Preliminary Pupil Headcount Report (DS-4898)

Complete this form if at least one of the following applies:

-The district is in their 1st or 2nd year of operation.

-The district is offering a grade level for the first time this year.

During the second week of September, count the number of students in attendance each day for each grade district-wide.

During the third week of September, report the highest count of students in attendance during the week prior for each grade district-wide, even if the grade level has been offered for more than two years.

This data will be used for payment purposes until your actual membership data has been submitted for the count.

District Information

Number of Years Operating