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Vocational and Educational Services for Individuals
with Disabilities (VESID)
Special Education and
Vocational Rehabilitation Services
Application for Joint CPSE
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Pursuant to section 4410.3(b) of Education Law and in accordance with section 200.16 of the Regulations of the Commissioner of Education, two or more Boards of Education may, subject to the approval of the Commissioner of Education, establish a joint Committee on Preschool Special Education (CPSE).
Instructions: Submit one copy of the application to your Regional Associate prior to establishing a joint CPSE.
School District #1________________________ BEDS Code _______________________
School Superintendent ______________________________________________________
Application Contact ________________________________________________________
Address _________________________________________________________________
Phone __________________________ Fax ______________________
E-mail ___________________________________________________
School District #2 _________________________ BEDS Code ________________________
School Superintendent _________________________________________________________
Application Contact ___________________________________________________________
Address ____________________________________________________________________
Phone ____________________________ Fax _________________________
E-mail _________________________________________________
Effective Start Date of Joint CPSE: _________________________________________________
Effective End Date of Joint CPSE: __________________________________________________
Narrative: Provide a typed narrative explaining the reason for the joint CPSE and a plan for holding meetings at a mutually agreed upon time and place in accordance with section 200.5(d) of the Regulations of the Commissioner of Education, for ensuring confidentiality of student records and for ensuring required CPSE membership.
Approval Process: The Boards of Education may not establish the joint CPSE until receipt of written notification of approval by the State Education Department. This approval will be granted if the application is consistent with applicable laws and regulations.
School Superintendent
We hereby certify that the application for a joint CPSE in our school districts is necessary for the functioning of the Committee on Preschool Special Education and that our Boards of Education participated in the development of this application.
Date: ________________ Signature: ____________________________________
Date: _________________ Signature: ___________________________________
For Department Use Only
Application Approved: o Date: ________________
Application Denied: o Date: ________________
Reasons for Denial: _________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________