District/School Use Only
Do Not Send to the California Department of Education – Local Use Only
Complete only one report per school site for the California English Language Development Test.
- Print or type all information at the top of each form. Be sure to include the 7-digit school code.
- Column A: Total number of English learners tested between July 1 and October 31, 2012 for annual assessment.
- Column B: Total number of pupils tested within 30 calendar days of enrollment of a school district for initial assessment between July 1, 2012 and June 30, 2013.
- Column C: Total number of pupils tested between July 1, 2012 and June 30, 2013. Sum the numbers in Columns A and B and enter in the “Total” column.
- Print or type the principal’s or charter director’s name and the CELDT site coordinator’s name where indicated. Have both sign the certification statement and date the form.
Charter Schools: If a charter school with multiple sites is testing and reporting separately from the district, the CELDT coordinator for the site and the charter director must collect the data for each site, submit the apportionment form, and sign and certify the information provided for all sites operated as part of the school charter