MO 500-2613 (03-13)

This collection is in regard to data for parentally-placed private school students for the 2012-2013 (July 1, 2012 – June 30, 2013) school year as required by the Individuals with Disabilities Education Act of 2004 (IDEA) Section 612(a)(10).

For more information about this form contact the Special Education Data Section at 573-751-7848 or

The Department of Elementary and Secondary Education does not discriminate on the basis of race, color, religion, gender, national origin, age, or disability in its programs and activities. Inquiries related to Department programs and to the location of services, activities, and facilities that are accessible by persons with disabilities may be directed to the Jefferson State Office Building, Office of the General Counsel, Coordinator – Civil Rights Compliance (Title VI/Title IX/504/ADA/Age Act), 6th Floor, 205 Jefferson Street, P.O. Box 480, Jefferson City, MO 65102-0480; telephone number 573-526-4757 or TTY 800-735-2966; email: