CHARTER SCHOOL ASSURANCES

FISCAL AGENCY:

NAME OF ORGANIZATION OR ENTITY:

ADDRESS:

PART I:

THE U. S. DEPARTMENT OF EDUCATION REQUIRES FLORIDA TO DOCUMENT THAT A CHARTER SCHOOL APPLICATION

FOR A GRANT UNDER THE FEDERAL CHARTER SCHOOL PROGRAM CONTAINS THE FOLLOWING ASSURANCES. THESE

ASSURANCES MAY BE ADDRESSED IN THE GRANT NARRATIVE OR THE SCHOOL’S CHARTER APPLICATION. STATE

THE PAGE NUMBER TO INDICATE WHERE EACH OF THE STANDARDS IS ADDRESSED IN EITHER OF THE TWO

DOCUMENTS. PROVIDE AN EXPLANATION ON A SEPARATE SHEET IF THE STANDARD IS NOT ADDRESSED IN EITHER

DOCUMENT.

ASSURANCES

GRANT NARRATIVE

PAGE NUMBER

CHARTER

APPLICATION PAGE

NUMBER

1.

A description of the educational program to be implemented by the proposed charter

school, including: (a) how the program will enable all students to meet challenging state

student academic achievement standards; (b) the grade levels or ages of children to be

served; and (c) the curriculum and instructional practices to be used.

2.

A description of how the charter school will be managed.

3.

A description of (a) the objectives of the charter school and (b) the methods by which

the charter school will determine its progress toward achieving those objectives.

4.

A description of the administrative relationship between the charter school and the

authorized public chartering agency.

5.

A description of how parents and other members of the community will be involved in

the planning, program design and implementation of the charter school.

6.

A description of how the authorized public chartering agency will provide for continued

operation of the school once the Federal grant has expired, if such agency determines

that the school has met the objectives described in Assurance #3 above.

7.

A request and justification for waivers of any Federal, statutory, or regulatory provisions

that the applicant believes are necessary for the successful operation of the charter

school; and a description of any state or local rules, generally applicable to public

schools, that will be waived for, or otherwise not apply to the school.

8.

A description of how the subgrant funds or grant funds, as appropriate, will be used,

including a description of how such funds will be used in conjunction with other Federal

programs administered by the Secretary, U.S. Department of Education.

9. A description of how students in the community will be (a) informed about the charter

school and (b) given an equal opportunity to attend the charter school.

10. An assurance that the eligible applicant will annually provide the Secretary, U.S.

Department of Education and the Florida Department of Education such information as

may be required to determine if the charter school is making satisfactory progress

toward achieving the objectives described in Assurance #3 above.

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11. An assurance that the eligible applicant will cooperate with the Secretary, U.S.

Department of Education and the Florida Department of Education in evaluating the

charter school assisted under this subpart.

12. A description of how a charter school that is considered a local educational agency

under state law, or a local educational agency in which a charter school is located, will

comply with sections 613(a)(5) and 613(e)(1)(B) of the Individuals with Disabilities Act.

PART II:

FLORIDA REQUIRES AN APPLICANT FOR A GRANT UNDER THE FEDERAL CHARTER SCHOOL PROGRAM TO DOCUMENT

THE FOLLOWING ASSURANCES. ON A SEPARATE PAGE, ATTACH AN EXPLANATION FOR ANY ASSURANCE MARKED

“NO.”

ASSURANCES

YES

NO

1. Funds received under this grant will be used to supplement and, to the extent practical,

increase the level of funds that would be made available from nonfederal sources, and

in no case will such funds be used to supplant funds from nonfederal sources.

2. Activities will be implemented which are consistent with state and federal fiscal and

program requirements.

3. The charter school will maintain accurate and timely project records which document

progress in implementing this project, and which demonstrate compliance with all

state and federal fiscal and program requirements.

4. The charter school and the district will provide all information required by the Florida

Department of Education for fiscal audit, program evaluation and annual reporting to

the U.S. Department of Education

.

5. The charter school will provide the Secretary, U.S. Department of Education and the

Florida Department of Education any information that may be required to determine if

the charter school is making satisfactory progress toward achieving the objectives

described in its charter.

6. The charter school will cooperate with the Secretary, U.S. Department of Education and

the Florida Department of Education in evaluating the charter school assisted under this

program.

7. The charter school will submit a timely annual report to the school district and to the

Florida Department of Education, as required by Section 1002.33, Florida Statutes,

containing all the information required by law.

CERTIFICATION IS HEREBY GIVEN THAT ALL FACTS, FIGURES, AND REPRESENTATIONS MADE IN THIS

APPLICATION WITH REGARD TO PARTICIPATION OF THE ORGANIZATION OR ENTITY SPECIFIED ABOVE

ARE TRUE AND CORRECT.

NAME AND TITLE OF AUTHORIZED REPRESENTATIVE (TYPED):

_____________________________________________________

_____________________

Signature of Authorized Representative