Alternative School Status Application

* required field

Application Type *

First Time Application

Recertification

All existing alternative schools must recertify annually.

Name

First Name *

Last Name *

Please provide your title *

Contact Information

Email *

Please provide your email address. This email will be used for communications regarding this application.

Phone Number *

Please provide your phone number. This number will be used for communications regarding this application.

Superintendent/Charter Holder Information

Superintendent/Charter Holder Name *

Please provide the Superintendent/Charter Holder's name.

Superintendent/Charter Holder Email *

Please provide the Superintendent/Charter Holder's email address. This will be used for the notification of approval/denial status.

Superintendent/Charter Holder Phone Number

(Optional) Please provide the Superintendent/Charter Holder's phone number.

School Information

School Name *

Please provide the name of the school for which you are submitting this application.

School Entity ID Number *

Please provide the entity ID of the school for which you are submitting this application. This number is typically four to five digits long (this is not the CTDS number). Important note: the entity ID number for the school and LEA are different. Incorrect submittal of entity ID will result in a rejection of the application. Make sure LEA and Entity ID are not erroneously flipped. You can use the "Find a School" application on the front page (azed.gov) to verify your entity and LEA IDs.

LEA Name *

Please provide the name of the LEA (district or charter holder) of the school.

LEA Entity ID Number *

Please provide the entity ID of the LEA (district or charter holder). This number is typically four to five digits long (not the CTDS number).

This school meets the following criteria (please check all that apply): *

A district school has adopted a mission statement that clearly identifies its purpose is to serve a specific student population that will benefit from an alternative school setting or a charter school that expressly states in their charter that its purpose is to serve a specific student population that will benefit from an alternative school setting.

The educational program and related student services of the school match the mission or charter (if applicable) of the school.

Schools offering secondary instruction for academic credit used to fulfill the Arizona State Board of Education graduation requirements (in part or in full) must offer a high school diploma of graduation.

This school will receive current year state assessment scores *

Yes

No

If you select "No" for this question, you have indicated that this school does not have current year state assessment scores and will be unable to submit this form. Please apply for alternative school status when the school meets this requirement.

Mission Statement as of October 1st, 2022 *

All schools are required to provide a current mission statement (as of October 1st, 2022 on record with your district/charter sponsor) regardless of alternative application type. Please copy/paste or type your current mission statement in the text area.

Supporting Documentation *

(ATTENTION: DO NOT HIT THE UPLOAD BUTTON. The upload button has been causing issues.) Please provide supporting documentation of the mission statement. Supporting documentation of this criterion may be the school report card, the school’s charter contract, the strategic plan, the school Improvement Plan, a Student-Parent Handbook, various school marketing materials (e.g., webpage or brochure), etc. as of October 1 of the application year.

Certification of Student Population

To complete this section, please include those students who are enrolled as of October 1, 2022. List each student only once and indicate below which category the students were listed under upon initial enrollment. Note: You must enter a number (0-999,999) in each field.

Number of students who have a documented history of disruptive behavioral issues. *