MINNESOTA SAFE ROUTES TO SCHOOL
2015-2016 PLANNING ASSISTANCE GRANT APPLICATION
Please see the MnDOT SRTS grants page for instructions and resources to fill out this application. Applications are due to
saferoutes.dot@state.mn.us by noon on January 8, 2016.
PART I: APPLICANT INFORMATION
Applicant Organization Name
Applicant Organization Type (city, school,
tribal, non-profit (please specify)
PART II: PLANNING ASSISTANCE TYPE
___ I live in the Twin Cities Metropolitan Region. I will work with the MnDOT Statewide Planning Consultant.
___ I live in Greater Minnesota. I will work with my local Regional Development Commission.
___ I live in Greater Minnesota. I will work with my local Metropolitan Planning Organization.
___ I live in Greater Minnesota. I will work with the MnDOT Statewide Planning Consultant.
PART III: CONTACT INFORMATION
Contact Name
Contact Title
Street Address
City ST ZIP Code
Phone
E-Mail Address
PART IV: PLANNING ASSISTANCE REQUESTED
Please review the following types of planning assistance available on page 8 of the application guide and on the SRTS
planning assistance application page. Rank the following types of planning assistance based on your community needs. #1 is
the applicant’s first choice and #9 is your last choice for the type of planning support requested:
___ Walk audit & report
___ Walking Routes for Youth Map
___ Non-infrastructure plan/workshop
___ SRTS planning charrettes/workshops (individual or multi-school)
___ High-school update
___ Minnesota SRTS travel plans (individual or multi-school)
___ SRTS plan update
___ School district or city-wide SRTS plan
Other ideas? Please write in a proposal that meets the SRTS planning goals:
WHICH PLANNING ASSISTANCE TYPE DID YOU SELECT AS YOUR #1 CHOICE? EXPLAIN WHY THIS IS
NEEDED AND WHY YOU BELIEVE IT IS THE BEST TYPE OF PLANNING SUPPORT FOR YOUR
COMMUNITY.
Please complete the following demographic information for each school applying for planning assistance.
PART V: SCHOOL INFORMATION SHEET (15 POINTS)
School One
School Two
School Three
School Four
School Five
School name
School population
Grades at school
City population
% students eligible for free and reduced
cost meals
% students currently walking
% students currently biking
% of students living within 2 miles of school
Distance eligibility for busing
% students in hazard bus areas
% students living in walk zone
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School One
School Two
School Three
School Four
School Five
School name
School population
Grades at school
City population
% students eligible for free and reduced
cost meals
% students currently walking
% students currently biking
% of students living within 2 miles of school
Distance eligibility for busing
% students in hazard bus areas
% students living in walk zone
PART VI: SRTS TEAM MEMBERS & LOCAL SUPPORT
1. SRTS TEAM (10 POINTS)
Members of a local SRTS team should be involved before, during, and after the SRTS planning process in your community.
Please mark the following individuals currently on your SRTS team. Please provide names where available.
Name and title of team leader:
Mark X next
to team
members:
Team Members:
Please list name and/or
title:
Role of
team
member:
School Principal
School/District Transportation Staff
Local Road authority (public works, county engineer, MnDOT)
City staff (planners, elected officials, city manager)
SHIP/public health practitioners
School District Reps
Parents, Community Members
Students, Teachers
Bicycling or walking group representative
Law Enforcement
Other team members (write-in):
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2. SRTS PLANNING IS A STRATEGY THAT SUPPORTS HEALTHY AND SAFE COMMUNITIES AND
SCHOOLS. DESCRIBE HOW THIS PLAN FITS INTO AND/OR SUPPORTS LARGER SCHOOL OR
COMMUNITY GOALS? (10 POINTS)
PART VII: EXISTING CONDITIONS AND IMPLEMENTATION SUPPORT
1. USING THE 5E’S- EDUCATION, ENCOURAGEMENT, ENFORCEMENT, ENGINEERING AND
EVALUATION- BRIEFLY DISCUSS THE SRTS ACTIVITIES THAT CURRENTLY HAPPEN IN YOUR
SCHOOL OR COMMUNITY. (10 POINTS)
2. WHAT IS YOUR TEAM’S VISION FOR A SUCCESSFUL SRTS PLAN? WHAT DO YOU PLAN TO
ACCOMPLISH DURING AND AFTER THE PLANNING PROCESS? (10 POINTS)
3. LOOKING AHEAD TO IMPLEMENTATION, WHAT WILL BE THE MOST SIGNIFICANT
CHALLENGE FOR SUCCESSFUL IMPLEMENTATION OF YOUR SRTS PLAN? (10 POINTS)
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4. POLICIES AT THE LOCAL LEVEL CAN SUPPORT AND ACT AS BARRIERS TO SUCCESSFUL SRTS
PROGRAMS. PLEASE DESCRIBE ANY KNOWN POLICIES (SCHOOL, DISTRICT, CITY, AND
COUNTY) THAT WILL IMPACT YOUR SRTS PLANNING EFFORTS AND IMPLEMENTATION.
PLEASE LIST POLICIES THAT WILL SUPPORT YOUR SRTS EFFORTS. EXAMPLES INCLUDE:
COMPLETE STREETS POLICIES, DISTRICT WELLNESS POLICIES, CITY BIKE PARKING.
PLEASE ALSO LIST POLICIES THAT MAY NEGATIVELY AFFECT SRTS PROGRAMS AT YOUR
SCHOOL. WHAT PLANS DO YOU HAVE TO ADDRESS THEM BEFORE, DURING, OR AFTER THE
PLANNING PROCESS? EXAMPLE: OUR ELEMENTARY SCHOOL DOES NOT ALLOW STUDENTS
TO WALK TO SCHOOL. (10 POINTS)
5. SRTS PLANS NEED MULTIPLE PARTNERS INVOLVED TO ENSURE IMPLEMENTATION SUCCESS.
WHO WILL BE RESPONSIBLE FOR IMPLEMENTATION OF THE PLAN? WHICH AREAS OF
IMPLEMENTATION WILL PARTNERS SUPPORT? (20 POINTS)
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PART VIII: BONUS SECTION
1. PLEASE DESCRIBE ANY EXISTING PLANS TO RELOCATE OR BUILD NEW SCHOOLS IN YOUR
COMMUNITY. WHERE ARE YOU AT IN THE PROCESS AND WILL THIS IMPACT SRTS
ACTIVITIES AT THIS PLANNING SITE IN THE NEXT TEN YEARS? (SEE EVALUATION CRITERIA)
2. THE 2015 MINNESOTA SRTS VISION STATEMENT SAYS: “MINNESOTA IS A STATE WHERE ALL
STUDENTS CAN WALK AND BICYCLE ON ROUTES THAT ARE SAFE, COMFORTABLE, AND
CONVENIENT. THAT ALL STUDENTS HAVE THE OPPORTUNITY TO WALK AND BICYCLE NO
MATTER THEIR RACE, E THNICITY, INCOME LEVEL, AGE, ABILITY, OR GEOGRAPHIC
LOCATION…”. HOW WILL THIS SRTS PLAN AND FUTURE IMPLEMENTATION SUPPORT THE
MINNESOTA VISION? (SEE EVALUATION CRITERIA)
3. SRTS INFRASTRUCTURE NEEDS IDENTIFIED DURING PLANNING CAN BE INCORPORATED
INTO FUTURE ROAD PROJECTS. PLEASE LIST ANY UPCOMING ROAD IMPROVEMENT
PROJECTS AROUND THE SCHOOL THAT MIGHT BENEFIT FROM SRTS PLANNING OR THAT
MIGHT BE A BARRIER TO THE PLANNING PROCESS. (SEE EVALUATION CRITERIA)
PART IX: LETTERS OF SUPPORT (5 POINTS)
Please attach the following letters of support:
1.
2.
Principal or school administrator letter of support
Letter of support from the local government
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