schools) 2. charter authorizer i. school information...

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I.SCHOOLINFORMATIONANDCOVERPAGE(TobeCompletedByAllCharterSchools)Created:07/20/2015

Lastupdated:07/29/2015

Pleasebeadvisedthatyouwillneedtocompletethistaskfirst(includingsignatures)beforealloftheothertasksassignedtoyoubyyourauthorizerarevisibleonyourtaskpage.Whilecompletingthistask,pleaseensurethatyouselectthecorrectauthorizeroryoumaynotbeassignedthecorrecttasks.

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1.SCHOOLNAMEANDAUTHORIZER

(Selectnamefromthedropdownmenu)

NEWVISIONSCHSFORADVANCEMATHANDSCIENCEIII(REGENTS)332200861053

2.CHARTERAUTHORIZER

(Fortechnicalreasons,pleasere-selectauthorizernamefromthedropdownmenu).

Regents-AuthorizedCharterSchool

3.DISTRICT/CSDOFLOCATION

NYCCSD22

4.SCHOOLINFORMATION

PRIMARYADDRESS PHONENUMBER FAXNUMBER EMAILADDRESS

3000AvenueXBrooklyn,NY11235

718-934-9240 718-934-9171

4a.PHONECONTACTNUMBERFORAFTERHOURSEMERGENCIES

ContactName GeriMolloy

Title ChiefOperatingOfficer

EmergencyPhoneNumber(###-###-####)

5.SCHOOLWEBADDRESS(URL)

http://www.newvisions.org/schools/entry/ams3

6.DATEOFINITIALCHARTER

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2012-11-0100:00:00

7.DATEFIRSTOPENEDFORINSTRUCTION

2013-08-0100:00:00

8.FINALVERIFIEDBEDSENROLLMENTFORTHE2014-15SchoolYearasreportedtoDepartment'sOfficeof

InformationandReportingServices(viatheNYCDOEforcharterschoolsinNYC)inAugust.

252

9.GRADESSERVEDINSCHOOLYEAR2014-15

Checkallthatapply

GradesServed 9,10

10.DOESTHESCHOOLCONTRACTWITHACHARTEROREDUCATIONALMANAGEMENTORGANIZATION?

Yes/No NameofCMO/EMO

Yes NewVisionsforPublicSchools

10a.Pleaseprovidethenameandcontactinformationforeachofthefollowingindividualswhoaremanagementlevel

personnelassociatedwiththeCMO.

Name WorkPhone AlternatePhone EmailAddress Contactthisindividualalsoinemergencies

CEO(e.g.,networksuperintendent)

RonaldChaluisan Yes

CFO(e.g.,networkCFO)

CynthiaRietscha Yes

ComplianceContact MatthewGill Yes

ComplaintContact LoriMei Yes

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11.FACILITIES

WilltheSchoolmaintainoroperatemultiplesites?

No,justonesite.

12.SCHOOLSITES

Pleaselistthesiteswheretheschoolwilloperatein2015-16.

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PhysicalAddress PhoneNumber District/CSD GradesServedatSite

SchoolatFullCapacityatSite

FacilitiesAgreement

Site1(sameasprimarysite)

3000AvenueXBrooklyn,NY11235

718-934-9240 CSD22 9-12 No DOEspace

Site2

Site3

12a.PleaseprovidethecontactinformationforSite1(sameastheprimarysite).

Name WorkPhone AlternatePhone EmailAddress

SchoolLeader NissiJonathan

OperationalLeader GeriMolloy

ComplianceContact GeriMolloy

ComplaintContact GeriMolloy

13.AretheSchoolsitesco-located?

No

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14.Werethereanyrevisionstotheschool’scharterduringthe2014-2015schoolyear?(Pleaseincludeboththosethat

requiredauthorizerapprovalandthosethatdidnotrequireauthorizerapproval).

No

15.NameandPositionofIndividual(s)WhoCompletedthe2014-15AnnualReport.

LoriMei,ManagingDirectorofCharterOperationsandSchoolDevelopment

16.Oursignaturesbelowattestthatalloftheinformationcontainedhereinistruthfulandaccurateandthatthischarter

schoolisincompliancewithallaspectsofitscharter,andwithallpertinentFederal,State,andlocallaws,regulations,

andrules.Weunderstandthatifanyinformationinanypartofthisreportisfoundtohavebeendeliberately

misrepresented,thatwillconstitutegroundsfortherevocationofourcharter.CheckYESifyouagreeandusethe

mouseonyourPCorthestylistonyourmobiledevicetosignyourname).

ResponsesSelected:

Yes

Signature,HeadofCharterSchool

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Signature,PresidentoftheBoardofTrustees

Thankyou.

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AppendixA:LinktotheNewYorkStateSchoolReportCardLastupdated:07/27/2015

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CharterSchoolName:

1.NEWYORKSTATEREPORTCARD

ProvideadirectURLorweblinktothemostrecentNewYorkStateSchoolReportCardforthecharterschool(See

https://reportcards.nysed.gov/).

(CharterschoolscompletingyearonewillnotyethaveaSchoolReportCardorlinktoone.Pleasetype"URLisnotavailable"inthespaceprovided).

http://data.nysed.gov/reportcard.php?year=2014&instid=800000075843

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AppendixA:ProgressTowardGoalsCreated:10/22/2015


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CharterSchoolName:

1.NEWYORKSTATEREPORTCARD

ProvideadirectURLorweblinktothemostrecentNewYorkStateSchoolReportCardforthecharterschool(See

https://reportcards.nysed.gov/)whichcapturesschool-levelenrollmentanddemographicinformation,staffqualifications,

electronicstudentrecords,andattendancerates,asprescribedbyNewYorkStatestatute(8NYCRR119.3).

(CharterschoolscompletingyearonewillnotyethaveaSchoolReportCardorlinktoone.Pleasetype"URLisnotavailable"inthespaceprovided).

http://data.nysed.gov/profile.php?instid=800000075843

2.APPENDIXA:PROGRESSTOWARDCHARTERGOALS

ThefollowingtablesreflectformattingintheonlineportalrequiredforBoardofRegents-authorizedcharterschoolsandNYCDOE-authorizedcharterschoolsonly.SchoolsshouldlistProgressTowardCharterGoalsbyAugust1,2015.IfthegoalsarebasedonstudentperformancedatathattheschoolwillnothaveaccesstobeforeAugust1,2015(e.g.,theNYSAssessmentresults),explainthisinthe"2014-2015ProgressTowardAttainmentofGoal"column.Theinformationcanbeupdatedwhenavailable.AppendixAmustbefullycompletednolaterthanNovember1,2015.

2a.ACADEMICSTUDENTPERFORMANCEGOALS

2014-15ProgressTowardAttainmentofAcademicGoals

AcademicStudentPerformanceGoal

MeasureUsedtoEvaluateProgressTowardAttainmentofGoal

2014-2015ProgressTowardAttainmentofGoal-Met,PartiallyMet,orNotMet

IfNotMet,DescribeEffortsSchoolWillTake

AcademicGoal1Theaveragedailyattendanceofstudentswillmeetorexceed90%

Averagedailyattendancerate 95%,exceedsgoal

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AcademicGoal2

90%ofstudentsinthe2012cohortwillattainascoreof65%oraboveontheRegentsMathematicsexamsbytheendoffouryears

Performance/scoreonRegentsExams

Aftertheirsecondyearofhighschool,83%ofthestudentsinthe2013cohorthavepassedaMathematicsRegentsExam,indicatingthattheschoolisontrackinmeetingthisgoal.

AMSIIIwillcontinuetoimplementthekeyelementsoftheschool'sacademicdesigntoensurethatstudentsmastertheskillsandknowledgenecessaryforsuccessinmathematics.SpecificinterventionsincludeMathLabforstudentsneedingadditionalsupport,afterschoolhomeworkhelp,andSaturdayAcademy.

AcademicGoal3

90%ofstudentsenrolledinthe2014-2015academicyearwillreturnforthe2015-2016academicyear

NumberofstudentsenrolledasofBEDSday2014comparedtoBEDSday2015

86%oftheAMSIIIstudentsenrolledinthe2014-2015academicyearreturnedforthe2015-2016academicyear.Theschoolcamewithin4%ofthegoal.

AMSIIIwillcontinuetoretainstudentsandincreasetheretentionratewithstrategiesthatincludeacademicinterventionsupport,familyengagementandaproactiveAttendanceTeam.

AcademicGoal4

90%ofstudentsinthe2012cohortwillattainascoreof65%oraboveontheRegentsScienceExamsbytheendoffouryears

Performance/scoreonRegentsExams

Aftertheirthirdyearofhighschool,75%ofthestudentsinthe2012cohorthavealreadypassedaScienceRegentsExam,indicatingthattheschoolisontrackinmeetingthisgoal.

AMSIIIwillcontinuetoimplementthekeyelementsoftheschool'sacademicdesigntoensurethatstudentsmastertheskillsandknowledgenecessaryforsuccessinmathematics.SpecificinterventionsincludeMathLabforstudentsneedingadditionalsupport,afterschoolhomeworkhelp,andSaturdayAcademy.

AcademicGoal5

AcademicGoal6

AcademicGoal7

AcademicGoal8

2a1.Dohavemoreacademicgoalstoadd?

No

2a2.Dohavemoreacademicgoalstoadd?

No

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2b.ORGANIZATIONALGOALS

2014-15ProgressTowardAttainmentofOrganizationalGoals

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OrganizationalGoal MeasureUsedtoEvaluateProgress

2014-15ProgressTowardAttainment


OrgGoal1

90%ofteachersonstaffinthe2014-2015schoolyearratedaseffectiveorhighlyeffectivewillreturnforthe2015-2016academicyear

Cumulativereviewofinformalandformalevaluations

Metgoal.AMSIIIretained90%oftheteachersratedeffectiveorhighlyeffectiveforthe2015-2016schoolyear.

OrgGoal2

OrgGoal3

OrgGoal4

OrgGoal5

2b.1Doyouhavemoreorganizationalgoalstoadd?

No

2c.FINANCIALGOALS

2014-15ProgressTowardAttainmentofFinancialGoals

FinancialGoals MeasureUsedtoEvaluateProgress

2014-2015ProgressTowardAttainment


FinancialGoal1

MaintainstronginternalcontrolsinregardstofinanceandcompliancemanagementthatmeetGovernmentAuditingStandardsasreviewedannuallybyanindependentauditingfirm

IndependentauditorreviewofinternalcontrolsoverfinancialreportingandcomplianceinaccordancewithGovernmentAuditStandards

Metgoal.Theschoolmaintainedinternalfinancialandcompliancecontrolsduringthe2014-2015thatmetGovernmentAuditingStandardswithoutdeficienciesormaterialweaknesses.

FinancialGoal2

FinancialGoal3

FinancialGoal4

FinancialGoal5

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AppendixB:TotalExpendituresandAdministrativeExpendituresperChildLastupdated:07/29/2015

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CharterSchoolName:

B.FinancialInformationThisinformationisrequiredofALLcharterschools.ProvidethefollowingmeasuresoffiscalperformanceofthecharterschoolinAppendixB(TotalExpendituresandAdministrativeExpendituresPerChild):

1.TotalExpendituresPerChild

Tocalculate‘TotalExpendituresperChild’taketotalexpenditures(fromtheunaudited2014-15ScheduleofFunctionalExpenses)anddividebytheyearendperpupilcount.(IntegersOnly.Nodollarsignsorcommas).

Line1:TotalExpenditures 3791259

Line2:YearEndPerPupilCount 242

Line3:DivideLine1byLine2 15666

2.AdministrativeExpendituresperChild

Tocalculate‘AdministrativeExpendituresperChild'taketherelevantportionfromthe‘personnelservicescost’rowandthe‘managementandgeneral’column(fromtheunaudited2014-15ScheduleofFunctionalExpenses)anddividebytheyearendperpupilcount.Therelevantportionthatmustbeincludedinthiscalculationisdefinedasfollows:

AdministrativeExpenditures:Administrationandmanagementofthecharterschoolincludestheactivitiesandpersonneloftheofficesofthechiefschoolofficers,thetreasurer,thefinanceorbusinessoffices,thepurchasingunit,theemployeepersonneloffices,therecordsmanagementoffices,orapublicinformationandservicesoffices.Italsoincludesthoseadministrativeandmanagementservicesprovidedbyotherorganizationsorcorporationsonbehalfofthecharterschoolforwhichthecharterschoolpaysafeeorothercompensation.Pleasenotethefollowing:

DonotincludetheFTEofpersonneldedicatedtoadministrationoftheinstructionalprograms.DonotincludeEmployeeBenefitcostsorexpendituresintheabovecalculations.AtemplatefortheScheduleofFunctionalExpensesisprovidedonpage20ofthe2014-15AnnualReportGuidelinestoassistschoolsidentifythecategoriesofexpensesneededtocomputethetwoperpupilcalculations.ThistemplatedoesnotneedtobecompletedorsubmittedonAugust1stasitwillbesubmittedNovember1staspartoftheauditedfinancialstatements.Thereforeschoolsshoulduseunauditedamountsfortheseperpupilcalculations.(Seethe2014-15AnnualReportGuidelinesin"Resources"areaofyourportaltaskpage).

Tocalculate‘AdministrativeExpendituresperChild'taketherelevantportionfromthe‘personnelservicescost’rowandthe‘managementandgeneral’column(fromthe2014-15ScheduleofFunctionalExpenses)anddividebytheyearendperpupilcount.(IntegersOnly.Nodollarsignsorcommas).

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Line1:RelevantPersonnelServicesCost(Row) 426913

Line2:ManagementandGeneralCost(Column) 105351

Line3:SumofLine1andLine2 532264

Line4:YearEndPerPupilCount 242

Line5:DivideLine3bytheYearEndPerPupilCount 2199

Thankyou.

Financial Audit Supplemental Data Request Formfor Regents-Authorized Charter Schools

School Name: New Visions Charter High School for Advanced Math & Science III

Date: June 30, 2015

School Fiscal Contact Name: Cynthia RietschaSchool Fiscal Contact Email:School Fiscal Contact Phone:District of Location: 22Authorizer: SEDYears of Operation: 2Facility: PublicGrades Currently Served: 9 through 10Planned Grades at Full Capacity: 9 through 12Enrollment: 252Max Enrollment: 500Year of Most Recent Data 2015School Fiscal Contact Phone: 212-645-5110

School Audit Firm Name: MBAFSchool Audit Contact Name: Marc TaubSchool Audit Contact Email:School Audit Contact Phone: 212-931-9200

Latest Audit Period (through June 30): 2015Do Not Use this Box New Visions Charter High School for Advanced Math & Science III2015

[email protected]

mailto:[email protected]

FILL IN GRAY CELLS

New Visions Charter High School for Advanced Math & Science IIISTATEMENTS OF FINANCIAL POSITION

FOR THE YEARS ENDED JUNE 30,

2015 2014ASSETS

CURRENT ASSETSCash and cash equivalents $657,011 $120,035 Grants and contracts receivable - 138,730 Accounts receivables - - Inventory - - Prepaid Expenses 538 677 Contributions and other receivables - -

Other - - TOTAL CURRENT ASSETS $657,550 $259,442

OTHER ASSETSInvestments $- $- Property, Plant and Equipment, Net 61,862 71,249

Restricted Cash - - OTHER ASSETS $61,862 $71,249

TOTAL ASSETS $719,411 $330,691

LIABILITIES AND NET ASSETSCURRENT LIABILITIESAccounts payable and accrued expenses $106,560 $60,927 Accrued payroll and benefits 11,257 49,924 Refundable Advances - - Dreferred Revenue - 3,355 Current maturities of long-term debt - - Short Term Debt - Bonds, Notes Payable - -

Other 1,204 41,095 TOTAL CURRENT LIABILITIES $119,021 $155,301

LONG-TERM DEBT, net current maturities $- $-

TOTAL LIABILITIES $119,021 $155,301

NET ASSETSUnrestricted $600,390 $175,390

Temporarily restricted - - TOTAL NET ASSETS $600,390 $175,390

TOTAL LIABILITIES AND NET ASSETS $719,411 $330,691

Check - -

FILL IN GRAY CELLS

New Visions Charter High School for Advanced Math & Science IIISTATEMENTS OF ACTIVITIESFOR THE YEARS ENDED JUNE 30,

2015 2014

Unrestricted Total Total

REVENUE, GAINS AND OTHER SUPPORT State & Local Operating Revenue $3,977,749 $- $3,977,749 $1,926,065 Federal - Title and IDEA 61,084 - 61,084 64,484 Federal - Other 175,971 - 175,971 311,493 State and City Grants - - - - Contributions and private grants - - - - After school revenue - - - - Other - - - -

Food Service/Child Nutrition Program - - - - TOTAL REVENUE, GAINS AND OTHER SUPPORT $4,214,804 $- $4,214,804 $2,302,042

EXPENSES Program Services

Regular Education $2,550,725 $- $2,550,725 $1,708,542 Special Education 582,551 - 582,551 332,082

Other Programs - - - - Total Program Services $3,133,276 $- $3,133,276 $2,040,625 Supporting Services

Management and general $629,580 $- $629,580 $529,401

Fundraising 28,407 - 28,407 18,492 TOTAL OPERATING EXPENSES $3,791,262 $- $3,791,262 $2,588,518

SURPLUS / (DEFICIT) FROM SCHOOL OPERATIONS $423,542 $- $423,542 $(286,476)

Contributions Foundations $- $- $- $- Individuals 178 - 178 - Corporations - - - 401,567

Fundraising - - - - Interest income 8 - 8 11 Miscellaneous income 1,271 - 1,271 60,288

Net assets released from restriction - - - - TOTAL SUPPORT AND OTHER REVENUE $1,457 $- $1,457 $461,866

CHANGE IN NET ASSETS $424,999 $- $424,999 $175,390

NET ASSETS BEGINNING OF YEAR $175,392 $- $175,392 $-

PRIOR YEAR/PERIOD ADJUSTMENTS - - - -

NET ASSETS - END OF YEAR $600,390 $- $600,390 $175,390

Temporarily Restricted

Request for Proposals to Establish Charter Schools Authorized by the Board of Regents

2015-16 Budget & Cash Flow Template

General Instructions and Notes for New Application Budgets and Cash Flows Templates

1 2

3

4 Funding by School District information for all NYS School district is located on the State Aid website at https://stateaid.nysed.gov/charter/. Refer to this website for per-pupil tuition funding for all school districts. Rows may be inserted in the worksheet to accomodate additional districts if necessary.

5 The Assumptions column should be completed for all revenue and expense items unless the item is self-explanatory. Where applicable, please reference the page number or section in the application narrative that indicates the assumption being made. For instance, student enrollment would reference the applicable page number in Section I, C of the application narrative.

New York State Education Department

Complete ALL SIX columns in BLUEEnter information into the GRAY cells

Cells containing RED triangles in the upper right corner in columns B through G contain guidance on that particular item

New Visions Charter High School for Advanced Math and Science IIIPROJECTED BUDGET FOR 2015-2016 Assumptions

July 1, 2015 to June 30, 2016 DESCRIPTION OF ASSUMPTIONS - Please note assumptions when applicable

Please Note: The student enrollment data is entered below in the Enrollment Section beginning in row 155. This will populate the data in row 10.

OTHER FUNDRAISING TOTAL

Total Revenue 5,860,466 819,724 - - - 6,680,190

Total Expenses 4,285,593 894,944 - - 1,183,216 6,363,753 Net Income 1,574,873 (75,220) - - (1,183,216) 316,437

Actual Student Enrollment 395 42 -

Total Paid Student Enrollment 395 42 437

PROGRAM SERVICES SUPPORT SERVICES


REVENUE

REVENUES FROM STATE SOURCES

Per Pupil Revenue

NYC $13,877.00 5,481,419 - - - - 5,481,419

School District 2 (Enter Name) - - - - - -




5,481,419 - - - - 5,481,419

Special Education Revenue - 774,082 - - - 774,082

Grants

Stimulus - - - - - -

Other - - - - - -

Other State Revenue - - - - - -

TOTAL REVENUE FROM STATE SOURCES 5,481,419 774,082 - - - 6,255,501

REVENUE FROM FEDERAL FUNDING

IDEA Special Needs - 45,642 - - - 45,642

Title I 135,069 - - - - 135,069

Title Funding - Other 7,800 - - - - 7,800

School Food Service (Free Lunch) - - - - - -

Grants

Charter School Program (CSP) Planning & Implementation 204,783 - - - - 204,783

Other - - - - - -

Other Federal Revenue - - - - - -

TOTAL REVENUE FROM FEDERAL SOURCES 347,652 45,642 - - - 393,294

LOCAL and OTHER REVENUE

Contributions and Donations, Fundraising - - - - - -

Erate Reimbursement - - - - - -

Interest Income, Earnings on Investments, - - - - - -

NYC-DYCD (Department of Youth and Community Developmt.) - - - - - -

Food Service (Income from meals) - - - - - -

Text Book 31,395 - - - - 31,395

Other Local Revenue - - - - - -

TOTAL REVENUE FROM LOCAL and OTHER SOURCES 31,395 - - - - 31,395

TOTAL REVENUE 5,860,466 819,724 - - - 6,680,190

List exact titles and staff FTE"s ( Full time eqiuilivalent)

EXPENSES

ADMINISTRATIVE STAFF PERSONNEL COSTS No. of Positions Executive Management 1.00 97,756 10,394 - - 36,050 144,200

Instructional Management 3.00 312,842 33,264 - - - 346,106

Deans, Directors & Coordinators 3.00 140,568 14,946 - - - 155,515

CFO / Director of Finance 1.00 - - - - 127,308 127,308

Operation / Business Manager 3.00 - - - - 165,959 165,959

Administrative Staff 7.00 - - - - 295,610 295,610

TOTAL ADMINISTRATIVE STAFF 18 551,165 58,605 - - 624,927 1,234,697

INSTRUCTIONAL PERSONNEL COSTS

Teachers - Regular 16.00 946,373 100,627 - - - 1,047,000

Teachers - SPED 4.00 - 232,000 - - - 232,000

Substitute Teachers - - - - - - -

Teaching Assistants - - - - - - -

Specialty Teachers 10.00 536,911 57,089 - - - 594,000

Aides - - - - - - -

Therapists & Counselors 4.00 229,028 24,352 - - - 253,380

Other - - - - - - -

TOTAL INSTRUCTIONAL 34 1,712,311 414,069 - - - 2,126,380

NON-INSTRUCTIONAL PERSONNEL COSTS

Nurse - - - - - - -

Librarian - - - - - - -

Custodian - - - - - - -

Security - - - - - - -

Other - - - - - - -

TOTAL NON-INSTRUCTIONAL - - - - - - -

SUBTOTAL PERSONNEL SERVICE COSTS 52 2,263,477 472,673 - - 624,927 3,361,077

PAYROLL TAXES AND BENEFITS

Payroll Taxes 247,849 51,757 - - 68,429 368,036

Fringe / Employee Benefits 316,888 66,174 - - 87,490 470,552

Retirement / Pension 158,444 33,087 - - 43,745 235,276

TOTAL PAYROLL TAXES AND BENEFITS 723,181 151,019 - - 199,664 1,073,864

TOTAL PERSONNEL SERVICE COSTS 2,986,658 623,693 - - 824,591 4,434,941

CONTRACTED SERVICES

Accounting / Audit 8,072 1,686 - - 2,229 11,986

Legal 16,836 3,516 - - 4,648 25,000

Management Company Fee 359,895 75,156 - - 99,364 534,415

Nurse Services - - - - - -

Food Service / School Lunch 16,760 3,500 - - 4,627 24,887

Payroll Services 10,751 2,245 - - 2,968 15,964

Special Ed Services - - - - - -

Titlement Services (i.e. Title I) - - - - - -

Other Purchased / Professional / Consulting 166,256 34,719 - - 45,902 246,876

TOTAL CONTRACTED SERVICES 578,569 120,821 - - 159,738 859,128

SCHOOL OPERATIONS

Board Expenses - - - - - -

Classroom / Teaching Supplies & Materials 136,993 28,608 - - 37,823 203,424

Special Ed Supplies & Materials - - - - - -

Textbooks / Workbooks 56,818 11,865 - - 15,687 84,370

Supplies & Materials other 50,003 10,442 - - 13,805 74,250

Equipment / Furniture - - - - - -

Telephone 41,753 8,719 - - 11,528 62,000

Technology 199,853 41,735 - - 55,178 296,766

Student Testing & Assessment 18,123 3,785 - - 5,004 26,911

Field Trips - - - - - -

Transportation (student) 20,203 4,219 - - 5,578 30,000

Student Services - other 13,469 2,813 - - 3,719 20,000

Office Expense 15,696 3,278 - - 4,333 23,307

Staff Development 16,740 3,496 - - 4,622 24,857

Staff Recruitment 23,570 4,922 - - 6,508 35,000

Student Recruitment / Marketing 1,684 352 - - 465 2,500

School Meals / Lunch - - - - - -

Travel (Staff) 1,083 226 - - 299 1,608

Fundraising - - - - - -

Other 48,488 10,125 - - 13,387 72,000

TOTAL SCHOOL OPERATIONS 644,475 134,583 - - 177,934 956,993

FACILITY OPERATION & MAINTENANCE

Insurance 16,965 3,543 - - 4,684 25,191

Janitorial - - - - - -

Building and Land Rent / Lease 3,367 703 - - 930 5,000

Repairs & Maintenance 28,621 5,977 - - 7,902 42,500

Equipment / Furniture 26,938 5,625 - - 7,437 40,000

Security - - - - - -

Utilities - - - - - -

TOTAL FACILITY OPERATION & MAINTENANCE 75,890 15,848 - - 20,953 112,691

DEPRECIATION & AMORTIZATION - - - - - -

DISSOLUTION ESCROW & RESERVES / CONTIGENCY - - - - - -

TOTAL EXPENSES 4,285,593 894,944 - - 1,183,216 6,363,753

NET INCOME 1,574,873 (75,220) - - (1,183,216) 316,437

REGULAR EDUCATION

SPECIAL EDUCATION

MANAGEMENT & GENERAL

REGULAR EDUCATION

SPECIAL EDUCATION


CY Per Pupil Rate

CSI:This line should show how many students a school intends to be paid for.

For Example:If a school plans on enrollment of 100 students however is budgeting to only receive 95% of those students, 95 should be entered in in this row. CSI:

Enter in the Per Pupil Rate (PPR) for the Current Year (CY).

For Example:If this application is being submitted in 2009-10 for a school opening in 2011-12, enter in the 2009-10 PPR for that district in the cells below. If a higher PPR is assumed indicate that % increase in the ASSUMPTION column. Refer to the State Aid website for the tuition rates. https://stateaid.nysed.gov/charter/

CSI:Sample titles that fall under this line: - Head of School - Superintendant - School Leader - Executive Director - CEO

CSI:Sample titles that fall under this line: - Principal - Vice-Principal - Assistant Principal - Chief Academic Officer

CSI:Sample titles that fall under this line:Director, Deans, Coordinators of: - Curriculum - Instruction - Faculty - Students - Assessment - Student Affairs - Student Achievement - Development

CSI:Sample titles that fall under this line: - Secretary - Receptionist - Attendance Clerk - Office Manager

CSI:Sample titles that fall under this line:Content/Subject Area Teachers: - ELA - Math - Social Studies - ScienceCSI:Sample titles that fall under this line: - ESL - Reading - Math and/or Literacy Specialists - Art - PE - Music - Foreign Languages - Photography - Ceramics

CSI:Sample titles that fall under this line: - Speech Therapists - Social Workers

CSI:CafeteriaOther

CSI:Health and DentalSocial SecurityMedicareUnemploymentOther

CSI:JanitorialConsultants - Assessment - Technology - OtherSecurityBackground ScreeningPublic Relations

CSI:DevelopmentConferences

CSI:Curriculum

CSI:InstructionalNon-InstructionalAthleticMusicOffice Equipment* Includes the Purchase or Lease of any of the above

CSI:HardwareSoftwareInternetWiringOtherCSI:UniformsSpecial EventsCSI:PrintingPostageCopyingAll Other

CSI:Conferences

CSI:Interest Bank ChargesBad DebtMisc. Fees (i.e. Licensing)Dues & MembershipAll Other (If any questions contact CSI)

CSI:FacilityEquipmentCSI:Facility Related* Includes the Purchase or Lease of any equipmentCSI:ElectricGasOther

CSI:$75,000 should be set aside for Dissolution and it can be spread out over the first THREE years if the school chooses. If spread out each year should minimally be $25k.

A note can be added under assumptions describing the breakout.

New Visions Charter High School for Advanced Math and Science IIIPROJECTED BUDGET FOR 2015-2016 Assumptions

July 1, 2015 to June 30, 2016 DESCRIPTION OF ASSUMPTIONS - Please note assumptions when applicable

Please Note: The student enrollment data is entered below in the Enrollment Section beginning in row 155. This will populate the data in row 10.


Total Revenue 5,860,466 819,724 - - - 6,680,190

Total Expenses 4,285,593 894,944 - - 1,183,216 6,363,753 Net Income 1,574,873 (75,220) - - (1,183,216) 316,437

Actual Student Enrollment 395 42 -

Total Paid Student Enrollment 395 42 437

PROGRAM SERVICES SUPPORT SERVICES


REGULAR EDUCATION

SPECIAL EDUCATION


REGULAR EDUCATION

SPECIAL EDUCATION


CSI:This line should show how many students a school intends to be paid for.

For Example:If a school plans on enrollment of 100 students however is budgeting to only receive 95% of those students, 95 should be entered in in this row.

ENROLLMENT - *School Districts Are Linked To Above Entries*

NYC 395 42 437

School District 2 (Enter Name) -




TOTAL ENROLLMENT 395 42 437

REVENUE PER PUPIL 14,837 19,517 -

EXPENSES PER PUPIL 10,850 21,308 -

REGULAR EDUCATION

SPECIAL EDUCATION TOTAL ENROLLED

CSI:$75,000 should be set aside for Dissolution and it can be spread out over the first THREE years if the school chooses. If spread out each year should minimally be $25k.

A note can be added under assumptions describing the breakout.

1

23456 Total Revenue7 Total Expenses8 Net Income9 Actual Student Enrollment

10 Total Paid Student Enrollment1112131415 REVENUE16 REVENUES FROM STATE SOURCES 2014-1517 Per Pupil Revenue Per Pupil Rate18 NYC CHANCELLOR'S OFFICE 1377719 - 020 - 021 - 022 - 023 - 024 - 025 - 026 - 027 - 028 - 029 - 030 - 031 - 032 - 033 ALL OTHER School Districts: ( Weighted Avg ) 034 TOTAL Per Pupil Revenue (Weighted Average Per Pupil Funding)1377735 Special Education Revenue36 Grants37 Stimulus38 DYCD (Department of Youth and Community Development)39 Other40 Other41 TOTAL REVENUE FROM STATE SOURCES4243 REVENUE FROM FEDERAL FUNDING44 IDEA Special Needs45 Title I46 Title Funding - Other47 School Food Service (Free Lunch)48 Grants49 Charter School Program (CSP) Planning & Implementation

Institute:This line should show how many students a school intends to be paid for.

For Example:If a school plans on enrollment of 100 students however is budgeting to only receive 95% of those students, 95 should be entered in in this row.

Institute:CURRENT YEAR PER PUPIL REVENUE RATE

Institute:All Districts after 15th highest enrolled district are combined under "ALL OTHER"

Institute:This figure is a weighted average of all other districts' rates under ALL OTHER

50 Other51 Other 52 TOTAL REVENUE FROM FEDERAL SOURCES5354 LOCAL and OTHER REVENUE55 Contributions and Donations56 Fundraising57 Erate Reimbursement58 Earnings on Investments59 Interest Income60 Food Service (Income from meals)61 Text Book62 OTHER63 TOTAL REVENUE FROM LOCAL and OTHER SOURCES6465 TOTAL REVENUE 666768 EXPENSES69 ADMINISTRATIVE STAFF PERSONNEL COSTS Avg. No. of Positions70 Executive Management 171 Instructional Management 372 Deans, Directors & Coordinators 373 CFO / Director of Finance 174 Operation / Business Manager 375 Administrative Staff 776 TOTAL ADMINISTRATIVE STAFF 187778 INSTRUCTIONAL PERSONNEL COSTS79 Teachers - Regular 1680 Teachers - SPED 481 Substitute Teachers 082 Teaching Assistants 083 Specialty Teachers 1084 Aides 085 Therapists & Counselors 486 Other 087 TOTAL INSTRUCTIONAL 348889 NON-INSTRUCTIONAL PERSONNEL COSTS90 Nurse 091 Librarian 092 Custodian 093 Security 094 Other 095 TOTAL NON-INSTRUCTIONAL 09697 SUBTOTAL PERSONNEL SERVICE COSTS 529899 PAYROLL TAXES AND BENEFITS

100 Payroll Taxes

Institute:Figures represent the average of the Quarterly Budgeted/Revised Budgeted FTE count for each position.Institute:

Sample titles that fall under this line: - Head of School - Superintendant - School Leader - Executive Director - CEO

Institute:Sample titles that fall under this line: - Principal - Vice-Principal - Assistant Principal - Chief Academic Officer

Institute:Sample titles that fall under this line:Director, Deans, Coordinators of: - Curriculum - Instruction - Faculty - Students - Assessment - Student Affairs - Student Achievement - Development

Institute:Sample titles that fall under this line: - Secretary - Receptionist - Attendance Clerk - Office Manager

Institute:Sample titles that fall under this line:Content/Subject Area Teachers: - ELA - Math - Social Studies - ScienceInstitute:Sample titles that fall under this line: - ESL - Reading - Math and/or Literacy Specialists - Art - PE - Music - Foreign Languages - Photography - Ceramics

Institute:Sample titles that fall under this line: - Speech Therapists - Social Workers

Institute:CafeteriaOther

Institute:Health and DentalSocial SecurityMedicareUnemploymentOther

101 Fringe / Employee Benefits102 Retirement / Pension103 TOTAL PAYROLL TAXES AND BENEFITS104105 TOTAL PERSONNEL SERVICE COSTS 52106107 CONTRACTED SERVICES108 Accounting / Audit 109 Legal110 Management Company Fee111 Nurse Services112 Food Service / School Lunch113 Payroll Services114 Special Ed Services115 Titlement Services (i.e. Title I)116 Other Purchased / Professional / Consulting117 TOTAL CONTRACTED SERVICES118119 SCHOOL OPERATIONS120 Board Expenses121 Classroom / Teaching Supplies & Materials122 Special Ed Supplies & Materials123 Textbooks / Workbooks124 Supplies & Materials other125 Equipment / Furniture126 Telephone 127 Technology128 Student Testing & Assessment129 Field Trips130 Transportation (student)131 Student Services - other132 Office Expense133 Staff Development134 Staff Recruitment135 Student Recruitment / Marketing136 School Meals / Lunch137 Travel (Staff)138 Fundraising139 Other140 TOTAL SCHOOL OPERATIONS141142 FACILITY OPERATION & MAINTENANCE143 Insurance144 Janitorial145 Building and Land Rent / Lease / Facility Finance Interest146 Repairs & Maintenance 147 Equipment / Furniture148 Security149 Utilities150 TOTAL FACILITY OPERATION & MAINTENANCE151

Institute:Health and DentalSocial SecurityMedicareUnemploymentOther

Institute:JanitorialConsultants - Assessment - Technology - OtherSecurityBackground ScreeningPublic Relations

Institute:DevelopmentConferences

Institute:Curriculum

Institute:InstructionalNon-InstructionalAthleticMusicOffice Equipment* Includes the Purchase or Lease of any of the above

Institute:HardwareSoftwareInternetWiringOther

Institute:UniformsSpecial EventsInstitute:PrintingPostageCopyingAll Other

Institute:Conferences

Institute:Interest Bank ChargesBad DebtMisc. Fees (i.e. Licensing)Dues & MembershipAll Other (If any questions contact Institute)

Institute:Include any Facility Rental/Leasing/Financing costs.Institute:FacilityEquipmentInstitute:Facility Related* Includes the Purchase or Lease of any equipmentInstitute:ElectricGasOther

152 DEPRECIATION & AMORTIZATION153 RESERVES / CONTINGENCY154155 TOTAL EXPENSES156157 NET INCOME158159 ENROLLMENT - *School Districts Are Linked To Above Entries*160 Number of Districts:161 NYC CHANCELLOR'S OFFICE 99.46685162 - 0163 - 0164 - 0165 - 0166 - 0167 - 0168 - 0169 - 0170 - 0171 - 0172 - 0173 - 0174 - 0175 - 0176 ALL OTHER School Districts: ( Weighted Avg ) 0177 TOTAL ENROLLMENT178179 REVENUE PER PUPIL180181 EXPENSES PER PUPIL

Institute:ElectricGasOther

14 15

NEW VISIONS CHARTER SCHOOL FOR ADVANCED MATH AND SCIENCE IIIBudget / Operating Plan2015-16

6680190.1698 6680190.16986363753.05 6363753.05

316437.1198 316437.1198

Total YearOriginal Budget Revised Budget

5481419.1698 5481419.16980 00 00 00 00 00 00 00 00 00 00 00 00 00 00 0

5481419.1698 5481419.1698774082 774082

0 0DYCD (Department of Youth and Community Development) 0 0

0 00 0

6255501.1698 6255501.1698

45642 45642135069 135069

7800 78000 0

Charter School Program (CSP) Planning & Implementation 204783 204783

Institute:CURRENT YEAR PER PUPIL REVENUE RATE

Institute:This figure is a weighted average of all other districts' rates under ALL OTHER

0 00 0

393294 393294

0 00 00 00 00 00 0

31395 313950 0

31395 31395

6680190.1698 6680190.1698

Avg. No. of Positions144200 144200

346105.75 346105.75155514.55 155514.55

127308 127308165958.75 165958.75

295610 2956101234697.05 1234697.05

1047000 1047000232000 232000

0 00 0

594000 5940000 0

253380 2533800 0

2126380 2126380

0 00 00 00 00 00 0

3361077.05 3361077.05

368036 368036

Institute:Figures represent the average of the Quarterly Budgeted/Revised Budgeted FTE count for each position.

470552 470552235276 235276

1073864 1073864

4434941.05 4434941.05

11986 1198625000 25000

534415 5344150 0

24887 2488715964 15964

0 00 0

246876 246876859128 859128

0 0203424 203424

0 084370 8437074250 74250

0 062000 62000

296766 29676626911 26911

0 030000 3000020000 2000023307 2330724857 2485735000 35000

2500 25000 0

1608 16080 0

72000 72000956993 956993

25191 251910 0

5000 500042500 4250040000 40000

0 00 0

112691 112691

0 00 0

6363753.05 6363753.05

316437.1198 316437.1198

16 17 18

NEW VISIONS CHARTER SCHOOL FOR ADVANCED MATH AND SCIENCE III

0 6680190.1698 6680190.16980 -6363753.05 -6363753.050 316437.1198 316437.1198

Total Year VARIANCEVariance Original Budget vs. PY BudgetRevised Budget vs. PY Budget

0 5481419.1698 5481419.16980 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 5481419.1698 5481419.16980 774082 774082

0 0 00 0 00 0 00 0 00 6255501.1698 6255501.1698

0 45642 456420 135069 1350690 7800 78000 0 0

0 204783 204783

0 0 00 0 00 393294 393294

0 0 00 0 00 0 00 0 00 0 00 0 00 31395 313950 0 00 31395 31395

0 6680190.1698 6680190.1698

0 -144200 -1442000 -346105.75 -346105.750 -155514.55 -155514.550 -127308 -1273080 -165958.75 -165958.750 -295610 -2956100 -1234697.05 -1234697.05

0 -1047000 -10470000 -232000 -2320000 0 00 0 00 -594000 -5940000 0 00 -253380 -2533800 0 00 -2126380 -2126380

0 0 00 0 00 0 00 0 00 0 00 0 0

0 -3361077.05 -3361077.05

0 -368036 -368036

0 -470552 -4705520 -235276 -2352760 -1073864 -1073864

0 -4434941.05 -4434941.05

0 -11986 -119860 -25000 -250000 -534415 -5344150 0 00 -24887 -248870 -15964 -159640 0 00 0 00 -246876 -2468760 -859128 -859128

0 0 00 -203424 -2034240 0 00 -84370 -843700 -74250 -742500 0 00 -62000 -620000 -296766 -2967660 -26911 -269110 0 00 -30000 -300000 -20000 -200000 -23307 -233070 -24857 -248570 -35000 -350000 -2500 -25000 0 00 -1608 -16080 0 00 -72000 -720000 -956993 -956993

0 -25191 -251910 0 00 -5000 -50000 -42500 -425000 -40000 -400000 0 00 0 00 -112691 -112691

0 0 00 0 0

0 -6363753.05 -6363753.05

0 316437.1198 316437.1198

19

DESCRIPTION OF ASSUMPTIONS

1of1

AuditedFinancialStatementChecklistLastupdated:10/29/2015

Page1

CharterSchoolName:

1.Pleasecheckeachitemthatisincludedinthe2014-15AuditedFinancialStatementsubmittedforyourcharterschool.

Yes/No

AuditedFinancialStatements(includingreportoncomplianceandreportoninternalcontroloverfinancialreporting)

Yes

SingleAudit(ifapplicable) Yes

CSPAgreedUponProcedures(ifapplicable) NotApplicable

ManagementLetter Yes

ReportonExtracurricularStudentActivityAccounts(ifapplicable) NotApplicable

CorrectiveActionPlansforanyFindings NotApplicable

2.Pleaseindicatedifthereisafinding(s)notedinanyofthefollowingsectionsofyourcharterschool's2014-15Audited

FinancialStatement.

Yes/No

ReportonCompliance No

ReportonInternalControloverFinancialReporting No

SingleAudit No

CSPAgreedUponProceduresReport NotApplicable

ManagementLetter No

Thankyou.

1of1

AppendixE:DisclosureofFinancialInterestFormLastupdated:08/28/2015

Page1

Alltrusteeswhoservedonaneducationcorporationgoverningoneormorecharterschoolsduringthe2014-2015

schoolyearmustcompletetheforminAppendixE(DisclosureofFinancialInterestForm).TheDisclosureofFinancial

InterestFormsaredueonNovember1,2015.AlinktoasafeandsecureformthateachTrusteemustcompletebythe

November1,2015dealinewillbeprovideherebySeptember1,2015orsooner.

ALLcharterschoolsormergededucationcorporationsmustcompletetheBoardofTrusteesMembershipTablewithin

theonlineportalinAppendixF(BoardofTrusteesMembershipTable).TheBoardofTrusteesMembershipTablemust

besubmittedbyAugust1,2015.

Regents-authorizedcharterschoolsmustuploadacompletesetofboardoftrusteeMeetingMinutesfromJuly2014-

June2015intoAppendixG(BoardMinutes).BoardofTrusteeMeetingMinutesmustbesubmittedbyAugust1,2015.

Yes,eachmemberoftheschool'sBoardofTrusteeswillreceivealinktotheDisclosureofFinancialInterestForm.

Yes

Thankyou.

1of2

AppendixF:BOTMembershipTableCreated:07/20/2015


Page1

1.CurrentBoardMemberInformation

TrusteeName EmailAddress CommitteeAffiliation(s)

VotingMember?(Y/N)

AreaofExpertise,and/orAdditionalRoleandSchool(parent,staffmember,etc.)

NumberofTermsServedandLengthofEach(Includeelectiondateandtermexpiration)

1 JennellaYoung Chair/BoardPresident

Yes Community-BasedOrganization

1,3Years(1/1/13-12/31/15)

2 LiorEvan Treasurer Yes Finance 1,3Years(1/1/13-12/31/15)

3 RonaldChaluisan Secretary Yes SchoolLeader2,2Years/3Years(1/1/13-12/31/17)

4 DavidBriggs o Trustee/Member Yes Architect 2,1year/3Years1/1/13-12/31/16)

5EleanorApplewhaite Trustee/Member Yes Lawyer

1,3Years(12/1/13-12/31/16)

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

2.TotalNumberofMembersJoiningBoardduringthe2014-15schoolyear

2of2

0

3.TotalNumberofMembersDepartingtheBoardduringthe2014-15schoolyear

0

4.AccordingtotheSchool'sby-laws,whatisthemaximumnumberoftrusteesthatmaycomprisethegoverningboard?

15

5.HowmanytimesdidtheBoardmeetduringthe2014-15schoolyear?

10

6.HowmanytimeswilltheBoardmeetduringthe2015-16schoolyear?

12

Thankyou.

1of1

AppendixI:TeacherandAdministratorAttritionLastupdated:07/29/2015

Reportchangesinteacherandadministratorstaffing.

Page1

CharterSchoolName:

InstructionsforcompletingtheTeacherandAdministratorAttritionTables

ALLcharterschoolsshouldprovide,forteachersandadministratorsonly,thefulltimeequivalent(FTE)ofstaffonJune

30,2014,theFTEforaddedstafffromJuly1,2014throughJune30,2015,andtheFTEforanydepartedstafffromJuly

1,2014throughJune30,2015usingthetwotablesprovided.

2013-14TeacherAttritionTable

FTETeachersonJune30,2014 FTETeachersAdditions7/1/14–6/30/15

FTETeacherDepartures7/1/14–6/30/15

11 16 8

2013-14AdministratorPositionAttritionTable

FTEAdministratorPositionsOn6/30/2014

FTEAdministratorAdditions7/1/14–6/30/15

FTEAdministratorDepartures7/1/14–6/30/15

3 1 0

Thankyou

1of1

AppendixJ:UncertifiedTeachersLastupdated:07/29/2015

"thirtypercentumor5teachers,whicheverisless"TocomplywithNYSEducationLawSection2854(3)(a-1),pleasereportthe(FTE)countofuncertifiedandcertifiedteachingstaffasofthelastdayofschoolforthe2014-15schoolyear.

Page1

CharterSchoolName:

NoteDefinitionofFTE:

Full-timeequivalentemployeesequalthenumberofemployeesonfull-timeschedulesplusthenumberofemployeesonpart-

timeschedulesconvertedtoafull-timebasis.Thenumberoffull-timeequivalentemployeesineachindustryistheproductof

thetotalnumberofemployeesandtheratioofaverageweeklyhoursperemployeeforallemployeestoaverageweeklyhours

peremployeeonfull-timeschedules.Anindustry’sfull-timeequivalentemploymentwillbelessthanthenumberofits

employeesonfull-andpart-timeschedules,unlessithasnopart-timeemployees(U.S.Commerce--BureauofEconomic

Analysisat:http://www.bea.gov/faq/index.cfm?faq_id=368#sthash.8Rbj89kq.dpuf)

HowmanyUNCERTIFIEDFull-TimeEquivalentTeacherswereemployedinthecharterschoolasoflastdayofschoolin

2014-15?

Foreachapplicablecategory(i-iv),inputtherelevantfulltimeequivalent(FTE)countofteachers.

FTE-(June30,2015)

(i)uncertifiedteacherswithatleastthreeyearsofelementary,middleorsecondaryclassroomteachingexperience

3

(ii)individualswhoaretenuredortenuretrackcollegefaculty 0

(iii)individualswithtwoyearssatisfactoryexperiencethroughTeachforAmerica

0

(iv)individualswhopossessexceptionalbusiness,professional,artistic,athletic,ormilitaryexperience

0

FTEcountofuncertifiedteacherswhodonotfitintoanyofthefourstatutorycategories

0

Total 3.0

HowmanyCERTIFIEDFull-TimeEquivalentTeacherswereemployedinthecharterschoolasofthelastdayofschoolin

2014-15?

16

Thankyou.

Principal

New Visions Charter High School for Advanced Math and Science III

2014-2015 Organizational Chart

Director, School Ops Assistant Principal Assistant Principal

Business Manager Teacher - Social Studies Teacher - Social Studies

Technology Manager Teacher - Science Teacher - Science

Dean Manager Teacher - Math Teacher - Math

School Associate Teacher - Math Teacher - English

School Assistant Teacher - English Teacher - English

Parent Coordinator Teacher - Physical Education Teacher - Special Education

School Coordinator Teacher - Special Education Teacher - Arts

Teacher - ArtsTeacher - Social Studies

Teacher - Physical Education Teacher - Science

Teacher Science Teacher - ESL

Teacher - Foreign Language

Mission and Key Design Elements New Visions Charter High School for Advanced Math and Science III is part of the New Visions Charter High Schools’ (NVCHS) network. NVCHS is a network of secondary schools dedicated to supporting all students in meeting the highest academic standards. We shift classroom dynamics from one where students receive information to one where students find solutions to community-defined problems by using their imagination coupled with a mastery of content and skills. We challenge our students to present and defend their learning as part of preparing and supporting them to graduate ready for college, careers and a 21st century economy. Teaching and learning in New Visions Charter High Schools is built upon the Lincoln Center Education Capacities for Imaginative Thinking, informed by challenge-based curricula that are aligned to Common Core Standards, applied to improving local communities and and driven by student performance data. NVCHS believe that education is about radically disrupting the cycle of poverty that prevents students from succeeding in life. That’s why we have created a network of charter schools and push to improve their performance. That’s why we are committed to work with high needs students in our most underserved neighborhoods. That’s why we focus on concrete goals, like preparing students for college and careers, that will enable them to be self-sufficient, contribute to their families and community, and be competitive in the global marketplace. All of our work is grounded in this vision. Five key principles underpin our school model and involve all members of our community:

High expectations for who we are and what we do; Individualized, scaffolded supports that lead to self-efficacy and self-

actualization; Imaginative thinking, combined with knowledge and skills to solve

challenges; Leadership that is expected and actively developed; and Classroom as community—and community as classroom.

These principles are made concrete through our school model that is structured as: a Lower House that provides students with a solid academic and socio-emotional foundation to succeed in Upper House and an Upper House that engages students in self-defined experiences with a post-secondary focus.

Required Form: 2014-15 Appendix E - Trustee Disclosure of FinancialInterest FormCreated Friday, August 28, 2015Updated Tuesday, September 01, 2015https://nysed.fluidsurveys.com/account/surveys/537586/responses/export//s/Regents-Appendix-E-BOT-Form/f3a582d497d8c515a43ef13ab7787425d4f57cce/

Page 1

Please open the link to this form using Google Chrome as your browser. Doing so will allowyou to input your signature on page 2 of the form. Thank you.

1. TRUSTEE NAMEFirst Name Last Name

Trustee Name David Briggs

2. *Your Home Address:2. *Your Home Address: | Street Address

2. *Your Home Address: | City/State

2. *Your Home Address: | Zip

3. *Your Business Address3. *Your Business Address | Street Address

3. *Your Business Address | City/State

3. *Your Business Address | Zip

4. *Daytime Phone Number:

5. *E-mail Address:

6. I am a Trustee of a parent education corporation listed below which governs one or morecharter schools.

New Visions Charter Schools (Ed Corp)

New Visions CHS for AMS III

New Visions CHS for AMS IVNew Visions CHS for the HUM III

New Visions CHS for the HUM IV

8. Select all positions you have held on the Board:

(check all that apply)

(No response)

9. Are you a trustee and also an employee of the school?

No

Page 2

10. Are you a trustee and an employee or agent of the management company or institutionalpartner of the charter school?

No

11. Have you or any of your immediate family members or any persons who live with you inyour house had an interest in or engaged in a transaction with the charter school during the timeyou have served on the board, and in the six-month period prior to such service?

No

12. Are you a member, director, officer or employee of an organization formally partnered witha school that is doing business with the charter school and in which such entity, during yourtenure as a trustee, you and/or your immediate family member or person living in your househad a financial interest or relationship?

No

Signature of Trustee

Thank you.

Required Form: 2014-15 Appendix E - Trustee Disclosure of FinancialInterest FormCreated Friday, September 11, 2015

https://nysed.fluidsurveys.com/account/surveys/537586/responses/export//s/Regents-Appendix-E-BOT-Form/81a61772736067949943a5d2ceef4bf4bf67c4d6/

Page 1



Trustee Name peter cantillo








5. *E-mail Address:







(check all that apply)• Other, please specify...: Trustee


No

Page 2


No


No


No


Thank you.

Required Form: 2014-15 Appendix E - Trustee Disclosure of FinancialInterest FormCreated Wednesday, November 04, 2015

https://nysed.fluidsurveys.com/account/surveys/537586/responses/export//s/Regents-Appendix-E-BOT-Form/ea38f462b6330a554b92eddc62036a20da97acea/

Page 1



Trustee Name Ronald Chaluisan








5. *E-mail Address:







(check all that apply)• Secretary


No

Page 2


Yes

10a. If YES, please provide a description of the position you hold and your responsibilities, yoursalary and your start date.

[cmoeY.0] 10a. If YES, please provide a description of the position you hold and yourresponsibilities, your salary and your start date. | Position Held

Vice President

[cmoeY.1] 10a. If YES, please provide a description of the position you hold and yourresponsibilities, your salary and your start date. | Responsibilities

Oversee Charter Initiative for NewVisions

[cmoeY.2] 10a. If YES, please provide a description of the position you hold and yourresponsibilities, your salary and your start date. | Salary

315,000

[cmoeY.3] 10a. If YES, please provide a description of the position you hold and yourresponsibilities, your salary and your start date. | Start Date

November 2, 2002


No


Yes

12a. Identify each individual, business, corporation, union association, firm, partnership,committee proprietorship, franchise holding company, joint stock company, business or realestate trust, non-profit organization, or other organization or group of people doing businesswith the school and in which such entity, during the time of your tenure as a trustee, you and/oryour immediate family member or person living in your house had a financial interest or otherrelationship. If you are a member, director, officer or employee of an organization formallypartnered with the school that is doing business with the school through a management orservices agreement, please identify only the name of the organization, your position in theorganization as well as the relationship between such organization and the school. If there wasno financial interest, write None.

OrganizationConducting Businesswith the School

Nature ofBusinessConducted

Approximate Valueof the BusinessConducted

Name of Trustee and/orImmediate Family Memberwith Interest

Steps Taken toAvoid Conflict ofInterest

1 New Visions forPublic Schools

ManagementOrganization

Management Fee(8%)

Ronald Chaluisan

2

3

4

5


Thank you.


https://nysed.fluidsurveys.com/account/surveys/537586/responses/export//s/Regents-Appendix-E-BOT-Form/411931902d228f694fd1beb71e7236807921e38e/

Page 1



Trustee Name Lior Evan








5. *E-mail Address:







(check all that apply)• Treasurer


No

Page 2


No


No


No


Thank you.


https://nysed.fluidsurveys.com/account/surveys/537586/responses/export//s/Regents-Appendix-E-BOT-Form/aae32828fdd29d7219a28497b2a12c91b190f675/

Page 1



Trustee Name Eleanor Applewhaite








5. *E-mail Address:







(check all that apply)• Other, please specify...: Board Member


No

Page 2


No


No


No


Thank you.

schools) 2. charter authorizer i. school information...

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