Application
Step 1: CTN Information: Principal and staff read and discuss the information about becoming a
WV Collaborative Teams Network Participating School.
Step 2: Principal Commitment Document: Principal signs and dates the commitment document
and submits by mail along with the other parts of the application.
Step 3: County Superintendent Commitment Document: County superintendent signs and dates
the appropriate commitment document. Applicant includes the county commitment document with
the other parts of the application and submits by mail.
Step 4: Staff Commitment Document: Principal and faculty senate chair sign the Staff
Commitment Assurance document after obtaining at least 80% commitment from professional
staff via secret ballot vote during a faculty senate meeting. Applicant submits the signed document
with the application.
Step 5: Completing the Application: Complete the Collaborative Teams Network Participating
School Application components. (The application is a Word document and may be saved to a
computer desktop for printing and email attachment).
Step 6: Submitting the Application: The application will be received first by email and sorted
electronically, so it is important to follow the electronic submission instructions carefully. The
application due date may be extended if a school obtains at least 80% staff commitment by the
May 6, 2011 deadline. The principal or faculty senate chair may send an email to
lyouell@access.k12.wv.us requesting an extended date.
a. In the subject line of the email, place the words “CTN Application”; your county; the date.
(Example: CTN Application Boone 5-9-11)
b. Attach the completed application to the email. (The application is a Word document and
may be saved to a computer desktop for easy email attachment). Submit the application by
email no later than 5:00 p.m. Friday, May 6, 2011 to Laura Bittle lbittle@access.k12.wv.us.
c. Immediately mail one copy of the application with the required commitment
documents/signatures.
Send application to:
Laura Bittle
Division of Educator Quality and System Support
Office of District Leadership Development
West Virginia Department of Education
1900 Kanawha Blvd. East, Bldg. 6, Room 617
Charleston, WV 25305-0330
304-558-3199
lbittle@access.k12.wv.us
County Superintendent Commitment to CTN School
***The county superintendent reviews the commitments below, signs where indicated, and CTN
school applicant submits the signed form as a part of the application.
The County Superintendent Commits to:
Supporting the WV Collaborative Teams Network Participating School (CTN School) by:
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Collaborating with Regional Support Teams
Selecting one (1) central office liaison to participate in all WV CTN trainings as part of the
school leadership team(s)
Monitoring progress of school teams through already scheduled principals’ meetings
Working with the district liaison to:
o Assist with modifying schedules and staff assignments to accommodate teaming
o Look for ways to link teams with relevant resources inside and outside of the building
(including other teams)
Providing financial support and resources that might include:
o Substitute costs or stipends for the school’s leadership team to attend WV CTN trainings
(Face-to-face workshops involve approximately 6 days of professional development)
o Title I, Title II, and RLIS Funds
o Services of support personnel such as instructional, technology, literacy, special
education & math coaches, Title I staff (in Title I schools), etc.
Working with the central office liaison for commitment of ISE days to professional staff training
in professional learning community processes
Attending state sponsored leadership forum along with the central office liaison
Date______________ Superintendent’s Signature__________________________________
West Virginia Department of Education
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Principal Commitment to CTN School
***The principal reviews the commitments below, signs where indicated, and submits the signed form
as a part of the application.
The Principal Commits to:
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Securing at least 80% staff commitment/consensus to participate in school collaborative teams
that engage in school improvement practices
Forming (or improving the operation of) a School Leadership Team (principal, teachers
representative of each collaborative team and others at the principal’s discretion)
Forming (or improving the operation of) teacher collaborative teams and providing time and
structure for the teams to meet weekly
Leading the school toward becoming a learning community using a distributive model of
leadership to support the work of teacher collaborative teams, collaborative team processes
and protocols focused on student learning
Working with the central office liaison to create time and support for collaborative teams to work
and learn in the school and to work toward removing county level barriers that impede progress
Guiding and monitoring school collaborative teams as they develop collaborative practices and
engage in action research and collective inquiry
Identifying and resolving problem areas of the collaborative team process, removing barriers
that make it difficult for collaborative teams to focus on the critical questions of learning
Facilitating site-based professional development led by the School Leadership Team that
involves all staff in learning how to collaborate to improve student learning
Facilitating documentation of school CT efforts in an electronic story board that will help other
schools learn effective practice
Assisting in evaluating the effectiveness of the support provided to your school
Attending face-to-face workshops
o Two-day forum for statewide leaders
o Regional trainings with school leadership team
o Monthly meetings with the leadership team and Regional Support Team member
Forming a mutual support network with two other schools during the regional workshops and
networking (online and face-to-face) with those schools throughout the CTN experience
Date______________ Principal’s Signature _____________________________________
Staff Commitment
West Virginia Department of Education
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West Virginia Collaborative Teams Network
Participating School (CTN School)
***The principal and faculty senate chair must sign this assurance of staff commitment and submit as
a part of the application.
After sharing the expectations and benefits of a CTN Participating School, results of a secret
ballot vote conducted during a Faculty Senate Meeting revealed at least 80% staff commitment
to the collaborative practices, processes and protocols of participation in the West Virginia
Collaborative Teams Network.
Date_________________ Principal Signature______________________________________
Date_________________ Faculty Senate Chair Signature ____________________________
West Virginia Department of Education
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The remaining sections I, II, III, IV, & V are all required for application, but only Sections II, IV &
V will be scored for selection.
I. School Profile (Section I is for statistical information only--not part of the scoring process
of the school’s application):
RESA:
SCHOOL NAME:
SCHOOL ADDRESS:
CITY, STATE, ZIP:
PHONE:
FAX:
COUNTY:
SUPERINTENDENT:
CENTRAL OFFICE LIAISON—Name and Job Title:
SCHOOL WEBSITE:
PRINCIPAL’S NAME:
PRINCIPAL’S EMAIL:
PRINCIPAL’S SIGNATURE:
DATE:
1. Grade Levels:
2. Enrollment:
3. Demographics:
4. Attendance Rate:
5. Highly Qualified Teacher Data:
West Virginia Department of Education
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6. Other Information-- Please indicate any relevant information about your school, such as
School of Excellence, Title I school, awards or recognitions received, etc. in the lines
below and then provide the requested information in A, B & C that follows.
A. Our school is involved in another collaborative teaming effort (Innovation Zones, I-3 Grant,
etc.).
Yes
No
If yes, please explain.
B. Our school is identified as an SSOS Tiered school and/or the leadership team is registered
to participate in the 2011 Teacher Leadership Institute.
Yes
No
C. The principal or a professional staff member(s) has participated in WVDE’s Classroom
Assessment Network (CAN1 or CAN2).
Yes
No
If yes, please explain.
West Virginia Department of Education
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II. School Organization (Section II is required to determine eligibility, but is not part
scoring process once eligibility is determined):
of the
A. LEADERSHIP TEAM. Does the school have a leadership team in place?
Yes
Our school does not have a leadership team in place, but is willing to create a
defensible structure
If the answer is yes, please describe the membership structure (number, job title, etc.) and
how team members are selected.
B. TEACHER COLLABORATIVE TEAMS. Does the school have teacher collaborative teams in
place or is willing to create structures for teams?
Yes
Our school does not have teacher collaborative teams in place, but is willing to create a
defensible structure
If the answer is yes, please indicate the type(s) of teams below, specify when the teams are
scheduled to meet (before, during or after the school day), and provide a brief description of
their work:
Grade level
Content
Interdisciplinary
Other
Before
Before
Before
During
During
During
After
After
After
Briefly explain the teams’ focus and indicate how often the teams meet.
West Virginia Department of Education
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Does (or will) each collaborative team have a team facilitator/leader?
Yes
Our school does not have teams in place yet
If the answer is yes, are the team facilitator/leaders members of the school leadership team
(as representatives of their collaborative team)?
Yes
No
III. School Culture: (35 points) In one page or less, please complete Section III (A, B, C &
D).
A. Describe how your school maintains a focus on student learning.
B. Describe what you and your staff value.
C. How is change embraced by school staff?
West Virginia Department of Education
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D. Describe how your school uses data and objective dialogue (rather than opinion) to guide
discussions about student learning.
IV. Support Services of Professional Personnel: (30 points) Please complete Section IV in
one page or less.
Briefly describe how the school might use or restructure the time and duties of existing professional
personnel to support collaborative teaming. Include in your answer any requests for time/services
of county support personnel (for example, instructional, technology, literacy, special education &
math coaches, Title I staff [in Title I schools], etc.) and how those services might fit into the school’s
collaborative structures.
V. School Aspirations: (35 points) Please complete Section V in one page or less.
Briefly state why your school should be selected as a participating school in the WV Collaborative
Teams Network. Reveal a vision of how your school (as a CTN School) could sustain the
processes and practices outlined in the expectations (referenced above & in the Information
Section).
West Virginia Department of Education
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