SAMPLE DATA SHEET
Information Compiled By:
Name:
Congressional District:
Address:
Phone:
Email:
PLEASE USE STATE AND LOCAL INFORMATION THAT IS PERTINENT TO YOUR PROGRAM (LEA, Early Intervention Program, University) –
Please feel free to customize this document OR create your own to provide the information you believe is relevant.
DATA tells a story, TELL YOUR STORY!
Local Data
State Data
STUDENT DATA
Total Student Population PK-12
# served Special Education Programs
# served Gifted and Talented Programs
# served Early Intervention-Birth to 3
# served Preschool Special Education-ages 3 to 5
Who is lead agency for Birth to 3
GRADUATION RATE
All Student Rate - %
Special Education Rate - %
Drop Out Rate
All Student Rate - %
Special Education Rate - %
FUNDING DATA
FUNDING – Ages 3-21
Federal IDEA $ SPED
State $ SPED
Local $ SPED
Excess Costs
% of federal funds received
EARLY CHILDHOOD FUNDING
Federal IDEA $ for Preschool 619 – ages 3-5
State $ SPED Preschool – ages 3-5
Local $ SPED Preschool – ages 3-5
Federal IDEA $ Part C – ages 0-3
State $ Early Intervention – ages 0-3
Local $ Early Intervention – ages 0-3
District will/will not meet MOE
Reasons for not meeting MOE
Total amount received for Medicaid Services to
children and youth with disabilities
School age
Early Intervention