CiTi Request for Services: Exploratory Enrichment - Cortland
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 21st, 2021.
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
Email address of person completing the form
Cortland Senior High School
Cortland Junior High School
Select your principal's email address
Name of the Program or Event
Location of Event
Number of students served: How many students will benefit from the field trip, artist, etc.
Name of Artist/Vendor
entity that we are paying
Contact person of vendor if different from above
Artist/Vendor Mailing Address
Please include city, state, and zip
THIS SHOULD NEVER BE A SCHOOL EMAIL ADDRESS
Artist/Vendor Phone Number
Event Start Date
If you have more than 2 dates, use this space to list them individually
Event End Date
Briefly describe what students will learn from this activity and the role the activity plays.
How will you and your class prepare for this program/activity?
Co-Ser: Choose one.
Enrichment (history, science, math, ELA, character ed, health, PE, etc.) 418
Total Fees for Program
These fees should not include travel, food or lodging. (total only, no unit costs please)
Does this require prepayment?
List the amount and due by date
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.
I have selected the standards below that pertain to my requested funding.
Please check which Art standards apply:
Anchor Standards for the Arts
1. Generate and conceptualize artistic ideas and work.
2. Organize and develop artistic ideas and work.
3. Refine and complete artistic work.
4. Analyze, interpret, and select artistic work for presentation.
5. Develop and refine artistic work for presentation.
6. Convey meaning through the presentation of artistic work.
7. Perceive and analyze artistic work.
8. Interpret intent and meaning in artistic work.
9. Apply criteria to evaluate artistic work.
10. Synthesize and relate knowledge and personal experiences to make art.
11. Relate artistic ideas and works with societal, cultural and historical context to deepen understanding.
Please check which ELA standards apply:
Anchor Standards for ELA: Speaking and Listening
1. Participate (initiate at higher grade levels) in collaborative conversations with diverse partners about grade level specific topics and texts with peers and adults in small and larger groups.
2. Confirm (integrate at higher grade levels) understanding of a text read aloud or information presented orally or through other media by asking and answering questions about key details and requesting clarifi cation if something is not understood.
3. Ask (at higher levels evaluate) and answer questions in order to seek help, get information, or clarify something that is not understood.
4. Report (present at higher levels) on a topic or text, tell a story, or recount an experience with appropriate facts and relevant, descriptive details, speaking clearly at an understandable pace.
5. Add (use strategically at higher levels) audio recordings and visual displays to presentations when appropriate to enhance the development of main ideas or themes.
6. Adapt speech to a variety of contexts and tasks, using formal English when appropriate to task and situation.
Please check which Social Studies standards apply:
Anchor Standards for Social Studies
1. Ask, develop, design, and frame questions about events and the world in which we live.
2. Recognize, use, and analyze different forms of evidence used to make meaning in social studies (including sources such as art and photographs, artifacts, oral histories, maps, and graphs).
3. Create an understanding of the past by using primary and secondary sources.
4. Demonstrate respect for the rights of others in discussions and classroom debates, regardless of whether one agrees with the other viewpoints.
5. Participate in activities that focus on a classroom, school, community, state, national, or global issue or problem.
6. Identify situations in which social actions are required and suggest solutions.
Please check which Science standards apply:
Next Generation Science Standards: Scientific and Engineering Practices
1. Asking questions and defining problems
2. Developing and using models
3. Planning and carrying out investigations
4. Analyzing and interpreting data
5. Using mathematics and computational thinking
6. Constructing explanations and designing solutions
7. Engaging in argument from evidence
8. Obtaining, evaluating, and communicating information
Please check which Math standards apply:
Anchor Standards for Math
1. Make sense of problems and persevere in solving them.
2. Reason abstractly and quantitatively.
3. Construct viable arguments and critique the reasoning of others.
4. Model with mathematics.
5. Use appropriate tools strategically.
6. Attend to precision.
7. Look for and make use of structure.
8. Look for and express regularity in repeated reasoning.
List other standards and appropriate curricular connections if any.
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
and one will be provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service