Instructions: All district charter school applicants must file this intent to apply form with the district at least 30 days before submitting an application to the Board of Education. The intent to apply form may be returned by fax or email to the superintendent of schools. 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: ________________________
Email: _____________________________________________________________
Please respond to the following:
- 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): ___________________________________________
- 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): ___________________________
- 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): __________________________
- 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: July 2010
Revised: June 2012
Reviewed: September 2020
Lake County School District R-1, Leadville, Colorado