Name of Grant Program: Innovation Schools Partnership Planning Grant
Fund Code: 156
Part VI – Innovation Schools Partnership Planning Grant Submission Assurances Form
This assurance form provides the Massachusetts Department of Elementary and Secondary Education with the
confidence that all appropriate parties have been apprised of this grant submission. Sign off by the school
committee representative and teacher union president does not signify endorsement and/or approval of grant
application.
Instructions: Please complete one form per application.
District Name:
Lead Applicant Assurances
The lead applicant is aware of this grant submission, participated in its preparation, and is fully aware
of the expectations set forth by the Massachusetts Department of Elementary and Secondary
Education.
District Assurances
The district must ensure that state funds are used in accordance with the Innovation Schools
Partnership Planning Grant RFP and ensure transparency and accountability, and report publicly on
the use of state funds. The district must also ensure that the all state funds used to must be used to
solely support the in-depth, innovation school development process.
The district must participate in any program evaluation and monitoring activities associated
with this grant.
Typed Name of Lead Applicant:
Signature of Lead Applicant:
Date:
Typed Name of Superintendent:
Signature of Superintendent:
Date:
Typed Name of School Committee Representative:
Signature of School Committee Representative:
Date:
Typed Name of Teacher Union President:
Signature of Teacher Union President:
Date:
As noted above, sign off by the school committee representative and teacher union president solely signifies
that they have been apprised of the district’s grant submission, and does not signify endorsement.