FLORIDA DEPARTMENT OF EDUCATION S TATE BOARD OF EDUCATION Memb ers DR. AK SHAY DESAI ? MAR R ? OBERTO MARTÍNEZ? ____________________________________ Printed Nam e of Superintendent ____________________________________ Signature of Superintendent ____________________________________ District June ______, 2011 By June 27, 2011, mail, fax, or e-mail this form to: Mailing Address: David Sikes ? Office of Instructional Materials ? ? 325 West Gaines Street, Suite 424 ? Tallahassee, FL 32399-0400 ? Fax Number: (850) 245-0826 E-mail Address: David.Sikes@fldoe.org DR. FRANCES HAITHCOCK? 325 W. GAINES STREET •SUITE 1502• TALLAHASSEE, FL 32399-0400 • (850) 245-0509 • www.fldoe.org
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