Special Education Data Collection
Exiting Data: July 1, 2008 - June 30, 2009
Due Date: June 30, 2009
Return to: Your Coop/District Office
Coop: ___________________________ District:_________________________
3-6 YEAR OLDS ONLY UNIQUE STATE ID (Nine (9) digits and not starting with zero(0)) DUPLICATE BIRTHDATE GENDER OVER(m/dd/yyyy) (M/F) RIDE () Positive SocialEmotional Skills (PSES) Acquisition and Use of Knowledge and Skills (AUKS) Appropriate New Behavior to Skills Meet Individual AUKS Needs (AB)
INITIALS (F M L)
LIST OF RACE SETTING DISABILITY ETHNI- GRADE OF CODES CITY SERVICE
Exiting Code
New Skills PSES
New Skills AB
Report students on this form who were in special education at the start of the reporting period, but were not in special education at the end of the reporting period, and were not listed on the prefilled exiting form that contains student data from the December 1, 2008, Child Count.