Student Data

STUDENT DATA
NOTE: This form must be completed by applicants under the Native American and Alaska Native Children in School Program (NAM).
Name of the applicant:
SECTION A
Name of the participant school (s).	Grade (s) to be served by the program.	Total number of students enrolled in the school.	Total number of Native American or Alaska native LEP students to be served by the program.	Total number of Native American or Alaska native students enrolled in the school.
SECTION B
Name of the Authorized Representative:
Signature:
Date:

OMB Number 1885-0551 Expires / /

Paperwork Burden Statement: According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is 1885–0551. The time required to complete this information collection is estimated to average 25 minutes per response, including the time to review instructions, search existing data resources, gather the data needed and complete and review the information collection. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Education, Washington, DC 20202-4651. If you have comments or concerns regarding the status of your individual submission of this form, write directly to: Native American and Alaska Native Children in School Program, Office of English Language Acquisition, Language Enhancement, and Academic Achievement for Limited English Proficient Students, U.S. Department of Education, 400 Maryland Avenue, S.W., LBJ, Room 5C145, Washington, D.C. 20202-4651