Intent to Participate Form

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Smart Step Literacy Lab
Classroom Project
Intent to Participate: 2004-05
Deadline: April 12, 2004
(The Intent form is not a commitment to participate in the project—only a commitment to attend the orientation.)
Principal:______________________________________________________
School:________________________________________________________
District:__________________________ Cooperative__________________
School Address:________________________________________________
_______________________________________________________________
Phone:_________________________________________________________
E-mail:_________________________________________________________
Team members:
Position
Name
Grade(s)
Principal
Reading/Language Arts
Teacher
Reading/Language Arts
Teacher
Reading/Language Arts
Teacher
We are interested in participating in the Smart Step Literacy Lab Classroom Project
and will attend the Orientation.
_________________________________
Signature of Principal
______________________________
Date
Return form to:
bellis@arkedu.k12.ar.us
or
Ben Ellis
K-12 Literacy Unit
Arkansas Department of Education
#4 Capitol Mall, Room 401B
Little Rock, AR 72201
Orientation information will be e-mailed by April 19th to the principal’s e-mail
address.
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