Local Solution Dropout Education Innovation Zones
West Virginia Department of Education
According to WVDE - BOE Policy 3236
2015- 2016 GRANT APPLICATION
Please fill out all appropriate boxes and respond to all questions. The application and plan
must be submitted using Times New Roman, 12 pt. font and is limited to 20 pages.
Application is due by 4:00 p.m., October 1, 2015 to Rebecca Derenge, in the Office of
School Improvement, WVDE, Bldg. 6, Room 330, 1900 Kanawha Blvd., Charleston
West Virginia 25305.
Section 1 – Applicant Information:
Applicant(s):
County:
Superintendent
Principal(s)
Grant Contact
Name & Title
E-mail:
Telephone:
Drop-Out Prevention Grant (must include community partners and three year budget proposal) The Local
School Dropout Prevention and Recovery Innovation Zone has been allocated $2.2 million of funding by the State
Legislature for this competitive grant process.
Place a check beside the appropriate designation as an innovation zone applicant:
______Single School (an entire faculty of a school working to implement a school-wide strategy)
______Consortium of Schools (fill out multiple listings below)
______Higher Education Institution (must include at least one county school system applicant)
Local Solution Dropout Education Innovation Zones
West Virginia Department of Education
According to WVDE - BOE Policy 3236
2015- 2016 GRANT APPLICATION
______Feeder System of Schools or schools of the same programmatic levels working within a
county or across counties to implement a strategy (to impact dropout prevention at the high
school level.
_____ District Application (district wide dropout prevention initiatives with less than a 90%
graduation rate, dropout prevention only)
_____ School System Collaborative Innovation Zones - The intent of this grant is to cause local
communities to take action by working in coalitions, creating partnerships, hosting community
conversations and ultimately creating comprehensive dropout prevention plans. The Education
Alliance of WV and the WV Center for Civic Life provide resources and training to organize
community dialogues and follow-up action.
_____ Innovation School Districts (to provide entrepreneurship education and include at least one
partner from the local business community with opportunities for greater collaboration to plan
and implement systemic approaches that include evidence-based solutions for increasing
graduation rates, increasing achievement and educational outcomes while reducing the number
of dropouts
Acknowledged Requirement (superintendent’s signature):
We acknowledge, as a requirement of receiving an Innovation Zone Grant or Dropout Prevention Grant, we must
use the Early Warning System provided by West Virginia Department of Education to determine students who
are at-risk of dropping out and provide direct interventions to support identified indicators. And upon request
grantee will provide data to support decisions based upon disaggregation of the data for at-risk identified students.
___________________________________
County, Superintendent:
_____________________________
Date:
Local Solution Dropout Education Innovation Zones
West Virginia Department of Education
According to WVDE - BOE Policy 3236
2015- 2016 GRANT APPLICATION
Name
LEADERSHIP TEAM MEMBERS
Identify the school or consortium’s leadership team.
For dropout prevention grants, the leadership team should include community partners
(add additional lines as necessary)
Title
Signature
Please ensure you have all of the supporting documents required completed and attached to the end of
this application:
______ Record of Commitment from Staff, Parent, and LSIC
______ Local Educational Agency Report of Support or Concerns
______ Multiple Community Partner Records of Commitment for Dropout Grants
Section 2 – Priorities:
Local Solution Dropout Education Innovation Zones
West Virginia Department of Education
According to WVDE - BOE Policy 3236
2015- 2016 GRANT APPLICATION
During the 2013 legislative session, Governor Tomblin sponsored several key education reform initiatives
through Senate Bill 359 and charged the WV Board of Education with supporting the successful
implementation. These areas have been identified for priority points in the grant review process.
If you are submitting an application for one of the identified priority areas please review guidance documents
and resources http://wvde.state.wv.us/innovationzones/
Applications for Drop-out Prevention grants that choose to focus on a priority area must show clear a
correlation between the priority area and the outcome of drop-out prevention. All applications that target a
priority area must identify it below:
_____ Community School Partnership
The term ‘‘community school’’ means a public elementary or secondary school that participates in a
community-based effort to coordinate and integrate educational, developmental, family, health, and
other comprehensive services through community-based organizations and public /private
partnerships. Community Schools provide access to such services for students, families, and the
community, such as access during the school year (including before and after-school), as well as during
the summer. Some may include: Early childhood education Programs under the Head Start Act,
including Early Head Start programs and child care; Remedial education activities and enrichment
activities, including expanded learning time; Summer enrichment and learning experiences; Dental
health care; Mental health counseling services (expanded-school mental health services). Complete
guidance on can be found at: http://wvde.state.wv.us/innovationzones/technical-assistance.html
_____
Comprehensive Literacy Development (creating a school-wide elementary focus on literacy
and numeracy)
_____
Career Development (middle school focus to prepare students in the middle grades to set goals
through interest and talent to view graduation as a culmination of planned activities and classes
from year-to-year to result in a career pathway)
_____
Redesign of Instructional Time (Intended to provide principals and teachers with flexibility
from the constraints of certain statutes, policies and rules in order to serve as testing grounds for
innovative reform strategies that enhance student success and increase accountability)
_____
Personalize Learning though Technology (Project 24) is an urgent call to action on the need
for systemic planning around the effective use of technology and digital learning to achieve the
goal of "career and college readiness" for all students.
_____
Entrepreneurship Education Innovation Zone to include at least one partner from the local
business community and thereby authorizing Innovation School Districts.
______
The STEM Innovation zone applies evidence-based approaches to a trans-disciplinary
Local Solution Dropout Education Innovation Zones
West Virginia Department of Education
According to WVDE - BOE Policy 3236
2015- 2016 GRANT APPLICATION
curriculum using project-based learning, differentiated instruction, and authentic assessment of mastery.
The school is designed to bridge the gap between how we live and how we learn in the 21st century by
blending formal schooling with cooperative learning experiences involving postsecondary education,
work and informal education.
Section 3 - ABSTRACT:
Provide a one page only project summary that briefly describes the project’s vision, goals, activities, and key
features for student success that will be addressed. Please limit the length of the abstract to the text box found
on this page only.
Local Solution Dropout Education Innovation Zones
West Virginia Department of Education
According to WVDE - BOE Policy 3236
2015- 2016 GRANT APPLICATION
Section 4 - Waiver Requests:
Requires that no exception be granted to assessment programs administered by the West Virginia Department
of Education (WVDE), provisions of NCLB or other federal law, nor exception from WV Code §§ 18A-2-7,
18A-4-7a, 18A-4-7b, 18A-4-8, 18A-5-8b. However, exceptions may include a proposal to require that a
candidate for a teaching vacancy in an innovation school possess qualifications over and above those stipulated
in statute if approved in a county-wide school staff election process.
Indicate the specific type(s) of policy or code that prohibit or constrain the design that you wish to
request a waiver from:
____ Specific waiver requested of county policy
____ Specific waiver requested of WVBOE policy
____ Specific waiver requested of WV code/statute
WV Code Waiver Request
(Specify section and article)
Impact of the waiver
What will the waiver enable the school to
do differently?
WVBOE Policy Waiver Request
(specify section and article)
Impact of the waiver.
What will the waiver enable the school to
do differently?
County Policy Waiver Request
(specify section and article)
Impact of the waiver.
What will the waiver enable the school to
do differently?
Local Solution Dropout Education Innovation Zones
West Virginia Department of Education
According to WVDE - BOE Policy 3236
2015- 2016 GRANT APPLICATION
Section 5- Project Design: Complete each section. Use as much space necessary.
1.
What is the purpose and expected outcome of this project?
2.
Explain how the school or consortium’s current data influenced the need for the project
described in question one?
3.
How is the school or consortium’s project connected to best practice and current research in
reference to raising student achievement and/or dropout prevention?
4.
What will other schools in West Virginia learn from your project and how will other schools
in West Virginia benefit from your project?
Local Solution Dropout Education Innovation Zones
West Virginia Department of Education
According to WVDE - BOE Policy 3236
2015- 2016 GRANT APPLICATION
Section 6 - Goals, Objectives, Evaluation, Timeline:
Complete this chart for each of your goals Goal:
Objectives
Identify the
measureable
objectives that will
be used to
determine success
in achieving these
goals
(Must be specific,
measurable,
attainable, relevant,
and timely goals
(SMART)
Activities
Personnel
Timeline
Budget
Develop activities
for each objective
that are: Creative
and innovative;
Impact student
success; Allow for
greater flexibility;
change the way the
school(s)/district
currently operate
Indicate the name
and title of
personnel that will
be responsible for
the activities.
Identify the
timeline for the
activities (include
month/year)
Indicate budget
requirements
(include formulas
used to derive totals
in budget sections
e.g. 3 subs
@$143/day=total)
Local Solution Dropout Education Innovation Zones
West Virginia Department of Education
According to WVDE - BOE Policy 3236
2015- 2016 GRANT APPLICATION
Section 7- Project Evaluation and Sustainability:
It is important to explain how you will measure the success of your project and how you plan to continue
the project after the grant funds are exhausted.
1. How will you evaluate and report the impact this innovation project has on increasing student
success and/or other stated goals and objectives?
2. How will this innovation project be sustained beyond the initial funding period?
Section 8- Budget Justification:
The Dropout Prevention Innovation Zone allocation is approximately $2,200,000. These funds will be awarded
in one competitive grant process and applicants must prepare proposals and accompanying budgets for three
school years. The budget should support the activities described in the above application. Major item requests
must be supported with activities within in the application. The budget range for each proposal is $50,000 to
$100,000 for each of the three years (total 3 year award range $150,000 to $300,000). *Dropout Innovation
Zone applicants need to complete a 3 year budget plan for FY 2015 – FY 2018
Local Solution Dropout Education Innovation Zones
West Virginia Department of Education
According to WVDE - BOE Policy 3236
2015- 2016 GRANT APPLICATION
FY 2015-16
Expenditure
Amount Requested
In-Kind (Optional)
Total
In-Kind (Optional)
Total
Professional Salaries
Fringe Benefits
Equipment
Supplies
Professional
Development
Travel
Contracts/Consultants
Other
Total
FY 2016-17
Expenditure
Professional Salaries
Fringe Benefits
Equipment
Supplies
Professional
Development
Travel
Contracts/Consultants
Other
Amount Requested
Local Solution Dropout Education Innovation Zones
West Virginia Department of Education
According to WVDE - BOE Policy 3236
2015- 2016 GRANT APPLICATION
Total
FY 2017-18
Expenditure
Professional Salaries
Fringe Benefits
Equipment
Supplies
Professional
Development
Travel
Contracts/Consultants
Other
Total
Amount Requested
In-Kind (Optional)
Total
Local Solution Dropout Education Innovation Zones
West Virginia Department of Education
According to WVDE - BOE Policy 3236
2015- 2016 GRANT APPLICATION
Appendix
Record of Commitment
Use this form to report the staff commitment regarding the innovation application and plan. A copy
must be forwarded to the Innovation Zone Committee with the application and the plan.
School: ___________________________________________________________________
Department (if applicable): _____________________________________________________
Notice of Meeting (Date provided to faculty or department/subdivision): ______________________
Meeting Date: ______________________________________________________________
Faculty Senate Elected Officers:
President: (Name) ________________________________ Signature: ____________________________
Vice-President: (Name)____________________________ Signature: ____________________________
Secretary: (Name) ________________________________ Signature: ____________________________
Treasurer: (Name) _______________________________ Signature: ____________________________
Other: (Name) ___________________________________ Signature: ____________________________
Service Personnel Representative:
Name: __________________________Position: ________________Signature: ____________________
Parent Representatives:
Name: __________________________Signature: ____________________________________________
Name: __________________________Signature: ____________________________________________
Name: _________________________ Signature: ____________________________________________
LSIC Representatives:
Name: __________________________Signature: ____________________________________________
Name: __________________________Signature: ____________________________________________
Name: __________________________Signature: ____________________________________________
We certify that 80 percent of the faculty affected by the application/plan has voted to support the
application/plan. (This Report Certification is not required of institutions of higher education in their
application or plan).
Local Solution Dropout Education Innovation Zones
West Virginia Department of Education
According to WVDE - BOE Policy 3236
2015- 2016 GRANT APPLICATION
Local Educational Agency Report of Support or Concerns
Use this form to report the county board or boards and superintendent’s support or concerns, or both, about the
innovation to the principal and faculty senate. A copy must be forwarded to the Innovation Zone Committee.
School: ___________________________________________________________________
Department (if applicable): _____________________________________________________
Date of School/Department/Subdivision Receipt of Application: ____________________________
Date of Regularly Scheduled County Board of Education Meeting: ___________________________
County Board of Education Elected Officers:
President: (Name) ________________________
Signature: ___________________________
Vice-President: (Name) __________________
Signature: ___________________________
Members
Name: _____________________________
Signature: ___________________________
Name: _____________________________
Signature: ___________________________
Name: _____________________________
Signature: ___________________________
Support:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Concerns:
__________________________________________________________________________________________
__________________________________________________________________________________________
______________________________________________________________________
(Report of the Local Education Agency must be forwarded to school/department/subdivision for submission to
West Virginia Board of Education with the application/plan).
(This Report Certification is not required of institutions of higher education in their application or plan).
Local Solution Dropout Education Innovation Zones
West Virginia Department of Education
According to WVDE - BOE Policy 3236
2015- 2016 GRANT APPLICATION
Community Partner Support
Use this form to document community organization/agency support
and partnership for the innovation dropout plan/project.
Use a separate form for each community partner.
Dropout grants must include meaningful documented partnerships.
School/Schools/District: ______________________________________________________
District: _________________________________________________________________
Date(s) of School/District/Community Partner Dialogues: _______________________________
________________________________________________________________________
Name of Community Organization/Agency: __________________________________________
Contact Person: ___________________________________________________________________________
Contact Person email address: _______________________________________________________________
Contact Person phone number: _______________________________________________________________
Contact Person address: ____________________________________________________________________
Explain the community organization/agency’s commitment to the Plan/Project:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________
List the resources and contributions (not monetary) that the organization/agency is making to this Plan/Project:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Agency Representative (Name) _________________________Signature: ____________________________
Title: _______________________________________________________
Local Solution Dropout Education Innovation Zones
West Virginia Department of Education
According to WVDE - BOE Policy 3236
2015- 2016 GRANT APPLICATION
Innovation Zone Requirements:
1.
2.
3.
4.
5.
6.
7.
8.
Proposals must be typed in 12 point font and received no later than 4:00 p.m. on October 1, 2015
Complete the application for Innovation Zone designation
Must include use of Early Warning System to provide data
*Approval by 80 percent of faculty (those affected by Innovation Proposal)
**Record of Support from Parents, LSIC, Business Partners, Students
Record of LEA/County Board Report (Support and Concerns) on application
Record of Support from Community Partners for Dropout Grants.
Submit your application/plan in a PDF document via email to Rebecca Derenge at rderenge@k12.wv.us
IMPORTANT NOTES:
*To determine staff support, the innovation application and plan must be submitted to all employees affected
by the design of the plan for a secret ballot vote at special meetings called to determine the level of
commitment.





The meeting is called with two weeks prior special notice, and the vote is conducted and certified to the
principal, superintendent, and county board president by a panel.
The panel must provide an absentee ballot to each employee eligible to vote who cannot attend the
meeting.
The panel consists of the elected officers of the faculty senate of the school or schools; one
representative of the service personnel of the school; and three parent members appointed by the
Local School Improvement Council (LSIC).
At least 80 percent of the employees who are eligible to vote must approve the school’s Innovation Zone
plan.
Any regular employee at a school applying for or designated as an Innovation Zone whose job duties may
be affected by implementation of the Innovation Zone plan or proposed plan may request a transfer to
another school in the school district. The county board shall make every reasonable effort to accommodate
the transfer.
**Please make sure your application is submitted to your local board in time to receive their signature and
supports/concern before the application due date.
Completed grant application must be RECEIVED via email by 4:00 p.m. on October 1, 2015.
Innovation Zone Grants are subject to funding.