CiTi Request for Services: Arts in Education and Exploratory Enrichment - LaFayette
NOTE: Schools are responsible to make all reservations and arrangements; CiTi oversees and prepares the contracts and payments only. This process can take 6-8 weeks in some cases, so you must fill out this form well ahead of the program date.

Deadline for all fiscal year requests are due no later than May 18th.

IMPORTANT: Consultants are allowed to have contact with students only when a district employee is present. Your submission of this form indicates that your school personnel understand this and that consultants in your school will not be asked to violate this rule.

Cancellations: It is the responsibility of the school to contact CiTi Arts-In-Ed ASAP if the program does not take place. CiTi Arts-In-Ed will pay an artist or vendor unless we hear otherwise from the school that the program/event was cancelled or rescheduled.

Name of person completing the form
Your answer
Email address of person completing the form
Your answer
Grade Level
Required
Specific Building
Select your principal's email address
Name of the Program or Event
Your answer
Location of Event
Your answer
Number of students served: How many students will benefit from the field trip, artist, etc.
Your answer
Name of Artist/Vendor
entity that we are paying
Your answer
Contact person of vendor if different from above
Your answer
Artist/Vendor Mailing Address
Please include city, state, and zip
Your answer
Artist/Vendor Email
THIS SHOULD NEVER BE A SCHOOL EMAIL ADDRESS
Your answer
Artist/Vendor Phone Number
Your answer
Event Start Date
MM
/
DD
/
YYYY
Multiple dates
If you have more than 2 dates, use this space to list them individually
Your answer
Event End Date
MM
/
DD
/
YYYY
Learning Targets/Outcomes
Briefly describe what students will learn from this activity and the role the activity plays.
Your answer
Preparation
How will you and your class prepare for this program/activity?
Your answer
Co-Ser: Choose one.
Only fill this section if requesting art/music Tickets (CoSer 415)
(# of tickets) X (price per ticket) = total cost $
Your answer
Total Fees for Program
These fees should not include travel, food or lodging.
Your answer
Does this require prepayment?
List the amount and due by date
Your answer
IMPORTANT:

1. Consultants are allowed to have contact with students only when a district employee is present. Your signature below confirms that your school personnel understand this and that consultants in your school will not be asked to violate this rule.

2. Cancellations: It is the responsibility of the School to contact Enrichment Services ASAP if this program does not take place.

*** New York State Education Department requires schools to show that Enrichment Activities are integrated into the curriculum in order to be BOCES-Aidable. You must include appropriate standards that relate to your activity in order to be approved for Aid.***
Check all standards that relate to your activity below.
Please check which Art standards apply:
Anchor Standards for the Arts
Please check which ELA standards apply:
Anchor Standards for ELA: Speaking and Listening
Please check which Social Studies standards apply:
Anchor Standards for Social Studies
Please check which Science standards apply:
Next Generation Science Standards: Scientific and Engineering Practices
Please check which Math standards apply:
Anchor Standards for Math
Other Standards
List other standards and appropriate curricular connections if any.
Your answer
Payment: CiTi is responsible for payment -- DO NOT PAY CONSULTANT DIRECTLY.
If you would like a copy of this request for your records, please email WJones@citiboces.org and one will be provided.
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