F13

New York City Adminstration for Children’s Services

Division of Early Care and Education

OFFICIAL ROSTER OF DAPC

OFFICERS, MEMBERS & COMMUNITY REPRESENTATIVES

Delegate Agency ______Site Address______

Head Start Director ______Telephone: ______

Parent Election Coordinator______E-Mail______

Telephone______Date: ______

Results: Conducted  Not Conducted 

Check Item(s) Reviewed:

By-Laws  Election Minutes  Class Minutes  Center Orientation  Number of Sites___ Number of Representatives per Site ___

Number of Community Representatives Members ___

Total number of representatives to the Delegate Agency Policy Committee______

Was There A Quorum? Yes  No 

If Not, Why? ______

Were All Motions Seconded? Yes  No 

Officers:

Chairperson ______Telephone______

Address ______Apt#______Email______

Vice - Chairperson______Telephone______

Address ______Apt#______Email______

Secretary ______Telephone______

Address ______Apt#______Email______

Treasurer ______Telephone______

Address ______Apt#______Email______

Personnel Practices Chairperson______Telephone______

Address ______Apt#______Email______

Grievance Chairperson ______Telephone______

Address ______Apt#______Email______

By-Laws Chairperson ______Telephone______

Address ______Apt#______Email______

Community Representative ______Telephone______

Address ______Apt#______Email______

Community Representative ______Telephone______

Address ______Apt#______Email______

Community Representative ______Telephone______

Address ______Apt#______Email______

Member _______Telephone______

Address ______Apt#______Email______

Member ______Telephone______

Address ______Apt#______Email______

Member ______Telephone______

Address ______Apt#______Email______

Member ______Telephone______

Address ______Apt#______Email______

Member ______Telephone______

Address ______Apt#______Email______

Member ______Telephone______

Address ______Apt#______Email______

Head Start Director______Date: ______

ACS/Head Start Monitor Signature ______Date:______

Delegate Agency Monitor ______Date: ______

(Self-Monitored Delegate Agencies)______

Revised August 8 2017