Department of public instruction title I migrant education program




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Wisconsin Department of Public Instruction

MIGRANT CONTINUING ENROLLMENT OR
RESIDENCY COUNT REPORT (CER)

PI-1717 (Rev. 03-13)



INSTRUCTIONS: Retain original and mail yellow copy, with original signature, or email electronic copy, within 30 days of the date classes start to:

DEPARTMENT OF PUBLIC INSTRUCTION

TITLE I MIGRANT EDUCATION PROGRAM

PO BOX 7841

MADISON, WI 53707-7841







A. School District Name

     


B. Short School District ID—NGS

WI           

C. Project Term of Enrollment Check

 Regular Term  Summer Term



D. Date Classes Start This Term

     








Recruiter’s/Administrator’s Signature



Date Signed Mo./Day/Yr.

Distribution

White—School

Yellow—DPI





The following Title I migrant children have not moved out of the school district attendance area since recruited within the past 36 months, and continue to reside or attend school in this district for this term.







Residence Verification

In the H/S/P column below, indicate whether the residence verification is



H = Home Visit S = School Records P = Partner Agency

E. TITLE I MIGRANT CHILDREN
To create a new row in the table below, press the tab key from within the last cell of the table.







Child’s Formal Name

Last First


M


HSP

Sex

Birthdate


Residence
Date on COE

Date Enroll. This Term

Gr.

NGS Unique
Student Identification

Last Qualifying Arrival Date Information
Refer to entries from the last COE

NGS
4-Letter School ID


































Date

From

Coquillo, JA, MX



To

Green Bay, WI



e.g.,
ABCD





























































































































































































































































































































































































































































































































































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