1. Request for Application (RFA)
    1. Revised Jan 05
      1. PROGRAM GOAL: 1
      2. Measure of Accomplishment:
      3. PROGRAM GOAL: 1 Sunshine State Standard:
      4. Program Objective: 1.1 Measure of Accomplishment:
      5. Program Activities: Evidence/Documentation of Outcome:
      6. Begin/End Date: Person Responsible:
      7. Proposed Budget Expenditure:
  2. Instructions for Completion of DOE 100A
      1. CERTIFICATION

FLORIDA DEPARTMENT OF EDUCATION
Request for Application (RFA)
Bureau / Office
: K-12 Schools, Bureau of Student Assistance, Office of Safe and Healthy Schools,
Coordinated School Health Program (CSHP)
Project Title
: Tobacco Prevention and Intervention Teacher Training Continuation Project – Final Year
Specific Funding Authority
: State: Title XXXIV Alcoholic Beverages and Tobacco-Tobacco Products,
section 569.11(6), Florida Statute.
Funding Purpose
: Tobacco Prevention and Intervention Teacher Training Projects will be continued to
support public school districts to enhance teacher knowledge and skills needed to impact the use of
tobacco among youth by providing quality training for teachers to implement effective tobacco
prevention and intervention programs.
Continuation projects shall
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develop a detailed work plan including goals, objectives, action steps, and evaluation strategies for
the continuation project;
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review the currently funded tobacco prevention and intervention teacher training project to identify
components that will be included in the continuation project;
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identify additional tobacco prevention and/or intervention curricula or programs requiring teacher
training;
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evaluate the results of additional training provided to teachers on tobacco prevention and/or
intervention curricula and/or programs; and
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assess student knowledge, identifying student gains in knowledge as a result of the tobacco
prevention and/or intervention curricula or programs taught by the trained teacher.
Support for Reading Initiative:
The grantee is required to address how the project will support Just
Read, Florida! Information about the initiative is available at http://www.justreadflorida.org/.
Type of Award
: Discretionary
Total Funding Amount
: $245,000.00 total allocation. Project awards will be a maximum of $35,000
per individual public school district.
Budget Period
: July 1, 2006 through June 30, 2007
Performance Period
: July 1, 2006 through June 30, 2007
Target Population
: Instructional personnel who will implement tobacco education in Florida public
schools.
Eligible Applicants
: Currently funded projects with the school districts of Duval, Hillsborough, Lake,
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Leon, Palm Beach, Sarasota, St. John’s.
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Application Due Date
: Upon receipt but no later than May 26, 2005. Applications received after 5:00
p.m. EST will not be processed.
Contact Person
: Dr. Antionette Meeks, 850.245.0480; Suncom: 205.0480; Fax: 850.245.5116; E-mail:
Antionette.Meeks@fldoe.org.
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Assurances
: The Department of Education has developed and implemented a document entitled,
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General Terms, Assurances and Conditions for Participation in Federal and State Programs, to comply
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with:
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34 CFR 76.301 of the Education Department General Administration Regulations (EDGAR) which
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requires local educational agencies to submit a common assurance for participation in federal
programs funded by the U.S. Department of Education;
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applicable regulations of other Federal agencies; and
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State regulations and laws pertaining to the expenditure of state funds.
In order to receive funding, applicants must have on file with the Department of Education, Office of the
Comptroller, a signed statement by the agency head certifying applicant adherence to these General
Assurances for Participation in State or Federal Programs. The complete text may be found at
http://www.firn.edu/doe/comptroller/gbook.htm
School Districts, Community Colleges, Universities, and State Agencies
: The certification of
adherence filed with the Department of Education Comptroller’s Office shall remain in effect indefinitely
unless a change occurs in federal or state law, or there are other changes in circumstances affecting a
term, assurance, or condition; and does not need to be resubmitted with this application.
General Education Provisions Act
: In accordance with the requirements of Section 427 of the
General Education Provisions Act (GEPA) Public Law 103-382, each applicant must include a
description of the steps the applicant proposes to take to ensure equitable access to, and participation
in, its program for students, teachers, and other program beneficiaries with special needs. For details
refer to URL: http://www.ed.gov/policy/fund/guid/gposbul/gpos10.html
Project Design
: There is an 8-page maximum for the narrative. Forms, Project Design Template,
attachments, and appendices are not included in this 8-page maximum. The project narrative should
be prepared using an 11-point font size, 1” margins, and single-sided typed 8.5 x 11-inch sized pages.
Include in the narrative how this project will support the Just Read, Florida! initiative and how the
project will be disseminated and marketed to the target audience. In addition to the narrative, use the
attached Program Design Template to provide an overview of your project. The narrative must provide
a detailed work plan of strategies and outcomes for the 2006-07 grant year. The work plan must
include the items listed below in the following order:
 
overall preliminary results report from 2005-06 tobacco grant project
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preliminary results report from 2005-06 tobacco grant project indicating the teacher trainings you
plan to continue
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description of new tobacco prevention and/or intervention programs and/or curricula on which
teachers will be trained
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list of training programs including proposed training dates, number of training days, number of
training contact hours, target audience (e.g., 6
th
grade science teachers), number of attendees
desired
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plan for the evaluation of the project, including impact on teachers trained and students receiving
the program/curricula from these teachers. The plan must include quantitative and qualitative
measures where appropriate. The evaluation plan is to:
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list goals and objectives for the project;
o
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describe how goals and objectives will be measured;
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identify project activities used to carry out the goals and objectives;
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measure the effectiveness of all project components outcomes;
o
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identify how data will be collected and analyzed, as well as the identifying the reporting
system;
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indicate how program data will be used to plan for continuous improvement.
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description of how the proposed project will incorporate one or more of the Florida State Board of
Education strategic imperatives. More information can be accessed at
http://www.fldoe.org/meetings/2005_01_18/StratPlanDetails.pdf.
 
completed Project Design Template
Reporting Outcomes
: All reports and deliverables are to be sent to:
Dr. Antionette Meeks, Coordinated School Health Program
Florida Department of Education
325 W. Gaines Street, Suite 554
Tallahassee, FL 32399-0400
Reports to be submitted:
1.
Provide a copy of the final evaluation report from the 2005-06 program year and any adjustment
to the previously submitted evaluation plan as indicated by this final evaluation report by
July 28, 2006.
2.
Provide a project interim report by
January 31, 2007.
This report will include information on
numbers of participants, program and/or curricula used, training session information, assessment of
training participants, and assessment of program and/or curricula impact on students resulting from
teacher training.
3.
Final Program Evaluation Report – due July 27, 2007
Dissemination/Marketing
: Programs must provide examples of the strategies used to market their
project to their target populations. Examples may include but are not limited to brochures, newsletters,
and Internet.
Funding Method
:
Quarterly Advance to Public Entity –
For quarterly advances of non-federal
funding to state agencies and LEAs made in accordance within the authority of the General
Appropriations Act. Expenditures must be documented and reported to DOE at the end of the project
period. If audited, the recipient must have expenditure detail documentation supporting the requested
advances.
Fiscal Requirements
1.
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All funded projects and any amendments are subject to the procedures outlined in the Project
Application and Amendment Procedures for Federal and State Programs (Green Book) and the
General Assurances for Participation in Federal and State Programs. The text for the Green Book
may be accessed on-line at http://www.firn.edu/doe/comptroller/gbook.htm.
2.
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Indirect costs shall only apply to federal projects.
3. Allowable Expenses
: Project funds must be used for activities that directly support the
preparation, training, and engagement in public school tobacco education in grades K-12, as well at
the evaluation of this project. Allowable expenditures include professional training fees, training
supplies and materials, teacher stipends, substitute teachers, tobacco curricula, evaluation and
report preparation, and audiovisual and room rentals.
Note
: Funds may be used for substitute
teachers only when classroom teachers attend training during normal working hours.
4.
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Unallowable Expenses:
Project funds may not be used for salaries of regular or temporary school
district employees, creation of positions or supplanting of existing programs and funding,
nonexpendable equipment or consumables such as computers, DVD players, TVs, VCRs, or other
electronic or telecommunications equipment, indirect administrative costs, student training or
transportation of students, food and beverages, financial incentives for staff and students, non-
educational products or gifts, (such as t-shirts), and materials not directly related to tobacco
prevention and intervention. Indirect costs cannot be applied to state funded projects.
Conditions for Acceptance
: The requirements listed below must be met for applications to be
considered for review:
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1.
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Application includes required forms: DOE 100A Application Forms and DOE 101 Budget Narrative
Forms and the narrative description as explained previously. DOE forms 100A and DOE 101 can
be accessed on-line at http://www.firn.edu/doe/comptroller/gbook.htm.
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Project Application Form (DOE 100A)
with the appropriate original signature made in an ink
color other than black.
NOTE:
The certification section must be an original signature by the
Superintendent. If the signature is by an official other than the Superintendent, the application
must include a letter signed by the Superintendent, or documentation citing action of the
governing body delegating authority to the person to sign on behalf of said official.
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Budget Narrative Form (DOE 101)
for July 1, 2006 through June 30, 2007.
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Submit two (2) copies of the original application.
2.
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Application is received in the DOE within the timeframe specified by the RFA
3.
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Application must be submitted to: Office of Grants Management
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Florida Department of Education
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325 W. Gaines Street, Room 325
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Tallahassee, Florida 32399-0400
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Attachments
Example of Suggested Planning Format
Program Design Template
DOE 100A Project Application
DOE 101 Budget Narrative Form
Revised Jan 05
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EXAMPLE OF SUGGESTED PLANNING FORMAT
PROGRAM GOAL: 1
A cadre of skilled tobacco prevention educators will be established.
Sunshine State Standard:
HEA132, HEA134, HEA131, HEB131, HEB134,
HEB231, HEB336, HEC133, HEC232
Program Objective: 1.1
Measure of Accomplishment:
1.0. All (20) 7
th
grade health teachers will be trained to implement
Tobacco Prevention
At least 95% of 7
th
grade health teachers will be trained to
Education
in their curricula, July 1, 2005 through May 27, 2006.
implement Project Tobacco Prevention Education.
Program Activities:
Evidence/Documentation of
Begin/End Date:
Person
Proposed Budget
Outcome:
Responsible:
Expenditure:
1.1.1 Quality curriculum will be identified
and reviewed
Review team reports
7/1-7/31/06
N/A
1.1.2 Materials will be ordered.
Purchase Order completed and
approved
7/31-8/10/06
2,800.00
1.1.3 Training programs will be organized
and presented.
Agenda and sign-in sheets from
training
8/31/06-2/27/07
10,000.00
1.1.4 Training participants will demonstrate
increased skills and knowledge
One hundred percent of training
participants will show a growth of at
least 80% in knowledge between pre-
and post-training testing.
8/31/06-2/27/07
N/A
1.1.5 Training program impact will be
evaluated
Student feedback will be gathered
10/1/06-5/27/07
N/A
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PROGRAM DESIGN TEMPLATE
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PROGRAM GOAL: 1
Sunshine State Standard:
Program Objective: 1.1
Measure of Accomplishment:
Program Activities:
Evidence/Documentation of
Outcome:
Begin/End Date:
Person
Responsible:
Proposed Budget
Expenditure:
1.1.1
1.1.2
1.1.3
1.1.4
1.1.5
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Instructions for Completion of DOE 100A
A.
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If not pre-printed, enter name of the program for which funds are requested.
B.
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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.
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Enter the total amount of funds requested for this project.
D.
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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.
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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.
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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 the DOE 100A when the application is submitted.
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________________________________________________
TAPS Number
FLORIDA DEPARTMENT OF EDUCATION
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Project Application
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Telephone:
Suncom: 205-0498
A
)
Teacher Trai
Final Year
DOE USE ONLY
Project Number (DOE Assigned)
D
)
Contact Name:
E-mail Address:
I, ______________________________________________, (
Please Type Name)
C
)
$
$
E)
Please return to:
Florida Department of Education
Bureau of Grants Management
Room 325 Turlington Building
325 West Gaines Street
Tallahassee, Florida 32399-0400
(850) 245-0498
Program Name:
Tobacco Prevention and Intervention
ning Continuation Project –
Date Received
B) Name and Address of Eligible Applicant:
Applicant Contact Information
Mailing Address:
Telephone Number:
SunCom Number:
Fax Number:
CERTIFICATION
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.
Total Funds Requested:
DOE USE ONLY
Total Approved Project:
Signature of Agency Head
DOE 100A
Revised 08/04
John L. Winn, Commissioner
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Instructions
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Budget Narrative Form
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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
.
(DOE USE ONLY)
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COLUMN 1
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FUNCTION: SCHOOL DISTRICTS ONLY:
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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:
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SALARIES
- describe the type(s) of positions requested. Use a separate line to describe each type of position.
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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.
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PROFESSIONAL/TECHNICAL SERVICES
- describe services rendered by personnel, other than agency personnel
employees, who provide specialized skills and knowledge.
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CONTRACTUAL SERVICES AND/OR INTER-AGENCY AGREEMENTS
- provide the agency name and description of the
service(s) to be rendered.
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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.
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CAPITAL OUTLAY
- provide the type of items/equipment to be purchased with project funds.
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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 – MUST BE COMPLETED FOR ALL SALARIES AND OTHER PERSONAL SERVICES.
FTE
- Indicate the Full Time Equivalent (FTE based on the standard workweek for the type of position) number of
positions to be funded. Determine FTE by dividing the standard number of weekly hours (e.g., 35 hours) for the type of
position (e.g., teacher aide) into the actual work hours to be funded by the project.
COLUMN 5
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 DOE-
100A or B.
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A)
Name of Eligible Recipient:
B)
TAPS Number
Project Number:
(DOE USE ONLY)
FLORIDA DEPARTMENT OF EDUCATION
Budget Narrative Form
Tobacco Prevention and Intervention Teacher Training Continuation Project – Final Year
(1)
FUNCTION
(2)
OBJECT
(3)
ACCOUNT TITLE AND NARRATIVE
(4)
FTE POSITION
(5)
AMOUNT
C) TOTAL
$
DOE 101
Rev. 01/05
John L. Winn, Commissioner
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