CTE Exemption Request FY 2014

Contact Person: : : mm/dd/yyyy
School: District: CTDS:
Program Name: CIP:
Has this program ever received a prior exemption? Yes in: FY04 FY05 FY06 FY07 FY08 FY09 FY10 FY11 FY12 FY13
Please identify, by checking the appropriate boxes, the exemption(s) requested for this program:
(May check more than one) Evidence to Consider Data Source
Coherent Sequence Alignment Report
Low Performance
1S1 AIMS Reading 1S2 AIMS Math
2S1 Technical Skill Proficiency 3S1 Diploma or GED
4S1 Graduation 5S1 Placement
6S1 Nontraditional Participant 6S2 Nontraditional Completion
Teacher Certification
(Teacher Name)
(Teacher Cert Number) 123456789
Certificate Copy
Please upload your teacher's certificate after submitting request.
Other See Attached
Please submit one request per program. Requests must be submitted by 7/21/2014.
Please contact Deb Payne at Deb.Payne@azed.gov or call 602-542-3034 if you have questions.