File: LBD*-E - Intent to Apply to Become a District Charter School File: LBD*-E - Intent to Apply to Become a District Charter School(Sample Form)
Instructions: All district charter school applicants must file this intent to apply form with the district at least thirty (30) days before submitting an application to the Board of Education. The intent to apply form may be returned to Salida School District by fax at 719-539-6220 or e-mail to dwebb@salidaschools.org. The form should also be the first document included in the district charter school application.
___________________________________________________________________
Date: __________________
Name of proposed district charter school: ________________________________
Name of education management provider (EMP), if applicable: ________________
Contact person: ____________________________________________________
Mailing address: ____________________________________________________
City: ______________________________ State: _______ Zip: ______________
Daytime phone: _______________________ Fax: _________________________
E-mail: ____________________________________________________________
___________________________________________________________________
Please respond to the following:
1. Applicant(s) has/will file an application to charter this school or a substantially similar school with other authorizers: [ ] Yes [ ] No If yes, please list the other authorizer(s): ____________________________________________
2. Applicant(s) submitting this form: (Check appropriate statement)
[ ] is incorporated in Colorado as a nonprofit
[ ] has filed application to become a Colorado nonprofit
[ ] (state type of entity, if other than above): __________________________
3. If applicant intends to contract with an EMP, the corporate status of the EMP is:
[ ] incorporated in Colorado as a nonprofit
[ ] has filed application to become a Colorado nonprofit
[ ] (state type of entity, if other than above): __________________________
4. The proposed district charter school will be located within the boundaries of the school district in which this intent to apply form is submitted:
[ ] Yes [ ] No, the proposed district charter school will be located in __________________.
Issued: December 14, 2010
Revised and Issued: September 11, 2012
Revised and Issued: December 10, 2013
Reviewed and approved: October 8, 2024