1.  
      2. TAPS Number
    1. 2006-2007 Title IV, Safe and Drug-Free Schools (SDFS) Entitlement Project
      1. CERTIFICATION
  1. Instructions for Completion of DOE 100A
      1. TAPS Number
  2. FLORIDA DEPARTMENT OF EDUCATION Budget Narrative Form
      1. FEDERAL GUN-FREE SCHOOLS ACT LOCAL EDUCATION AGENCY ACTIVITIES SURVEY
      2. Fiscal Year: 2005-2006
      3. 2. Modified Expulsions
      4. 3. Alternative Placements
      5. 4. Students With Disabilities
      6. DISTRICT SAFE AND DRUG-FREE SCHOOLS PROJECT COMPREHENSIVE PLAN
      7. SECTION I: NEEDS ASSESSMENT
      8. School /Community Characteristics
      9. Public Schools Private, Non-Profit Schools
      10. # of Schools # of Students
      11. Enrolled
      12. # of Schools
      13. # of Students
      14. Enrolled Elementary
      15. Middle High
      16. Combination Schools TOTAL
      17.   2. County-/State-level Student Behavior Trend Data
      18. SESIR Data Selected Incidents (per 1000 students) - county aggregate
      19. Discipline (per 1000 students) - county aggregate
      20. FYSAS Data
      21. Grades 6-8 Grades 9-12
      22. 30 Day Prevalence Rates (%) for:
      23. 2000 2002 2004 2004
      24. (SA)* 2000 2002 2004
      25. 2004 (SA)*
      26. Alcohol Binge Drinking Cigarettes
      27. Smokeless Tobacco
      28. Marijuana Any Illicit Drug Other Than
      29. Marijuana Mean Age of First Use for:
      30. Cigarettes Marijuana
      31. Alcohol (more than a sip)
      32. 4. Prioritized List of Needs
      33. Priority Student Behavior Direction of Change
      34. Target Population
      35. Need #1
      36. SECTION II: DISTRICT-DEVELOPED GOALS
      37. District Goal #1:
      38. District Goal #2:
      39. SECTION V: PROGRAM ACTIVITY PROFILE*
      40. 2. Provide the following information for all other programs not on this list.
      41. 4. Prioritized Need(s)
      42. 5. Primary Target Group(s) to be served:
      43. Elementary Middle High K 1 2 3 4 5 6 7 8 9 10 11 12
      44. Students School Staff Parents
      45. Private, Non-profit Other
      46. If other, specify: Total Schools Served
      47. 6. Targeted Changes (check all that apply):
      48. 7. Implementation Plan for this Program
      49. 9. Program Specific Objectives
      50. Program Outcome Objective #1:
      51. Program Process Objective #1:
      52.   10. Program Specific Expenses
      53. PROGRAM SPECIFIC EXPENSE WORKSHEET
      54. Function Object Account Title and Narrative FTE Amount
      55. GENERAL PROJECT COORDINATION EXPENSES WORKSHEET
      56. Function Object Account Title and Narrative FTE Amount

FLORIDA DEPARTMENT OF EDUCATION
Request for Application (RFA)
Bureau / Office
:
K-12 Schools/Bureau of Student Assistance/Office of Safe and Healthy Schools
Project Title
:
?
Safe and Drug-Free Schools (SDFS) Entitlement Project
?
Specific Funding Authority (ies)
CFDA #84.186, Federal Program, Title IV, section 4002, No Child Left Behind Act of 2001. – Safe and Drug-
Free Schools
Funding Purpose
Section 4002, NCLB states that the purpose of this grant is: “to support programs that prevent violence in and
around schools; that prevent the illegal use of alcohol, tobacco, and drugs; that involve parents and
communities; and that are coordinated with related Federal, State, school, and community efforts and resources
to foster a safe and drug-free learning environment that supports student academic achievement…”
Type of Award:
Entitlement
Total Funding Amount
$12,261,007
Budget Period
July 1, 2006 – June 30, 2007
Performance Period
July 1, 2006 – June 30, 2007
Target Population
Students, school staff, school administrators, parents, and community members as deemed appropriate
Eligible Applicant(s)
School Districts, Developmental Research Schools, and the Florida School for the Deaf and Blind
Application Due Date
The due date refers to the date of receipt in Grants Management by the close of business on June 30,
2006. Facsimile and email submissions will not be accepted.
1

Complete applications must be submitted via web-based reporting system
received by the close of business
on
June 30, 2006. Project Application (DOE 100A) with original signature of the Superintendent must be
submitted by this same date in order for the application to be consider received. Facsimile and email
submissions of the DOE 100A will not be accepted.
The effective date of the application will be determined
by the date the DOE 100A, with original signature is received by the Office of Grants Management.
Contact Persons
Project Application Support: Office of Safe and Drug-Free Schools, Brooks Rumenik, Educational Program
Director, by phone at (850) 245-0416, Suncom 205-0416, or via email at Brooks.Rumenik@fldoe.org
Grants Management: Kinisha Murphy, Grants Specialist II, Office of Grants Management by phone at (850)
245-0731, Suncom 205-0731, or via email Kinisha.Murphy@fldoe.org
Technical Support with On-line Application: Safe and Drug-Free Program Staff at (850) 245-0416, Suncom
205-0416, or visit http://www.firn.edu/doe/besss/staff_assignments.html for regional managers.
Assurances
?
The Department of Education has developed and implemented a document entitled, General Terms,
?
Assurances and Conditions for Participation in Federal and State Programs, to comply with:
?
 
34 CFR Part 76.301 of the Education Department General Administration Regulations (EDGAR)
which requires local educational agencies to submit a common assurance for participation in federal
programs funded by the U.S. Department of Education;
 
applicable regulations of other Federal agencies; and
 
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.
2
?

 
NARRATIVE SECTION
General Education Provisions Act
In accordance with the requirements of Section 427 of the General Education Provisions Act (GEPA) Public Law
103-382, request that each applicant for Federal funding provide a concise description of the steps proposed to
ensure equitable access to, and participation of students, teachers, and other program beneficiaries with special
needs.
Please Note: Due to the fact that this is an on-line application, applicants are required to maintain documentation
at the local level which supports compliance with the requirements of the General Education Provisions Act.
Documentation must include a concise description of the process to ensure equitable access to, and participation of
students, teachers, and other program beneficiaries with special needs.
For details refer to URL:
http://www.ed.gov/fund/grant/apply/appforms/gepa427.pdf. NOTE: Upon completion of the on-line application, each
applicant will be required to submit confirmation of compliance with this requirement. Assurance, including GEPA
requirements are part of the “Print Application” function of the on-line application.
Project Design - Narrative
Section 4002 of the No Child Left Behind Act states that the purpose of this grant is: “to support programs that prevent
violence in and around schools; that prevent the illegal use of alcohol, tobacco, and drugs; that involve parents and
communities; and that are coordinated with related Federal, State, school, and community efforts and resources to foster a
safe and drug-free learning environment that supports student academic achievement.”
Programs funded must be based on an assessment of objective data regarding the incidence of violence and illegal drug
use in the schools served. Analysis of the conditions and consequences must include delinquency and serious discipline
problems among students who attend such schools (including private school students who participate in the drug and/or
violence prevention program). Needs must be prioritized and five year goals set to address these prioritized needs. In
order to supplement the Prioritized Needs not being addressed, applicants must seek the assistance of outside
professionals to provide additional programming or funding.
Applicants are required to complete a program profile for each SDFS funded program planned for implementation during
the 2006-2007 year including type of program, target population(s), specific impact objectives, implementation protocol,
and methods for program evaluation.
Support for Reading/Strategic Imperatives
Describe how the proposed project will incorporate reading initiatives and one or more of the Florida State Board
of Education (SBE) strategic imperatives.
URL: h
ttp://www.fldoe.org/meetings/2005_01_18/StratPlanDetails.pdf
The Safe and Drug-Free Schools project supports the Florida Reading Initiative by providing a safe, violence-free, and
drug-free environment that allows all students an opportunity to learn.
Dissemination/Marketing
Describe methods /strategies you will use to disseminate and market information about the project to appropriate
populations.
The Safe and Drug-Free Schools project supports the Florida Reading Initiative by providing a safe, violence-free, and
?
drug-free environment that allows all students an opportunity to learn.
?
Districts are required to submit annual progress reports which provide data and an analysis of the district’s measurable,
?
outcome objectives.
?
Districts are required to regularly report on project needs assessments, planning initiatives, program activities, and
?
program evaluations to advisory councils, school improvement teams, and the school board. Districts are required to
?
include parents in the development and administration of the district SDFS project.
?
3

Reporting Outcomes
Districts are required to submit annual progress reports which provide data and an analysis of the district’s measurable,
outcome objectives.
Funding Method
Federal Cash Advance – On-Line Reporting required monthly to record expenditures.
?
Federal cash advances will be made by state warrant or electronic funds transfer (EFT) to a recipient for disbursements.
?
For federally funded projects, requests for federal cash advance must be made on the Electronic Federal Cash Advance
?
Request System. If at times it is determined that disbursements are going to exceed the amount of cash on hand plus cash
?
in transit, an on-line amendment can be made prior to the due date of the next Federal Cash Advance distribution on the
?
Electronic Federal Cash Advance Request System.
?
FISCAL REQUIREMENT
Supporting documentation for expenditures is required for all funding methods. Examples of such documentation
include: invoices with check numbers verifying payment, and/or bank statements; all or any of which must be
available upon request.
School districts receiving funds under Title IV, No Child Left Behind may use not more than two percent (2%) of such
funds for the cost of administering this program.
Conditions for Acceptance
The completed application must be submitted via the 2006-07 Title IV, Part A, Online Application. LEAs must also
submit the Project Application Form (DOE 100A) with original signature of the district superintendent (preferably in
blue ink) to Office of Grants Management:
Office of Grants Management
?
Florida Department of Education
?
325 W. Gaines Street, Room 344
?
Tallahassee, Florida 32399-0400
?
The on-line application requires all LEAs to complete all sections of the application. LEAs must press the final submit
button in order for completed application to be sent to FDOE. The system will provide applicant with an electronic
confirmation if application is submitted in accordance with instructions.
Funds shall be obligated no earlier than the date the Project Application Form (DOE 100A) with original signature is
received by the Bureau of Grants Management or the effective date of the federal grant award, whichever is late. An
application is considered to be in substantially approvable form when the DOE 100A, with original signature is received
and the complete on-line project application is successfully submitted to the Florida Department of Education.
NOTE:
Project Application Form (DOE 100A) 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.
Method of Review
The on-line project application, including budget narrative shall be reviewed by FDOE staff in accordance with
established project application review checklists and requirements set forth in the No Child Left Behind Act of 2001;
applicable non-regulatory guidance and other applicable federal regulations and guidelines.
4

FLORIDA DEPARTMENT OF EDUCATION
Project Application
TAPS Number
Please return to:
Florida Department of Education
Office of Grants Management
Room 344 Turlington Building
325 West Gaines Street
Tallahassee, Florida 32399-0400
Telephone: (850) 245-0496
Suncom: 205-0496
A)
Program Name:
2006-2007 Title IV, Safe and Drug-Free
Schools (SDFS) Entitlement Project
DOE USE ONLY
Date Received
B) Name and Address of Eligible Applicant:
Project Number (DOE Assigned)
C
)
Total Funds Requested:
$
DOE USE ONLY
Total Approved Project:
$
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
________________________________________________
DOE 100A
Revised 01/03
Page 1 of 2
John L. Winn, Commissioner

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Instructions for Completion of DOE 100A
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 the DOE 100A when the application is submitted.
DOE 100A
Revised 01/03
Page 2 of 2
John L. Winn, Commissioner

A)
Name of Eligible Recipient:
B)
TAPS Number
Project Number:
(
DOE USE ONLY)

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FLORIDA DEPARTMENT OF EDUCATION
Budget Narrative Form
(1)
FUNCTION
(2)
OBJECT
(3)
ACCOUNT TITLE AND NARRATIVE
(4)
FTE
POSITION
(5)
AMOUNT
C) TOTAL
$
DOE 101
Rev. 01/05
Page 1 of 2
John L. Winn, Commissioner

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
.
(DOE 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 – 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.
DOE 101
Rev. 01/05
Page 2 of 2
John L. Winn, Commissioner

STATE ASSURANCES FOR DISTRICT SAFE AND DRUG-FREE SCHOOLS PROJECTS
?
The school district provides an assurance that it complies with the following:
2% Cap on Administrative Costs
: The district will not use more than 2 percent of its allocation for the administrative
costs (which include indirect costs) as defined by section 80.3 of EDGAR, in carrying out its responsibilities under this
project
[NCLB 4114(a)(2)].
Program Development:
(A)
Timely and Meaningful Consultation -
The district has developed its application through timely and meaningful
consultation with State and local government representatives, representatives of schools to be served (including
private, non-profit schools, teachers and other staff, parents, students, community-based organizations, and others
with relevant and demonstrated expertise in drug and violence prevention activities (such as medical, mental
health, and law enforcement professionals).
(B)
Continued Consultation -
The district will, on an ongoing basis, consult with above mentioned representatives
and organizations in order to seek advice regarding how best to coordinate activities with other related strategies,
programs, and activities being conducted in the community.
(C)
Design and Development -
To ensure timely and meaningful consultation, the district at the initial stages of
design and development of a program or activity shall consult with appropriate entities and persons on issues
regarding
the design and development of the program or activity, including efforts to meet the Principles of
Effectiveness [NCLB 4114(c].
Principles of Effectiveness:
The activities or programs in this project comply with the Principles of Effectiveness (POE)
described in subsection 4115(a) of NCLB and foster a safe and drug-free learning environment that supports academic
achievement
[NCLB 4114(d)(1) and 4115(a)].
To comply with the standards set by the POE, programs and activities
shall:
(A) Be based on an assessment of objective data about the drug and violence problems in the schools and
communities to be served, including an objective analysis of the current conditions and consequences regarding
said drug and violence problems that is based on ongoing local assessment or evaluation activities;
(B) Be based on performance measures aimed at ensuring that these schools and communities to be served have a
safe, orderly, and drug-free learning environment;
(C) Be based on scientifically based research that provides evidence that the program to be used will reduce violence
and illegal drug use;
(D) Be based on an analysis of the prevalence of risk factors, protective factors, buffers, assets; or other variables in
schools and communities in the State identified through scientifically based research;
(E) Include meaningful and ongoing consultation with and input from parents in the development of the application
and administration of the program or activity;
(F) Be evaluated periodically to assess its progress toward reducing violence and illegal drug use in schools to be
served based on locally established performance measures; results shall be used:
(i) to refine, improve, and strengthen the program,
(ii) to refine the performance measures, and
(iii) shall also be made available to the public upon request, with public notice of such availability provided.
Public Review:
The project application includes a request for a waiver of the requirement that programs or activities be
based on scientifically-based research that provides evidence that the program will reduce violence and illegal drug use.
The waiver process is found in Section V of this application and will be available for public review after submission of the
application.
Wrong and Harmful:
The drug and violence prevention programs supported under this project convey a clear and
consistent message that acts of violence and the illegal use of drugs are wrong and harmful
[NCLB 4114(d)(6)].
Comprehensive Plan
: The district has, or the schools to be served have, a plan for keeping schools safe and drug-free
that includes:
(A)
Discipline policies
- Appropriate and effective school discipline policies that prohibit disorderly conduct, the
illegal possession of weapons, and the illegal use, possession, distribution and sale of tobacco, alcohol, and other
drugs by students;

 
(B)
Security procedures -
Security procedures at school and while students are on the way to and from school;
(C)
Prevention activities -
Prevention activities that are designed to create and maintain safe, disciplined, and drug-
free environments;
(D)
Crisis management plan
- A crisis management plan for responding to violent or traumatic incidents on school
grounds; and
(E)
Code of Conduct Policy -
A code of conduct policy for all students that clearly states the responsibilities of
students, teachers, and administrators in maintaining a classroom environment that —
(i) allows a teacher to communicate effectively with all students in the class;
(ii) allows all students in the class to learn;
(iii) has consequences that are fair, and developmentally appropriate;
(iv) considers the student and the circumstances of the situation; and
(v) is enforced accordingly.
[NCLB 4114(d)(7)]
Gun-Free Schools Act:
The district is in compliance with section 1006.13(2), Florida Statutes, the State law required by
subsection 4141(b)(1) of the federal Gun-Free Schools Act, which requires district school boards to adopt a zero tolerance
policy requiring students found to have brought a firearm or weapon, as defined in chapter 790, Florida Statutes, to
school, to any school function, or onto any school-sponsored transportation or possessing a firearm at school to be
expelled, with or without continuing educational services, from the student’s regular school for a period of not less than 1
full year, and to be referred to the criminal justice or juvenile justice system.
[NCLB 4141(d) and 1006.13(2)(a), Florida
Statutes]
Parent Input:
Parents were included in the development of this project application and programs and/or activities
conducted under this project will include meaningful and ongoing consultation with, and input from, parents in the
administration of the programs and/or activities.
[NCLB 4116(b)(1) and 4115(a)(1)(E)]
Required Reports:
The district will submit to the Florida Department of Education such information, and at such
intervals, that the Department requires to complete the State Report required by the United States Secretary of Education
including information on the prevalence of drug use and violence by youth in the schools and the community. Such
information shall be made readily available to the public. [NCLB 4116(b)(1)]
Smoking within Indoor Facility:
No person permits smoking within any indoor facility owned or leased or contracted
for, and utilized by, such person for provision of routine or regular kindergarten, elementary, or secondary education or
library services to children or of regular or routine health care or day care or early childhood development (Head Start )
services. [NCLB 4303(a) and (b)(1)]
Supplement not Supplant:
SDFS funds are used to increase the level of State, local, and other non-Federal funds that
would, in the absence of funds under SDFS, be made available for programs and activities authorized under SDFS, and
are in no case used to supplant such State, local, and other non-Federal funds. [NCLB 4114(d)(4)]
General Assurances:
The district has on file with the DOE a single set of assurances, that provides that the district will --
?
Administer programs in accordance with all applicable statutes, regulations, program plans, and this application;
?
Assure that control of funds and title to property acquired with program funds will be in the district;
?
Apply the proper methods in administering the funds and property to the extent required by the authorizing
statutes;
?
Adopt and use proper methods of administering each such program, including the enforcement of any obligations
imposed by law and other recipients responsible for carrying out each program; and the correction of deficiencies
in program operations that are identified through audits, monitoring, or evaluation;
?
Cooperate in carrying out evaluations conducted by or for the DOE, the Secretary of the U.S. Department of
Education, or other Federal officials;
?
Use such procedures as will ensure proper disbursement of, and accounting for, Federal funds under this project;
?
Submit reports to DOE that are required by the SEA and the U.S. Department of Education.
?
Maintain such records, provide such information, and afford such access to the records as the SEA or USED may
reasonably require;
?
Afford opportunity for public comment on application and consider such comment prior to submission.
[NCLB
9306(a)]

 
FEDERAL GUN-FREE SCHOOLS ACT LOCAL EDUCATION AGENCY ACTIVITIES SURVEY
Fiscal Year: 2005-2006
Select this box if this was a Gun-Free School Year for the entire __________ County School District.
(If
your school district was Gun-Free this year, please complete Section II of this survey only)
SECTION I: SCHOOL LEVEL DATA
1. School Incidents
Directions: You must complete this form for each school in which a student has been found to have brought a
firearm to school or possessed a firearm as defined by Chapter 790, Florida Statutes at school during the 2005-2006
school year.
1a. Indicate the number of students who were found to have brought a firearm to school or possessed a
firearm at school. Include all infractions in your answer.
School Level
_____________________________________
(Elementary, Middle or High School)
Select a School
_____________________________________
Number of Students who brought/possessed a Handgun
_____________________________________
(Enter “0” if there are no students or “MD” for missing data)
Type of Handgun
_____________________________________
(Enter NA for none, or “MD” for missing data)
Number of Students who brought/possessed a Rifle/Shotgun _____________________________________
(Enter “0” if there are no students or “MD” for missing data)
Type of Rifle/Shotgun
_____________________________________
(Enter NA for none, or “MD” for missing data)
Number of Students who brought/possessed Other Firearm
_____________________________________
(Enter “0” if there are no students or “MD” for missing data)
Type of Firearm
_____________________________________
(Enter NA for none, or “MD” for missing data)
1b. How many of the incidences reported in Item 1a were terminated before an expulsion disposition? Provide an
explanation for each incident reported in 1b.
__________________________________________________
Note:
Any student found to have brought a firearm (as defined by Chapter 790, Florida Statutes) to school or possessed a
firearm at school should be reported as an infraction, even if the expulsion is shortened or no penalty is imposed. Any
incidents in which a student covered by the provisions of IDEA brought a firearm to school or possessed a firearm at
school should also be included, even if it is determined that the incident is a manifestation of the student’s disability.
Modifications of the one-year expulsion requirement should also be reported in Question 2 of this report.
If a single student is found to have brought or possessed more than one firearm, report the student as a single incident. A
note that explains the circumstances surrounding the incident, including the types of firearms that were removed from the
student should be described in the data caveat section of this report.
If the same student is involved in more than one incident that involves bringing or possessing a firearm, each
incident would be counted as one incident. A note explaining the circumstances surrounding the incident, including
information about the disposition of that student, should be described in the data caveat section of this report.

2. Modified Expulsions
How many of the incidences reported in Item 1a were shortened to a term of less than one year by the
?
Superintendent under the case-by-case modification provisions of Section 1006.13(2), Florida Statutes?
_______
2a.
?
Number of Modified Expulsions
________________
2b.
?
Number of Expulsions Not Modified
________________
2c.
?
Number of Non-Expulsions
________________
-
EXPLAIN (required)
_________________________________________________________
3. Alternative Placements
How many of the incidences reported in Items 2a and Item 2b resulted in a referral of the student to an
alternative school or program for the school listed in 1a?
________________
3a.
?
Number of Alternative Placements among students with modified expulsions:
________________
3b.
?
Number of Alternative Placements among students with expulsions NOT MODIFIED
________________
4. Students With Disabilities
How many of the modifications reported in Item 2a were for students with and without disabilities as defined
in Section 602(a)(1) of the IDEA (see below) for the school listed in 1a?
________________
Note
: The total figure shown in the table below should EQUAL the total number of modified expulsions reported in Item
2a.
4a.
?
Number of Modifications were for disabled students
________________
4b.
?
Number of Modifications for students who are not disabled
________________
Note:
The GFSA explicitly states that the Act must be construed in a manner consistent with the Individuals with
Disabilities Education Act (IDEA). Compliance with the GFSA can be achieved consistent with the IDEA as long as
discipline of such students is determined on a case-by-case basis under the GFSA provision that permits modification of
the expulsion requirement on a case-by-case basis. A student with a disability who brings a firearm to school, or possesses
a firearm at school, may be removed from school for ten school days or less, and in accordance with State law, placed in
an interim alternative educational setting that is determined by the student’s individualized education program team, for
up to 45 calendar days. If the student’s parents initiate due process proceedings under the IDEA, the student must remain
in that interim alternative educational setting during authorized review proceedings, unless the parents and school district
can agree on a different placement. Before an expulsion can occur, the IDEA requires a determination by a group of
persons knowledgeable about the student on whether the bringing of a firearm to school, or the possession of a firearm at
school, was a manifestation of the student’s disability. A student with a disability may be expelled only if this group of
persons determines that the bringing of a firearm to school, or the possession of a firearm at school, was not a
manifestation of the student’s disability, and the school follows applicable IDEA procedural safeguards before the
expulsion occurs. Under IDEA, students with disabilities who are expelled in accordance with these conditions must
continue to receive educational services during the expulsion period. Under Section 602 (a)(1) of the IDEA, the term
“children with disabilities” is defined as:
children --
(i)
?
with mental retardation, hearing impairments including deafness, speech or language impairments, visual
?
impairments, including blindness, serious emotional disturbance, orthopedic impairments, autism, traumatic brain
?
injury, other health impairments, or specific learning disabilities; and
?
(ii) who, by reason thereof, need special education and related services

SECTION II: LEA COMPLIANCE WITH GUN-FREE SCHOOLS ACT (GFSA)
?
1
. This is to assure that
__________
County School District is in compliance with Section 1006.13(2)(a), FS, that
requires that a student who brings a firearm to school, or possesses a firearm at school, be expelled for no less than a
year.
Is your district in compliance with Section 1006.13(2)(a), Florida Statutes?
Yes
No
2.
?
This is to assure that __________County School District is in compliance with the requirement in
Section1006.13(2)(a), Florida Statutes, that a district have in place a policy requiring referral to the criminal justice or
juvenile delinquency system of any student who brings a firearm to a school, or possesses a firearm at school.
Is your
district in compliance with Section 1006.13(2), Florida Statutes?
Yes
No

 
DISTRICT SAFE AND DRUG-FREE SCHOOLS PROJECT COMPREHENSIVE PLAN
SECTION I: NEEDS ASSESSMENT
NCLB Requirement
Programs funded by Title IV, Part A, must be based on an assessment of objective data regarding the incidence
of violence and illegal drug use in the schools served. Analysis of the conditions and consequences must include
delinquency and serious discipline problems among students who attend such schools (including private school
students who participate in the district drug and/or violence prevention programs).
1.
School /Community Characteristics
1a
.
Identify several community characteristics and/or unique community features that impact student
ATOD use and violence behavior
. As appropriate, include community demographics (economic indicators,
income levels, rural/urban settings, race/ethnicity…).
1b.
The chart below indicates the number of schools and student enrollment in your district.
Public Schools
Private, Non-Profit
Schools
# of Schools
# of
Students
Enrolled
# of
Schools
# of
Students
Enrolled
Elementary
Middle
High
Combination Schools
TOTAL
*Combination schools combine grades across levels (e.g.: grades K-8 housed in one school site)

 
2.
County-/State-level Student Behavior Trend Data
To help identify prevention needs, county level SESIR and FYSAS district-level data are provided below.
SESIR Data
Selected Incidents (per 1000 students) - county aggregate
ATOD
ES
MS
HS
Year
Fighting
ES
MS
HS
Battery
ES
MS
HS
Threat/
Intimidation
ES
MS
HS
Sexual
Harassment
ES
MS
HS
Weapons
Possession
ES
MS
HS
A
T
D
2001-2002
2002-2003
2003-2004
2004-2005
Discipline (per 1000 students) - county aggregate
Year
In-School
Suspensions
Elementary
Out-of-school
Suspensions
Elementary
In-School
Suspensions
Middle
Out-of-School
Suspensions
Middle
In-School
Suspensions
High
Out-of-School
Suspensions Grades
High
2001-2002
2002-2003
2003-2004
2004-2005
FYSAS Data
Grades 6-8
Grades 9-12
30 Day Prevalence
Rates (%) for:
2000
2002
2004
2004
(SA)*
2000
2002
2004
2004
(SA)*
Alcohol
Binge Drinking
Cigarettes
Smokeless
Tobacco
Marijuana
Any Illicit Drug
Other Than
Marijuana
Mean Age of First
Use for:
Cigarettes
Marijuana
Alcohol (more
than a sip)
*State Average

  
  
3.
School-level Student Behavior Data Sources
Provide the names of any local-level objective data sources that can be used to identify SDFS prevention needs
in your district.
For each source listed, provide a brief explanation of what the data source measures.
4.
Prioritized List of Needs
List 3-7 needs in order of priority
. Provide rationale that justifies the identified need by including: (a) the data
indicator(s) used; (b) name and year(s) of data source(s); and (c) a trend and/or comparison analysis. Begin with
school-level data whenever possible. List needs in terms of student behavior, direction of change, and specific
target population. If a need is not justified by the data, provide a rationale for its priority.
Priority
Student Behavior
Direction
of Change
Target
Population
Need #1
Rationale
(200 word limit)

SECTION II: DISTRICT-DEVELOPED GOALS
NCLB Requirement
Programs funded by Title IV, Part A funds must be based on performance measures aimed at ensuring that
recipient schools and communities have a safe, orderly, and drug-free learning environment. Performance
measures, thus, must include goals that relate to reducing violence or drug use. Recipients may also adopt goals
related to changing attitudes that are predictors of or precursors to youth drug use or violent behavior or goals
related to the quality of program implementation.
Write your own district developed long-term goals (terminating June 30, 2012) that will specifically
address your district's identified needs.
Include a minimum of one violence prevention goal and one ATOD
goal.
District Goal #1:
Date:
June
30,
2012
?
Target Population:
?
Direction of Change:
?
Amount of Change:
?
Data Element:
?
Baseline –Year:
?
Data Source:
?
Statistic:
?
District Goal #2:
Date:
June
30,
2012
?
Target Population:
?
Direction of Change:
?
Amount of Change:
?
Data Element:
?
Baseline –Year:
?
Data Source:
?
Statistic:
?

_____________________
____________________________
_____________________________
SECTION III: COLLABORATIONS
?
Provide the following information regarding the groups with whom you are collaborating. A collaboration is a
joint effort between the local school district and another funding source/agency; no SDFS funds are used in
implementing these collaborations.
Identify at least 3 and a maximum of 5 collaborators. Complete this
form for each group with whom you will collaborate during the 2006-07 school year.
1.
Agency Name:
2.
Program Title (explain acronyms):
3.
Type of Collaborator:
Federal State Local
…
Title
I
…
Dropout
Prevention
…
  
Community Coalition (identify by
name):______________________
…
Title
II
…
  
Department of Juvenile Justice
…
Law
Enforcement
…
 
Title IV (21
st
Century)
…
Coordinated
School
Health
…
County
Government
Program
…
Title
V
…
Department of Health Grantee
…
  
County Health Department
…
School-to-Work
…
Department of Children and
…
Community-Based
Organization
…
CSAP
Families Prevention Partnership
Grantee
…
 
Service Clubs: identify by
name:_____________________
…
 
Safe Drug Free
Community (SDFC)
…
Other
(Describe)
…
  
Other District Program
(Describe)
…
Other (Describe)
4. Type of program
ATOD-Use Prevention
Violence Prevention
Parent Involvement
School-wide Climate
Student Discipline
Other, If other please
specify____________
5. Specify the prioritized need(s) identified in Section I that are addressed through this program.
6. Primary Target Group(s) to Be Served:
?
(List specific grade levels)
Elementary Middle High
Students _________ _________ _________
School Staff
_________ _________ _________
Parents _________ _________ _________
Private, Non-Profit
_________ ______
___ _________
Other _____________
_________ ______
___ _________
Total schools served
_________
__________
__________
7. Describe the program activities/strategies implemented through this collaboration.

 
SECTION IV: PARENT INVOLVEMENT
?
Programs funded by Title IV, Part A, must include meaningful and ongoing consultation with and input from
parents in the development of the application and administration of programs and/or activities.
Provide a narrative for following questions
.
1.
Program Planning
1a.
How will parents/families be made aware of opportunities to assist in the planning and implementation for
violence and drug prevention activities?
1b.
What opportunities are available for parents/families to participate in the planning and implementation for
violence and drug prevention activities?
2. Program
Participation
2a.
How will parents/families be made aware of opportunities available to them in professional
development, trainings or workshops in the area of violence and drug prevention activities?
2b.
What opportunities are available for parents/families to participate in professional development, trainings or
workshops for them in the area of violence and drug prevention or child behavior management?

SECTION V: PROGRAM ACTIVITY PROFILE*
NCLB Requirement
Programs funded by Title IV, Part A must be based on scientific research that provides evidence that the
program will reduce violence and illegal drug use. A LEA may apply to the State for a waiver to allow
innovative activities or programs that demonstrates substantial likelihood of success. This waiver process is
addressed in Item 2.
Complete one Program Profile for
each
SDFS funded program you plan on implementing during the 2006-2007
year.
1. Program Name*:
________________________________________________
* If you are using a program on the Proven Programs Inventory, skip to Question #3.
2. Provide the following information for all other programs not on this list.
2a.
Is this a district-developed or commercially-developed program?
District-Developed or
Commercially-Developed
2b
. Provide:
?
A brief program description;
?
The rationale for using this program;
?
At least two primary scientifically-based research strategies implemented in this program (e.g. social
skills training, mentoring, peer leaders, etc.). Include bibliographic citations from peer review articles
published within the last 10 years for each strategy listed. (If you are unsure of what strategies to list,
contact your program developer.)
2c
. If this program has been evaluated in your district, please provide:
?
A
brief
summary of the most recent evaluation results demonstrating measurable program outcomes or
other data about program effectiveness;
?
The year of the most recent evaluation.
3
.
Type of Program
:
(check all that apply)
ATOD-Use Prevention
Violence Prevention
Parent Involvement
?
School-wide Climate
?
Student Discipline
Other, if other please specify____________
4. Prioritized Need(s)
Specify the prioritized need(s) identified in Section I that are addressed through this program.
5. Primary Target Group(s) to be served:
Elementary
Middle
High
K
1
2
3
4
5
6
7
8
9
10
11
12
Students
School Staff
Parents
Private, Non-profit
Other
If other, specify:
Total Schools Served

6. Targeted Changes (check all that apply):
Attitude
Behavior/Skills
Knowledge
Perceptions
7. Implementation Plan for this Program
7a.
In how many schools, in what grade(s) specifically, and during what time period or content area will the
?
program be implemented?
?
7b.
Who will be responsible for delivering program activities and services directly to students?
?
7c.
How will personnel directly responsible for delivering program curriculum and activities be trained?
7c.
?
7d.
Has this program been implemented in your district in the past (regardless of funding source)? If so, provide
?
a brief history describing the number of years implemented, program expansion, program sustainability, etc.
?
7e.
If program was used in past years, identify any challenges with program implementation that schools
?
experienced; and, identify any strategies that will be used to improve program implementation for the 2006
?
-
2007 school year.
?
7f.
What tracking forms (implementation checklist, report form, or other monitoring instrument) will be used to
?
assess accountability of program implementation at the classroom level and at the school level? In the text box
below, clearly provide the title of each instrument and state its purpose. In addition, upload a copy of each
instrument.
7g.
Who at the school level will be responsible for filling out the above tracking form(s)?
?
7h.
When will the above specified school-wide tracking form be turned in to the SDFS Coordinator?
?
8. Program Evaluation
*
NCLB Requirement
Programs funded by Title IV, Part A funds must be evaluated periodically against locally-selected performance
measures. Results will be used to refine, improve, and strengthen the program and will be made available to the
public.
8a
. If not already addressed in question 2c, please answer the following: Has this program been evaluated within
your district in the past? If so, when (identify year)?
8b
. Do you intend to formally evaluate this program in the 2006-2007 school year?
Yes
No
8c
. Will you use an outside evaluator?
Yes
No
*All program evaluation plans for the 2006-2007 school year will be due to Meena Harris, Program
Manager/Coordinator of Research by September 30, 2006.

 
 
9. Program Specific Objectives
Program performance measures should be directly related to the results of the program and linked to the
?
district’s established goals.
?
Provide at least one program outcome objective that measures a change in student behavior or attitude.
?
(
Program
outcome objectives include performance measures that relate to reduced violence or drug-use,
?
changing attitudes that are predictors of or precursors to youth drug abuse or violent behavior.)
?
(Duplicate as necessary)
?
Program Outcome Objective #1:
Date:
?
Target Population:
?
Direction of Change:
?
Amount of Change:
?
Data Element:
?
Baseline-
Year:
?
Data Source:
Statistic:
Provide at least one program process (implementation) objective that measures fidelity of program
delivery.
(Program process objectives should include performance measures that relate to the fidelity of
program implementation.) (Duplicate as necessary)
Program Process Objective #1:
Date:
?
Target Population:
?
Direction of Change:
?
Amount of Change:
?
Data Element:
?
Baseline-
?
Year:
Data Source:
Statistic:

 
10.
Program Specific Expenses
10a.
List all costs specifically related to the program (e.g., materials, supplies, program teacher training, teacher
stipends, substitute teachers…)
10b.
Provide a mathematical breakdown of any line item that exceeds $2,000 except for line items that are for
one employee’s salary/benefits, or for consultant services to conduct evaluations/ needs assessments/trainings.
PROGRAM SPECIFIC EXPENSE WORKSHEET
Function
Object
Account Title and Narrative
FTE
Amount
TOTAL

SECTION VI: GENERAL PROJECT COORDINATION EXPENSES
?
11a
. List all general project coordination program expenses (e.g. coordinator salaries, needs assessment
consultants, travel to state meetings and conferences…).
11b
. Provide a mathematical breakdown of any line item that exceeds $2,000 except for line items that are for
one person’s salary/benefits or for consultant services to conduct evaluations/needs assessments/ training, etc.
11c.
If funds are to be transferred to another Title, provide the
name
of the Title to which the funds are to be
transferred. Also, provide the amount of funding that is to be transferred. Districts are allowed to transfer up to
50% of SDFS allocation to another federal Title.
GENERAL PROJECT COORDINATION EXPENSES WORKSHEET
Function
Object
Account Title and Narrative
FTE
Amount
TOTAL

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
Preliminary District Allocations
District
# District
Name
Title IV
Alachua
$127,939
Baker
$17,870
Bay
$116,958
Bradford
$17,710
Brevard
$287,876
Broward
$1,211,427
Calhoun
$10,374
Charlotte
$64,830
Citrus
$72,299
Clay
$93,766
Collier
$157,820
Columbia
$50,130
Miami-Dade
$2,355,800
DeSoto
$30,209
Dixie
$12,001
Duval
$614,121
Escambia
$242,103
Flagler
$34,242
Franklin
$7,020
Gadsden
$42,672
Gilchrist
$12,533
Glades
$7,207
Gulf
$9,593
Hamilton
$12,277
Hardee
$30,367
Hendry
$40,562
Hernando
$90,854
Highlands
$60,262
Hillsborough
$888,409
Holmes
$17,226
Indian River
$62,356
Jackson
$33,018
Jefferson
$9,595
Lafayette
$5,482
Lake
$152,786
Lee
$293,555
Leon
$131,151
Levy
$30,980
Liberty
$5,855
Madison
$16,217
Manatee
$164,806
Marion
$218,652
Martin
$61,035
Monroe
$32,253
Nassau
$32,541
Okaloosa
$107,304
Okeechobee
$33,565

48
Orange
$788,118
49
Osceola
$193,673
50
Palm Beach
$733,680
51
Pasco
$254,883
52
Pinellas
$528,117
53
Polk
$420,187
54
Putnam
$69,349
55
St. Johns
$70,257
56
St. Lucie
$158,094
57
Santa Rosa
$85,282
58
Sarasota
$138,422
59
Seminole
$225,682
60
Sumter
$33,889
61
Suwannee
$29,480
62
Taylor
$15,619
63
Union
$8,743
64
Volusia
$293,133
65
Wakulla
$16,754
66
Walton
$33,463
67
Washington
$18,759
68
FSDB
$4,441
69
70
72
FAU Lab (A.D.)
$1,988
73
FSU Lab
$6,212
74
FAMU
$2,090
75
UF School (P.K.)
$3,088
76
TOTAL
$12,261,007

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