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Act 551 and 622, 2021 School Information Form
Academic School Year 2021-2022
Note: If a field does not apply, enter "Not Applicable"
School District/Open Enrollment Charter School Information
School District/Open Enrollment Charter School Name?
(Required)
Name of the Person Completing This Form? (The person whom we can contact if needed about this submission.)
(Required)
Phone Number of the Person Completing This Form?
(Required)
Email Address of the Person Completing This Form?
(Required)
Superintendent Information
Superintendent Name?
(Required)
Superintendent Email Address?
(Required)
Superintendent Phone Number?
(Required)
School/District School Safety Coordinator/Director Information
School/District School Safety Coordinator/Director Name?
(Required)
School/District School Safety Coordinator/Director Email Address?
(Required)
School/District School Safety Coordinator/Director Phone Number?
(Required)
Does your school have an Institutional Police Department?
(Required)
Yes
No
Number of School Resource Officers (SROs) in School District? (If zero, enter zero.)
(Required)
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