Form 1
Directions For Completing
Intent to Purchase Certified Instructional Materials Form
The Intent to Purchase Form (DOC; 38KB; 1p.) is a word document in table form. You can use the online form or you can use a hard copy of the form. Please fill in all the information. This information is required by provisional language of Assembly Bill 1802, the education trailer bill Chapter 79 of the Statutes of 2006. The district information requested at the top of the form will help the California Department of Education (CDE) contact districts if clarification is necessary to process the apportionment.
Publisher Information
Please list the full title of the publisher, not just the first word; e.g. Pearson/Longman ESL, not just “Pearson.” Many companies have several divisions, and the entire name of the division is needed. Also include the title of the program and the publisher contact information.
Column one - Title
Please list the full title of the materials you intend to purchase.
Column two - Type
This could be a student textbook, a teacher’s edition, a dictionary, or electronic materials.
Column three - Domain
Please list the English Language Arts domain that the materials cover, such as reading, listening, speaking, or writing.
Column four - Grade Level(s)
Please list the grade levels you intend to purchase. If the materials are available for kindergarten through grade 6, but you intend to purchase only kindergarten through grade 3, just list kindergarten through grade 3.
Column five - International Standard Book Number (ISBN)
Each item has an ISBN number. It also helps to distinguish different editions.
Column six - Number of Pupils
The number of students that will be using the materials purchased.
Column seven - Cost Per Pupil
The approximate cost per pupil.
Please Note
The Intent to Purchase Certified Instructional Materials form must be received by the CDE no later than April 5, 2007.
Mail To:
Jim Long
Curriculum Frameworks and Instructional Resources Division
California Department of Education
1430 N Street, Suite 3207
Sacramento, CA 95814-5901
The CDE will not accept fax copies, original forms must be mailed to the CDE at the address noted above.
