Atlanta Public Schools
REQUEST FOR PETITIONS FOR
START-UP CHARTER SCHOOL
TO OPEN FOR 2016-2017
PETITION SUBMISSION DEADLINE:
Monday, March 16, 2015, 4 p.m.
Deliveries will be accepted
March 9, 2015 – March 16, 2015
between the hours of 10 a.m. and 4 p.m.
Office of Innovation, 8th Floor
Center for Learning and Leadership
Atlanta Public Schools
130 Trinity Avenue SW
Atlanta, Georgia 30303
Atlanta Public Schools
Petitioner Timeline
For Start-up Charter Schools
Proposing to Open for 2016-2017
APS Petition provided
Petitioner’s Letter of Intent due to Atlanta Public Schools *
January 9 , 2015
February 01, 2015
Petitioner’s Workshop
February 3, 2015
Petition due by 4 pm**
March 16, 2015
Notice of Completeness sent
APS review
Applicant interviews
Atlanta Board of Education action, approvals and denials
of petitions
April 14-18, 2015
March 17, 2015 – April 13, 2015
April 28, 2015 – May 1, 2015
June 2015 Legislative Meeting
Petitioner’s Intent to Resubmit to Atlanta Public Schools
June 08, 2015
Petitioner’s Resubmitted Application Due Date
June 15, 2015
Review of Submitted Application
Resubmit to APS Board action, approvals and denials of
petitions
June 15 – 30, 2015
August 03, 2015
Initially approved petitions submitted to Georgia
Department of Education for review and
recommendation to State Board of Education Charter
Committee
August 2015
Resubmitted and approved petitions submitted to
Georgia Department of Education for review and
recommendation to State Board of Education Charter
Committee
September 01, 2015
APS Charter School Agreement
Denial letters mailed
State Board of Education action
TBD (timeline dependent on
State approval)
Within 90 days of Board denial
TBD
* The only petitions that will be evaluated and considered for 2016-2017 will be from those
individuals who filed a letter of intent with Atlanta Public Schools by February 1, 2015 (same
deadline as the GaDOE) and who meet the March 16 deadline for petition submissions.
**Petitions must be received by Office of Innovation employees by 4:00 pm on March 16, 2015.
There will be no exceptions made, so please review all requirements carefully.
INSTRUCTIONS
Letter of Intent
Petitioners are required to submit a letter of intent to Atlanta Public Schools (APS) by February 1,
2015. Without exception, individuals who do not have a letter of intent on file with APS as of the
February 1, 2015 deadline will not be eligible to submit a petition for the 2016-2017 petition cycle. It
is the petitioner’s responsibility to submit a letter of intent to the state Department of Education.
See the applicable state guidance for any questions.
Deadline
Complete petitions for charter schools proposing to open for 2016-2017 must be hand-delivered to
the Office of Innovation at Atlanta Public Schools Center for Learning and Leadership no later than 4
p.m. on Monday March 16, 2015. No exceptions will be made to this deadline. Note: Handdelivered applications will be accepted Monday, March 9 thru Monday, March 16 from 10 a.m. to
4 p.m. No mailed petitions can be accepted. All hand-delivered applications must be left with
employees from the APS Office of Innovation.
Completeness of Application
Failure to submit a timely and complete petition will serve as grounds to deny a petition. A notice
indicating completeness or incompleteness of submitted charter applications will be mailed to all
applicants by April 18, 2015. All requested content must be included and all formatting guidelines
must be followed in order for an application to be considered complete. Incomplete petitions will
not be considered for 2016-2017 and must be resubmitted in a subsequent annual application
round.
Applicant Workshop
Atlanta Public Schools will offer an informational workshop for charter applicants on February 3,
2015. This workshop will take place at 130 Trinity Avenue. Applicants will be notified by email of the
date and time. The workshop will cover the following topics: Governance, Finance, Facilities,
Transportation, Student Information and Community Support. Attendance is limited to two people
from each group having submitted a letter-of-intent(LOI) to APS for the 2016-2017 opening date.
Attendees for these sessions must RSVP with the Office of Innovation by the (LOI) due date.
Attendance is not mandatory, but is strongly recommended.
Applicant Interviews
Applicants who have submitted exemplary applications by March 16, 2015 will be scheduled for an
applicant interview. Interviews will be held April 28, 2015 – May 1, 2015 at 130 Trinity Avenue SW,
Atlanta, GA 30303. If an applicant is scheduled for an interview, notice of the time and room will be
sent via email by April 18, 2015. Interviews cannot be rescheduled for any reason. Although the
entire applicant team need not be present, it is recommended that all key board and leadership
members attend. A maximum of seven applicant team members may attend the interview.
Those applicants not scheduled for an interview will receive a notice of recommendation for denial
by April 18, 2015 and then a formal denial letter within 90 days of submission, as required by state
law. If applicants have received neither an invitation nor a notice of recommendation for denial by
close of business April 13, 2015, it is the responsibility of the applicant to contact this office before
April 28, 2015 to obtain their status information.
This is a rigorous process and applications will be reviewed for program innovation, a demonstrably
effective curriculum and academic plan, solid financial planning, depth and breadth of
community support, evidence of strong academic leadership and an effective board and
carefully designed accountability measures. If a proposed school or school location is determined
not to be in the best interest of Atlanta Public Schools, the Atlanta Board of Education has the
authority to deny the petition.
Petition Format
The petition shall be submitted adhering to requirements set forth in the Atlanta Public Schools
Petitioner Guidelines for 2016-2017. Petitioners must meet the following requirements. Each petition
shall:
___ include the completed APS Petitioner Cover Sheet
___ include Conflict of Interest Forms for all team members
___ answer all requirements following the outline as it appears on pages 7 to 22
___ be typewritten in 11-point font Times New Roman font and one-inch margins with a header
showing the school’s name and a footer showing consecutive page numbers printed on 8.5” x
11” white paper
___ include a table of contents and a number on each page in the petition
___ not exceed a maximum of 100 single-sided pages, not including attachments/appendices.
___ have all appendices labeled and numbered
___ one (1) hard copy to be submitted in a three-ring binder (no clips, staples, rubber bands or
folders)
___ one (1) electronic copy in Microsoft Word format(CD or flash drives with labels on each copy)
(appendices may be in .pdf format)
___ include tabs for attachments/appendices
___ include state cover sheets with required signature in blue ink
___ entire petition must be hand-delivered (one binder hard copy and one electronic copy for APS,
one clipped hard copy and one electronic copy for GaDOE) no later than 4 p.m. on March
16, 2015 to:
Office of Innovation-8th Floor, Center for Learning and Leadership
Atlanta Public Schools, 130 Trinity Avenue SW, Atlanta, Georgia 30303
Attention: Ms. Tara Jackson, Research Associate, Office of Innovation
ONLY HAND-DELIVERED PETITIONS WILL BE ACCEPTED
Please direct any questions to:
Office of Innovation
Gayle Burnett, Executive Director of Innovation
telephone
404 802 2815
fax
404 802 1807
Tara Jackson, Research Associate
telephone
404 802 2881
fax
404 802 1807
Please follow the APS and DOE Required Petitioner Narrative Outline, addressing each
requirement as thoroughly and clearly as possible in the sequence in which they appear.
Be sure to complete and include the following documents:
APS Petitioner Cover Sheet
DOE Cover Sheet
Conflict of Interest Forms (should be included in Appendix)
APS and DOE Assurance Form and Signature Pages
The petitioner is responsible for addressing all requirements in the petition as described by
state and local documents. All state requirements are available from the Georgia
Department of Education website, including Charter School Law, Charter School Rule,
and Guidance. Local requirements are contained within GaDOE Guidelines and in the
Atlanta Board of Education policy on Charter Schools - IBB. The petitioner may attend the
APS informational workshops offered and should call the APS Office of Innovation office
with any questions about the process.
Petitions will be reviewed to ensure that they are complete and that all guidelines have
been followed. Incomplete applications will not move forward during this cycle. All
complete applications will be reviewed by the APS Charter School Petition Review Panel.
All petitioners submitting exemplary petitions will be required to attend an interview with
the APS Charter School Petition Review Panel. The APS Charter School Petition Review
Panel will submit its findings to the Office of Innovation Office, which will work with the
Superintendent to develop recommendations to the Atlanta Board of Education.
The Superintendent will make a recommendation to the Atlanta Board of Education
(ABE) for either approval or denial. Following any ABE approval, the petitioner and APS
will complete a contract referred to as the APS Charter School Agreement. The APS
Charter School Agreement will not be executed until after the locally approved petition
has been submitted to the Georgia Department of Education and is approved by the
State Board of Education.
Note: Petitioners will be required to follow APS directions regarding corrections, revisions,
amendments, etc. Coordination of final documents and required electronic formats will
be at the direction of APS.
Atlanta Public Schools
Petitioner Cover Sheet for 2016-2017
Name of Proposed Charter School:__________________________________________________
Proposed School Address: ________________________________________________________
City NPU: __________________________________________ Zip Code:_________________
Name of Group/Organization Applying for the Charter: _________________________________
Contact Person: ____________________________ Relationship to Group: ________________
Address: _________________________________ City: ______________ Zip Code: _________
Daytime Telephone: ___________________ Evening Telephone:________________________
FAX: _______________________ Email: _________________________________________
Recommendations for approval to the Atlanta Board of Education for initial start-up
charter schools will not exceed five (5) year terms.
Number of Students
K
1
2
3
4
5
6
7
8
9
10
11
YEAR 1
YEAR 2
YEAR 3
YEAR 4
YEAR 5
Projected School Opening Date in 2016: ________________________
Length of School Year: _________ Days / Length of School Day: _____ AM to _____ PM
_____________________________________
Board Chair Signature
_________________
Date
12
Atlanta Public Schools
Charter School Petitioner Requirement
Conflict of Interest Form
(This form must be completed by each founding and/or governing board
member, the proposed school leader, CFO/business manager and included as
Appendix A)
Instructions: If you answer “yes” to any of the following questions, please provide a
substantive explanation on a separate sheet of paper. Please label explanations with the
number of the corresponding question. Attach explanations behind the corresponding
Conflict of Interest Form in Appendix A
1.
Do or will you or your spouse have any contractual agreements with the proposed
charter school?
Yes__
No__
2.
Do or will you, your spouse, or any member of your immediate family have any
ownership interest in any educational service provider (ESP) or any other legal
entity contracting with the proposed charter school?
Yes__
No__
3.
Did or will you or your spouse lease or sell property to the proposed charter school?
Yes__
No__
4.
Did or will you or your spouse sell any supplies, materials, equipment or other
personal property to the proposed charter school?
Yes__
No__
5.
Have you or your spouse guaranteed any loans for the proposed charter school or
loaned it any money?
Yes__
No__
6.
Are or will you, your spouse, or any member of your immediate family be employed
by the proposed charter school, its ESP or other contractors?
Yes__
No__
7.
Did you or your spouse provide any startup funds to the proposed charter school?
Yes__
No__
8.
Did or do you or your spouse, or other member of your immediate family, have
ownership interest, directly or indirectly, in any corporation, partnership, association
or other legal entity which would answer “yes” to any of the questions 1-7?
Yes__
No__
9.
Does any other board, group, or corporation believe it has a right to control or
have input on votes you will cast as a founding member or member of the Board?
Yes__
No__
10.
Do you currently serve as a member of the Board of any public charter school?
Yes__
No__
11.
Do you currently serve as a public official?
Yes__
No__
12.
Have you, your spouse, or any member of your immediate family applied to
establish or participated in the establishment of a charter school?
Yes__
No__
13.
To the best of your knowledge, are there situations not described above that may
give the appearance of a conflict of interest between you and the proposed
charter school, or which would make it difficult for you to discharge your duties or
exercise your judgment independently on behalf of the proposed charter school?
Yes__
No__
Signature
School Role
Legibly Printed Name
Date Submitted
Name of Proposed Charter School
APS ASSURANCE FORM
AND SIGNATURE SHEET
The law requires your school provide assurances that it will do certain things and comply
with certain laws. This Assurance Form enumerates all of these requirements and, when you
submit this signed Signature Sheet with this Assurance Form as part of your Start-up Charter
School Application Package, you are providing the legal assurance that your charter school
understands and will do these things. This form must be signed by a duly authorized
representative of the school
As the authorized representative of the applicant, I hereby certify that the information
submitted in this application for a charter for
(name of school) located in the city of
Atlanta is true to the best of my knowledge and belief; I also certify that if awarded a
charter:
ACADEMIC DESIGN
The Charter School shall:
 Establish a Student Support Team (SST) in accordance with state guidelines and
local school board policies as explained in the manual
 Use APS forms for SST
 Establish a Section 504 team in accordance with state guidelines and local school
board policies
 Use APS forms for Section 504
 Handle all discipline issues regarding Section 504 students in accordance with
federal regulations, state guidelines, and local school board policies
 Participate in workshops, in-service and/or trainings offered by APS for persons
serving as SST/Section 504 chairpersons
 Comply with Section 504 by providing the appropriate accommodations and
equipment
 Immediately notify the APS Charter School Office upon receipt of a complaint
made by a parent/guardian or student concerning Section 504, furnish a copy of
such complaint and cooperate fully in the investigation, defense and resolution
of such complaint
 Hire or contract certified special education teachers to provide services to
eligible students
 Develop an Individualized Education Plan (IEP) for each student identified as
needing special education services, with the full participation of appropriate APS
staff
 Employ substitute teachers as required by state guidelines until certified
teachers are hired if the charter school does not have certified staff
 Submit and verify documentation quarterly on certified staff to the Director of
the APS Special Education program
 Participate in workshops, in-services and/or training offered by APS OSPS for
special education staff



Use APS forms for special education
Handle discipline issues regarding special education students in accordance with
federal guidelines, state rules and APS policy, and with the full participation of
APS Special Education staff
Immediately notify the APS Office of Innovation upon receipt of a complaint
made by a parent/guardian or student concerning the Individuals with
Disabilities in Education Act, furnish a copy of such complaint and cooperate
fully in the investigation, defense and resolution of such complaint
SUPPORT FOR LEARNING
The Charter School shall:
 Hire or contract with a licensed school counselor, certified school psychologist or
a licensed clinical psychologist, licensed school social worker, and a licensed
school nurse to provide services to students in accordance with state guidelines
and APS policy
 Participate in workshops, in-services and/or training offered by APS for persons
serving in these fields
 Use APS forms for services
 Report all allegations of child abuse and/or neglect to the charter school social
worker and to the persons required to receive such reports pursuant to state
law
The Charter School will adhere to the following documentation guidelines:
 Georgia Certificate of Immunization (Form 3231) must be on file
 Affidavit affirming that immunization requirements conflicting with parents’
religious beliefs will be allowed
 Each student must have a Certificate of Ear, Eye, Dental Examination (Form
3300)
 Students must present an updated certificate within 30 days after the date of
expiration
 Students out of compliance must be excluded
 Children entering grades K-12 for the first time must show proof of vaccination
or immunity to varicella and proof of a second dose of the vaccine that includes
measles (usually in the form of MMR)
 Hepatitis B Vaccine is required for all new students enrolling in school at any age
 Enrollment and Registration Requirements by showing proof of the following
documents for each student
1. proof of residence requirements
2. birth certificate
3. parent/legal guardian photo identification
4. immunization certificate or religious exemption to immunization
5. eye, ear and dental certificate
6. social security card or objection to use of social security card
7. transcript from previous school*
8. report card from previous school*
9. discipline report from previous school*
10. proof of legal guardianship*
11. proof of legal custody *
*if applicable
ACCOUNTABILITY
The Charter School shall:
 Administer all state mandated assessments according to the policies and
procedures of the Atlanta Public Schools
 Designate a testing coordinator who will be responsible for test material
distribution and collection, as well as all other testing processes and operations
within the school
 Attend all APS mandated testing and assessment trainings
 Provide, by the APS established deadlines, all accountability data, assurances
and verifications as required by the Georgia Department of Education. This
includes, but is not limited to FTE, CPI and student demographic data
 The school leader will register and maintain a working account within the
MyGADOE portal, used for secure data transfer
STUDENT INFORMATION SYSTEM
The Charter School shall:
 Integrate the Infinite Campus system and the school’s operational technology
plan will fully comply with district expectations.
 Report its progress in meeting goals and objectives by October 1 of each year, in
accordance with the Charter School Act of 1998 and the Atlanta Public Schools
Board of Education policy.
 Maintain all student records in accordance with applicable federal and state
laws, regulations, rules and policies and ensure the privacy and confidentiality of
each student’s educational record in accordance with the Family Educational
Rights and Privacy Act (FERPA), 20 U.S.C. Section 1232g, and shall not disclose to
any unauthorized third party any personally identifiable information concerning
any student enrolled in the charter school without first obtaining prior written
parental permission.
 Participate in collecting Federal Impact Aid Questionnaires and all other
documents required to secure or retain federal funds and shall submit
completed forms by the stated deadline of each year to the APS.
 Determine the annual Full Time Equivalent (FTE) required by the State Board of
Education, no later than September 15, November 15 (special education
students only), and February 15 of each school year.
 Submit electronic data for the state Student Data Record report according to the
schedule provided by the state.
 On years it is due and the Charter School has been designated by the federal
office to participate, the Charter School shall complete and submit the biennial
Office of Civil Rights Report two weeks prior to the due date in a format as
specified by the Office of Civil Rights to the APS

For the purpose of completing the Certified/Classified Personnel Information
Data Collection Report (CPI) required by the Georgia Department of Education,
no later than September 15, and February 15 of each school year, the Charter
School shall submit personnel information to APS.
FINANCE/TERMINATION CLOSURE
The Charter School shall:
 In the event that the charter is not renewed or is terminated, any balance of
public funds or assets purchased with public funds will revert back to Atlanta
Public Schools.
 In the event that the charter is not renewed or is terminated, submit a financial
audit for the final year of operation, prepared by an independent Georgialicensed certified public accountant. This audit shall include a detailed inventory
of all assets.
 In the event that the charter is not renewed or is terminated, within one month
of the board decision, along with the district employees, develop a specific
timeline for closure with regard to finances, students, staff and district property.
HUMAN RESOURCES
The Charter School shall:
 Ensure that all personnel will be in compliance with the Drug Free Public Work Force
Act of 1990.
 Inform charter school employees they are not employees of Atlanta Public Schools
and are not eligible for any benefits provided by the Atlanta Board of Education.
This Charter School Application, Assurance Form, and attached Exhibits were approved by
the
Board of Education on the
day of
, 201_.
_____________________________________
Authorized Representative, Charter School
________________________
Date
_____________________________________
Chair, Local Board of Education
________________________
Date
A signed Statement of Assurance guarantees accountability to Atlanta Public Schools by
petitioner if granted a charter school contract. The form must be signed by an authorized
representative of the school.
_____________________________________
Authorized Representative, Charter School
________________________
Date
_____________________________________
Chair, Local Board of Education
________________________
Date
Charter School Application
Start-up and Conversion (New and
Renewal)
SCHOOL NAME
SCHOOL CONTACT ADDRESS
Dr. John D. Barge
State School Superintendent
JUNE 2014
INTRODUCTION
Start-up Charter Applications are proposals to create new or renew existing start-up charter
schools. Conversion charter Applications are for existing public schools that wish to convert to
charter schools. The evaluation of your Application will focus on whether implementing the
proposals in your Application will lead to the improved academic, organizational, and financial
performance you are promising in exchange for freedom from much of Georgia’s education law,
rules and guidelines. It will also determine whether the proposed charter school would comply
with all applicable laws, rules, regulations, policies and procedures (including the Charter
Schools Act of 1998, as amended [O.C.G.A. §§ 20-2-2060 through 20-2-2071], State Board of
Education Rule 160-4-9-.04 et. seq., and Department of Education Guidelines accompanying the
Charter School Rules); whether the academic, organizational and financial plans are viable; and
whether the charter school is in the public interest.
Filing an application for a charter school does not guarantee that a charter will be granted.
DEADLINE AND SUBMISSION PROCEDURES
Your Application must be approved by your local Board of Education in accordance with the
rules and regulations of your local board. After local submission, review and approval, you must
submit your application to the address below for GaDOE review. Initial start-up applications
must be received Please note that applications are processed and interviews are scheduled on a
first-come, first-served basis. The application approval process consists of local board review,
GaDOE review and panel interview, SBOE approval (generally 2 months). Your application must
go through this entire process in the year before you plan to open, convert or renew.
Interviews are currently scheduled for August 13, August 14, September 16, September 17,
October 15, October 16, November 18, November 19, December 3, December 4, December 10,
and December 11. Applications must be received at least two weeks prior to your panel
interview. General guidelines to remember:
Applications should be sent to:
Georgia Department of Education
Charter Schools Division
2053 Twin Towers East
205 Jesse Hill Jr. Drive, SE
Atlanta, Georgia 30334
Faxed or emailed copies will not be accepted. Only complete petitions that comply with these
guidelines will be evaluated. Applications will not be returned; please keep a copy for your
records.
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 2 of 43
APPLICATION PACKAGE CHECKLIST
Your Charter Application Package must comply with the following submission procedures.
 An Application Package includes an original and two copies of the following items:
 APPLICATION COVER SHEET (Use the form on pages 4-5; the form may not be
altered in any way).
 CHARTER APPLICATION (Your answers to the questions posed on pages 7-22).
 The Application is limited to 75 double-spaced pages using an 11-point
Times New Roman font and one-inch margins with a header showing the
school’s name and a footer showing consecutive page numbers. (Up to 100
pages with APS Addendum)
 The original must be signed in blue ink. Stamped signatures will not be
accepted.
 ASSURANCES FORM AND SIGNATURE SHEET (Use the Assurances Form and
Signature Sheet below on pages 23-25; the Form and the Sheet may not be altered
in any way).
 The original must be signed in blue ink; stamped signatures will not be
accepted.
 Electronic copy of assurances must be signed. Blank copies will not be
accepted.
 DOCUMENTATION OF VOTE *CONVERSIONS ONLY (Use the form on page 26)
 The original must be signed in blue ink; stamped signatures will not be accepted.
 EXHIBITS (See list of required Exhibits below on page 27-28
 ).
 Required Exhibits should be as limited in size as possible.
 All Exhibits must be tabbed.
 Your Application Package must be bound by a binder clip; do not enclose your Application
Package in a notebook, binder, or folder.
 Your Application Package must also include a single CD or USB drive that includes a:
 Microsoft Word version of your Application Cover Sheet
 Microsoft Word version of your Application and Exhibits
 PDF Version of your application in the following order: Cover Sheet, Application,
signed Assurances Form, and Exhibits
 PDF version of your Governance Matrix
 Excel version of your completed Budget Templates
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 3 of 43
 Renewals only – an Excel version of your completed Self-Assessment
CHARTER APPLICATION COVER
PAGES
Check one:
___New Start-Up
___Start-up renewal
___New Conversion
___Conversion Renewal
If renewal, when was the original charter term start date? _____
If renewal, for how many charter terms has the school been in existence? ____
* Due to changes in Georgia State law, all charter contracts—including those of conversion
charter schools—must be held by a Georgia non-profit corporation.
Name of the Georgia nonprofit corporation that will hold the charter if granted:
_______________________________________________________________________
Name of Proposed Charter School: __________________________________________
Local school system in which charter school will be physically located:
________________________________________________________________________
Contact person:
Name
Title
Contact address:
Telephone number of contact:
Fax number of contact:
E-mail address of contact:
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 4 of 43
Charter School Name __________________________________________
Type _________________________(Locally-approved Start-up, State Chartered Special School,
Career Academy, Jointly Authorized, Virtual)
Approved by the _____________________________ Board of Education on _____________
Grade Levels Served _________________________
Ages Served ________________________________
Proposed Opening/Renewal Date ______________
Proposed Charter Term ______________________ (If this is a renewal petition with a term
other than 5 years requested, please give the rationale for the requested term length)
Mission Statement ______________________________________________________________
______________________________________________________________________________
For each year of the proposed charter term, please indicate the number of pupils the
charter school plans to serve.
K
1
2
3
4
5
6
7
8
9
10
11
12
Total
Yr 1
Yr 2
Yr 3
Yr 4
Yr 5
Yr 6
Yr 7
Yr 8
Yr 9
Yr 10
Pursuant to O.C.G.A. § 50-36-1(e)(2), please complete the following Affidavit. A
list of secure and verifiable documents can be found on our website. This form
should be completed by the CEO or President of the Non-profit Corporation.
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 5 of 43
O.C.G.A. § 50-36-1(e)(2) Affidavit
By executing this affidavit under oath, as an applicant for a charter school contract, as referenced
in O.C.G.A. § 50-36-1, from the State Board of Education, the undersigned applicant verifies one of
the following with respect to my application for a public benefit:
1) _________ I am a United States citizen.
2) _________
I am a legal permanent resident of the United States.
3) _________
I am a qualified alien or non-immigrant under the Federal Immigration and Nationality
Act with an alien number issued by the Department of Homeland Security or other
federal immigration agency.
My alien number issued by the Department of Homeland Security or other federal
immigration agency is:____________________.
The undersigned applicant also hereby verifies that he or she is 18 years of age or older and has
provided at least one secure and verifiable document, as required by O.C.G.A.
§ 50-36-1(e)(1), with this affidavit.
The secure and verifiable document provided with this affidavit can best be classified as:
_______________________________________________________________________.
In making the above representation under oath, I understand that any person who knowingly and
willfully makes a false, fictitious, or fraudulent statement or representation in an affidavit shall be
guilty of a violation of O.C.G.A. § 16-10-20, and face criminal penalties as allowed by such criminal
statute.
Executed in ___________________ (city), __________________(state).
____________________________________
Signature of Applicant
____________________________________
Printed Name of Applicant
SUBSCRIBED AND SWORN
BEFORE ME ON THIS THE
___ DAY OF ___________, 20____
_________________________
NOTARY PUBLIC
My Commission Expires:
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 6 of 43
CHARTER APPLICATION
The Application includes 20 questions grouped into eight sections. Applicants should complete
each section unless otherwise noted.
THE CASE
1. Why do you want a charter?

What is your motivation for applying to be a charter school?

What will you be able to do with a charter that you cannot do without a charter?

Describe how parents, community members, and other interested parties were
involved in developing the petition and will be involved with the school.
ACADEMIC OBJECTIVES, PLANS, AND WAIVERS
2. What are your school’s performance objectives for the proposed charter term?

As background for your answer to this question, please see the CCRPI and Beating
the Odds goals (Attachments A and B) and review the PowerPoint found on the
Charter Schools Division’s website. These goals will be included in your charter
contract.

In your answer to this question, you will list the specific areas you will target to
achieve your CCRPI and Beating the Odds goals.

For example, you may choose to target Math or ELA to raise your overall CCRPI score
– because your current Math or ELA scores are dragging your CCRPI score down.

As a way to be competitive on Beating the Odds, you may also choose to focus on
closing the gap in your school between educationally advantaged and educationally
disadvantaged students – or you may choose to ensure gifted students are wellserved, since average-performing gifted students will lower your Beating the Odds
ranking compared to schools and districts with high-performing gifted students.

Indicate the expected rate of student performance growth in each year of the
proposed charter term.

You are encouraged to include all or some of the components of the current draft of
the Georgia Department of Education’s College and Career Readiness Performance
Index (CCRPI).

You are urged to include cohort measures that show the progress over time of a
single cohort of students.
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 7 of 43

You are also urged to include national norm-referenced test results among your
performance measures.

Be specific, measurable, attainable, relevant, and time-based (SMART).
3. How will the charter school governing board, management, instructional leadership,
faculty and staff know that students are on track to meet these academic goals?

What assessments will the school administer to obtain performance data for
each student?

Describe how the school will obtain baseline achievement data.

Describe how the school will benchmark student growth.

Explain how the charter school will work with the local school system to
participate in all state-mandated assessments.
4. What specific actions will the school’s management, instructional leadership, faculty
and staff take to ensure student performance objectives are met during the
proposed charter term?

Describe the focus of the curriculum.

Describe the educational innovations that will be implemented.

Provide a clear explanation of how the innovations will increase student
achievement.

Describe why the innovations are appropriate for this unique school.

Describe the anticipated teacher-to-student ratios and the rationale for
maintaining these ratios.

If this is a charter high school, describe how the charter high school will
determine that a student has satisfied the requirements for high school
graduation, including the credits or units to be earned and the completion
credentials to be awarded.
5. What are the school’s plans for educating special populations? (Reciting the
requirements of law and rule is not sufficient)
6. Describe how the charter school will meet the needs of students identified as gifted
and talented.

Describe how the charter school will provide state and federally mandated
services for students with disabilities.

Describe how the charter school will provide state and federally mandated
services for English Language Learners (ESOL).
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 8 of 43
7. Which of the specific actions in the academic plan require a waiver of state law, rule,
or guidelines?

Although you will be granted a broad flexibility waiver if you are granted a
charter, please demonstrate why a charter is necessary for this school by
providing examples of significant components of your academic plan for which
you need a waiver. Please also identify the specific waivers that are required to
allow the implementation of those components.
Atlanta Public School Addendum
Academic Standards and Curriculum
 Describe what is innovative or distinctive about the proposed instructional
methods and materials that will be used to provide high quality instruction and
educational programs.
 Explain how your innovative program is research-based and standards-driven.
Explain the research that demonstrates that this approach will work with your
anticipated student population.
 Discuss how your school will address the needs of those students who do not
perform at grade level either upon enrollment or shortly after enrolling in the
proposed school. What actions, after school hours and during the regular school
day, will the school take to help students make the kinds of progress that will
enable them to achieve at grade level or higher? What long-range interventions
will be established to address these needs?
 Describe your school’s instructional technology plan, ensuring that all students
are prepared to use technology as a tool for learning and as a critical component
of today’s society.
 The Atlanta Public Schools (APS) Department of Special Education has developed
guidelines for charter schools outlining specific responsibilities for both charter
school administration and staff, and Atlanta Public Schools. These guidelines are
incorporated into the checklist and your plan for compliance with these
guidelines must be incorporated into your application. Atlanta Public Schools will
monitor the special education services provided by the charter schools.
 Describe the school’s approach to educating children with special needs.
 Describe with specificity the school’s policy and procedures that adhere to
federal Child Find Procedures.
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 9 of 43
 Explain how the school’s innovative curriculum and approach to instruction will
be designed or adapted to serve children with special needs. How and when will
parents be involved in the aforementioned processes?
 Pursuant to federal and state special education regulations (including LRE and
FAPE), describe how the charter school will provide the continuum of special
education services (including related services) to eligible students. Please
describe where this continuum will begin and end for students, using concrete
examples.
 Describe the job duties and responsibilities of the employee who will oversee
your school’s special education program.
 How would the school handle a student that enrolls with an IEP with services that
the school does not currently provide?
 Describe how your school will coordinate its special education program with
Atlanta Public Schools in order to ensure compliance with all aspects of IDEA.
 Describe accommodations that will be made to provide ancillary services such as
diagnostic and psychological testing and health-related support to students.
Student Assessment
Charter Schools are mandated by Georgia statute to participate in the administration of
state assessments. Materials for these assessments are provided by the state. The
Charter School, as part of the local education agency, will administer all state
assessments during the APS system-testing window. Charter Schools, at their expense,
may implement additional assessments.
 Describe the school’s plan to obtain student performance data for each student,
including how the baseline standard of achievement shall be determined in
order to meet the goals and objectives stated in the petition. For the charter
school’s first year, initial baseline student achievement data shall be collected
within three months of the first day of school. This data is not limited to, but
may include, standardized assessment results from previous school years.
Describe what baseline data will be submitted to APS no later than November
15 of the school’s first year.
 Describe plans to formally and informally assess student performance in the
core academic areas and other areas of interest to stakeholders. Describe how
the charter school’s assessment plan will measure improvement and over what
period of time.
 Provide a statement detailing how the charter school shall comply with the
accountability provisions of O.C.G.A. §20-14-30 through §20-14-41 and federal
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 10 of 43
accountability requirements. Describe how the charter school will work with
Atlanta Public Schools to participate in all state-mandated assessments.
 If students will participate in charter-initiated assessment programs, describe
the assessments, when testing will occur, how data will be collected and
managed, and how data will be used to drive instruction and improve student
outcomes.
 For charter schools containing high school grades, describe the method for
determining that a student has satisfied the requirements for graduation
required by the State Board of Education Rule 160-4-2-.47.
School Achievement Goals and Nonacademic Performance Goals
The school agrees to have its academic, financial and organizational performance
measured using the APS Performance Framework metrics. Decisions regarding renewal,
probation and closing will be based upon the school’s results, as defined by the
framework.
A copy of the APS Performance Framework can be found in January, 2014 on the Office
of Innovation website at http://www.atlantapublicschools.us/Page/783
Support for Learning
 Describe the charter school’s core values and the type of unique culture the
school aims to develop. Explain the strategies the school will employ to develop
a positive culture that is supportive of students, faculty, and families.
 Summarize the school’s discipline policy, code of conduct and appeals process
for the general student population and students with special needs. Please
describe how you will provide due process for students facing expulsion and
how you will prepare expelled students for placement after expulsion.
 Describe your school’s bullying policy; according to the Georgia Department of
Education’s Bullying Law O.C.G.A. 20-2-751.4. What will you do, specifically, to
convey the “No-Tolerance” policy to parents, students and school staff? Please
describe, step-by-step, the actions that will be taken should a student, parent or
staff member suspect that bullying has occurred?
 Describe provisions for providing students with counseling services and health
services. Please describe how your school will keep and manage student health
records.
 Describe the rules and procedures concerning how the school will address
grievances and complaints from students, parents and teachers, including the
role the governing board will play in resolving such grievances and complaints.
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 11 of 43
Community Partnerships
 Provide a list of organizations that have committed to partnering with your
school and explain the potential nature of the partnerships. Include letters of
support from your partners (these should be included as Appendix C). All
partnerships listed in the petition must have letters of support. Describe the
steps you have taken to develop any strategic partnerships and your plans to
further develop additional partnerships. Explain how the partnerships will be
utilized, before, during or after school. Describe how the partnership will benefit
the students, parents/family and/or staff. If the partner will be involved during
the school day, explain how the partner’s program will be integrated into the
school program.
 Describe how parents, members of the community and other interested parties
will be involved in the school after approval, including governing board
involvement.
ORGANIZATIONAL OBJECTIVES, PLANS, AND WAIVERS
8. State the school’s Organizational Goals and Measures.

School organizational performance objectives should reflect where the school
envisions itself organizationally at the end of the charter term.

Objectives should include areas such as: governing board training, student and
teacher retention, and student, parent and teacher satisfaction.
9. What specific actions will the school take to achieve its organizational performance
objectives?

Describe the organizational innovations that will be implemented during the
proposed charter term.

Provide a clear explanation of how the innovations will increase organizational
effectiveness.

Describe why the innovations are appropriate for this unique school.
10. Which of the specific actions in the organizational plan require a waiver of state law,
rule, or guidelines?

Although you will be granted a broad flexibility waiver if you are granted a
charter, please demonstrate why you need a charter by providing examples of a
significant component of your organizational plan for which you need a waiver.
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 12 of 43
Please also identify the waivers that are required to allow the implementation of
that component.
GOVERNANCE
A key characteristic of charter schools is that an autonomous governing board makes decisions
on behalf of the school. It is imperative that all governing boards demonstrate substantial
autonomy, decision-making authority and capacity.
11. Describe how an autonomous governing board will make decisions for the school.
*Please note that the following relates to the board that will immediately replace the
founding board, as well as future boards:

Identify each member of the governing board; describe the composition of the
governing board (number of members, skillsets to be represented, how members
are/will be representative of the school and the community, etc.; describe how
and when board members will be selected, and the terms that governing board
members will serve.

Describe the governing board’s function, duties and role in the areas of budget,
resource allocation, personnel decisions (primarily school leader selection,
evaluation, and termination), establishing and monitoring the achievement of
school improvement goals, curriculum and school operations.

Please use the Governance matrix (found on the Charter School Division’s
website) to illustrate the level of autonomy your Governing Board will have.
Please note: This matrix will become part of your charter contract.

Use this section to provide a narrative of your matrix, including anything in the
matrix that requires further explanation or clarification.

Describe your plan for ensuring that you maintain a diverse board with broad
skillsets.

Describe how and why governing board members may be removed.

Georgia law now requires Charter Schools to provide initial training for newly
approved charter school Governing Boards as well as annual governance
training thereafter. Governance training should help build the capacity needed
to make decisions in the above-mentioned areas. Trainers must be selected
from a SBOE-approved list that ensures that the training covers certain SBOE
requirements. Beyond those requirements, as a best practice, Charter Schools
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 13 of 43
should also ensure that it selects a training program that covers areas of
identified needs.

Describe your plan and timeline for securing a provider for your initial
governance training as well as annual training thereafter. Include in this plan,
areas of focus that are specific to your board and school.

Disclose any potential conflicts of interest and describe how the governing board
will ensure that current and future board members avoid conflicts of interest.
Atlanta Public School Addendum
Profile of the Founding Board and/or Initial Incorporators
 Provide resumes for all founders and all proposed governing board members. If
known, include resumes for the school leader(s) (resumes should be included as
Appendix E).
 Individual resumes should not exceed two pages in length.
 The Atlanta Board of Education reserves the right to require fingerprinting and
background checks of the founding and/or charter school board members.
School Governance
 Describe how the proposed school will be governed and a statement
acknowledging that the governing board shall be subject to the control and
management of the local board and subject to the provisions of O.C.G.A. § 5014-1 et seq. and O.C.G.A. § 50-18-70 et seq.
 How often will the board meet? How will parents be notified of meetings?
 Describe plans of the board of directors to prepare and submit to the Atlanta
Board of Education and Georgia State Board of Education an annual report of
academic progress by October 1 of each year in compliance with the Charter
School Act of 1998 and related rules.
Charter School Implementation Timetable
Recommendations to the Atlanta Board of Education for contracts with start-up
charter schools will not typically exceed five (5) year terms.
 What is the proposed duration of the charter? Describe how the program will be
phased in over the initial term.
 Present a detailed timetable of the projected steps for implementing the
charter from local and state charter approvals to the first day of classes for
2015-2016. Include dates for the execution of each element.
CONTRACTS WITH EDUCATIONAL SERVICE PROVIDERS OR
OTHER CHARTER PARTNERS
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 14 of 43
12. Does the charter school intend to contract, or has the school contracted, with an
education service provider (ESP) or other charter partner, to provide management or
consulting services? If so, please complete this section and include a signed,
operationalized agreement submitted as an exhibit.

Describe how the arrangement will be in the best educational and financial
interests of the charter school.

Describe other education service providers or charter partners that were
considered and the reasons this ESP or partner was selected above all others.

Describe the history of the ESP or partner selected, including academic results,
closures, non-renewals and separations.

Describe how the contract was negotiated.

Briefly describe the range of services the education service provider or partner
will provide for the school.

Describe how the governing board will monitor and assess the performance of
the management organization.
Atlanta Public School Addendum
Relationship of Founders to Charter Governing Board and Management
 Discuss any business arrangements or partnerships with educational
institutions, businesses, for profit or nonprofit organizations, and a disclosure of
any potential conflicts of interest. Include a copy of any intended contracts for
the provision of any educational management services, extracurricular
programs or supplemental educational services.
 If the charter board intends to enter into a contract with an education
management organization (EMO), education service provider (ESP), profit or
non-profit, or any third party entity to manage the charter school attach a copy
of the signed and executed management contract (include as Appendix G)..
o How will the proposed charter school board resolve any conflicts with
the entity?
o How will the charter school survive if the relationship between the
board and the entity is terminated?
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 15 of 43
FINANCIAL OBJECTIVES, PLANS, AND WAIVERS
13. State the school’s Financial Goals and Measures.

School financial performance objectives should reflect where the school
envisions itself financially at the end of the charter term.

Objectives should emphasize fiscal health and sustainability.
14. What specific actions will the school take to achieve the financial performance
objectives?

Describe the financial innovations that will be implemented during the proposed
charter term.

Provide a clear explanation of how the innovations will increase financial
effectiveness.

Describe why the innovations are appropriate for this unique school.
15. Which of the specific actions in the financial plan require a waiver of state law, rule,
or guidelines?

Although you will be granted a broad flexibility waiver if you are granted a
charter, please provide examples of a significant component of your financial
plan for which you need a waiver – and the waivers that are required to allow
the implementation of that component.
Atlanta Public School Addendum
Financial Management
 Explain who will manage the school’s finances, including fiscal controls, internal
accounting and reporting procedures. Describe the financial systems that will be
established for daily business operations to manage cash flow, purchasing, payroll,
and audits. What financial documents and statements will the school regularly
produce? Who will prepare them? How often? Who will review them and for what
purpose? Describe your plan to ensure sufficient financial controls through
segregation of duties.
 Identify the representatives of the school who will be responsible for the financial
management of the charter, and describe plans to procure and maintain during the
entire length of the charter a Crime/Fidelity Bond covering all persons receiving or
disbursing funds. The APS required bond amount is $1 million.
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 16 of 43
 Please identify the individual who will serve in the capacity of Chief Financial Officer.
Per state guidance, at a minimum the individual must possess the following
qualifications: (a) A baccalaureate or higher degree in business, accounting, or
finance from an accredited college or university and minimum of four years’
experience in a field related to business or finance; or (b) Documented experience
of ten or more years in the field of business and financial management. Please
include the CFO’s resume with Appendix.
Budget
Please use the budget instructions and templates provided through the Georgia
Department of Education website to complete questions 1 and 2 below. For the 2016 –
2017 school year, use a base funding (QBE and local share) amount of $9,000 per FTE.
This is only an estimate, actual funding levels will either be more or less than this
amount and depend not just on extrinsic factors (tax revenues, QBE allotments,
austerity measures), but intrinsic factors (student characteristics, school programs,
teacher training and experience).
 Provide a monthly cash flow projection detailing revenues and expenditures for the
charter school’s first two (2) years of operation and for the year prior to opening
(Year 0). Also provide contingency 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. All budgets should be included as Appendix H.
 It is critical that you define and give support for assumptions behind revenue and
expenditure projections. Please provide a detailed budget narrative that explains all
budget assumptions. As part of your budget narrative, detail your contingency plans
should you experience a budget shortfall, lower than anticipated student
enrollment, higher than expected personnel costs, underestimated costs of
technology maintenance, and any other costs that could be potential operational
difficulties. Explain how the school will make certain sufficient funds are available to
cover any special education costs incurred (include with Appendix).
STUDENT ADMISSIONS
16. How will students be admitted to the charter school?

What is the school’s attendance zone?

Please check any of the following enrollment priorities pursuant to O.C.G.A. § 202-2066(a)(1) that apply put them in the rank order in which you will use them. If
the school will not utilize any enrollment priorities, please leave this section
blank.
□ 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
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 17 of 43
□ A student whose parent or guardian is a member of the governing board of
the charter school or is a full-time teacher, professional, or other employee
at the charter school
□ Students matriculating from a local school designated in the charter

Describe the rules and procedures that will govern admission and registration.
Please note that “enrollment priorities”, “admission” and “registration” are
different concepts. To avoid confusion the Department recommends the
following:

“enrollment priorities” describe those students granted priority pursuant
to O.C.G.A. § 20-2-2066(a)(1);

"admission" describes pre-lottery processes and forms; and

"registration" describes post-lottery processes and forms after the
student has been offered a seat at the school through enrollment
priorities or the lottery process.

How will the charter school reach students representative of the racial and
socioeconomic diversity in the school system?

How does the school plan to recruit students and maintain/increase enrollment?
Atlanta Public School Addendum
Recruiting and Marketing Plan
 Provide evidence that there is sufficient interest in your school to meet your
requested maximum enrollment. Convey clearly and concretely the scope of
community backing for the proposed charter school and its founding board.
Document this community support among teachers, parents of potential
students, students, community members, institutional leaders, and others
through the use of letters of support, surveys, or other tangible means (include
with Appendix C).
 Provide a description of the method used to recruit the number of anticipated
students and a statement setting forth the school’s plan for maintaining and/or
increasing attendance.
 Please include a copy of your proposed parent/student handbook in the
Appendix.
Admissions and Registration Plan
The charter school must be open to any student who resides within the City limits of
Atlanta. The charter school can only enroll students who reside within the City limits of
Atlanta. The only eligible out-of-district enrollees are children of teachers, staff, and
board members of the charter school.
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 18 of 43
 Provide the calendar to be used for recruiting, registering, and admitting
students the initial year, and years following including a plan for an admissions
lottery if the number of applicants exceeds the school capacity.
 Describe the policies and procedures that will guide the admission, enrollment
and withdrawal of students, including verification of city residency. Indicate any
priorities for enrollment. Indicate any specific targeted traditional school
attendance zones and/or City Neighborhood Planning Units (NPU).
FACILITIES ( START-UPS ONLY)
A charter school’s facility is a very important part of implementation. Without a proper facility,
the charter school will not be feasible. Best practice is that a school’s facility costs should not
exceed 15% of its total expenditures. Additionally, please be aware that all facilities must be
approved by the Department’s Facilities Services Unit (more information regarding this step can
be found on the Department’s website). For this reason, it is imperative that the charter school
not commit to a facility before it has been approved. We encourage new schools that are
planning construction or major renovations prior to the admission of students consider a
planning year to safely complete the construction process. We also strongly encourage
Memorandums of Understanding (MOU) pending approval. Also for this reason, it is
encouraged that a school have at least two facility options.
17. Describe the school facility that the charter school proposes to use.

What is the location of the facility?

Is the facility new or existing?

Will the facility require renovations? If so, describe the extent of the renovations
and source of funding to pay for the renovations.
18. Does the charter school have an MOU for the facility pending charter and facility
approval?
□ Yes, we have an MOU and it is provided as Exhibit ___.
□ No, we do not have an MOU.

The MOU should include the total proposed facility cost.

The MOU should set forth any material terms that will be reflected in a lease,
such as the lease term.
19. Does the charter school have a Certificate of Occupancy (CO) for the proposed
facility?
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 19 of 43
□ Yes, we have a CO and it is provided as Exhibit ___.
□ No, we do not have a CO but plan to have one by _____________ (date).

Please note that schools must obtain a CO no later than 45 days before the start
of the charter term on July 1.
20. Does the charter school have an emergency safety plan pursuant to O.C.G.A. § 20-21185 for the proposed facility?
□ Yes, we have an emergency safety plan and it is provided as Exhibit ___.
□ No, we do not have an emergency safety plan but plan to submit one to the
Georgia Emergency Management Agency by _____________ (date).

Please note that schools must submit an emergency safety plan no later than 45
days before the start of the charter term on July 1.
Atlanta Public School Addendum
Facility
 Identify the geographic region in which the school plans to locate by the
neighborhood, the designated Atlanta City Neighborhood Planning Unit (NPU),
the street address, and description of neighboring areas. If the facility is an
unused district facility, please provide its name and address.
 Describe the facility to be used and how it meets the required space needed for
the proposed school, including number and type of classrooms, administrative
offices, any program specific space (science labs, art workshops, etc.), media
center, meeting space, and kitchen facility. Is it an existing building or will it be
newly built?
Atlanta Public School Additional Requirements
School Staff
 Describe the qualifications and attributes of an ideal teacher for the proposed
school and how they will support the mission and effective student learning.
 Provide a plan for ensuring that recruitment and selection procedures will
reinforce these desired qualities in the school’s faculty.
 Describe your plans for developing and implementing an effective professional
development program.
 Detail how the evaluation system for teachers and administrators will support
the school’s mission and educational philosophy. Explain how the principal’s
performance will be appraised and by whom.
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 20 of 43
 Indicate the number of teachers and other professional and non-professional
school staff, by position, to be hired for each year. If necessary, describe the job
position.
 Describe the school’s plan for staffing special education, and staff for English
Language Learners including necessary qualifications.
 Describe the human resource policies governing processes for hiring, dismissal,
compensation, and required fingerprinting and criminal record checks.
 Describe provisions that will be made for all required staff to participate in the
mandatory Teachers Retirement System (TRS) of Georgia.
 State whether or not the charter school will elect to participate in the State
Health Benefit Plan.
Insurance / Risk Management
Evidence of all required insurance must be submitted prior to school opening for 20152016, no later than August 1, 2014. Applicants should, at a minimum, address local and
state requirements. The following types and levels of coverage are required by the
Atlanta Board. Each applicant should investigate their proposed school’s insurance
needs. Many charter schools purchase higher levels of coverage and additional coverage
based on the type of school they propose to establish.
 Describe all insurance coverage that will be secured including but not limited to
workers compensation, general liability insurance, property damage, and motor
vehicle.
Legal Services
 Identify the charter board’s legal counsel including contact information: name,
firm, address, telephone number. If the petitioner does not currently have legal
counsel, provide a timeline for obtaining counsel prior to the proposed school’s
opening.
Transportation
Atlanta Public Schools does not contract with charter schools to provide daily
transportation service, although a proportional share of transportation funding is
provided to each school with eligible riders. For local field trips, charter schools are
eligible for bus services from APS at the same rate as any APS school is charged and are
required to follow reservation procedures. For any special needs students enrolled in the
charter school with an IEP requiring special transportation to and from school, the
charter school can contract with APS for a fee for transporting any such student.
 Describe plans, if any, for the school to transport students to and from school.
Please account for these plans in the budget.
 Include arrangements made for students who would not have their own
means of transportation. While it is understood that you may be unable
to provide an exact transportation plan without knowledge of your
actual student enrollment, please be as specific as possible.
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 21 of 43
 Describe policies that will ensure transportation is not a barrier to access for
students. If transportation will not be provided, demonstrate how that will not
be a barrier for all those who are eligible to attend.
 If transportation shall be provided, the petition must include a statement that
the transportation program will comply with applicable law.
Food Services
Atlanta Public Schools does not contract with charter schools to provide food service. APS
charter schools are responsible for providing APS-provided household survey forms for
each student to determine free or reduced eligibility. The dissemination, collection, and
submission of eligibility forms to APS for the purposes of determining the charter school’s
eligibility for Title I funds is required even if the charter school does not provide food
service.
 Provide a brief description of any proposed food service program.
 Indicate if the school plans to participate in the National School Lunch Program
through the Georgia Department of Education.
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 22 of 43
ASSURANCES FORM AND
SIGNATURE SHEET
The law requires your school provide assurances that it will do certain things and comply with
certain laws. This Assurance Form enumerates all of these requirements and, when you submit
this signed Signature Sheet with this Assurance Form as part of your Start-up Charter School
Application Package, you are providing the legal assurance that your charter school understands
and will do these things. This form must be signed by a duly authorized representative of the
school.
As the authorized representative of the applicant, I hereby certify that the information
submitted in this application for a charter for
(name of school) located in
County is
true to the best of my knowledge and belief; I also certify that if awarded a charter the school:
1. Shall be nonsectarian in its programs, admissions policies, employment practices, and all
other operations;
2. Shall be subject to the control and management of the local board of the local school
system in which the charter school is located, as provided in the charter and in a manner
consistent with the Constitution;
3. Shall not discriminate against any student or employee on the basis of race, color, ethnic
background, national origin, gender, disability or age;
4. Shall be subject to all federal, state, and local rules, regulations, court orders, and
statutes relating to civil rights; insurance; the protection of the physical health and
safety of school students, employees, and visitors; conflicting interest transactions; and
the prevention of unlawful conduct;
5. Shall be subject to the provisions of O.C.G.A § 20-2-1050 requiring a brief period of quiet
reflection;
6. Shall ensure that the charter school and its governing board are subject to the
provisions of O.C.G.A. § 50-14-1 et seq. and O.C.G.A. § 50-18-70 et seq.;
7. Shall ensure that the charter school’s governance board members may only receive
compensation for their reasonable and actual expenses incurred in connection with
performance of their duties;
8. Shall ensure that the charter school’s governing board members receive initial training
and annual training thereafter, provided by a SBOE-approved vendor;
9. Shall ensure that the charter school’s governing board adopts and abides by a conflicts
of interest policy;
10. Shall ensure that all teachers will be certified or highly qualified in compliance with No
Child Left Behind;
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 23 of 43
11. Shall comply with O.C.G.A. §20-2-210(b)(1) and implement an evaluation system as
adopted and defined by the State Board of Education for elementary and secondary
school teachers of record, assistant principals, and principals;
12. Shall comply with the accountability provisions of O.C.G.A. § 20-14-30 through § 20-1441 and federal accountability requirements, and participate in statewide assessments;
13. Shall adhere to all provisions of federal law relating to students with disabilities,
including the IDEA, Section 504 of the Rehabilitation Act of 1974, and Title II of the
Americans with Disabilities Act of 1990, as applicable;
14. Shall provide state and federally mandated services for English Language Learners, as
applicable;
15. Shall provide for supplemental educational services as required by federal law and
pursuant to SBOE Rule 160-4-5-.03, and for remediation in required cases pursuant to
SBOE Rule 160-4-5-.01;
16. Shall notify the state of any intent to contract with a for-profit entity for education
management services;
17. Shall notify the state of any changes in for-profit entity contracted with for management
services;
18. Shall be subject to the requirement that it shall not charge tuition or fees to its students
except as may be authorized by local boards by O.C.G.A. § 20-2-133;
19. Shall comply with federal due process procedures regarding student discipline and
dismissal;
20. Shall be subject to all laws relating to unlawful conduct in or near a public school;
21. Shall have a written grievance procedure to resolve student, parent, and teacher
complaints;
22. Shall have a written procedure for resolving conflicts between the charter school and
the local board of education;
23. Shall comply with the provisions of O.C.G.A. § 20 -2-211.1 relating to fingerprinting and
criminal background checks;
24. Shall remit payments to TRS on behalf of employees and shall employ teachers in
accordance with TRS;
25. Shall ensure that if transportation is provided for its students, the school shall comply
with all applicable state and federal laws;
26. Shall ensure that if the charter school participates in federal school meals programs,
then it shall comply with all applicable state and federal laws;
27. Shall prepare a safety plan in accordance with O.C.G.A. § 20-2-1185 and submit and
obtain approval from the Georgia Emergency Management Agency;
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 24 of 43
28. Shall comply with the state facility requirements regarding site codes, facility codes, the
submission of architectural plans for any new facility that the school may build or
occupy during the charter term and all other facility requirements as established by the
Department;
29. Shall be subject to all reporting requirements of O.C.G.A. § 20-2-160, subsection (e) of
O.C.G.A. § 20-2-161, O.C.G.A. § 20-2-320, and O.C.G.A. § 20-2-740;
30. Shall be subject to an annual financial audit conducted by the state auditor or, if
specified in the charter, by an independent certified public accountant licensed in this
state;
31. Shall designate a Chief Financial Officer that meets all requirements as established by
the Charter Schools Rule and Guidelines;
32. Shall secure adequate insurance coverage prior to opening and shall maintain such
coverage throughout the charter term in accordance with the laws of the State of
Georgia;
33. Shall acknowledge that all criteria used to calculate QBE funding may not be waived;
and
34. Shall follow any and all other federal, state, and local laws and regulations that pertain
to the applicant or the operation of the charter school.
This Charter School Application, Assurance Form, and attached Exhibits were approved by the
Board of Education on the
day of
_____________________________________
Authorized Representative, Charter School
_____________________________________
Chair, Local Board of Education
, 201_.
________________________
Date
________________________
Date
If a Charter is granted, Petitioners assure that the proposed charter school’s programs,
services, and activities will operate in accordance with the terms of the Charter and all
applicable federal, state, and local laws, rules, and regulations.
_____________________________________
Authorized Representative, Charter School
________________________
Date
_____________________________________
Chair, Local Board of Education
________________________
Date
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 25 of 43
DOCUMENTATION OF VOTE
(CONVERSIONS ONLY)
This petition has been agreed to, by secret ballot, by a majority of the faculty and
instructional staff members at a meeting called with two weeks’ advance notice during
which time a complete petition draft was available for review.
Date of Vote
Total Number of Faculty and Instructional Staff
Number Approving
______
Number Disapproving ______
Percent Approving
Percent Disapproving
_____________________________
Principal’s Signature
Date
This petition has been agreed to, by secret ballot, by a majority of the parents or guardians
of the students enrolled in the school who were present at a meeting called for the purpose
of deciding whether to submit the petition. Two weeks’ advance notice of the meeting was
published during which time a complete petition draft was available for review.
Date of Meeting
Total Number of Parents Attending Meeting
Number Approving
Percent Approving
Number Disapproving
Percent Disapproving
_____________________________
Principal’s Signature
Date
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 26 of 43
EXHIBITS
The following Exhibits are required to complete your Charter School Application Package. Please
tab the Exhibits to match the item numbers below. Exhibits should be as limited in size as
possible.
1. Attach an official copy of the certificate of incorporation for the required Georgia nonprofit
corporation from the Georgia Secretary of State. Note – Please Note: All charter school
contracts—including those of start-up and renewal conversion charter schools—must now
be held by a Georgia nonprofit corporation.
2. Attach a copy of the by-laws for the nonprofit corporation. .
3. Attach a copy of any admissions (pre-lottery) application the charter school proposes to use.
4. Attach the charter school’s proposed annual calendar and a draft of the charter school’s
daily school schedule.
5. Attach a copy of any intended contracts for the provision of education management
services. Such contracts shall describe the specific services for which the contracting
organization is responsible. Such contracts should clearly delineate the respective roles and
responsibilities of the management organization and the governing board in the
management and operation of the charter school.
6. Attach a copy of any agreements with your local authorizer.
7. Attach a copy of any MOU for a proposed facility.
8. Complete and attach the start-up budget template located on the Charter Schools Division’s
website: Please note that the budget template includes:

A monthly cash flow projection detailing revenues and expenditures for the charter
school’s first two (2) years of operation;

An alternative monthly cash flow projection detailing revenues and expenditures for
the first two (2) years of operation with the assumption of one-half (1/2) of the
projected student enrollment; and

A spreadsheet projecting cash flow, revenue estimates, budgets, and expenditures
on an annual basis for the first five (5) years of the charter term.

Note – Any sources of revenue appearing in the template that are anticipated to
come from outside of state and local funding must be supported by documentation.
Failure to provide supporting documentation will result in the revenue source being
removed from the budget.
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 27 of 43
Atlanta Public School Addendum
Labeled tabs/ dividers should separate the Appendices. Please only include the following
appendices:
 Conflict of Interest forms along with explanations (if needed)
 Letters of partnership and support
 Board member, school leader, business manager/CFO résumés
 Organizational chart
 Budget Forms with narratives
 Parent/student handbook
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 28 of 43
ATTACHMENT A
Start-Up Charter Goals:
Goal 1:
During each year of its first five-year charter term, the Charter School shall
“beat the odds” as determined by a formula measuring expected student growth.
A. The Beating the Odds analysis is a cross-sectional, fixed effects regression
model that uses the following factors from the CCRPI school-level dataset,
GaDOE student record file, and GaDOE CPI 1 data.
a. Student-based Factors:








% African American
% Hispanic
% White
% Other
% Free/Reduced Lunch
% Students with Disabilities
% English Learners
% Gifted
b. School-based Factors:





School Size (FTE)
Student/Teacher Ratio
School Configuration/CCRPI Score Type (i.e. Elementary, Middle,
High)
Locale Type (i.e. City, Town, Rural)
District Performance (fixed effect)
Renewal decisions for new charter schools first opening in 2015 or later will be based in
part on whether the school “beat the odds” in each of the first four years of its first
charter term (Years 1-4).
Goal 2: The Charter School will demonstrate proficiency and/or improvement on the
CCRPI.
A. Measure 1: For new start-up charter schools first opening in 2015 or later,
using Year 1 of the charter term to establish a CCRPI baseline, the Charter
School’s CCRPI score shall be equal to or better than both the State and
1
Certified/Classified Personnel Information
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 29 of 43
local district in Year 2, and better than both the State and local district in
Years 3-5 of the charter contract.
B. Measure 2: If the school’s first-year CCRPI score is lower than either or
both the local district and the State, the school shall have until the end of
Year 2 of the charter term to close the gap between the Charter School
and whichever score is higher, the local district or the State.
C. Measure 3: In Years 3-5 of the charter term, the Charter School’s CCRPI
score shall be better than both the State and the local district.
Renewal decisions for new start-up charter schools first opening in 2015 or later will be
based in part on whether the school’s CCRPI score was equal to or better than both the
State and local district in Year 2, and better than both the State and local district in Years
3-4 of the charter contract.
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 30 of 43
ATTACHMENT B
Conversion Charter Goals:
Goal 1:
During each year of its first five-year charter term, the Charter School shall
“beat the odds” as determined by a formula measuring expected student growth.
B. The Beating the Odds analysis is a cross-sectional, fixed effects regression
model that uses the following factors from the CCRPI school-level dataset,
GaDOE student record file, and GaDOE CPI 2 data.
a. Student-based Factors:








% African American
% Hispanic
% White
% Other
% Free/Reduced Lunch
% Students with Disabilities
% English Learners
% Gifted
b. School-based Factors:





School Size (FTE)
Student/Teacher Ratio
School Configuration/CCRPI Score Type (i.e. Elementary, Middle,
High)
Locale Type (i.e. City, Town, Rural)
District Performance (fixed effect)
The renewal decision at the end of the charter term will be based in part on whether the
school “beat the odds” in all years of the charter term except for the year in which
renewal is sought.
Goal 2: The Charter School will demonstrate proficiency and/or improvement on the
CCRPI.
2
Certified/Classified Personnel Information
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 31 of 43
D. Measure 1: The Charter School’s CCRPI score shall be equal to or better
than both the State and the local district in 2015-16, and better than both
the State and local district in 2016-17 and all remaining years of their
charter contract.
E. Measure 2: If the school’s baseline CCRPI score (2014-15) is lower than
either or both the local district and the State, the School shall have until
the end of the 2015-16 school year to close the gap between the Charter
School and whichever score is higher, the local district or the State.
F.
Measure 3: In 2016-17 and all remaining years of the charter contract, the
Charter School’s CCRPI score shall be better than both the State and the
local district.
The renewal decision at the end of the charter term will be based in part on whether the
school’s CCRPI score was equal to or better than both the State and local district in
2015-16, and better than both the State and local district in 2016-17 and in all but the
last of the remaining years of their charter contract
Dr. John D. Barge, State School Superintendent
June 3, 2014 ● Page 32 of 43