FLORIDA DEPARTMENT OF EDUCATION

FLORIDA DEPARTMENT OF EDUCATION

Office of Independent Education and Parental Choice Office of K-12 School Choice

325 W. Gaines St., Ste. 1044, Tallahassee, FL 32399-0400 Fax: 1-850-245-0875 Email: schoolchoice@

School Choice Information Hotline: 1-800-447-1636

Private Boarding School Registration Application

Instructions: If your school provides residential services for students, and intends to operate as a boarding school, you must: 1. Complete the first 2 sections of this form. 2. Submit the completed form by fax or mail, including copies of any required supporting documents. (Fax # and Address listed above)

Section I - Private School Contact Information and Data

School Name ____________________________________ Federal Employer Identification Number __ __ __ __ __ __ __ __ __

__________________________________ ___________________________ ________ ___________ __________________

Street Address

City

State

Zip

County

Owner Name ________________________________________________ Owner E-mail ___________________________

Director Name _______________________________________________ Director E-mail ___________________________

School Phone # ____________________________ School E-mail _________________________________

School website ________________________________________________

Section II - Required Boarding School Program Information

1. Is the school registered as a Private School with the Florida Department of Education?

Yes No

? If yes, provide school code ___ ___ ___ ___

2. Does the school provide residential facilities for students?

Yes No

3. Does the school have academic and residential accreditation? (Designated accrediting agencies must provide verification)

Yes No

?

Academic accrediting agency_____________________________________________________

?

Residential accrediting agency____________________________________________________

4. If the answer to question #3 above is no, has the school provided a letter verifying application for accreditation to the

Florida Department of Children and Families?

Yes No

Application Submitted By ________________________________________________ Date______________

--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------FOR OFFICE USE ONLY

Eligibility Approved Entered by ________________________________________________ _____ Date ______________ Denied

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