1. FLORIDA DEPARTMENT OF EDUCATIONBUREAU OF EQUITY, SAFETY & SCHOOL SUPPORT
      2. TITLE I PROGRAMS
    1. EARLY CHILDHOOD COMPONENT SURVEY2002 - 2003
      1. LOCAL EDUCATION AGENCY NAME:
      2. CONTACT PERSON: TITLE:
      3. ADDRESS:
      4. CITY, STATE, ZIP CODE:
      5. PHONE: FAX:
      6. E-MAIL ADDRESS:
      7. PleaseCheck One
FLORIDA DEPARTMENT OF EDUCATION
BUREAU OF EQUITY, SAFETY & SCHOOL SUPPORT
TITLE I PROGRAMS
EARLY CHILDHOOD COMPONENT SURVEY
2002 - 2003
LOCAL EDUCATION AGENCY NAME:
CONTACT PERSON:
TITLE:
ADDRESS:
CITY, STATE, ZIP CODE:
PHONE:
FAX:
E-MAIL ADDRESS:
The purpose of this survey is to obtain information concerning the Title I, Part A preschool
programs and early childhood activities being conducted in your district. In an effort to
maintain this data at the State level, we are asking that the survey be completed and returned
to our office by
October 25, 2002.
Please provide the following information:
Please list the type and/or
name of the program(s)
being used to provide Early
Childhood services in this
component.
List the site(s) where
the program is
housed.
Indicate the
number of students
to be served at each
site by age span.
Please
Check One
Age 3 Age 4
School
based
District-
wide
TOTAL NUMBER TO BE SERVED:
TOTAL TITLE I, PART A FUNDS FOR THIS COMPONENT:
Please e-mail or fax the completed survey:
To
: Jessie Simmons,
Jessie.Simmons@fldoe.org
or fax (850) 922-9668

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