Membership Application
LEA Information
LEA Name
Total Enrollment
SY22-23 Membership Levels
Co-op membership dues are based on your LEA's TOTAL enrollment
<201 ($
4,502
)
201-500 ($
5,628
)
501-999 ($
6,753
)
1000+ ($
7,879
)
Provisional - for schools in their planning year ($1,000)
LEA Contact Information
Executive Dir/Head of School First Name
Executive Dir./Head of School Last Name
Executive Director/Head of School Email
Special Ed. Director First Name
Special Ed. Director Last Name
Special Ed. Director Email
Finance First Name
Finance Last Name
Finance Email
Membership Add-on programs and services
Co-op members can customize their memberships by choosing to add on one or more of
these services
.
Certification
I certify that all information herein is true and complete to the best of my knowledge and belief. I also certify I am authorized to enter into this membership agreement on behalf of my LEA. I hereby apply for membership with the DC Special Education Cooperative (legally named the DC Public Charter School Cooperative, Inc.), and have read and understand the qualifications of membership and dues payment requirements. By signing below, I acknowledge that my LEA is in agreement with the vision and mission of the DC Special Education Cooperative.
Certification Signature
Type your name below to sign the application
Contact Information