A r c h i v e d  I n f o r m a t i o n

Staff Development Grant Application
January 1996 - June 1997

District Information

District_________________________________________ County________________

Address______________________________________________________________
_________________________________________ Zip___________________

Superintendent________________________ Phone___________ Fax____________

School Information

Name__________________________________________ Grade/Age level__________

Address_______________________________________________________________
________________________________________ Zip________________________

Contact Person__________________________ Phone__________ Fax___________

School building totals:

Students______________________ FTE Teachers________________________
Classified_____________________ Administrators________________________

Complete one application per participating school site

Application Checklist

Please submit the original plus two copies of each of the following documents for each participating school site:

_____ 1. Cover Sheet

_____ 2. One-page Narrative

_____ 3. Statement of Assurances

_____ 4. District Improvement Plan - (Only ONE copy of the January 1995 CIM Plan or latest version is required per school district)

Submit to:

Staff Development Grants
Oregon Department of Education
Office of Curriculum, Instruction and Field Services
255 Capitol Street NE
Salem, Oregon 97310-0203

Application deadline is 5:00 p.m., Tuesday, January 16, 1996

Faxed copies will not be accepted.

One page narrative

Describe the existing conditions that support your site's need for staff development to refine and/or implement a school improvement plan and the commitment of staff and community to continuous improvement.

Statement of Assurances

Statement of Assurances for
_______________________________________________
(school building site)

This is to certify that the Staff Development Grant in the _________________________ School District meets the following conditions.

1. The grant application has been approved by the district school board. The application is consistent with existing district policies, rules and contracts bargained under ORS 243.650 to 243.782.

2. The application has been approved by
   ________________________________.
   (bargaining unit)

3. The establishment of the 21st Century Schools Council is consistent with the requirements of this program under ORS 329.570.

4. None of the monies received through this Staff Development Grant shall be used to replace expenditures for existing programs that are a responsibility of the school district.

5. Staff Development Grant monies will be budgeted for release time only to enable teams at each school site to develop and refine a school improvement plan at the school site and to attend a one-day regional workshop associated with this grant program.

6. At the completion of the project, June 30, 1997, the 21st Century Schools Council will submit a school improvement plan and expenditure report.

Signatures:

_____________________________________________ Date__________________
School Board Chair

_____________________________________________ Date__________________
Superintendent

_____________________________________________ Date__________________
Representative of Local Bargaining Unit

_____________________________________________ Date__________________
21st Century Schools Council Chair

Form 581-2206-X (New 9/95)

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