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Name: |
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| *
Title: |
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| *
Work Phone (with area code): |
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| *
Home Phone (with area code): |
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| Email
Address: |
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| Other
Persons on Grant Team (include names and titles): |
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| *School
Name: |
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| *Grade
Span: |
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| *
Address (Line 1): |
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| Address
(Line 2): |
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| *
City: |
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| *
State: |
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| *
Zipcode: |
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| *School
District: |
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| *Number
of Students in district: |
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| *Number
of Students in school: |
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| *Number
of Students in school with physical/sensory disabilities: |
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| *Number
of Students in school with other disabilities: |
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| *Demographics
of School (ie. urban, suburban, or rural): |
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*Describe your school’s need for an inclusive science program
that serves students with physical and/or other disabilities. |
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*Explain your commitment to the long-term goal of providing
all students, including those with disabilities, optimum
access to the field of science? Tell how your project will
address the CLASS Project goals. |
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*Briefly tell how your Grant Team will collaborate to coordinate,
implement, and evaluate the plan of action stipulated in
another section of this application. |
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*Statement of support for project from administrator: |
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*Specifically describe how you will increase access to science
for all students, particularly those with disabilities,
through a collaborative effort between science and special
educators and others who are interested in facilitating
successful, inclusive, learning communities. Address student
characteristics, curriculum, pedagogy, school culture, resources,
and any other areas you believe are pertinent. Include specific
objectives you hope to accomplish through this project,
a plan for evaluating the effectiveness of your project,
and a timeline for implementation and completion. Response
should be no more than two pages in length. |
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*Please describe in as much detail as possible, how you
will use the $5,000 grant funds to implement and support
your inclusive science program. It is important to account
for all of the money. However, the budget may be amended
if needed at a later date. |
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Please copy in any letters that indicate support for your
project from administrators, other classroom teachers, related
services personnel, parents, counselors, students, etc. |
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