Please take a moment to check your answers.
If everything is right click the "Submit" button to
submit your answers. If not, make your corrections
and click the "Submit" button. Click on the "Cancel"
button to cancel and close this window.
Program name:
Admin Login
Street address 1:
Street address 2:
City:
State:
Zip Code:
Phone:
Fax:
Email Address:
Website:
School District :
Mission/Focus :
First Year Training Costs:
$
First Year Materials Costs:
$
First Year Personnel Costs:
$
First Year Other Costs:
$
Second Year Training Costs:
$
Second Year Materials Costs:
$
Second Year Personnel Costs:
$
Second Year Other Costs:
$
Third Year Training Costs:
$
Third Year Materials Costs:
$
Third Year Personnel Costs:
$
Third Year Other Costs:
$
Fourth+ Year Training Costs:
$
Fourth+ Year Materials Costs:
$
Fourth+ Year Personnel Costs:
$
Fourth+ Year Other Costs:
$
Year introduced in schools:
Number of urban schools:
Number of suburban schools:
Number of rural schools:
Grade level served:
Program has Shown Evidence of Positive Effects for
Diverse Student Populations for the Following Groups:
High-poverty students
Minority students
ELL students
Special Needs students
Urban
Rural
Other
Program has Shown Results in These Subject Areas:
Reading
English/Language Arts
Math
Science
Social Studies
Writing
Other
Program has Shown Evidence of Positive Effects on
Additional Outcomes in These Areas:
School Climate
Student Attendance
Retention/Promotion
Graduation Rates
Discipline Rates
Teacher Satisfaction
Other
150 Word Summary of Research Backing Your Program
Provide 3 citations:
First Citation:
Second Citation:
Third Citation:
Provide 3 school references
School name:
Street address 1:
Street address 2:
City:
State:
Zip Code:
Phone:
Fax:
Email Address:
Website:
Second school reference
School name:
Street address 1:
Street address 2:
City:
State:
Zip Code:
Phone:
Fax:
Email Address:
Website:
Third school reference
School name:
Street address 1:
Street address 2:
City:
State:
Zip Code:
Phone:
Fax:
Email Address:
Website: