ACT State Council
Information Packet & Application Forms
2015
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Thank you for being a part of ACT’s 2015 College and Career Readiness Campaign. ACT is pleased to
be collaborating with your state to recognize businesses, community colleges, high schools, and
high school students that encourage, promote, or exemplify college and career readiness through
their activities and accomplishments.
This packet of information includes an application form as well as a list of frequently asked
questions. Your completed application will be reviewed by members of your ACT State Council,
which is composed of members of the education and workforce communities in your state. These
reviewers will also receive relevant data from ACT.
Each participating state is in the midst of making selections—some by application and some by
committee—of exemplary candidates in each of the four categories. If the State Council chooses
your application as one of your state’s exemplars in the categories of employer, community college,
high school, or high school senior, the Council will fill out a nomination form that will officially
inform us of your state’s selections. That form will also serve as your state’s nomination form for
the ACT Selection Committee. In early April, this committee will evaluate all applications and
announce four national semifinalists per category (for a total of 16 national semifinalists). These 16
semifinalists will then be submitted to the National Selection Committee in May, where one
exemplar per category will be chosen as our National Exemplar.
The State Council asks that you complete and submit these forms by January 23, 2015. Your
cooperation in meeting this deadline is greatly appreciated, as the ACT State Council will need
sufficient time to carefully review each application.
All application forms must be submitted, via email (preferred) or mail, by January 23, 2015 to:
Shannon Hayes
Shannon.Hayes@act.org
One Dupont Circle NW
Suite 220
Washington, DC 20036
Thank you again for participating in ACT’s 2015 College and Career Readiness Campaign.
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Frequently Asked Questions
What is the ACT College and Career Readiness Campaign?
The College and Career Readiness Campaign is an annual campaign in which ACT works with top
state officials and ACT State Councils to celebrate achievement and create awareness around the
goal of college and career readiness for all.
The Campaign seeks to recognize—across the education and workforce continuum—exemplary
college and career readiness efforts by an employer, a community college, a high school, and a high
school student in each participating state. Our focus is on those who have gone above and beyond
expectations: A student who has overcome adversity and excelled beyond what his or her previous
test scores would have predicted; a high school that sends more disadvantaged students on to
postsecondary education than its peers; a community college with higher retention and graduation
rates than the statistics of its student body would indicate; or an employer which seeks to hire
traditionally overlooked workers and offers the training and support necessary for these workers to
succeed in their careers.
What is meant by college and career readiness?
ACT has long defined college and career readiness as the knowledge and skills a student needs to
enroll and succeed in credit-bearing first-year courses at a postsecondary institution such as a 2- or
4-year college, trade school, or technical school, without the need for remediation.
How are ACT’s national award recipients selected?
Once states have made their nominations for the award categories, they complete nomination
forms to demonstrate to ACT’s National Selection Committee how each of the state’s nominees
exemplifies the core college and career readiness criteria in its respective category.
Nominated groups or individuals will be evaluated on the following criteria:
Workplace Success Award (Employer)
- Strength of relationships with local colleges and high schools
- Use of career readiness assessments for recruitment and advancement within the company
- Dedication to providing employees with opportunities to acquire new knowledge and skills
- Demonstrated effort to create and maintain diversity in its workforce
- Demonstrated efforts of employer and employees to give back to the local community
- Nominees are encouraged but not required to use the ACT National Career Readiness
Certificate or ACT WorkKeys program
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Career Preparedness Award (Community College)
- Accessibility of career readiness assessments and career preparation programs
- Strength of relationships with local employers
- Student success indicators including retention, graduation, and four-year college transfer
rates, including for students of underrepresented racial/ethnic and socioeconomic
backgrounds
- Demonstrated dedication to career planning and to providing a support structure for
students
- Demonstrated commitment to providing leadership opportunities for students outside the
classroom
- Nominees are encouraged but not required to administer ACT solutions to students or
require any assessments administered by ACT, but if there is insufficient data from ACT
solutions to show student success, other data should be included with the application
College and Career Transition Award (High School)
- Demonstrated student growth toward meeting ACT’s College Readiness Benchmarks
between grade 8 and grade 12
- Aggregate ACT scores and percentage of students meeting ACT’s College Readiness
Benchmarks
- Demonstrated success in serving students of underrepresented racial/ethnic and
socioeconomic backgrounds
- Demonstrated dedication to ensuring that students gain the knowledge and skills needed to
prepare them for success after high school
- Demonstrated commitment to providing leadership opportunities for students outside the
classroom
- Nominees are encouraged but not required to have a certain percentage of students take
the ACT test but should require or strongly encourage their students to take a college
admissions assessment. If nominees do not have a rich data set of scores from ACT’s
continuum of assessments, nominees must include data from other sources showing student
growth and success towards post-secondary readiness. Special consideration will be given to
schools serving a large percentage of traditionally underserved students, as demonstrated
by factors such as the percentage of students receiving free or reduced-price lunch
Student Readiness Award (High School Student)
- Performance in relation to ACT’s College Readiness Benchmarks in English, mathematics,
reading, and science
- Demonstrated progress toward college and career readiness between grade 8 and grade 12
- Demonstrated success in high school coursework, as signified by high school grade point
average
- Success beyond the classroom, including extracurricular activities, leadership positions,
community service, and work experience
- Success in the face of adversity or other extraordinary circumstances
- Nominees must have taken the ACT test and should come from a household making less
than $60,000 annually
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In early April, an ACT selection committee will review all state nominations and choose the national
semifinalists. The semifinalists will be presented to a National Selection Committee, which will
select the most exemplary employer, community college, high school, and high school student from
among the semifinalists.
What is the makeup of the National Selection Committee?
The National Selection Committee is composed of national education and workforce development
thought leaders who are committed to the goal of preparing all individuals for college and career
success. In 2014, the committee was chaired by Ginny Edwards, Editor-in-Chief of Education Week,
and included representatives from the National Association of State Boards of Education, BusinessHigher Education Forum, Association for Career and Technical Education, National Association of
Manufacturers, Council of Chief State School Officers, and National Council for Community and
Education Partnerships.
How will the national award recipients be announced?
National award recipients will be announced and celebrated at ACT’s National Gala on College and
Career Readiness in Washington, DC. ACT will cover travel expenses to the gala for each of the four
national recipients and one guest of each recipient.
National award recipients will be presented with crystal awards. All recognized students—one from
each participating state—will receive scholarships to the postsecondary institution of their choice.
Additional questions?
Please feel free to contact Campaign Manager Shannon Hayes at 202.223.2318 or
Shannon.Hayes@act.org.
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Student Readiness Award Application Form
High School Senior
If your State Council chooses your application as your state’s exemplary high school student who
embodies successful readiness for college and career, they will fill out a nomination form which will
officially inform us of your state’s selection.
An ACT committee will objectively evaluate each state’s high school student candidate in April 2015 and
choose four national semifinalists to be evaluated by our National Selection Committee, which will select
one to receive the Student Readiness Award.
All student exemplars will be evaluated based on the following criteria, wherever applicable:
(1) Performance in relation to ACT’s College Readiness Benchmarks in English, mathematics, reading,
and science
(2) Demonstrated progress toward college and career readiness between grade 8 and grade 12
(3) Demonstrated success in high school coursework, as signified by high school grade point average
(4) Success beyond the classroom, including extracurricular activities, leadership positions,
community service, and work experience
(5) Unique qualities such as personal traits, future plans, or success in the face of adversity or other
extraordinary circumstances
High school student applicants must have taken the ACT test. These criteria will be considered in
combination by the State Council to select one statewide high school student exemplar. In addition, your
signature and that of your parent or guardian (if you are under 18) are required on the enclosed
Authorization to Release Personal Information to allow ACT to share your data with members of the State
Council. This data may include, but is not limited to, scores on ACT’s continuum of assessments, high
school performance data, and student background information. Students’ names and high schools will be
redacted in the applications given to State Council members.
If you are chosen to receive the national Student Readiness Award, ACT will cover travel expenses to
Washington, DC, for you and a guardian so that you can be recognized at our National Gala on College and
Career Readiness, to be held on June 9, 2015.
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STUDENT INFORMATION
FULL NAME (Last, First,
MI)
MAILING ADDRESS
CITY / STATE / ZIP CODE
PHONE NUMBER
DATE OF BIRTH
(MM-DD-YYYY)
GENDER
GUARDIAN’S FIRST AND
LAST NAME
HIGH SCHOOL GPA
(Not Weighted)
ACT SCORES
ENGLISH
MATHEMATICS
READING
SCIENCE
COMPOSITE
PLAN SCORES
(GRADE 9 or 10—
optional)
EXPLORE SCORES
(GRADE 8—optional)
ENGLISH
MATHEMATICS
READING
SCIENCE
COMPOSITE
ENGLISH
MATHEMATICS
READING
SCIENCE
COMPOSITE
HIGH SCHOOL CORE
COURSE GRADES
English 9:
English 10:
English 11:
Algebra 1:
Geometry:
Algebra 2:
US History:
Biology:
Chemistry:
Physics:
HIGH SCHOOL INFORMATION
SCHOOL NAME
DISTRICT
SCHOOL OFFICIAL’S FIRST AND
LAST NAME
SCHOOL OFFICIAL’S TITLE
SCHOOL OFFICIAL’S PHONE
Your school official should be someone who can be contacted with questions that ACT or the State
Council members may have (e.g., a principal, guidance counselor, or advisor).
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STUDENT EVALUATION (please answer at least the first two questions)
1. Please use the space below to describe your successes outside the classroom, for example
extracurricular activities, leadership positions, community service, artistic accomplishments, and work
experience. Please provide specific details for each of the examples you choose. (250 words maximum)
2. Please use the space below to describe what makes you unique. For example, what personal traits do
you exemplify? What are your plans for the future? Have you succeeded in the face of hardship or other
extraordinary circumstances? Please provide specific details to support your claims. (500 words maximum)
3. If you did not take EXPLORE or PLAN (see Student Information above), please use the space below to
describe the ways in which you have made academic progress toward college and career readiness since
grade 8. Please provide specific details to support your claims. (250 words maximum)
Please email or mail completed application by 1/23/15 to:
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Shannon Hayes
Shannon.Hayes@act.org
One Dupont Circle NW, Suite 220
Washington, DC 20036
AUTHORIZATION
TO RELEASE PERSONAL INFORMATION
I, ____________________________________
,
(your full name)
hereby consent to the release of any and all records in the possession of ACT, Inc. (“ACT”) which
are in any way related to me, for the purpose of my nomination for the Student Readiness Award
provided through the ACT College and Career Readiness Campaign. The records relevant to the
nomination may include:
name, address, date of birth, gender, race/ethnicity, expected education level,
ACT Explore scores, ACT Plan scores, scores on the ACT college readiness
assessment, core high school course grades, high school GPA, extracurricular
activities, and out-of-class accomplishments.
ACT is authorized to release and make full disclosure of such records, and to discuss any
information relating to those records, to members of the ACT State Council of the state in which
you reside, for which individual membership information is available at
http://www.act.org/stateorgs/index.html.
This authorization is effective immediately and will remain in effect until revoked in writing.
I hereby release and hold harmless ACT and its agents from any and all claims and actions based
upon, arising out of, or relating in any way to any disclosure of records or information pursuant
to this AUTHORIZATION TO RELEASE PERSONAL INFORMATION.
A copy of this document shall serve as the original.
Signature:
Date:
_
If the above-named individual is under the age of 18, the parent or legal guardian of the
individual must also sign below indicating consent and agreement to this AUTHORIZATION TO
RELEASE PERSONAL INFORMATION.
Signature of Parent
or Legal Guardian:
Date:
Please complete and send original signed copy to:
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Shannon Hayes
One Dupont Circle NW
Suite 220
Washington, DC 20036
Phone: 202.223.2318
_