Advanced Placement Form C (CA Dept of Education)

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Advanced Placement Form C (CA Dept of Education) Powered By Docstoc
					                                                                                                                                        California Department of Education
                                                                                                                                                           (Rev. 01/31/10)

                                2009-10 Advanced Placement Test Fee Reimbursement Program
                                                     School Worksheet
                          (School Coordinator must complete and provide to District Office to submit CDE Form C online)


School Name:
School Coordinator:
School Coordinator Telephone:                                                    School Coordinator Email:
                                               Reimbursement for                                                        Number of                    Total Amount
                                      Advanced Placement (AP) Examinations                                               Exams          Multiplier
Enter the total number of AP Tests taken by eligible students -- household income did not exceed 185 percent of the
federal poverty income level. This number must match Line N on the College Board Invoice. If submitting for multiple                     x $51.00
schools, total of line N for all schools.
Enter the total number of AP Tests taken by all students for your school, regardless of household income. This must
match Line A on the College Board Invoice. If submitting for multiple schools, total of line A for all schools.
                                      TOTAL AP AMOUNT REQUESTED


                       Reimbursement for International Baccalaureate (IB) Examinations                                  Number of
                                                                                                                         Exams/        Multiplier    Total Amount
                                                                                                                       Registrations
Enter the total number of IB Tests taken by eligible students – household income did not exceed 185 percent of the
federal poverty income level.                                                                                                             x $87
Enter the total number of IB Exams taken by all students for your school, regardless of household income level.

Enter the total number of IB registrations for eligible students for your school – household income did not exceed
185 percent of the federal poverty income level.                                                                                          x $130
Enter the total number of IB registrations for all students for your school, regardless of household income level.

                                       TOTAL IB AMOUNT REQUESTED


                                                                                                                                       Number of     Number of IB
                                                       Total Number of Students                                                            AP         Students
                                                                                                                                        Students
Enter the total number of income eligible students who took the AP exams.
Enter the total number of students at the school(s) who took the AP exams, regardless of household income level.
Enter the total number of income eligible students who took the IB exams.
Enter the total number of students at the school(s) who took the IB exams, regardless of household income level.

 To ensure the CDE has accurate information, please send an e-mail to: aptest@cde.ca.gov with district and school AP & IB Coordinator
 contact information and/or changes.

				
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