2002 Qualified Zone Academy Bond Program Application

Remit to: Florida Department of Education

Office of Educational Facilities

325 W. Gaines Street

1004G Turlington Building

Tallahassee, FL 32399-0400

Application Deadline: March 1, 2003

Date:

Contact Person:

District:

Title:

School:

Address:

Address:

City:

City:

Zip:

Zip:

Phone/Fax:

E-mail:

Certificate of Eligibility

The School Board certifies through a board resolution dated _____________________,

that the school district has satisfied Criterion 1a or 1b, and Criteria 2 through 4. Please

check appropriate boxes.

Criterion 1 - Qualified by virtue of location or composition of student body:

a. Location

The school district is located in an Empowerment Zone or in an Enterprise

Community.

b. Composition of Student Body

There is a reasonable expectation, as of the date of issuance of the

bonds, that at least 35 percent of the students attending the school of

participation in the program will be eligible for free or reduced cost lunches

established under the National School Lunch Act.

Criterion 2 - Qualified by virtue of private business contribution:

The eligible school district has written commitments from private entities to

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make qualified contributions having a present value, as of the date of the

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issuance, of not less than 10 percent of the proceeds of the bond issue,

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including such items as:

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Equipment for use in the qualified zone academy (including state-

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of-the-art technology and vocational equipment),

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Technical assistance in developing curriculum or training teachers

to promote market-driven technology in the classrooms,

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Internships, field trips, or other educational opportunities outside

the academy for students,

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Any other property (including cash) or service specified by the

Local Education Agency.

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Written verifications from private entities must be attached to the

application. Providers of services or materials for the proposed project are

not eligible as contributors to meet the 10 percent contribution

requirement.

Criterion 3 - Qualified by virtue of characteristics of the program:

The public school or academic program within a public school is

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established by and operated under the supervision of an eligible local

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education agency as defined in Section 14101 of the Elementary and

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Secondary Education Act of 1965 to provide education or training below

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the post-secondary level, and

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such school or program is designed in cooperation with business to

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enhance the academic curriculum, increase graduation and

employment rates, and better prepare students for the rigors of

college and the increasingly complex workforce, and

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?

students in the academy are subject to the same academic

standards and assessments as other students educated by the

school districts, and

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?

the comprehensive education plan of the program is approved by

the school district.

Criterion 4 - Qualified by virtue of use of bond proceeds:

For the purposes of the application, the proceeds of QZABs can be used

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for:

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Rehabilitating or repairing the public school facility in which the

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academy is established,

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Providing equipment for use at such academy,

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Providing instructional materials, and

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Providing professional development for teachers.

A written spending plan is attached to the application.

Y2002 QZAB bonds must be issued by December 31, 2004.

Amount of Bond Authorization Requested: $

District Financing Source:

I certify under penalty of perjury that to the best of my knowledge, the information in this

application is true and correct and is in compliance with statutes and administrative

provisions of the Florida Department of Education. The school board has authorized

me to sign this application on its behalf.

Signature of Superintendent / Date