Please submit all completed forms to [email protected]
- To add an additional parent/guardian: Additional Parent/Guardian Request Form
- For proof of residency you can utilize the Affidavit of Shared Residence Form.
- To remove a Student from the ESA Program: Close Account Request Form
- If applying under Legal Guardian is Blind: Blindness Confirmation Form
- If applying under Legally Deaf/Hard of Hearing: Confirmation of Deaf or Hard of Hearing
- To appeal the department’s decision reference: Example of Appeal Letter from Applicant
- 2019/2020 Paper Application (You must submit this form with the copies of ALL the required documents.)
- For the 19/20 Attestation Form: Update as of 3/29/19 — the attestation process is being reviewed. Please check back in the next few weeks or call the ESA Hotline.
Expense Report Forms
Submitting your expense report by using the paper form means the ESA staff are submitting your expenses through the portal for you. Due to the high volume of submissions received, there may be a delay to your report being submitted and you may continue to receive automated Quarterly Submission Reminders and Late Notices. If at all possible, it is strongly recommended you submit through the ESA Portal to ensure it has been entered on time.
*ESA Online Application and ESA Applicant Portal are better viewed in Google Chrome, Microsoft Edge and IE11 web browser.
If you are unable to complete an expense report through the online portal, paper expense reports should be submitted to [email protected], or mailed to: Arizona Department of Education Attn: ESA 1535 W. Jefferson Street Bin #41 Phoenix, Arizona 85007
icon Important There are three kinds of expense report forms:
- If you only pay private school expenses (tuition, textbooks, fees, and uniforms), complete the Private School Only Expense Report
- If you have student without a disability and spend in multiple categories (tutoring, curricula, etc.), complete the General Expense Report
- If you have a student with a disability and utilize therapies and services, complete the Student with Disability Expense Report
- Example of itemized invoice.
There is no “wrong” expense report, however completing the expense report that properly suits your needs will result in a shorter form. Please create a new expense entry (with attached receipt) for each time the ESA card is used.
icon ImportantComplete Submission Requirements:
An incomplete submission will not be accepted by ESA (in-person, by postal mail, or e-mail).
- You must provide all of the following:
- You are required to complete this form by hand. ESA will not accept digital signatures for this form.
- The completed Expense Report Form.
- An itemized invoice (this includes the student’s name, the vendor name, the service or item paid for, and payment date).
- You can view an example here.
- Current credentials, if applicable, must be provided with each quarter even if they have been provided previously.
- It is the Account Holder’s responsibility to verify the credentials are current each quarter.
- ESA will not accept an e-mail with your invoice or receipts only. This is not how you submit your Quarterly Expense Report.
- If you are submitting your report in-person, ESA is unable to make copies for you. Make sure that what you bring is what ESA can keep. (We do not recommend providing originals.)
- If you are submitting your report in-person, ESA is unable to verify that all the required documents are being turned in at that same time.
- (If dropping off or mailing to ESA make sure you already have copies, ESA will not provide copies of your documents.)
- ESA strongly recommends comparing your expense report to your ESA Prepaid Card Bank Statement to make sure all expenses and additional documentation are accounted for.
- If your submission is incomplete, ESA will reach out to notify you that it cannot be submitted without all the required documentation. If the expense report is not submitted on time, that can result in account suspension, termination, and fund forfeiture (sections 3 and 4. D. of the contract and Chapter 6 of the Parent Handbook).
Need more Space?
Print and complete the appropriate addendum sheet for adding more line items: