Enrollment Authorization Form

Enrollment for the purposes of this program, is based upon the district of residence of the private school. Please complete the top half of the form with the total number of students enrolled at the non-public school as reported on BEDS October 1st of the preceding school year. For purposes of verification, please attach a list of the students including addresses. We have provided an excel spreadsheet if you wish to export your student list for ease of submission. See "Related Files" on this page. 

Please submit the Enrollment Authorization Form with the attached list to (only one form required for each non-public school): 

Monroe #1 BOCES
Kathy Altieri
15 Linden Park
Rochester, NY  14625

Email Kathy Altieri
Phone: 585-249-7289 
Fax: 585-249-7809

Requests for Library and Computer Software materials will be processed after enrollment has been verified. You may wish to submit enrollment forms before submitting your requests. 

Please note:

It is not necessary to submit a separate enrollment verification form for each (library and software) service.