PART VI- REVIEW SHEET (informational purposes only)
FUND CODE 156
Reviewer Names:
School Name:
District:
New/Conversion/Academy:
Key Design Element(s):
Prospectus Review
Directions: Please review the approved innovation school prospectus to determine if the applicant is proposing a school that is
fundamentally designed to implement an educational model that focuses on at least one of the key design areas. Points received for
this section will be reflected in the Priority Section of the scoring sheet.
The applicant intends to establish an innovation school that focuses on one or more of the following key design areas (check all
that apply):
Blended and/or personalized learning model
Emphasis on English language learners or inclusion model for students with disabilities
Wraparound zones
Redesigned teacher and student time
Comments:
Rating Rubric (to be used for Description of Fund Use and Budget Workbook sections)
Rating
Points Rating Level Description
Meets
2
All required areas were addressed and the responses provided were clear and specific.
Partially Meets
1
All or a majority of the required areas were addressed, but the responses lacked clarity or
specification.
Did not Address
0
This section was not addressed
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PART VI- REVIEW SHEET (informational purposes only)
FUND CODE 156
Description of Fund Use
Directions: Please review the Description of Fund Use and place a check mark next to each required component. Utilize the rating
rubric to determine the section’s total score.
The Description of Fund Use clearly describes:
Purpose for seeking innovation schools planning grant funds;
Need(s) identified by the district, and how innovation status is expected to assist with addressing the identified need(s);
Why the autonomies included in the approved prospectus were selected, and how they are expected to address the
need(s) identified;
How grant funds will be used to support the in-depth, new, or conversion innovation school development planning
process, and how the district will determine the effectiveness of the use of funds; and
Anticipated challenges to the new or conversion innovation school planning process, and how they will be addressed.
Section Total (2 point max):
Comments:
Budget Workbook
Directions: Please review the Budget Workbook to determine if it is aligned to the approved innovation school prospectus and
description of fund use. Utilize the rating rubric to determine the section’s total score.
The application includes a completed (Parts I and II) budget workbook and it is aligned to the approved innovation school
prospectus.
Section Total (2 point
max):
Comments:
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PART VI- REVIEW SHEET (informational purposes only)
FUND CODE 156
Priority Areas: Sections A and B-Level Designations
Directions: Please provide a rating of either “0” or “1” for the criterion below.
Rating
The applicant intends to establish a school or academy in a Level 3, Level 4, or Level 5 district.
The applicant intends to convert an existing Level 3 school or a school that has exited from Level 4.school that is currently
designated as Level 4.
Section Total (2 point max):
Additional Priority Areas: Section C-Key Design Areas
Directions: Please provide a rating of either “0” or “5” for each key design model reflected in the innovation school prospectus.
Blended and/or Personalized Learning Model (5pts)
Emphasis on English Language Learners or Inclusion Model for Students with Disabilities (5pts)
Wraparound Zones (5 pts)
Redesigning Teacher and Student Time (5pts)
Section Total (20 point max):
Comments:
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PART VI- REVIEW SHEET (informational purposes only)
FUND CODE 156
Identification of Staff Member and/or External Partner
Directions: Please indicate via check mark if the application includes the identification of a district staff member and/or external
partner. This section is not scored.
The application indentifies:
Dedicated staff member who will be responsible for coordinating all aspects of the innovation schools planning process
External partner with demonstrated expertise related to the educational model and/or area to be implemented
Comments:
Assurances Form
Directions: Please indicate via check mark that the application includes the required assurances form. This section is not scored.
The assurances form includes the signature of the lead applicant and district superintendent.
Comments:
Approval Calendar
Directions: Please indicate via check mark that the application includes the required approval calendar. This section is not scored.
The approval calendar reflects that the first stage of approval is completed and includes dates for the second stage of
approval.
Comments:
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PART VI- REVIEW SHEET (informational purposes only)
FUND CODE 156
Applicant Interview
As noted in the RFP, all applicants are required to participate in a panel interview at the Department of Elementary and Secondary
Education. The lead applicant, district superintendent or designee, and members of the district leadership team (as appropriate)
must be in attendance. Interviews will be held Wednesday, November 18, 2015 through Friday, November 20, 2015.
Interview Scoring Rubric- 0-Inadequate; 1- Partially Meets; 2-Meets
 Inadequate: Responses failed to address the key components of the interview questions.
 Partially meets: Responses address most of the components of the interview questions, but the responses lacked clarity.
 Meets: Response indicate a solid understanding of the interview questions.
Applicant Interview
Rating
Directions: Using the interview scoring rubric, please provide a rating of either “0”, “1”, or “2” for each criterion below.
Knowledge of initiative and approval process: The applicants demonstrated a strong and clear understanding of the
Massachusetts Innovation School model and approval process.
Rationale for seeking innovation status: The applicants clearly described the impetus for seeking innovation status.
Student population and identified need: The applicants clearly described the student population(s) to be served and the
needs that will be addressed.
Educational model and key design areas: The applicants demonstrated a clear understanding and expertise of the
educational model and key design area(s) that will be implemented. The applicants clearly articulated the process used to
identify the educational model and key design areas and how it is expected to meet the needs of the identified student
population.
Community support: The applicants demonstrate a clear understanding of how community support for the prospective
innovation school or academy will be garnered.
Section Total (10 point max):
Comments:
Total number of points awarded to applicant (application and interview):
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