Private School Affidavit Instructions

Step 1 of 11: School Information

Item 1. Name of School *

Enter the name of your school. If you are homeschooling and your child(ren) is currently enrolled in a public school, this is not the name of the public school you are removing your child(ren) from. If this is a home school, you will need to establish a school name. This can be any name you choose; however, we ask that you follow the California Department of Education (CDE) school naming guidelines when reporting the school name. These guidelines consist of:

• Omit “School” from school names except when it falls in the middle of a name (e.g., “Corona School of the Arts”).
• Omit “The” from school names except when it falls in the middle of a name (e.g., “Corona School of the Arts”).
• If initials are used for schools named after a person, include a space between initials.

Note: The CDE will apply these naming guidelines to schools with six or more students prior to the inclusion of the school in the CDE California School Directory.

Item 2 CDS Code *

The County-District-School (CDS) code is a unique 14-digit code assigned by the CDE to private schools with six or more students enrolled. The CDS code should not be confused with your confirmation code.

If the school has been assigned a CDS code and you will be filing based on the previous year's affidavit, the CDS code will be prepopulated. Otherwise, this field is not applicable and you can skip to the next item. In the event that you did not file an affidavit the previous year, yet your school has been issued a CDS code in a previous year, please contact the CDE Private School Data staff for assistance.

Item 3. County *

Select the name of your resident county from the provided drop-down list. This is the county where the school is located, or the county associated with your local public school district.

Item 4. District *

Select the School District in which your school resides from the provided drop-down list. This is the district associated with your local public school district. If you are unsure of which district to choose, you may look up your district using the Great Schools website.

Note: In cases where district boundaries overlap between elementary and high school districts, select the district that best represents the grade levels offered by your school. For example, if most of your students are in the elementary grades (K-8), select the elementary school district. If most of your students are in the high school grades (9-12), select the high school district. If your school offers grades K-12, you may select either the elementary or the high school district based on whether the majority of the students are in elementary or high school grade levels.

Item 5. School Type *

Indicate the school type based on the gender(s) served by the school. Select from the following options:

• Coeducational – Serving all genders.
• Boys Only – Serving boys only.
• Girls Only – Serving girls only.

Item 6. School Accommodations *

Indicate the type of boarding accommodations offered by the school. Select from the following options:

• Day Only – Students live off campus.
• Residential Boarding Only – Students reside on campus.
• Both – Students live on and off campus.

Item 7. Does the School Provide Special Education?

Indicate whether or not the school provides special education to students with disabilities. This may include students who have an existing individual education plan (IEP) or evaluation.

Item 8. Does the School Provide a High School Diploma? *

Indicate whether or not the school provides a high school diploma.

Item 9. Low Grade *

Report the lowest grade that the school offers, regardless of current year enrollment.

Item 10. High Grade *

Report the highest grade that the school offers, regardless of current year enrollment.

Item 11. Classification of School *

Select the classification that best describes your school. Choose from the drop-down list of religious and non-religious categories.

Step 2 of 11: School Address

Items 12-16. Physical Address *

Enter the school’s actual physical location where instruction will be provided. This cannot be a P.O. Box or an out-of-state address. For home schools, enter your home address.

Items 17-21. Mailing Address *

Enter the address where the school will receive mail. If the mailing address is the same as the physical address, select the "Copy Physical Address" link to have the physical address copied into the mailing address fields. This can be a P.O. Box. or out-of-state address.

Step 3 of 11: School Contact Information

Item 22. Phone *

Enter the phone number of the school, including the area code.

Item 23. Fax Number

Enter the fax number of the school, including the area code.

Item 24. Primary Email *

Enter the school’s primary email address.

Item 25. Website

Enter the school’s web address (URL) if applicable. Example: www.gmail.com.

Step 4 of 11: Prior Year Changes

This section only applies to schools that have previously filed and affidavit. If you have never filed an affidavit, select the “No” option for questions 26 and 28 prior to proceeding to the next section.

Item 26. Has the school’s name changed since last filing an affidavit? *

Indicate whether or not your previous affidavit was filed under a different school name.

Item 27. If “yes”, enter the name that the school last filed under

If you answered “Yes” to item 26, provide the name that the school last filed under.

Item 28. Has the public school district in which the private school is located changed since last filing an affidavit? *

Indicate whether or not your previous affidavit was filed under a different school district.

Item 29. If “yes”, specify which school district the school last filed under

If you answered “Yes” to item 28, provide the name of the previous school district by selecting from the drop-down-list.

Step 5 of 11: Statistical Information

Items 30-32. Student Ages *

Report the age range of the students enrolled in Kindergarten through grade twelve. Note: the youngest age may not be younger than 4 years 9 months old as of September first of the current school year.

Items 33-45. Enrollment *

Report the counts of students enrolled in each grade level, kindergarten through grade twelve on or around the date the affidavit is filed.

Students who were previously identified with a grade level of Ungraded Elementary should be assigned the grade level most aligned with the student's age at the time of enrollment. Students who were previously identified with a grade level of Ungraded Secondary should be assigned the grade level most aligned with their age, or a grade level based on credits earned.

Do not include preschool enrollment; schools that offer only preschool should not file an affidavit and are governed by California Department of Social Services Child Care Licensing.

Note: The total enrollment must be greater than zero.

Item 46. Graduate *

Report the number of students who graduated from twelfth grade in the previous school year.

Items 47-50. Number of Staff *

Report the number of full- and part-time teachers, administrators, and other staff employed at the school. Other staff includes, but is not limited to, regular janitorial, kitchen, and classroom aides.

Do not include individuals who are hired on a temporary or short-term basis, such as to present on a topic once or twice a year.

Note: The total number of staff must be greater than zero.

Step 6 of 11: Administrative Staff

Items 51-62. Site Administrator *

Enter the contact information for the site administrator. The site administrator is the individual responsible for the day-to-day operations of the school. This may be the same person as other contacts reported on the affidavit.

Note: The site administrator’s email address is the email address that will be used to send the affidavit filing confirmation and any follow-up communication.

Items 63-74. Director or Principal Officer *

Enter the contact information for the director or principal officer. The director or principal officer is the individual responsible for the academic structure and application for the school. This may be the same person as other contacts reported on the affidavit. If this person is the same as the Site Administrator, select "Copy Site Administrator."

Step 7 of 11: School Records

Per California EC Section 33190 private schools are required to maintain the following records, provide the location of these records, and name a Custodian of Records.

• Records required per EC Section 48222
• The courses of study offered by the institution.
• The names and addresses, including street and city of it's faculty, together with a record of the educational qualifications of each.

Items 75-86. Custodian Contact *

Enter the contact information for the custodian of records. The custodian of records is responsible for the creation and maintenance of all required school records. This may be the same person as other contacts reported on the affidavit.

Item 87-91. Records Location *

Enter the actual location where the school records are maintained. If the records location address is the same as the custodian of records’ address, select "Copy Contact Address."

Check Box Acknowledgment *

Check the box acknowledging that the above mentioned records are maintained at the address stated, and are true and accurate.

Step 8 of 11: Tax Status

Items 92-95. Tax Status *

Indicate which tax exemption(s) apply to the school. Options include:

• Tax exempt, nonprofit status under U.S. Internal Revenue Service, Section 501(c)(3)
• Tax-exempt, nonprofit status under the California Revenue and Taxation Code Section 2370d
• Property Tax exemption under the California Revenue and Taxation Code Section 214
• None of the Above

Note: This section is to help identify incorporated, nonprofit, tax exempt schools. If the school is not confirmed by the federal or state governments as nonprofit/tax exempt, select "None of the above."

Step 9 of 11: Acknowledgments and Statutory Notices

Once you have read the information and notices listed on the Acknowledgments and Statutory Notices page, check the box to acknowledge that you have read and understand the Statutory Notices and assure the school's compliance. This is a required field.

Step 10 of 11: Signature *

By signing, or electronically filing, the affidavit, you are declaring under penalty of perjury and the laws of the State of California, that you are the owner or other head of the school, and that the information contained in the affidavit is true, accurate and complete. As part of the signature and submission process, please provide all of the following information:

• Name, title, and email address of the owner or other head of school. Note that the email address provided here will be used to send your affidavit filing confirmation, as well as any follow-up communication.
• Security question and answer. Please select a security question from the drop-down list and then provide an answer to the selected question. This will be used for verification purposes.

Step 11 of 11: Review

The Review page provides a summary of the information you have provided on the affidavit. Please review this information prior to submitting your affidavit. If corrections are necessary, select the Edit link corresponding to the section you need to correct.

When reviewing your information, please pay close attention to the following items:

• Correct use of capital letters, punctuation and spelling.
• Verify the accuracy of the site administrator’s email address and the email address provided in the signature section. These will be used to send confirmation of your filing.
• Double-check your enrollment numbers. A common mistake is to report the grade level rather than the enrollment count, for example people often report six students in sixth grade when in fact the only have one sixth grader.
• Double-check your tax status for accuracy.

Once you have verified the accuracy of the information provided on your affidavit, and are ready to file, select "Submit Affidavit" to submit this affidavit to the California Department of Education.

Note: Selecting the "Cancel" option will exit you out of the affidavit and all entered information will be lost.