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Form NameBasic InformationApplicant Information ToolMain Contact InfoCo-ApplicantSite-InformationSite-Information 2Site-Information 3Site-Information 4Site-Information 5Collaborative Advisory CommitteeSchool Building VerificationProject AbstractAssessment of Need Quality of Project ModelFacility DescriptionProgram PersonnelProfessional developmentEvaluation of ProjectProgram Management Project Plan – Grant Performance Results Act (GPRA) MeasurementsProject Plan-Local GoalsCapacityBudget DetailAssurances and Certifications for Federal Programs
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Needsneed formsite name, address info, License Number Effective Date Expiration Date
Licensed Capacity Approved Age Range on License Number of Students to be Served
Name of Authorized Official (for this site) Email of Authorized Official Amount Requested

Select
Name of Principal (for this site) Email of Principal County		need prairie info and narrativestatement of needs: 400 words; DESCRIPTION OF THE PROJECT: Also serves as summary.640 words; PROJECT OUTCOMES/EVALUATION PLAN: Summarize anticipated outcomes.960 words; QUALIFICATIONS OF KEY PERSONNEL: Complete Program Personnel Section and summarize on this page.400 words.
Assessment of Need 800 wordsQUALITY OF PROJECT MODEL 44000 words; 11 sectionsNeed site name, address info, license number, effentive date, expiration date, licensed capacity, approved age range of license, number of students to be served and plan to transport or escort students for each site. Need all state license verificationsNeed: project director: number of hours per day, number of days per week, number of weeks per year, degrees and/or certifications and summary of experience. Assistant project director: number of hours per day, number of days per week, number of weeks per year, degrees and/or certifications and summary of experience. Site coordinators: number of hours per day, number of days per week, number of weeks per year, degrees and/or certifications and summary of experience. Frontline staff and vendors: Description (staff or vendor role in the program) 400 words. Number of staff (total of all site and vendor staff) 400 words. Schedule of services to be delivered per week 400 words. Summary of certifications 400 words. Summary of experience 400 words.
Professional development 4000 wordsEvaluation of Project 5000 wordsProgram Management 4000 wordsGPRA Measurement Goal 1-5: Activities, Tasks and Staff to Achieve Anticipated Outcomes: 1300 wordsGoal Statement for Local Goal 1: 100 words; Objectives and anticipated outcomes for goal 1: 400 words; Measurement Strategies for goal 1: 400 words; Activities, tasks, and staff to achieve the objectives for goal 1: 800 words.need sustainabilityNumber of expenditures, type of expenditure, description of expenditure and amount. total budget. local agency share proposed. enter total amount requested.
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