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Private Non-Profit or Other Non-Public School

Private non-profit schools or other types of non-public schools may submit counts of low income students in order to be included on the Teacher Loan Forgiveness Program Directory of low income schools. Student counts from Census Day (first Wednesday in October), of the prior year determine low income status in the current year.

Designated Low-Income – Application Information

Please submit the following data on agency letterhead, with an original signature:

  1. School name
  2. Address
  3. Type of school - private  nonprofit, non-public school, or educational service agency
  4. CDS code - county, district, school code
  5. Grades - the grade span of students being taught at the school
  6. School district that the school is located in (Name & CDS code)
  7. Time Frame of data – e.g., as of Census Day, October 2015
  8. Enrollment of students age 5-17, inclusive, as of Census Day
  9. National School Lunch Program aggregate counts for students age 5-17, inclusive, as of Census Day
    1. Number of students age 5-17 that are eligible for free meals
    2. Number of students age 5-17 that are eligible for reduced-price meals
  10. Signature of Principal or Executive Director
  11. Submit original letter to the address shown below.

A determination will then be made on the school's eligibility for placement on the designated low-income list of schools eligible for Teacher Loan Forgiveness in the applicable fiscal year. For example, the October 2015 data are used to determine eligibility for fiscal year 2016-17, October 2014 data are used to determine eligibility for 2015-16, etc. These data must be submitted annually. Please mail the above information to:

Attn: Ross Valentine
School Fiscal Services Division
California Department of Education
1430 N Street, Suite 3800
Sacramento, CA 95814

Questions:   Ross Valentine | | 916-327-4405
Last Reviewed: Thursday, January 21, 2016
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