Name of Grant Program: Collaborative Partnerships for
Student Success (CPSS)
Fund Code: 619 (School Year)
592 (Summer)
PART III – REQUIRED PROGRAM INFORMATION
Application for Fiscal Year 2011-2012 (FY12) Academic Support Competitive Grant
Collaborative Partnerships for Student Success
Fund Code: 619 (School Year)/592 (Summer)
THIS DOCUMENT MAY BE DOWNLOADED FROM THE DEPARTMENT OF
ELEMENTARY AND SECONDARY EDUCATION WEBSITE.
http://finance1.doe.mass.edu/grants/
Please provide the following information.
I. GENERAL INFORMATION
1. Lead District or Approved Private Special Education School or Collaborative:
2. Program Coordinator Name and Title:
3. Address:
4. Email Address:
5. Phone Number:
6. Fax Number:
7. Funds Requested:
Through Fund Code: 619: $_________
+ Through Fund Code: 592 $________
= TOTAL: $___________
Total Projected Per Pupil Cost: $ ____________
REMINDER REGARDING BUDGETS:
Each application must include two budgets and both combined must not exceed $50,000 for Category A
applicants and $30,000 for Category B applicants. One budget (Fund Code: 619 School Year) must be
submitted for planning, recruitment activities, and services that take place upon approval through June 30,
2012. The second budget (Fund Code: 592 Summer) must be for services and activities that take place from
July 1 – August 31, 2012. Each budget should be submitted with a corresponding budget narrative.
8. Number of Students you are proposing to serve:
A. In ELA: _____ B. In Mathematics: _____
C. In Science and Technology/Engineering:____
D. TOTAL unduplicated number of students _______ (may be less than A+B+C)
9. Ratio of Students to Teachers (maximum 10:1): ______
10. Partnering organizations:
Partner:_______________________________________________________________________
Partner:_______________________________________________________________________
Partner: _______________________________________________________________________
(Add more lines and attach pages, as needed.)
Name of Grant Program: Collaborative Partnerships for
Student Success (CPSS)
Fund Code: 619 (School Year)
592 (Summer)
II. PROGRAM DESIGN
Please answer the following program overview questions (A-D), using no more than six (6) pages.
A. Identification of Target Populations and CPSS Team Members
1. Describe the academic needs and social/emotional challenges of the students who are targeted through this
effort. Explain the need for and value of increased awareness for students and their families of the impact
educational decisions are likely to have on future economic, career, and educational opportunities. Explain
how the support provided to students and their families through this Collaborative Partnership for Student
Success (CPSS) will take into consideration their needs and how the support will help them to become more
successful in school. If applicable, please note how growth model or the Early Warning Indicator Index data will
be used to ensure that those students most in need of assistance will be targeted through the program.
2. Describe the team members (e.g., students, families, school/district staff, program coordinators, and
community representatives) and the role each will play in the CPSS development for students who need (or
are likely to need) support in order to earn their Competency Determinations required for high school diplomas.
B. Program Implementation Plans
1. Explain how the proposed program fits into a
district/school/collaborative that includes goals such as:
comprehensive
intervention
plan
in
the
a. closing achievement gaps that exist;
b. ensuring an infrastructure at the middle and/or high school that prepares and supports students to take
challenging courses to successfully meet the benchmarks of academic mastery;
c.
providing students with the courses and supports that address English language arts, mathematics,
and science and technology/engineering learning standards and helping students gain the skills and
knowledge needed to score at least at the proficiency standard on their first taking of the 10th grade
MCAS English Language Arts and Mathematics and/or the high school Science and
Technology/Engineering tests; and
d. helping students understand and begin to chart pathways towards college and career readiness.
2. Describe the proposed academic services for the CPSS program, including at a minimum:
a. program goals, how progress will be measured towards the attainment of those goals, and how the
activities planned for students will help them reach these goals;
b. professional development, program planning, and orientation activities for the CPSS team and program
instructors; and
c.
community partnerships and specific ways in which each partner will be involved with and invested in
the success of program implementation.
3. Explain, in detail, how the program will meet the needs of students with differentiated learning styles as well
as varied academic needs and strengths. Please consider the following in your response:
a. How will the learning activities be engaging and develop students’ skills in alignment with
Massachusetts Curriculum Frameworks? In particular, what types of active, engaging, hands-on, and
relevant curriculum will be incorporated into the program that addresses gaps in students’ knowledge
and skills?
b. Are there materials or services developed/undertaken by the students as a result of their participation
in this program, including service learning projects, internships, etc.?
c.
Along with the data gathered from MCAS and other assessments, what other kinds of skills and guiding
principles will be used in the development of the program?
d. What types of opportunities will students have to reflect on their learning?
Name of Grant Program: Collaborative Partnerships for
Student Success (CPSS)
Fund Code: 619 (School Year)
592 (Summer)
4. How will the program tap into and cultivate short-term and long-term incentives/motivations for students to
be enrolled in the program?
5. Describe how the transportation needs (both logistical and financial) of participating students will be taken
into consideration and addressed, particularly for the summer portion of the grant.
6. Indicate the number of staff and staff qualifications related to the proposed Fund Code: 619/592 program.
NOTE: Recipients of these grants must agree to provide staff who have content matter knowledge in the
subjects they are teaching. The programs must have some staff available with training or education that
addresses working with students with limited English proficiency as well as students with disabilities.
7. Describe how the staff selection, the staff qualifications (that were indicated in #6), the learning
environment, and other aspects of program design are well suited to meeting the needs of the targeted
students, including students with disabilities and English language learners. Describe how the program has
considered purposefully the needs of and ensured access to students who are English language learners,
homeless, or in alternative programs.
C. Program Product/Behavioral Health Assessment Tool
Please select and describe plans for producing a CPSS product and/or completing the behavioral health and public
schools assessment tool. (Programs are only required to select one of these elements to incorporate into the
CPSS but have the option of selecting both if desired):
1. CREATING A CPSS PRODUCT
Describe the CPSS product (or products) that will be developed for use by students, staff, and/or families by
the CPSS team to increase college and career readiness, which may or may not include enhancement of a
previous year’s CPSS product. Please include what is the expected form of the product(s) and how they will be
used in the program and/or school. The product could include but is not limited to a how-to manual, curriculum,
or planning guide about strategies for successfully making one’s way through high school, about the value of
college, and/or about career exploration. For more examples, please go to the Academic Support Program
Examples webpage: http://www.doe.mass.edu/as/examples. The CPSS product must be able to serve as a
model that other communities may adapt and replicate in the future for academic support programs and
beyond. The final CPSS product(s) must be provided to the Department via acsupport@doe.mass.edu in an
electronic format for web posting or, if a curriculum module, entered into the Contextual Learning Portal by
August 31, 2012.
2. USING THE BEHAVIORAL HEALTH AND PUBLIC SCHOOLS SELF-ASSESSMENT TOOL
Expectations for using the web-based tool that was created by the Massachusetts Behavioral Health and
Public Schools Task Force (available on http://BHPS321.org) include the following:
a. Identifying one school contact person for this effort (to communicate with the Department);
b. Gathering a small team of approximately 3-10 people from the school community to contribute
to thinking through and filling in the responses to the web based assessment tool during 1-2
meetings for a total of 3-5 hours combined; and
c.
Indicating “DONE” on the Team Contact Info page by August 31, 2012.
Describe plans for using the Behavioral Health and Public Schools Assessment Tool. Include in
the description:

The composition of the team that will fill out the tool and how this intersects with CPSS team members.

The process and timeline for completing all sections of the tool, and for reflecting on the content and next
steps for moving forward with areas identified for improvement. (NOTE: A username and password to use
the tool can be requested via achievement@doe.mass.edu.)
Name of Grant Program: Collaborative Partnerships for
Student Success (CPSS)
Fund Code: 619 (School Year)
592 (Summer)
D. Provide a timeline for the Collaborative Partnership for Student Success. Address stages and decision points
regarding CPSS development, implementation (include programming and product and/or use of the Behavioral
Health and Public Schools Assessment Tool), and evaluation (include periodic assessment of students’
progress throughout the program). This timeline may include planning time during the school year and/or initial
programming that is connected to the summer program.
III. SCHEDULE FOR STUDENT SERVICES
School Year Program Offerings and Schedule
Location of the school year program:______________________________________________________
Program Type
School Year Programs and
Services (Fund Code: 619 only)
Underline Classes to be served.
2014 2015 2016*
Number of Students:
English Language Arts
Time:____ to _____
Underline days
program meets.
Mon. Tues. Wed.
Thurs. Fri. Sat.
Mathematics
Time:____ to _____
Underline days
program meets.
Mon. Tues. Wed.
Thurs. Fri. Sat.
Science and
Technology/Engineering
Time:____ to _____
Underline days program
meets.
Mon. Tues. Wed.
Thurs. Fri. Sat.
Total weeks: _______
Total weeks: _______
Total weeks: _______
Total hours: _______
Total hours: _______
Total hours: _______
Start date:
_______
Start date:
_______
Start date:
_______
End date:
_______
End date:
_______
End date:
_______
*If proposing to serve 8th graders (class of 2016) during the school year and/or summer, a partnership is required
for this grant that includes at least one of the feeder middle schools and at least one of the recipient high schools.
Summer Program Offerings and Schedule
Location of the summer program:______________________________________________________
Program Type
Summer Programs and
Services (Fund Code: 592 only)
Underline Classes to be served.
2014 2015 2016*
Number of Students:
English Language Arts
Time:____ to _____
Underline days
program meets.
Mon. Tues. Wed.
Thurs. Fri. Sat.
Mathematics
Time:____ to _____
Underline days
program meets.
Mon. Tues. Wed.
Thurs. Fri. Sat.
Science and
Technology/Engineering
Time:____ to _____
Underline days program
meets.
Mon. Tues. Wed.
Thurs. Fri. Sat.
Total weeks: _______
Total weeks: _______
Total weeks: _______
Total hours: _______
Total hours: _______
Total hours: _______
Start date:
_______
Start date:
_______
Start date:
_______
End date:
_______
End date:
_______
End date:
_______
*If proposing to serve 8th graders (class of 2016) during the school year and/or summer, a partnership is required
for this grant that includes at least one of the feeder middle schools and at least one of the recipient high schools.
Name of Grant Program: Collaborative Partnerships for
Student Success (CPSS)
Fund Code: 619 (School Year)
592 (Summer)
IV. REMINDERS
1. Grantees must use Evaluation Guidelines to prepare a narrative report on the overall effectiveness of the
school year and summer programs by September 28, 2012. These Guidelines will be posted on the
Department’s web page at http://www.doe.mass.edu/as/data, and will be similar to those for FY11
.
2. Individual Student Data information must be compiled and submitted to the Department via the online
application in the security portal. Directions
and Additional Information are posted at
http://www.doe.mass.edu/as/data/. Information regarding the School Year time period will be due on July
31, 2012 and information regarding the summer time period will be due on September 28, 2012.
3. The CPSS Product and/or Behavioral Health and Public Schools Assessment Tool must be completed
by August 31, 2012.
4. Assurances Document - Applicants must agree to the information outlined on the Fund Code: 619/592
Assurances Document. (See Required Forms section in the RFP.) Applicants must submit a signed version
of this document in order to demonstrate this commitment.
5. Professional Development/Technical Assistance Sessions
Grantees are expected to have personnel (coordinators, data entry staff, instructors, etc.) attend
appropriate Academic Support professional development workshops and data training sessions. We
welcome your input and feedback on the workshops. A schedule of sessions will be sent to grantees and
posted on the Department's Academic Support web page (http://www.doe.mass.edu/as/pd/).