Assurances Form for BEDS Educational Personnel Forms

Fall 2007

BEDS Educational Personnel Forms must be accurate and complete because they will be used to satisfy both State and federal reporting requirements.

In order to process BEDS Educational Personnel Forms from school districts, BOCES or charter schools, the Department must receive a completed copy of this form signed by the chief administrator. For further information, please contact SED’s Office of Information and Reporting Services at (518)-474-7965.

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I assure that my school district, BOCES or charter school has a system for identifying teachers who are not “highly qualified” for the courses they are teaching and these forms reflect the accurate and complete reporting of that information as of the dates that these forms were completed.

School District, BOCES or Charter School Name

School District, BOCES or Charter School 12-digit BEDS Code

Respondent’s position (Check only one.)

School Superintendent

BOCES District Superintendent

Chief Administrator of a Charter School

Respondent’s Name (Please print.)

Respondent’s Signature

Date (MM/DD/YY)

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