New York State Education Department

Print Request for STAC Forms from a Word  or PDF format.


Request For STAC Forms

Quantity 
Requested

Description of Form

Available Online
Word   PDF    HTML
  STAC-1 Preschool Request for Commissioner's Approval of Services for Students with Disabilities

 Yes      Yes       Yes
  STAC-1 School Age Request for Commissioner's Approval of Services for Students with Disabilities  No       Yes       Yes
  OCFS & OMH STAC-200 Notice of Other State Agency Placement of Children With Handicapping Conditions  No        No        No
  OMRDD 
STAC-200		 Notice of Other State Agency Placement of Children With Handicapping Conditions  No        No        No
  STAC-202 (DSS) Designation of School District of Attendance for a Homeless Child  Yes      Yes       Yes
  STAC-4 Request for Commissioner's Approval of Services for Children in Temporary Housing  No       Yes      Yes
  STAC-5 Request for Commissioner's Approval of Reimbursement for Evaluations  No       Yes      Yes
  Rates Exceeding
$75,000		 High Cost Student Data Report for Students with 10-month Education Rates of $74,999+  Yes        No       Yes
  OTHER Training Packets, manuals etc. (specify requested material) (List below):  No        No       No
 

 
Please fill in complete address where forms should be mailed:
Attention:                                                                                                        Phone:
School:
Street:
City:                                                                                         State:                            Zip:
 

Please Fax Completed form to:  (518) 402-5047
or mail to:
New York State Education Department
STAC and Special Aids Unit
Room 514W EB
Albany, NY  12234
 
Date of Request:                                                               Date Filled:

Page Last Updated on 03/26/2007 10:22 AM by Barb Mastriano