.C.G.A. § 20-2-85, or another similar board,
which shall be subjected to the provisions of O.C.G.A § 50-14-1, et seq. (Open and
Public Meetings) and O.C.G.A. § 50-18-70, et seq. (Inspection of Public Records)? If
the charter school elects to utilize a board other than a local school council as
provided for in O.C.G.A. § 20-2-85, the petition shall state its role, function,
composition, and how and when members should be selected.
NI
Does the petition provide that no petitioner and no member of the governing board
of the petitioner or the charter school shall sell, lease, or receive payment for
providing textbooks, supplies, services, equipment, facilities, or land to a charter
school or other public school in this District?
NI
Does the petition disclose any potential conflicts of interest of the founding board
members?
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Comments:
Y
N
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Comments:
Y
N
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Y
N
NI
Does the petition describe how the governing board will ensure that current and
future board members avoid conflicts of interests?
NI
Does the petition describe the method that the local board and charter school plan to
utilize for resolving conflicts?
NI
Does the petition state that if the charter school intends to contract, or has
contracted for, the services of a for-profit entity or any other educational
management agency? If so, describe how the contract will be in the best educational
and financial interests of the charter school.
NI
Does the petition state that the charter school shall be subject to the control and
management of the Cobb County Board of Education in a manner consistent with
the Charter Schools Act of 1998, as amended, and the Georgia Constitution?
NI
Does the petition describe how the charter school shall comply with the
constitutional rights of students including, but not limited to, due process,
prohibition against unreasonable searches and seizures, and First Amendment
guarantees of freedom of speech and religion?
NI
Does the petition state ways in which the charter school will meet state and federal
requirements for student immunizations, food inspections, hazardous chemicals, and
other health and safety issues?
Page
Comments:
Y
N
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Comments:
Y
N
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Comments:
Y
N
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Comments:
Y
N
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Comments:
Y
N
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K
Y
Instructional Technology/Technology Infrastructure
N
NI
Does the petition include an instructional technology plan or provisions for
developing one?
NI
Does the petition include an outline describing the acquisition and distribution of
technology needed to support the instructional program?
NI
Does the petition designate a person(s) as the point of contact and support for the
technology infrastructure?
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Comments:
Y
N
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Comments:
Y
N
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Comments:
L
Y
Operation
N
NI
Does the petition describe the rules and procedures concerning how the school will
address grievances and complaints from students, parents, and teachers, including
the role the governance board will play in resolving such grievance and complaints?
NI
Does the petition describe the instructional and other personnel that the charter
school expects to employ and the qualifications for those positions?
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Comments:
Y
N
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Y
N
NI
Does the petition indicate that the faculty and instructional staff employed in the
charter school, at a minimum, hold an appropriate current professional certificate
issued by the Georgia Professional Standards Commission? If the petition proposes
that students will be taught by individuals other than those certified by the Georgia
Professional Standards Commission, the petition shall so state and generally
describe the qualifications of such personnel. Non-certified personnel shall be
considered “at will” employees and shall not be contracted for specific periods of
time.
NI
Does the petition describe the proposed employee recruitment procedures, hiring
practices, compensation, and employee evaluation procedures?
NI
Does the petition acknowledge that background checks will be conducted on any
employee or sub-contractor who will be working on the charter school’s property
(delivery personnel excluded)? A Comprehensive criminal history background
check to include both GCIC and NCIC will be conducted on each applicant assigned
to the charter school. Minimum findings that warrant exclusion include:
• Any felony conviction
• Any drug conviction
• Any crime against children
• Any sex-related conviction
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Comments:
Y
N
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Comments:
Y
N
Does the petition acknowledge that it is preferred that all necessary checks be
completed prior to the employee beginning work? If business demands warrant
assignment before the check is completed, then it is acceptable for employee to begin
assignment as long as the background check is in progress and the application for
employment does not list offenses of any type.
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Comments:
Y
N
NI
Background checks must be provided to the CCSD HR Department upon request by
CCSD.
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Y
N
NI
Does the petition describe employment screening procedures to ensure that
applicants are asked the following questions:
A) Has the applicant ever received an Unsatisfactory annual evaluation?
B) Has the applicant ever failed to have a teaching contract renewed, been
terminated from employment, or been asked to resign?
C) Has the applicant ever been sanctioned by the Georgia Professional
Standards Commission?
D) Is the applicant currently under investigation for any unethical conduct?
NI
Does the petition describe a plan for resolving employment-related issues, employee
grievances and termination procedures?
NI
Does the petition describe how and by whom the principal’s performance will be
appraised?
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Comments:
Y
N
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Comments:
Y
N
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Comments:
O
Y
Special Needs Student
N
NI
Does the petition list the students to be served, including students with special needs
and disabilities?
NI
Does the petition describe how students with disabilities will be provided state and
federally mandated services?
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Comments:
Y
N
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Y
N
NI
Does the petition state that the charter school will:
(1) be obligated to provide a full continuum of services to disabled students to the
same extent as other schools in the CCSD?
NI
(2) require its teachers and administrators to attend the CCSD’s special education
training programs to the same extent required of other schools in the CCSD?
NI
(3) implement the same identification, evaluation, placement, reporting, and due
process procedures and use the same special education forms as other schools in the
CCSD?
NI
(4) submit to program review by state and local officials to the same extent required
of other schools in the CCSD?
NI
(5) provide copies of all Individual Education Plans (IEP’s) to the CCSD?
NI
(6) provide free transportation and other related services when required by a
student’s IEP?
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Comments:
Y
N
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Y
N
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Y
N
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Y
N
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Y
N
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P
Y
Student Conduct
N
NI
Does the petition state or describe the charter school’s code of conduct and the rules
and procedures that will be used for the discipline and dismissal of students,
including:
NI
(a) the types of disciplinary measures that will be imposed (e.g., in-school
suspension, out-of-school suspension, expulsion, etc.) and in what circumstances?
NI
(b) the “due process” procedures that will be used before a student is suspended or
dismissed from the charter school?
NI
(c) any unique or innovative behavior management methods that will be used?
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Comments:
Y
N
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Comments:
Y
N
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Comments:
Y
N
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Comments:
Q
Y
Transportation
N
NI
Does the petition state whether transportation will be provided for students and, if
so, how?
NI
Does the petition state that any vehicles or drivers used for transporting students
will meet the same safety standards applicable to public schools in this State?
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Comments:
Y
N
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R
Y
Waiver of State and Local Provisions
N
NI
Does the petition identify any state and local rules, regulations, policies, procedures,
or provisions of Title 20 of the Official Code of Georgia that are to be waived and
explain how the specified student performance will be improved through the waiver,
in whole or in part, of the identified provisions?
State law does not allow the following provisions to be waived:
(a) the Charter Schools Act (O.C.G.A. § 20-2-2061 through §20-2-2071);
(b) the accountability assessment program (O.C.G.A. § 20-14-30 through §20-14-41);
(c) the Open Meetings Act (O.C.G.A. § 50-14-1 through §50-14-6) and the Open Records Act
(O.C.G.A. § 50-18-70 through § 50-18-79);
(d) federal, state, and local statutes, rules, regulations, and court orders relating to civil rights; special
education; insurance; the protection of the physical health and safety of students, employees, and
visitors; conflicting interest transactions; and the prevention of unlawful conduct;
(e) laws relating to unlawful conduct in or near a public school;
(f) laws prohibiting the charging of tuition or fees to attend a public charter school;
(g) the reporting requirements of O.C.G.A. § 20-2-320; and
(h) the brief period of quiet reflection provision of O.C.G.A. § 20-2-1050.
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Comments:
Y
N
NI
Does the petition demonstrate how the waiver does not undermine and is consistent
with the intent of the waived state and local rules, regulations, policies, and
procedures or the provisions and the provisions of Title 20 of the Official Code of
Georgia?
NI
Does the petition show evidence that the proposed charter school program cited in
the petition could not be achieved through application of the CCSD educational
program?
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Comments:
Y
N
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Comments:
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S
Annual Report
Y
N
NI
Does the petition state that the charter school shall provide an annual report to
parents/guardians of students attending the charter school, the local board, and the
State Board? The charter school shall make available to the community copies of the
annual report. The annual report must indicate the progress made in the previous
year in meeting the performance-based goals identified in the charter and include all
state-mandated assessment scores and state-mandated accountability indicators.
NI
Has the petitioner completed the GADOE Charter Petition Checklist? Has the
Charter Petition Checklist been included as an appendix?
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Comments:
Y
N
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Comments:
T
Y
Appendices
N
NI
Does the petition include the following appendices?










App. _____ Attach an official copy of the certificate of incorporation for the
required Georgia nonprofit corporation from the Georgia Secretary of State
(LEA start-ups and state and local public entities are not subject to this
requirement pursuant to O. C. G.A. §20-2-2065(b)(4)).
App. _____ Attach a copy of the articles of incorporation, by-laws and any
amendments for the nonprofit corporation (LEA start-ups and state and local
public entities are not subject to this requirement pursuant to O.C.G.A. §202-2065(b)(4)).
App. _____ Attach a copy of any admissions application the charter school
proposes to use.
App. _____ Attach the charter school’s proposed annual calendar and a draft
of the charter school’s daily school schedule.
App. _____ Attach a monthly cash flow projection detailing revenues and
expenditures for the charter school’s first two (2) years of operation.
App. _____ Attach alternative monthly cash flow spreadsheets projecting
revenues and expenditures that assume one-half (1/2) of the projected student
enrollment for the first two (2) years of operation.
App. _____ Attach spreadsheets projecting cash flow, revenue estimates,
budgets, and expenditures on an annual basis for the first five (5) years of the
charter term.
App. _____ Attach documentation of any sources of revenue appearing in the
spreadsheet that are anticipated to come from private sources such as;
Education Management Organizations (EMO) and Charter Management
Organizations (CMO).
App. _____ Attach any fully executed contract/management agreement (with
EMO. CMO, etc)
App. _____ Attach a copy of any agreements with other local schools for the
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

charter school students’ participation in extracurricular activities such as
interscholastic sports and clubs.
App. _____ Attach a copy of any intended contracts for the provision of
educational management services or the provision of supplemental
educational services and remediation. Such contracts shall describe the
specific services for which the contracting organization is responsible. In the
case of a management organization, such contracts shall clearly delineate the
respective roles and responsibilities of the management organization and the
governing board in the management and operation of the charter school.
App. _____ Attach a copy of the GADOE Charter Petition Checklist.
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