Everett Public Schools

Identifying Uses of Funds for Allowable Activities Aligned to School Goals

Everett Public Schools

School:

Date proposal submitted:

Grade level(s) impacted:
Select the instructional programs the funds will support:
· English Language Arts (ELA)	· Math	· Behavior	· Science	· English Lang. Development
· Other, please describe:

The funds will support students through– The following document provides examples of activities that Local Educational Agencies (LEAs) might be able to use – Unlocking State and Federal Program Funds to Support Student Success .

· MTSS – Tier 2 and Tier 3

· Professional Learning

· Literacy Support Services

· Graduation Supports

· Parent/Family Engagement

· Behavior Supports

· Supplemental Curriculum

· Summer School Instruction

· Early Learning Activities

· Supplemental Materials

· Extended Learning Opportunities

· Transition Activities

· Positive School Climate

· Instructional Coach

· Technology

· Advance Learning Opportunities (Dual Credit)

· Regular Attendance Interventions

· Coaching

· Co-Teaching

· Push-in, Pull-out Model

· Other, please described below

For other, please describe here:

Briefly describe your activity and enter or attach ( AGENDA with this form / SIGN-IN SHEETS after event / P-CARD REPORT by date due , etc.). All applicable supporting documentation must be available for audit purposes.

Activity Name: Implementation Date:

When determining if the activity or activities are appropriate, if applicable, answer the following questions:

· How does this activity directly support student achievement?

· How does this activity directly support staff professional development?

· How does this activity increase the participation of parents in school activities or assist parents to support student achievement?

Total Amount Requested: Breakdown of funds (if needed):

Remember to keep the following documentation of the activity for auditing purposes:

· Activity agenda – clearly states the purpose of the activity (must be an allowable activity).

· Sign in sheets for all participants (this includes all attending family members).

· Itemized receipts should provide enough detail to determine the purchase and number of items purchased.

PRINCIPAL SIGNATURE:

Name:

Title:

Signature:

Date:

☐ Not Approved Reason:
☐ Approved – The request aligns to (check all that apply):
Title I, Part A – ☐ Schoolwide Plan Learning Assistance Program (LAP) – ☐ iGrants FP 218 Plan ☐ Menu of Best Practices ( Math , ELA , Behavior ) LAP High Poverty – ☐ EL – ☐ Basic Education – ☐ Other – ☐
The activity will be funded with (check all that apply) – All funding sources must support allowable activities. If unsure, direct any questions to the Federal Program staff at OSPI. ☐ Basic Education Funds ☐ Title I, Part A funds ☐ Learning Assistance Program (LAP) funds ☐ Bilingual funds (EL) ☐ LAP High Poverty ☐ Other REGIONAL SUPERINTENDENT APPROVAL:
Name:	Title:
Signature:	Date:

           School Office Manager: PLEASE COMPLETE THIS SECTION BEFORE SUBMITTING (Categorical programs will fill in the budget code once approved)

BUDGET CODE:

The activity will be funded with (check all that apply) – All funding sources must support allowable activities. If unsure, direct any questions to Tami (x4035) in Categorical Programs.

   CHOOSE ONE                                                                    CHOOSE ONE                                          ENTER ITEM #
☐ Basic Education
   ☐ Title I, Part A                                                                  ☐ PD ☐ EXT. DAY ☐ PFE ITEM #__
   ☐ LAP Basic                   ☐ PD ☐ EXT. DAY ☐ PFE ITEM #__
   ☐ LAP High Poverty                 ☐ HPT ☐ EXT. DAY ☐ PFE ITEM #__
   ☐ EL       [ ☐ Title III ☐ TBIP]      ITEM #__
☐ Other

Categorical Budget Authority Approval :
Name: Title:
Signature: Date:

OSPI May 2019

School Office Manager: PLEASE COMPLETE THIS SECTION BEFORE SUBMITTING (Categorical programs will fill in the budget code once approved)
BUDGET CODE:

The activity will be funded with (check all that apply) – All funding sources must support allowable activities. If unsure, direct any questions to Tami (x4035) in Categorical Programs. CHOOSE ONE CHOOSE ONE ENTER ITEM # ☐ Basic Education ☐ Title I, Part A ☐ PD ☐ EXT. DAY ☐ PFE ITEM #__ ☐ LAP Basic ☐ PD ☐ EXT. DAY ☐ PFE ITEM #__ ☐ LAP High Poverty ☐ HPT ☐ EXT. DAY ☐ PFE ITEM #__ ☐ EL [ ☐ Title III ☐ TBIP] ITEM #__ ☐ Other Categorical Budget Authority Approval :
Name:	Title:
Signature:	Date: