Name of Grant Program:
Quality Enhancements in After-School and Out-ofSchool Time (ASOST-Q)
Fund Code: 530B
PART III – REQUIRED PROGRAM INFORMATION
All of the requested information on this page must be completed here AND submitted online using this link:
http://www.surveygizmo.com/s3/2265168/FY16-Fund-Code-530B-ASOST-Q-Grant-General-Information
Total Amount of Grant Funds Requested
($31,000 maximum):
School Year
(through 6/30/16)
Summer
(7/1/16-8/31/16)
$
$
Lead Applicant Agency:
City/Town:
Grant Contact/Coordinator Name/Title:
Email:
Phone:
OST Site Information
School or Organization:
OST Program Name (if different from site name)
Site Contact Name/Title:
Program Type (e.g. school, CBO, etc.)
Address:
Phone:
Email:
Students to be served: Please provide the following information about the projected number / percentage of students
who will engage in the summer service-learning (SL) project.
Grade-level
K-5
# of students
Sub-groups
% of students
Low-Income
6-8
English Language Learners
9-12
Students with Disabilities
Total
Content Area(s) to be covered in the proposed curriculum.
STEM, English language arts, social studies, mathematics, etc.
(Include all that apply.)
Service-Learning Topic: to be covered in the proposed
curriculum. (If known.)
The service-learning topic is the community need or problem
area that the students will work on. For example, students might
focus on: hunger/homelessness, environment, school safety,
bullying, etc.
It is not required that a topic is chosen prior to applying,
however, funded applicants will finalize the topic during planning.
REMINDER: All of the information on this page must also be entered online using this link:
http://www.surveygizmo.com/s3/2265168/FY16-Fund-Code-530B-ASOST-Q-Grant-General-Information
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Name of Grant Program:
Quality Enhancements in After-School and Out-ofSchool Time (ASOST-Q)
Fund Code: 530B
Responses to the following questions (shaded in gray) must be completed within this document within the
indicated page limits, and must maintain the existing margins, question text, and font style and size.
A. Expertise/Experience (maximum 3 pages)
1. Please briefly describe the lead applicant’s experience developing curriculum.
2. Please describe the lead applicant’s experience developing and/or implementing social-emotional learning (SEL)
practices and/or curricula. (Include specific information about the curricula used, training received, etc.)
B. Curriculum Development (maximum 4 pages)
3. If known, please describe the team that will participate in the required professional development and work on
developing the curriculum. (If not yet known, how will you build your team, who will be included, etc.?)
4. Provide a brief description of the planning time your team will have to work on developing the new curricula.
Reminder: It is required that your team be provided with sufficient planning time to write the curriculum, including
a minimum of at least one day for coaching/support on-site from the Department and/or its partners. It is
encouraged that teams be given flexibility and support to schedule ample planning time. Grant funds may be
used to support these costs.
5. Please describe the academic needs of the students who are targeted through this effort. If known, please
include the specific content area(s) and standards that will be the focus of the curriculum to be developed.
6. Please describe the social/emotional needs of the students who are targeted through this effort.
7. Please briefly describe what will be different as a result of implementing this SL curriculum. Include anticipated
outcomes for both students’ academic and social-emotional needs, as well as a brief description of how these
outcomes will be measured.
8. If known, please describe the SL topic which will be the focus of the curriculum to be developed, as well as a
rationale for the selection. (If not known, how will your team identify the topic?) Reminder: The team should be
identifying the SL topic ONLY, not the projects/solutions that the students will implement. Projects/solutions will
be identified and chosen by the students through the SL process.
C. Curriculum Implementation (maximum 3 pages)
9. Describe the overall structure of the existing summer program (including the general schedule, scope of activities
offered, etc.)
10. Describe how the SL curriculum will be integrated into the existing summer program. (e.g., a new SL activity will
be created as an offering, or the SL curricula will be used to modify or supplement an existing activity.)
11. Please provide the program schedule using the chart below. Insert rows as needed if program operates during
different hours on different days of the week. NOTE: Programs must have a minimum of 25 hours over a
minimum of 4 weeks during which the SL curriculum will be implemented. It is not recommended that programs
implement the curriculum in fewer than 8 days.
Overall Program Schedule (showing the total time that students are engaged in the summer program)
Start Date:
Start Time
End Date:
End Time
# Hours/day
# of Days/week
SL Activity Schedule (showing the time that students will engage in the SL curriculum)
Start Date:
Start Time
End Date:
End Time
# Hours/day
# of Days/week
12. Describe how the lead applicant will support/provide training and planning time prior to the summer program for
staff who were not part of the curriculum development. (Grant funds may be requested to cover these costs.)
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Name of Grant Program:
Quality Enhancements in After-School and Out-ofSchool Time (ASOST-Q)
Fund Code: 530B
13. Total Funding to Support OST Programming in FY16: Please complete the chart below describing all funds
that will support the OST programming where the SL curriculum will be implemented. Please indicate the amount
of funding, and in the “Detail” column list the sources. Please do not include the amount you are requesting from
this proposal.
Funding Category
Federal (include 21st Century Community Learning Center
funds here)
State (include Early Education and Care subsidies here)
Local
Private (include foundation grants, private donations, etc.)
Tuition
Other
Total Funding to Support OST Programming:
Total Amount
Detail
(ALL APPLICANTS THAT ARE AGENCIES AND ORGANIZATIONS OTHER THAN A SCHOOL, SCHOOL DISTRICT,
CITY, OR TOWN, please provide a response to Question 14)
*Note: The response to this question will not be counted in the above page limits. The response to part 14a. should not
exceed one page maintaining the existing margins question text, and font style and size.
14. Program Capacity: Applicants that are agencies and organizations other than a school, school district, city, or
town must provide the following additional information:
a. Describe the agency/organization’s previous experience with similar amounts of funding at state, federal, or
local levels through government, foundation, or private grants.
b. Append to this application proof of fiscal responsibility, for example, a copy of the most recent annual audit
letter. (Please note: the entire audit need not be attached.)
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