WEST VIRGINIA
1003(g) SCHOOL IMPROVEMENT GRANT
APPLICATION COVER
TIER III SCHOOLS
Complete a separate application for each school served by the LEA.
County___________________________________________________________________________
LEA Title I Director____________________________________________E-mail_______________________
LEA Curriculum Director________________________________________E-mail_______________________
LEA Special Education Director__________________________________ E-mail_______________________
Others may be added as needed by the LEA.
Superintendent Signature__________________________________________ Date____________
LEA Title I Director Signature______________________________________Date____________
Provide a brief summary of the LEA’s proposed Title I school improvement grant program.
LEA APPLICATION
I. SCHOOLS TO BE SERVED: List each Tier III school the LEA commits to serve and provide
principal information.
Tier III Schools:
School Name/
NCES ID#
II.
Principal
Email Address
DESCRIPTIVE INFORMATION: Address the following subsections.
A. The needs assessment and capacity index were previously provided in the letter of intent to apply.
The letter of intent to apply has been evaluated according to the established criteria and if it was
deemed to have met the standard, no further action is required. If revisions were required,
attach a copy of the revised letter of intent with changes highlighted.
B1. For each Tier III school the LEA will serve, develop measurable summative and growth
goals that will be used by the LEA to monitor progress of student achievement on the
State’s assessments in both reading/language arts and mathematics. Annual growth goal
example: “The percentage of students who exhibit typical growth in grades 6-8 in
mathematics will increase annually as measured by the WESTEST 2.”
School Name:
Annual Summative Achievement Goal for Reading/Language Arts:
Annual Growth Goal for Reading/Language Arts:
Annual Summative Achievement Goal for Mathematics:
Annual Growth Goal for Mathematics:
Respond to the following:
 How were these goals determined?
 What interim assessment activities will be used throughout the school year by the school
staff to track progress toward meeting the annual goals?
B2. Describe below how the summative and growth goals will be utilized by the LEA to evaluate
the school’s academic progress.
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III.
TIER III ACTIVITIES: Identify activities and establish timelines for implementation
consistent with the final requirements as directed below. LEAs should address
applicable areas in subsections A-E. LEAs are required to complete subsection F and
Sections IV-VII.
A. Comprehensive instructional reform programs. Identify any activities that will be completed
as ‘pre-implementation’ (see APPENDIX A, if applicable).
1. Describe how the school staff will use data to identify and implement an instructional
program that is research-based and vertically aligned from one grade to the next as well
as aligned with State academic standards.
2. Describe how the school staff will promote the continuous use of student data to inform
and differentiate instruction.
3. Describe other permissible activities, as defined in the regulations, the school staff will
implement as comprehensive instructional reform programs (if applicable).
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B. Increasing learning time and creating community-oriented schools. Identify any activities that
will be completed as ‘pre-implementation’ (see APPENDIX A, if applicable).
1. Describe how the school staff will establish schedules and strategies that provide increased
learning time and create community-oriented schools. An additional 300 hours per year is
recommended by ED.
2. Describe how the school staff will provide ongoing mechanisms for family and community
engagement.
3. Describe other permissible activities, as defined in the regulations the school staff will
implement to increase learning time and create community-oriented schools (if
applicable).
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C. Provide operating flexibility and sustained support.
1. Describe the operational flexibility (e.g., staffing, calendar, time, budget) the school staff
will be given in order to fully implement a comprehensive approach to substantially
improve student achievement outcomes and increase the graduation rate.
2. LEA Technical Assistance: Provide a description of the ongoing, intensive technical
assistance and related support the LEA staff will provide to the school.
3. Describe the intensive technical assistance and related support for the school staff will
be provided by a designated external lead partnership organization, if applicable.
4. Describe other permissible activities the school staff will implement to provide operating
flexibility and sustained support.
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D. Describe the strategies the district staff will utilize to recruit, place and retain staff in the
schools served by the 1003(g) grants (if applicable).
E. Describe other permissible activities, as defined in the regulations, the district staff chooses
to implement in each school to develop teacher and school leader effectiveness.
F. Describe how high quality, job-embedded professional development will be provided.
Identify any activities that will be completed as ‘pre-implementation’, if applicable.
1.
All schools that receive a Title I 1003(g) school improvement grant will be required to
have PLCs as a means for providing job-embedded, sustained professional development
that will lead to lasting change. Describe the format for the professional learning
communities in the district and further delineate where the individual schools differ, if
applicable. The description must address the following items:
 Structure (e.g., grade level, content area, facilitators)
 Frequency of meetings
 Major areas of focus for the work of the PLCs
 Monitoring the effectiveness of the PLCs
2. Provide an overall description of the professional development plan for the school staff
describing the focus of the PD and how it will fundamentally change teaching and
learning in the school.
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3. In addition, provide a specific description of professional development activities by year
in the chart below. Note: All professional development must be both research-based and
sustainable.
‘Pre-Implementation’ (see APPENDIX A): June 2011 - August 2011
Date
Topic
Presenter(s)
Year One: September 2011 - August 2012
Date
Topic
Presenter(s)
Year Two: September 2012 - August 2013
Date
Topic
(month)
Presenter(s)
Year Three: September 2013 - August 2014
Date
Topic
(month)
Presenter(s)
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IV.
BUDGET: Include a budget and narrative indicating the amount of school
improvement funds the LEA will allocate per year.
An LEA’s proposed budget will span a three-year period, (SY 11-12; SY 12-13; SY 13-14), as the
SEA has applied for a waiver to extend the period of availability of funds. The overall LEA budget
must indicate how it will allocate school improvement funds, over a three-year period, as well as any
‘pre-implementation’ activities, among the Tier III schools it commits to serve.
Submit budget spreadsheets and narrative as specified below:
1. LEA Budget Detail
a. Budget Spreadsheet: Complete the LEA budget spreadsheet and detail how the
requested funds will be used at the LEA level to support the school improvement
models in Tier III schools.
b. The budget narrative shall include the following items:
 An overview of the activities included in the budget
 A description of how other federal, state, and local funds will be leveraged to
further support school improvement plans
 A description of any broad items in the budget (e.g., personnel, contracted
services, professional development, equipment, travel expenses)
2. School-Level Detail
a. Budget Spreadsheet: The LEA will complete a separate budget spreadsheet for each
eligible school receiving school improvement funds.
b. The budget narrative shall include the following items:
 An overview of the activities included in the budget
 A description of how other federal, state, and local funds will be leveraged to
further support school improvement plans
 A description of any broad items in the budget (e.g., personnel, contracted
services, professional development, equipment, travel expenses)
Align other resources with the intervention as detailed in the budget and the budget narrative for each
school.
 The detailed budget narrative will provide evidence of how other sources (regular school
Title I; Title I 1003(a); Title II, Part A; Title III, Part A; state/local commitment and
community resources) are aligned with the selected interventions.
 The LEA will provide a narrative description of how other resources (e.g., personnel,
materials, services) to support the selected intervention model in the grant application.
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VI. ASSURANCES: The LEA must include the following assurances in its application for a
school improvement grant. Check the applicable boxes.
The LEA assures it will adhere to the following actions:

Establish annual goals (summative and growth) for student achievement on the State’s
assessments in both reading/language arts and mathematics and measure progress on the leading
indicators in Section III of the final requirements in order to monitor each Tier III school.

Organize the school staff into PLCs and provide high quality job-embedded professional
development.

Participate in the SEA on-site monitoring and technical assistance.

Comply with all state statutes and federal laws related to the Title I Part A, 1003(g) program.
Appropriate records will be provided to the State Educational Agency (SEA) as needed for fiscal
audit and program evaluation.

Assure that funds made available through this statute will be used to supplement and not
supplant funds from non-federal sources.

Maintain accurate program records which document progress in implementing the plans
approved in this application.

Report to the SEA the school-level data required under Section III of the final requirements upon
request.
VII. WAIVERS: The SEA has obtained waivers of requirements applicable to the LEA’s School
Improvement Grant. The LEA must check the box below if it intends to enact the waiver.

Extending the period of availability of school improvement funds.
The LEA that chooses to implement one or more of these waivers will comply with section I.A.7 of
the final requirements.
The LEA assures that it will implement the waiver(s) only if the LEA receives a school improvement
grant and requests to implement the waiver(s) in its application. As such, the LEA will only
implement the waivers(s) in Tier III schools, as applicable, included in this application.
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APPENDIX A
Pre-Implementation: As soon as it receives the funds, an LEA may use part of its first year
allocation (2011-2012) during the (2010-2011 school year) for SIG-related “pre-implementation”
activities. These pre-implementation activities shall be budgeted separately (see budget sheet). Preimplementation activities must (1) support the full and effective implementation of the intervention
model selected by the LEA, (2) address the needs identified by the LEA, (3) be reasonable and
necessary for full implementation, and (4) help improve student achievement. Possible activities that
an LEA may carry out during the spring or summer prior to full implementation may include the
topics listed below. This list should not be considered as exhaustive or required.
Preparation for Accountability Measures:
 Analyze data on leading baseline indicators.
 Develop and adopt interim assessments for use in SIG-funded schools.
Professional Development and Support:
 Train staff on the implementation of new or revised instructional programs and policies
aligned with the school’s comprehensive instructional plan and the school’s intervention
model.
 Provide instructional support for returning staff members, such as classroom coaching,
structured common planning time, mentoring, consultation with outside experts, and
observations of classroom practice, that is aligned with the school’s comprehensive
instructional plan and the school’s intervention model.
Instructional Programs:
 Provide remediation and enrichment to students in schools that will implement an
intervention model at the start of the 2011-2012 school year through programs with
evidence of raising student achievement (e.g., summer school for in-coming freshmen,
summer school programs designed to prepare low achieving students to participate
successfully in advanced coursework, such as Honors, AP or IB).
 Identify and purchase instructional materials that are research-based, aligned with State
academic standards, and have data-based evidence of raising student achievement.
 Compensate staff for instructional planning, such as examining student data, developing a
curriculum that is aligned to State standards and aligned vertically from one grade level
to another, collaborating within and across disciplines, and devising student assessments.
Family and Community Engagement:
 Hold community meetings to review school performance.
 Discuss the school intervention model to be implemented.
 Develop school improvement plans in line with the intervention model selected.
 Survey students and parents to gauge needs of students, families, and the community.
 Communicate with parents and the community about school status, improvement plans,
and local service providers for health, nutrition, or social services through press releases,
newsletters, newspaper announcements, parent outreach coordinators, hotline, and direct
mail.
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