ca09-hollow-hills-fundamentaldoc：ca09中空丘陵fundamentaldoc.docVIP

2004-2005 No Child Left Behind - Blue Ribbon Schools Program U.S. Department of Education Cover Sheet Type of School: X Elementary __ Middle __ High __ K-12 Name of Principal Mrs. Barbara Patten (Specify: Ms., Miss, Mrs., Dr., Mr., Other) (As it should appear in the official records) Official School Name Hollow Hills Fundamental School (As it should appear in the official records) School Mailing Address__828 Gibson Avenue_______________________________________________ (If address is P.O. Box, also include street address) Simi Valley CA 93065-5665 City State Zip Code+4 (9 digits total) County Ventura School Code Number* 56 72603 6055701 Telephone ( 805 ) 520-6720 Fax ( 805 ) 520-6106 Website/URL www.hollowhills.simi.k12.ca.us E-mail bpatten@simi.k12.ca.us I have reviewed the information in this application, including the eligibility requirements on page 2, and certify that to the best of my knowledge all information is accurate. Date____________________________ (Principal’s Signature) Name of Superintendent* Dr. Kathryn Scroggin (Specify: Ms., Miss, Mrs., Dr., Mr., Other) District Name Simi Valley Unified School District Tel. ( 805 ) 520-6500 I have reviewed the information in this application, including the eligibility requirements on page 2, and certify that to the best of my knowledge it is accurate. Date____________________________ (Superintendent’s Signature) Name of School Board President/Chairperson Mrs. Janice DiFatta (Specify: Ms., Miss, Mrs., Dr., Mr., Other) I have reviewed the information in this package, including the eligibility req