GUIDANCE ON APPLICATION TO BE COMPLETED

1. Cover Sheet

   Title of Program:
   Applicant Organization:
   Name of Primary Contact Person:
       Contact's Title/Position:
   Address:
   City:
   State:
   ZIP:
   Telephone:
   E-Mail:
   Fax:
   WWW Home Page for Program:

2. Program Profile and Demographic Data
1. Type of Organization (Applicant)

__ Local Education Agency __ Intermediate Education Unit __ State Education Agency __ Institution of Higher Education __ Private School

__ Adult Education Agency __ Bureau of Indian Affairs School __ Correctional Facility __ Community Agency, Organization, Institution, or Network __ For Profit/Business __ Other Nonprofit: Specify ________________

2. Program Information

1. Source(s) of Funding (Complete all that apply)

(E.g., Federal/XYZ Agency Grant/$100,000/1990 -- Local/Shangri-La Foundation Grant/$ 60,000/1993.)

Federal: Specify Source ____________________ $___________ year _______
State: Specify Source ______________________ $___________ year _______
Local: Specify Source ______________________ $___________ year _______
Other: Specify Source ______________________ $___________ year _______
2. Population/Area Served by the Program (check as many as appropriate):

__ Urban __ Suburban __ Suburban with urban characteristics __ Small town __ Isolated rural area

__ Region within a state __ Statewide __ Multiple states __ All of the above __ Other: Specify ____________________

3. Racial/Ethnic Composition of Students Served by Program

__ %African American or Black __ % American Indian or Alaska Native __ % Asian

__ % Hispanic __ % Native Hawaiian or Other Pacific Islander __ % White

4. Program Target Population

Students (Check all that apply)	Adults (Check all that apply)
__ Regular classrooms __ Language minority __ Special education __ Talented and gifted __ Incarcerated youth __ Other: Specify ____________________	__ Pre-service teachers __ In-service Teachers __ Staff development specialist/teacher trainer __ Curriculum coordinator __ Administrators __ Parent/Community representatives __ Other: Specify ____________________

5. Grade Level(s) Served by Program (check as many as appropriate):

__ PreK __ K __ 1st __ 2nd __ 3rd __ 4th

__ 5th __ 6th __ 7th __ 8th __ 9th __ 10th

__ 11th __ 12th __ All of the above __ Other: Specify _______________________

6. Content Area Focus (check as many as appropriate and list specific course for each area checked):

__ Math: ____________________ __ Science: __________________ __ Language arts: _____________ __ Social Studies: _____________

__ Visual and Performing Arts ___________ __ Foreign Language: ___________ __ Other: Specify ____________________

3. Program Abstract: Briefly summarize the program, program goals, population served, and outcomes (maximum of 250 words).

4. Program Costs:
Indicate the total start-up and ongoing costs for implementing the program and give a breakdown (e.g., personnel, training, materials and supplies, hardware, software, technical support, replacement or upgraded hardware or software, etc.).

Program Costs	Start Up	Ongoing
Personnel: Training: Materials/Supplies: Hardware: Software: Technical Support: Replacement Hardware: Replacement Software: Other:	$ $ $ $ $ $ $ $ $   Total	$ $ $ $ $ $ $ $ $   Total

Explain briefly how these costs are related to major program activities (maximum of 250 words).

5. Meeting the Evaluation Criteria:
Address each of the following six criteria as indicated.
1. Quality of Program (maximum of 2,500 words)

Criterion 1. The program addresses an important educational issue or issues and articulates its goals and design clearly.

2. Educational Significance (maximum of 2,500 words for Criteria 2, 3, and 4 combined)

Criterion 2. The program develops complex learning and thinking skills for its target audience.

Criterion 3. The program contributes to educational excellence for all.

Criterion 4. The program promotes coherent organizational change.

3. Evidence of Effectiveness (include as much material as necessary to make a persuasive case and complete the chart in Appendix A.)

Criterion 5. The program has rigorous, measurable evidence for its achievements for at least one criterion among Criteria 2, 3, and 4 (learning, equity, organizational change ).

4. Usefulness to Others (maximum of 750 words)

Criterion 6. The program is adaptable for use in multiple contexts.

Appendix A: Claims of Program Effectiveness

The Expert Panel requires evaluation data demonstrating improvement in student learning, equity, and/or organizational change. In the chart below, please list all of your claims and describe the corresponding evaluation methods used and evidence of success or effectiveness. Note the following definitions.

Program Claims are concise statements of your program?s impact. A claim statement should refer to the target population as well as the nature and direction of the change in learning.

Examples of acceptable claims include: Project XYZ students in grades K-6 demonstrated greater gains than a comparison group on the ABC Achievement Test. Project Clearwater students analyzed water samples and established that the local river was polluted. They wrote letters citing their data and persuaded the city Water and Reclamation Department to clean up the river. Three years ago N girls were enrolled in physics courses. An outreach project, Seeking Marie Curie, embarked on attracting more girls into science classes. This year 2N girls are enrolled, and in an attitudinal survey, they attribute their increased interest to Project Curie. As a result of participation in Project Brainstorm, ten students entered the local science fair, and four won prizes or were given honorable mention. In the previous year, before the advent of Project Brainstorm, two students entered the science fair and neither received a prize or citation.

Examples of insufficient claims include: Students rated the Project Smile teachers and activities highly on a classroom survey. Students engaged in more exploration of science concepts through participation in the Frogs vs. Lizards Project. Students appear to be more motivated and eager to attend classes after participation in the Self-Esteem Project.

Evaluation Methods refer to the program?s design, sample, instruments, and data analysis. The evaluation should be designed to persuade friendly or skeptical observers and reviewers that change in student learning can be attributed to the program.

The following is an example of an acceptable entry in the evaluation methods column: Pre-post comparison group design Project XYZ = 98 K-6 students from 3 school sites Comparison group = 87 K-6 students from the same 3 school sites ABC Achievement Test

Evidence of Effectiveness refers to support for each claim. To assist the reviewers in judging significance of change, respondents should provide compelling information to support each claim (e.g., baseline or comparison data) and report significance levels or effect sizes if available. Applicants should also specify whether results were uniformly positive or mixed across sites.

In sum, measurable changes in behavior, aggregated and disaggregated (in accord with the subject populations listed in Criterion 1, d) are much more highly valued than attitudinal surveys or anecdotes. The more quantified evidence you can present, the more persuasive you will be.

Program Claims	Evaluation Methods	Evidence of Effectiveness

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6. CERTIFICATE OF ACCURACY AND COMPLETENESS

   The district superintendent or other equivalent official must certify that the information provided in this submission is true, accurate, and complete. Submissions should acknowledge strengths and weaknesses of the program. Also, if more than one evaluation has been conducted, evidence from all evaluations is provided, not just those with the best results.

   Print out, sign, and mail a hard copy of the Certificate of Accuracy and Completeness to: Educational Technology Expert Panel, c/o RMC Research Corporation, 1000 Market Street, Building 2, Portsmouth, N.H. 03801.

   I, ___________________________________________, certify that the information provided in the electronic submission to the Educational Technology Expert Panel is true, accurate, and complete.

   Name (typed):	Organization:
   Title:	Title of Program:
   Signature:	Date:	Control No.

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