• Student Report for Aids To Nonpublic Students

    Student Report for Aids To Nonpublic Students

    Division of School Finance 400 NE Stinson Blvd., Minneapolis, MN 55413 
  •  - -

  • DUE: 10/1/2025

    General information and instructions: This form must be completed at the nonpublic school level and filed with the public school district offices coordinating the program by October 1, 2025. A copy is to be sent by the local public school district to the Minnesota Department of Education, Division of School Finance at the above address by October 15, 2025. This form must be filled out completely to be considered valid. 

  • Nonpublic School Identification Information

  • Location at which Student Request Forms are filed (if other than above): 13305 12th Ave N, Plymouth, MN 55441

    Telephone Number:763-745-5284

    Name of Program Administrator in Local Public School District: Jennifer Welk

    Email Address: jennifer.welk@wayzataschools.org 

  • Participation of Eligible Pupils

    For each Program Element in which you wish to participate, provide the number of students, by student grade level, that are eligible to receive service. To be eligible, the students must be enrolled on or before September 15, and must request (in writing) the service desired. Weight each student count as indicated and enter totals for each Program Element. If there are no requests for a service, or if a service will not be offered, please indicate nonparticipation by checking the box provided. Weighted Total of Eligible Students Factor

  • Program Element: Textbooks, Individualized Instructional Materials and Standardized Tests

  • For each Program Element in which you wish to participate, provide the number of students, by student grade level, that are eligible to receive service.

  •  
  •  

  • Program Element: Health Services

  • For each Program Element in which you wish to participate, provide the number of students, by student grade level, that are eligible to receive service.

  •  
  •  

  • Program Element: Guidance/Counseling

  • For each Program Element in which you wish to participate, provide the number of students, by student grade level, that are eligible to receive service.

  •  

  • Certification

    I hereby certify that the students reported above meet the conditions of eligibility as prescribed by Minnesota Statutes 2022, section 123B.- 123B.48 and that the above school is located within a public school district in which the public schools provide the services indicated to students of the same grade levels. All of the information provided above is true and correct to the best of my belief and knowledge.
  • Clear
  •  / /
  • Should be Empty: