CSP Data Collection Form - State Entity (SE) Grantees

---

Overview

Instruction Sheet
Part A-CSP Grant Award
Part B-CSP Subgrant Awards
Summary Sheet

---

Sheet 1: Instruction Sheet

Charter Schools Program (CSP)
Office of Elementary and Secondary Education
U.S. Department of Education
CSP Data Collection Form - State Entity (SE) Grantees
Instructions
Purpose of Data Collection:										The new data collection will collect CSP grant award information from SE grantees to create a new database of subgrant award data. The CSP Data Collection Form will allow the U.S Department of Education (ED) to monitor CSP grant performance and analyze data related to accountability for academic performance and financial integrity. The data collection will assist in carrying out the purpose of the Charter Schools Program which is to expand the number of high quality charter schools and increase the national understanding of the charter school model.
										The CSP Data Collection Form has two parts:
										Part A asks for CSP SE grantee award information. The state name, the state contact person, and the contact person's title has already been entered in the form. If this information is incorrect, please contact the data collection administrators (see "Contact Information" below). In the gray boxes, please enter the number of new CSP subgrantees that receive CSP funds for each Federal Fiscal Year. The Total Number of Current Active Subgrants in Part A should match the number of subgrant awards in Part B.
										Part B asks for CSP subgrant award information. In all, grantees will provide the following information for each active subgrant within the State's project period: 1) the name and contact information for the charter school and LEA; 2) the charter school's management organization (CMO, EMO or freestanding); 3) the authorized public chartering agency; 4) the total amount of funding an applicant received to start a charter school, along with the beginning and end date of the grant project period and budget periods; and 5) other charter school information (e.g., enrollment) as needed.
Form Submission:										The completed CSP Data Collection Form should be sent to CSPdatacollection@wested.org. In the subject heading please include "CSP Data Collection" followed by your state name. Please be sure to save a copy of the completed form for your own records.
Contact Information:										If you have any questions or concerns regarding the completion of the CSP Data Collection Form, please contact WestEd. You can email us at CSPdatacollection@Wested.org, or call toll-free 866-902-4887.
Paperwork Burden Statement:										According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is 1855-0016. Public reporting burden for this collection of information is estimated to average two hours per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The obligation to respond to this collection is required to obtain or retain benefit in accordance with the Education Department General Administrative Regulations (EDGAR) 34 CFR 75.253. If you have any comments concerning the accuracy of the time estimate, suggestions for improving this individual collection, or if you have comments or concerns regarding the status of your individual form, application or survey, please contact the Charter Schools Program c/o Nicoisa Jones, 400 Maryland Avenue SW, Washington, DC 20202, Nicoisa.Jones@ed.gov directly.
OMB Number: 1855-0016 Approval Expires 7/31/2021

---

Sheet 2: Part A-CSP Grant Award

		Data Collection Form: Part A: SE CSP Grant Award Information
State:
State Contact Person:
Title of Contact Person:
PR/Award #:	S282A20XXXX
Project Period Begin Date:	10/1/2020
Project Period End Date:	9/30/2025
Total Award Amount Obligated:	$0
			The award amount includes the total amount obligated to your state from each Budget Period, including the original obligated amount and additional supplemental, frontloading and continutation obligation amounts. See the breakdown of funds across years below.
			In the gray boxes below, please list the number of new subgrants funded from your CSP grant in each Budget Period. The total should equal the number of subgrants funded across your entire grant. On the following worksheet, you will provide award information for each of these subgrantees.
			Number of new subgrant awards per Budget Period
Budget Period 1 - FY 2020 (10/1/20-9/30/21)	$0	$0
		Total Number of Subgrants: =>	0
Comments? If any of the above information is incorrect, or if you need to provide any additional information regarding your CSP grant, please use the box below. You may also direct comments to us at CSPdatacollection@Wested.org, or call toll-free 866-902-4887.
		Please turn to Part B to provide data for each subgrant
		OMB Number: 1855-0016 Approval Expires 7/31/2021 (Version 4/2021)

---

Sheet 3: Part B-CSP Subgrant Awards

Data Collection Form: Part B: SE CSP Subgrant Award Information
		1) Charter School Contact Information. For each active subgrant, please identify: 1) the name and contact information for the charter school; and 2) the LEA/District information, including whether or not the school acts as its own LEA.																2) Charter School Management. Please indicate if the charter school is operated by a non-profit Charter Management Organization (CMO), a for-profit Education Management Organization (EMO), or is "freestanding" (operated by neither). If operated by a CMO or EMO, please provide the name and contact information.							3) Authorized Public Chartering Agency. Please identify the charter authorizer by type and name.							4) Subgrant Award Information. Please provide the breakdown of funds obligated to subgrantees within each Budget Period. The total amount obligated across one or more years will equal the Total Subgrant Award Amount Obligated (column AI) for that subgrantee. The Total Payments to Subgrantee (column AJ) should equal the total amount dispersed to each subgrantee to date. Projected Future Obligations (column AK) are future obligations anticipated over the grant project period.									5) Charter School Operation. Please indicate the school year in which the charter school first enrolled students, and the yearly enrollment data. While we can access some of this information in EDFacts, it is not always available for charter schools, so we must also request it here. When providing the status of the charter school, please explain the circumstances surrounding schools that have "Closed" or "Will Not Open" (e.g., enrollment targtes were not reached or a charter was not approved or revoked, etc.).						Additional Comments.
		Charter School Information																Charter School Management Organization							Authorized Public Chartering Agency							Total award amount obligated from ED (from Part A)-->		$0		Projected Future Obligations	$0	<--Budget Period award amount from ED (from Part A)
																																Total subgrant obligations (sum of column AI)-->		$0	Grant Payments		$0	<--Total obligated to subgrantees (sum of column AL)
																																Total award amount remaining from ED (from Part A)-->		$0	$0	$0	$0	<--Total remaining
									LEA/District Information																												Budget Period 1 – FY 2020 FUNDS (10/1/20-9/30/21)
		Charter school name	School NCES ID	address line 1	address line 2	city	state	zipcode	LEA/District name	LEA/District NCES ID	address line 1	address line 2	city	state	zipcode	Does the charter school act as its own LEA?	Is it an LEA with only charter schools?	Management Organization Type (choose one)	Management Organization Name ("NA" if Freestanding)	address line 1	address line 2	city	state	zipcode	Authorizer Type (choose one)	Authorizer Name	address line 1	address line 2	city	state	zipcode	Project Period Begin Date	Project Period End Date	Total Subgrant Award Amount Obligated (calculated from amounts provided in each Budget Period columns)	Total Payments to Subgrantee	Total Projected Subgrant Obligations	Dollar amount of subgrant award	Beginning date of subgrant budget period	End date of subgrant budget period	Type of subgrant (choose one)	School year in which the school first enrolled students	School enrollment in 2018-19 (if not opened, enter "0")	School enrollment in 2019-20 (if not opened, enter "0")	School enrollment in 2020-21 (if not opened, enter "0")	School status (if "Closed" or "Future" please explain in next column)	School status explained (Please provide a reason for schools that Will Not Open or Closed)	If you need to provide any additional information regarding this CSP subgrant, please use the box below. You may also direct comments to us at CSPdatacollection@Wested.org or call toll-free 866-902-4887.
Subgrant	1																																	$0.00
Subgrant	2																																	$0.00
Subgrant	3																																	$0.00
Subgrant	4																																	$0.00
Subgrant	5																																	$0.00
Subgrant	6																																	$0.00
Subgrant	7																																	$0.00
Subgrant	8																																	$0.00
Subgrant	9																																	$0.00
Subgrant	10																																	$0.00
Subgrant	11																																	$0.00
Subgrant	12																																	$0.00
Subgrant	13																																	$0.00
Subgrant	14																																	$0.00
Subgrant	15																																	$0.00
Subgrant	16																																	$0.00
Subgrant	17																																	$0.00
Subgrant	18																																	$0.00
Subgrant	19																																	$0.00
Subgrant	20																																	$0.00
Subgrant	21																																	$0.00
Subgrant	22																																	$0.00
Subgrant	23																																	$0.00
Subgrant	24																																	$0.00
Subgrant	25																																	$0.00
Subgrant	26																																	$0.00
Subgrant	27																																	$0.00
Subgrant	28																																	$0.00
Subgrant	29																																	$0.00
Subgrant	30																																	$0.00
Subgrant	31																																	$0.00
Subgrant	32																																	$0.00
Subgrant	33																																	$0.00
Subgrant	34																																	$0.00
Subgrant	35																																	$0.00
Subgrant	36																																	$0.00
Subgrant	37																																	$0.00
Subgrant	38																																	$0.00
Subgrant	39																																	$0.00
Subgrant	40																																	$0.00
Subgrant	41																																	$0.00
Subgrant	42																																	$0.00
Subgrant	43																																	$0.00
Subgrant	44																																	$0.00
Subgrant	45																																	$0.00
Subgrant	46																																	$0.00
Subgrant	47																																	$0.00
Subgrant	48																																	$0.00
Subgrant	49																																	$0.00
Subgrant	50																																	$0.00
Subgrant	51																																	$0.00
Subgrant	52																																	$0.00
Subgrant	53																																	$0.00
Subgrant	54																																	$0.00
Subgrant	55																																	$0.00
Subgrant	56																																	$0.00
Subgrant	57																																	$0.00
Subgrant	58																																	$0.00
Subgrant	59																																	$0.00
Subgrant	60																																	$0.00
Subgrant	61																																	$0.00
Subgrant	62																																	$0.00
Subgrant	63																																	$0.00
Subgrant	64																																	$0.00
Subgrant	65																																	$0.00
Subgrant	66																																	$0.00
Subgrant	67																																	$0.00
Subgrant	68																																	$0.00
Subgrant	69																																	$0.00
Subgrant	70																																	$0.00
Subgrant	71																																	$0.00
Subgrant	72																																	$0.00
Subgrant	73																																	$0.00
Subgrant	74																																	$0.00
Subgrant	75																																	$0.00
Subgrant	76																																	$0.00
Subgrant	77																																	$0.00
Subgrant	78																																	$0.00
Subgrant	79																																	$0.00
Subgrant	80																																	$0.00
Subgrant	81																																	$0.00
Subgrant	82																																	$0.00
Subgrant	83																																	$0.00
Subgrant	84																																	$0.00
Subgrant	85																																	$0.00
Subgrant	86																																	$0.00
Subgrant	87																																	$0.00
Subgrant	88																																	$0.00
Subgrant	89																																	$0.00
Subgrant	90																																	$0.00
Subgrant	91																																	$0.00
Subgrant	92																																	$0.00
Subgrant	93																																	$0.00
Subgrant	94																																	$0.00
Subgrant	95																																	$0.00
Subgrant	96																																	$0.00
Subgrant	97																																	$0.00
Subgrant	98																																	$0.00
Subgrant	99																																	$0.00
Subgrant	100																																	$0.00
Subgrant	101																																	$0.00
Subgrant	102																																	$0.00
Subgrant	103																																	$0.00
Subgrant	104																																	$0.00
Subgrant	105																																	$0.00
Subgrant	106																																	$0.00
Subgrant	107																																	$0.00
Subgrant	108																																	$0.00
Subgrant	109																																	$0.00
Subgrant	110																																	$0.00
Subgrant	111																																	$0.00
Subgrant	112																																	$0.00
Subgrant	113																																	$0.00
Subgrant	114																																	$0.00
Subgrant	115																																	$0.00
Subgrant	116																																	$0.00
Subgrant	117																																	$0.00
Subgrant	118																																	$0.00
Subgrant	119																																	$0.00
Subgrant	120																																	$0.00
Subgrant	121																																	$0.00
Subgrant	122																																	$0.00
Subgrant	123																																	$0.00
Subgrant	124																																	$0.00
Subgrant	125																																	$0.00
Subgrant	126																																	$0.00
Subgrant	127																																	$0.00
Subgrant	128																																	$0.00
Subgrant	129																																	$0.00
Subgrant	130																																	$0.00
Subgrant	131																																	$0.00
Subgrant	132																																	$0.00
Subgrant	133																																	$0.00
Subgrant	134																																	$0.00
Subgrant	135																																	$0.00
Subgrant	136																																	$0.00
Subgrant	137																																	$0.00
Subgrant	138																																	$0.00
Subgrant	139																																	$0.00
Subgrant	140																																	$0.00
Subgrant	141																																	$0.00
Subgrant	142																																	$0.00
Subgrant	143																																	$0.00
Subgrant	144																																	$0.00
Subgrant	145																																	$0.00
Subgrant	146																																	$0.00
Subgrant	147																																	$0.00
Subgrant	148																																	$0.00
Subgrant	149																																	$0.00
Subgrant	150																																	$0.00
Subgrant	151																																	$0.00
Subgrant	152																																	$0.00
Subgrant	153																																	$0.00
Subgrant	154																																	$0.00
Subgrant	155																																	$0.00
Subgrant	156																																	$0.00
Subgrant	157																																	$0.00
Subgrant	158																																	$0.00
Subgrant	159																																	$0.00
Subgrant	160																																	$0.00
Subgrant	161																																	$0.00
Subgrant	162																																	$0.00
Subgrant	163																																	$0.00
Subgrant	164																																	$0.00
Subgrant	165																																	$0.00
Subgrant	166																																	$0.00
Subgrant	167																																	$0.00
Subgrant	168																																	$0.00
Subgrant	169																																	$0.00
Subgrant	170																																	$0.00
Subgrant	171																																	$0.00
Subgrant	172																																	$0.00
Subgrant	173																																	$0.00
Subgrant	174																																	$0.00
Subgrant	175																																	$0.00
Subgrant	176																																	$0.00
Subgrant	177																																	$0.00
Subgrant	178																																	$0.00
Subgrant	179																																	$0.00
Subgrant	180																																	$0.00
Subgrant	181																																	$0.00
Subgrant	182																																	$0.00
Subgrant	183																																	$0.00
Subgrant	184																																	$0.00
Subgrant	185																																	$0.00
Subgrant	186																																	$0.00
Subgrant	187																																	$0.00
Subgrant	188																																	$0.00
Subgrant	189																																	$0.00
Subgrant	190																																	$0.00
Subgrant	191																																	$0.00
Subgrant	192																																	$0.00
Subgrant	193																																	$0.00
Subgrant	194																																	$0.00
Subgrant	195																																	$0.00
Subgrant	196																																	$0.00
Subgrant	197																																	$0.00
Subgrant	198																																	$0.00
Subgrant	199																																	$0.00
Subgrant	200																																	$0.00
Subgrant	201																																	$0.00
Subgrant	202																																	$0.00
Subgrant	203																																	$0.00
Subgrant	204																																	$0.00
Subgrant	205																																	$0.00
Subgrant	206																																	$0.00
Subgrant	207																																	$0.00
Subgrant	208																																	$0.00
Subgrant	209																																	$0.00
Subgrant	210																																	$0.00
Subgrant	211																																	$0.00
Subgrant	212																																	$0.00
Subgrant	213																																	$0.00
Subgrant	214																																	$0.00
Subgrant	215																																	$0.00
Subgrant	216																																	$0.00
Subgrant	217																																	$0.00
Subgrant	218																																	$0.00
Subgrant	219																																	$0.00
Subgrant	220																																	$0.00
Subgrant	221																																	$0.00
Subgrant	222																																	$0.00
Subgrant	223																																	$0.00
Subgrant	224																																	$0.00
Subgrant	225																																	$0.00
Subgrant	226																																	$0.00
Subgrant	227																																	$0.00
Subgrant	228																																	$0.00
Subgrant	229																																	$0.00
Subgrant	230																																	$0.00
Subgrant	231																																	$0.00
Subgrant	232																																	$0.00
Subgrant	233																																	$0.00
Subgrant	234																																	$0.00
Subgrant	235																																	$0.00
Subgrant	236																																	$0.00
Subgrant	237																																	$0.00
Subgrant	238																																	$0.00
Subgrant	239																																	$0.00
Subgrant	240																																	$0.00
Subgrant	241																																	$0.00
Subgrant	242																																	$0.00
Subgrant	243																																	$0.00
Subgrant	244																																	$0.00
Subgrant	245																																	$0.00
Subgrant	246																																	$0.00
Subgrant	247																																	$0.00
Subgrant	248																																	$0.00
Subgrant	249																																	$0.00
Subgrant	250																																	$0.00
Subgrant	251																																	$0.00
Subgrant	252																																	$0.00
Subgrant	253																																	$0.00
Subgrant	254																																	$0.00
Subgrant	255																																	$0.00
Subgrant	256																																	$0.00
Subgrant	257																																	$0.00
Subgrant	258																																	$0.00
Subgrant	259																																	$0.00
Subgrant	260																																	$0.00
Subgrant	261																																	$0.00
Subgrant	262																																	$0.00
Subgrant	263																																	$0.00
Subgrant	264																																	$0.00
Subgrant	265																																	$0.00
Subgrant	266																																	$0.00
Subgrant	267																																	$0.00
Subgrant	268																																	$0.00
Subgrant	269																																	$0.00
Subgrant	270																																	$0.00
Subgrant	271																																	$0.00
Subgrant	272																																	$0.00
Subgrant	273																																	$0.00
Subgrant	274																																	$0.00
Subgrant	275																																	$0.00
Subgrant	276																																	$0.00
Subgrant	277																																	$0.00
Subgrant	278																																	$0.00
Subgrant	279																																	$0.00
Subgrant	280																																	$0.00
Subgrant	281																																	$0.00
Subgrant	282																																	$0.00
Subgrant	283																																	$0.00
Subgrant	284																																	$0.00
Subgrant	285																																	$0.00
Subgrant	286																																	$0.00
Subgrant	287																																	$0.00
Subgrant	288																																	$0.00
Subgrant	289																																	$0.00
Subgrant	290																																	$0.00
Subgrant	291																																	$0.00
Subgrant	292																																	$0.00
Subgrant	293																																	$0.00
Subgrant	294																																	$0.00
Subgrant	295																																	$0.00
Subgrant	296																																	$0.00
Subgrant	297																																	$0.00
Subgrant	298																																	$0.00
Subgrant	299																																	$0.00
Subgrant	300																																	$0.00

---

Sheet 4: Summary Sheet

		Data Collection Form: SE Summary Sheet
Check your data:	This sheet summarizes the CSP Grant Award Data already provided in Part A and the CSP Subgrant Award data you entered in Part B. If there are discrepancies in the amount of funds obligated and awarded in each Budget Period, please use the gray space below to explain.
State:	0
State Contact Person:	0
Title of Contact Person:	0
PR/Award #:	S282A20XXXX
Project Period Begin Date:	10/1/2020
Project Period End Date:	9/30/2025
Total Award Amount Obligated:	$0
					|------------Summarized from Part B------------|
		Supplemental Award Amount	Number of new subgrant awards per Budget Period	Total award amount obligated from ED per Budget Period	Total subgrant award amount per Budget Period	Total remaining to be obligated
Budget Period 1 - FY 2020 (10/1/20-9/30/21)	$0	$0	0	$0	$0	$0
		Total Number of Subgrants:	0	$0	$0	$0
		Comments or questions? Please contact us at CSPdatacollection@Wested.org, or call toll-free 866-902-4887.
		OMB Number: 1855-0016 Approval Expires 7/31/2021