ATTACHMENT 1
PROJECT APPLICATION FORM
Please return to:
Florida Learn & Serve
325 John Knox Drive
Building F, Suite 210
Tallahassee, FL 32303
850-487-0262
A
)
Program Name:
State Farm Florida
2005-2006
Competitive Projects
INTENAL USE ONLY
Date Received
B) Name and Address of Eligible Applicant:
Project Number (Internal Use)
D
)
Applicant Contact Information
Contact Name:
Mailing Address:
Telephone Number:
SunCom Number:
Fax Number:
E-mail Address:
CERTIFICATION
I, ______________________________________________, (
Please Type Name)
do hereby certify that all facts, figures, and
representations made in this application are true, correct, and consistent with the statement of general assurances and specific
programmatic assurances for this project. Furthermore, all applicable statutes, regulations, and procedures; administrative and
programmatic requirements; and procedures for fiscal control and maintenance of records will be implemented to ensure proper
accountability for the expenditure of funds on this project. All records necessary to substantiate these requirements will be
available for review by appropriate state and federal staff. I further certify that all expenditures will be obligated on or after the
effective date and prior to the termination date of the project. Disbursements will be reported only as appropriate to this project,
and will not be used for matching funds on this or any special project, where prohibited.
Further, I understand that it is the responsibility of the agency head to obtain from its governing body the authorization for the
submission of this application.
E) ________________________________________________
_____________________________________________
Signature of Agency Head
Title
C
)
Total Funds Requested:
$
INTERNAL USE ONLY
Total Approved Project:
$
Page 1
Page 2
Instructions for Completion of Project Application Form
A.
If not pre-printed, enter name of the program for which funds are requested.
B.
Enter name and mailing address of eligible applicant. The applicant is the public or non-public
entity receiving funds to carry out the purpose of the project.
C.
Enter the total amount of funds requested for this project.
D.
Enter requested information for the applicant’s contact person. This is the person responsible for
responding to all questions regarding information included in this application.
E.
The original signature of the appropriate agency head is required.
The agency head is the
school district superintendent, university or community college president, state agency
commissioner or secretary, or the president/chairman of the Board for other eligible applicants.
•
Note:
Applications signed by officials other than the appropriate agency head identified above
must have a letter signed by the agency head, or documentation citing action of the governing body
delegating authority to the person to sign on behalf of said official. Attach the letter or
documentation to this form when the application is submitted.
Page 4
Instructions
Budget Narrative Form
This form should be completed based on the instructions outlined below, unless instructed otherwise in the Request for Proposal (RFP)
or Request for Application (RFA).
A.
Enter Name of Eligible Recipient.
B
.
(INTERNAL USE ONLY)
COLUMN 1
FUNCTION:
SCHOOL DISTRICTS ONLY:
Use the four digit function codes as required in the Financial and Program Cost Accounting and Reporting for Florida
Schools Manual.
COLUMN 2
OBJECT:
SCHOOL DISTRICTS:
Use the three digit object codes as required in the Financial and Program Cost Accounting and Reporting for Florida
Schools Manual.
COMMUNITY COLLEGES:
Use the first three digits of the object codes listed in the Accounting Manual for Florida’s Public Community Colleges.
UNIVERSITIES AND STATE AGENCIES:
Use the first three digits of the object codes listed in the Florida Accounting Information Resource Manual.
OTHER AGENCIES:
Use the object codes as required in the agency’s expenditure chart of accounts.
COLUMN 3
-
ALL APPLICANTS:
ACCOUNT TITLE:
Use the account title that applies to the object code listed in accordance with the agency's accounting
system.
NARRATIVE:
Provide a detailed narrative for each object code listed. For example:
•
SALARIES
- describe the type(s) of positions requested. Use a separate line to describe each type of position.
•
OTHER PERSONAL SERVICES
– describe the type of service(s) and an estimated number of hours for each type of position. OPS is
defined as compensation paid to persons, including substitute teachers not under contract, who are employed to provide
temporary services to the program.
•
PROFESSIONAL/TECHNICAL SERVICES
- describe services rendered by personnel, other than agency personnel employees, who
provide specialized skills and knowledge.
•
CONTRACTUAL SERVICES AND/OR INTER-AGENCY AGREEMENTS
- provide the agency name and description of the service(s) to be
rendered.
•
TRAVEL
- provide a description of each type of travel to be supported with project funds, such as conference(s), in district or out of
district, and out of state. Do not list individual names. List individual position(s) when travel funds are being requested to perform
necessary activities.
•
CAPITAL OUTLAY
- provide the type of items/equipment to be purchased with project funds.
•
INDIRECT
COST
- provide the percentage rate being used. Use the current approved rate. (Reference the DOE Green Book for
additional guidance regarding indirect cost.)
COLUMN 4
AMOUNT -
Provide the budget amount requested for each object code.
C. TOTAL -
Provide the total for Column (4) on the last page
.
Must be the same amount as requested on the Project Application Form
Page 5
ATTACHMENT 3
Proposal Data Form
(10% of total score)
Respond to all applicable items; this form is a required component of the proposal.
# of students who will conduct service-learning activities:_____
# of adult volunteers/partners:_____
# who will be served: Students_____ Adults_____
Grade level(s) of students serving:_____
Grade level(s) of students being served by other students, if applicable:_____
Name/Grade level of course(s) into which service will be integrated ___________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Portion of grade(s) that will be based on student service learning activities: _____________
__________________________________________________________________________
__________________________________________________________________________
List of the primary (no more than three) Sunshine State, Goal 3, and/or Applied Technology Standards
the project will address: ______________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
# of service activities to be conducted:___________________________________________
Frequency of service activities:_________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Products to be made as part of the project:________________________________________
__________________________________________________________________________
__________________________________________________________________________
Average # service-learning hours students will provide (min. 20 per semester per
student):___________
Projected # of total service hours for the project (hours times number of students):________
Page 7
ATTACHMENT 5
SERVICE-LEARNING DEFINITION, ELEMENTS, AND EXAMPLES
Definition
Service learning is a method by which students learn and develop through active participation in thoughtfully
organized service that
•
Is conducted in and meets real needs of a community (schools may be defined as communities),
•
Is integrated into and enhances the academic curricula of students,
•
Provides structured time for students to reflect on their service experiences and demonstrate knowledge
or skills they have gained, and
•
Helps foster civic responsibility.
In service-learning projects, students practice skills and behaviors they need to learn (i.e., that teachers want
them to learn) through the service they do. Service is a means and application of learning.
Elements
What distinguishes service learning from other service and volunteering? In a school context, the service is
directly related to curricula. Activities are design to address and apply specific learning objectives, standards,
and curriculum frameworks. Effective service-learning projects have the following elements:
1. Preparation/Planning/Design
•
Needs identification/assessment—those being
served help define their needs and how to meet
them.
•
Learning the context for the need(s) to be
addressed.
•
Issue discussion and selection.
•
Examination of stakeholders, policies, and
systems impacting the need(s) to be addressed.
•
Designing activities to meet identified needs.
Teachers assign students work/projects/tasks to learn
about the context for the service the students will
subsequently provide. The service that follows is
derived from this new knowledge, involves student
voice and design, but remains within the curricular
framework the teacher has established.
2. Action
•
Research- and knowledge-based service
activities.
•
Student leadership in conducting and
leading project activities.
•
Activities are often fluid and evolve as
the project progresses, original needs
are addressed, and others are identified.
•
Students work collaboratively with
service recipients and partners.
•
Application of multiple learning styles
including individual work, teamwork,
using technology, tactile/manual work,
oral presentations, data collection,
writing, construction, etc.
•
Activities flow from preparation and are
not wholly pre-planned by teachers.
Page 8
3.
Reflection
is integrated into successful projects
from beginning to end as students form and test
opinions, project outcomes, measure results and
impacts, discuss actions and reactions, and make
improvements and future plans. It allows students
to process and absorb what they have experienced
and is critical to meaningful learning. Reflective
activities include the following:
•
Journaling,
•
Projecting project impacts,
•
Discussion,
•
Conducting formative and summative
evaluation,
•
Making project refinements, and
•
Conducting future planning.
4.
Demonstration
is another application of
service learning that involves students in
educating others about the issues they are
addressing. Demonstration takes various
forms—many of which are actual service-
learning projects in themselves—including
the following:
•
Advocacy campaigns
•
Putting on public forums/presentations
•
Performance on the service issues
•
Teaching others about the project and
the issues behind it
•
Creating films, portfolios, books, web
sites, publications, works of art, etc.
5. Recognition/Celebration
Throughout the project but especially at the end, students should be recognized for their efforts. In
successful projects, all participants join together to reflect and to plan future efforts.
6. Youth Empowerment
An implicit or explicit component of the above elements, youth empowerment and leadership enrich
every aspect of service learning. The greater the voice students have in identifying needs and designing
activities, the more motivated they will be about the project. Having to demonstrate to (i.e., teach)
others about the needs and issues being addressed requires a higher assimilation of learning. Effective
projects have students conduct much of the evaluation, saving teachers labor and making students
responsible for determining whether or not their efforts were successful. Strong student roles are
hallmarks of effective projects, in which students . . .
•
Are involved in project design and planning, with meaningful leadership roles (including needs
identification and helping to decide what service activities will be conducted). Teachers in
effective projects assign students organizing and logistical duties involved in arranging,
providing, measuring, evaluating, reporting, and celebrating service activities.
•
Conduct a lot of service over time. It is better to have fewer students doing a lot of service
learning than to have a lot of students conduct only surface-level efforts.
7. Reciprocity
Reciprocity (could also be defined loosely as collaboration) ensures that activities actually provide
service that is necessary, exposes student to people different from themselves, provides different
perspectives on the needs and service, and brings outside assistance, expertise, match, publicity, and
coordination to service-learning projects. In effective projects, teachers and students design activities
based on what they hear and learn from those in need and not based on preconceived notions.
When these elements are in place, the impacts of curriculum-based service learning go far beyond those of
traditional community service and volunteering. Service learning combines academic and affective learning to
engage students hands-on in the real world. This combination—not to mention the incentive to get out of
class—is what makes service learning such a powerful tool, pedagogy, and strategy.
For more information, go to the Florida Learn & Serve web site at the following address:
www.fsu.edu/~flserve