Required District and School ReportsAccountability Programs :

General Information: This form is to be used by all districts as a means of reporting to MDE the decision to waive up to the 2% staff development set aside as provided for under Minn. Stat. 122A.60. Please complete all sections of this form and send the original to Alicia Mathews at the address stated above or via email to Alicia.Mathews@state.mn.us. This must be completed and submitted to MDE once the decision is approved.

DISTRICT IDENTIFICATION INFORMATION

District Name and Number:

Superintendent:

Phone:

Email:

Fax:

District Address:

__________________________________________________________________________________________

__________________________________________________________________________________________

(city) (state) (zip code)

Please provide a brief explanation of the decision to waive the set aside for the 2007-08 School Year.

_____% of set aside to be waived.

Signatures below indicate a majority vote of licensed teachers and majority vote of the school board.

Everything contained in this report is true and accurate and evidence of this decision is available upon request.

_________________________________________ _______________________________________

Superintendent’s signature Date

_________________________________________ _______________________________________

School Board Chair’s signature Date

_________________________________________ _______________________________________

President of the Exclusive Date

Representative of the Teachers