ELEMENTARY SCHOOL SURVEY, 2014– 2015
/ Name of Principal:Name of School:
City:
Report Completed by:
A / Enrollment (PK-3 & PK-4 count as 2 rooms) / B / Race and Ethnicity/Religious Background
GRADE / Male / Female / TOTAL / *Open Seats Per Grade / Classrooms Per Grade / Ethnicity / Catholic / Non-Catholic / TOTAL
How many students are Hispanic or Latino? / 0
Pre-K (3 yr. old) / 0
Pre-K (4 yr. old) / 0 / Race
Kindergarten / 0
First / 0 / American Indian or Alaskan Native / 0
Second / 0
Third / 0 / Asian / 0
Fourth / 0
Fifth / 0 / Black or African American / 0
Sixth / 0
Seventh / 0 / White / 0
Eighth / 0
TOTAL / 0 / 0 / 0 / * / 0 / 0 / Native Hawaiian or Other Pacific Islander / 0
**Indicate the number of additional students you can accommodate per grade without opening additional classrooms. / Two or more races / 0 / *
TOTAL / 0 / 0 / 0
C
W / Family Information /
PK-8 families with: / Parish / Out of Parish / Non-Catholic / Total Families / Total Students
1 Child / 0 / 0 / Please Return Survey by October 1, 2014
Email the survey to:
Please Put The Name of Your School and City
In The Subject Line of the Email.
Thank you!
2 Children / 0 / 0
3 Children / 0 / 0
4 Children / 0 / 0
5 Children / 0 / 0
6 Children or more / 0 / 0
TOTALS / 0 / 0 / *
D / Zip Codes Replaced by PowerSchool Use
E / Enrollment Waiting List
Only include eligible students, according to local admission policy, who would be enrolled in the school if there were room in that grade.
PK (3 yr. Old) / Second Grade / Sixth Grade
PK (4 yr. Old) / Third Grade / Seventh Grade
Kindergarten / Fourth Grade / Eighth Grade
First Grade / Fifth Grade / Total / 0
F / Facilities
1. / Total classrooms available
2. / Total classrooms in use
3. / How many additional students could your school accommodate if there were 25 students in each existing classroom?
4. / How many additional rooms could be available for homeroom classrooms if needed?
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G / Catholic Out of Parish Students1. / How many CATHOLIC students are registered in your school from OTHER PARISHES WITHOUT SCHOOLS?
Name of Parish / Students / Name of Parish / Students
2. / Total CATHOLIC students registered in your school from OTHER PARISHES WITH SCHOOLS?
H
/ Scholarship/Tuition Assistance Information1. / Number of students currently receiving any form of financial assistance (FY 14)
2. / Total scholarship amount awarded (FY 14)
I
/ Tuition & Fees (Fill in exact amounts as provided to families for 2014-15)1. TUITION** (K-8) / Parish / Out of Parish / Non-Catholic / 2. PRE-SCHOOL TUITION + FEES / PRE-K (3 yr. old) / PRE-K (4-yr. old)
A. 1 child / Whole-day / Half-day / Whole-day / Half-day
B. 2 children / A. 1 Day
C. 3 or more / B. 2 Day
D. Fees (including books) / C. 3 Day
E. Fundraising (mandatory) / D. 5 Day
F. Totals (A+D+E) / 0 / 0 / 0 / E. Fundraising (mandatory)
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J
/ Transfers Out (Sept. 15, 2013 – Sept. 15, 2014) - Please make sure that the total for each grade match on both tables.Transferred to / Transferred Because
Where / Pk3 / Pk4 / K / 1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / Total / Why / Pk3 / Pk4 / K / 1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / Total
A.O.C Catholic Schl. / 0 / Moved / 0
Public
School / 0 / Financial / 0
Charter
School / 0 / Program Dissatis-faction / 0
Out of A.O.C / 0 / Academic
Ability / 0
Out of State / 0 / Discipline
Policies / 0
Other / 0 / Other / 0
Total / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / Total / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0
1. / Total Transfers Out All Grades
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K / Transfers In Students enrolled after the 1st day of schoolSchool Year Transfers (September 15, 2013 - May 30, 2014) / Summer Transfers (June 1, 2014 – September 15, 2014)
Where / Pk3 / Pk4 / K / 1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / Total / Pk3 / Pk4 / K / 1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / Total
A.O.C.
School / 0 / 0
Public
School / 0 / 0
Charter
School / 0 / 0
Out of
A.O.C. / 0 / 0
Out of
State / 0 / 0
Other / 0 / 0
Total / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0
1. / Total of School Year Transfers / 2. / Total of Summer Transfers
L
/ Food Service Program (Free and Reduced Lunch and Breakfasts)1. / # Students receiving Free/Reduced Breakfast
2. / # Students receiving Free/Reduced Lunches / 3. / # Students eligible to receive Free/Reduced Lunches
M
/ Religion1. / School Religion Coordinator:
2. / Professional Requirements for Catholic Theology and Ongoing Formation (# Teachers, 2013-2014 only)
a. / NEW teachers who must meet requirement - Policy 220.1 (New Teachers are defined as teaching three years or less.)
b. / Teachers who completed a pillar course
c. / Teachers certified by Archdiocese of Chicago as Catechist
d. / Principal and site administrators certified by Archdiocese of Chicago as CR
3. / YES NO / Retreat or other religion professional development provided locally?
4. / YES NO / Are all religion teachers certified?
N
/ Indicate the Race and Ethnicity of Full Time Professional StaffEthnicity / Full-Time
Teaching Staff / Full-Time President/Principal and Other Professional Staff
Catholic / Non-Catholic / Catholic / Non-Catholic / TOTAL
Hispanic/Latino / 0
Race
Asian / 0
Native Hawaiian or Other Pacific Islander / 0
Black or African American / 0
American Indian or Alaskan Native / 0
White / 0
Two or more races / 0
Unknown / 0
TOTAL / 0 / 0 / 0 / 0 / 0
O / School Personnel
Categories / Full-Time / Part-Time
Religious / Lay / Religious / Lay
M / F / M / F / M / F / M / F
1. Principal
2. Assistant Principal
3. Teachers (PK-8)*
4. Teacher Aides (PK-8)
5. Counselors
6. Librarians
7. Business Manager
8. Secretaries/Clerks
9. Janitors/Maintenance
10. Grand Total (Total Rows 1 – 9) / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0
All staff paid by the school (this includes service corps teachers)
*Include all Art, Music, P.E. teachers in this category.
11. Teacher Certification(List each teacher only once) / Religious / Lay
FT / PT / FT / PT / TOTAL
Illinois State Certified / 0
Certified by OTHER State / 0
Degreed but Not Certified / 0
Non Degreed / 0
TOTAL / 0 / 0 / 0 / 0 / 0
12. / Teacher and Student Average daily attendance
a. / % / Student average daily attendance
b. / % / Faculty average daily attendance
c. / Student/Teacher Ratio (Divide total number of students by number of full time faculty)
P / IDEA and Title Sections Replaced by survey by University of Notre Dame to be emailed to principals. Due October 1st.
Q / Stakeholders and Engagement Check N/A if not applicable. This section is mandatory. / N/A
1. / School Board Chairperson (Name)
Email Address
Phone Number
2. / Family School Association Contact (Name)
Email Address
Phone Number
3. / Legislative Action Person (Name)
Email Address
Phone Number
4. / Marketing Director
Email Address
Phone Number
5. / Please describe your School Board: / Advisory Board Board of Specified Jurisdiction N/A
6. / How often does your Board meet? / Monthly Quarterly Twice a year or less
7. / Committees Active on Board (check all) / Finance Marketing/Enrollment Academic
Capital Advancement/Fundraising Catholic Identity
8. / Do you have an Annual Fund : / Yes Amount Raised FY14 No
9. / Donor Management System Used (fill-in):
R / Technology Survey Replaced by survey by the Coleman Group to be emailed to principals. Due October 1st.
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