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Petition of Support from Households

A suggested form to certify the petition. You MUST have signatures, which will be retained at the school. For the purpose of this renewal application, you will only need to submit the notarized form that certifies the petition.

A certified petition in support of the charter school renewing its charter status signed by not less than 75 percent of the households whose children were enrolled in the charter school at Subsection J of 22-8B-12 NMSA 1978.

I am the head administrator of the __________________________________Charter School, hereinafter referred to as "the Charter School". I hereby certify that the attached petition in support of the Charter School renewing its charter was circulated to households whose children were enrolled in our charter school.

It contains the signatures of _________ households which represents _________ percent of the households whose children were enrolled in the Charter School.

STATE OF NEW MEXICO)
ss.
COUNTY OF  __________________________)

I, _________________________, being first duly sworn, upon oath state:

That I have read the contents of the attached Petition, and my statements herein are true and accurate to the best of my knowledge and belief.

Notary Public Name: ____________________________

Subscribed and sworn to before me this _____ day of _____ , 20____.

Notary Public Signature: ____________________________ My Commission Expires: