Alternative Education Program Renewal Application

Created for Whitney Coake by Nhan Nguyen on 05/16/2022
Alternative Education Program Renewal Application
LEA Number*
LEA Name*
Alternative Education Program Name*
Alternative Education Program Number*
Alternative Education Program DOE issued School Number, if applicable.

Please list additional participating LEAs being served under this Alternative Education Program, if applicable.

	Joint LEA Name	Joint LEA Number
1
2
3
4
5

Address of Alternative Education Program*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Alternative Education Program Website
Superintendent Name*

First NameLast Name
Superintendent Email*
example@school.k12.in.us
Alternative Education Program Contact *

First NameLast Name
Alternative Education Program Contact Email*
example@school.k12.in.us
Alternative Education Program Contact Phone Number*

Area CodePhone Number
Alternative Education Program Contact Role*
If other was selected for Program Contact role, please describe.
Indicate the grade levels served by the Alternative Education Program. Select all that apply.*

Grade 6Grade 7Grade 8Grade 9Grade 10Grade 11Grade 12
Does the Alternative Education Program offer services over summer?*

Session times, days, and estimated number of students: Please note that each session must be at least 3 hours. *

	Session start and stop times	Amount	Average Number of students enrolled and attending per day
Morning Session
Afternoon Session
Evening Session

Is an instructional time waiver being requested?*

YesNo
How many students will have instructional time requirements waived if a waiver is being requested?

Less than 25%26%-50%51%-75%76%-99%100%
Will any students in grades 6-8 receive an instructional time waiver if a waiver is being requested?

YesNo
How will the success be determined for students who are receiving an instructional time waiver if a waiver is being requested?
Select the site or location that best represents the main location of the Alternative Education Program.*

Classroom w/in Traditional SchoolCommunity SiteDetention CenterEducation CenterSolely Home-BasedSeparate School Corporation FacilityVocational/Career CenterMallSchool w/in School
If School within a School was selected above, please provide the 4-digit school number.
Write a brief description of the Alternative Education Program's mission and how the program functions.*
How would you best describe the primary focus of the Alternative Education Program? (Choose one)

A short-term placement at a Detention Center. The program keeps these students involved in educational programming that addresses skill deficits and individualizes instruction so they continue to progress academically and do not lose credits.To bring students who have not passed necessary state tests, who have failing grades, or who are in need of credits back to the level of their peers. School personnel employ a variety of strategies to assess, remediate and accelerate learning for these students, with the goal of transitioning students to the traditional classroom setting when they have reached appropriate academic levels.To deal with students who have had recurring behavioral/discipline issues (disruptive students). The purpose is to remove these students from the traditional classroom in order to modify their behavior so that they can return and be successful. These programs may operate as an alternative to expulsion, with the goal of transitioning students back to the traditional classroom setting when they have appropriately modified their behavior.To prepare students for life after high school by helping them finish their academic studies and teaching them to be productive members of the community. Programming seeks to reengage disengaged students, prepare pregnant or parenting students, and assist students who must work to support themselves or their families by linking the academic programming with career and service learning opportunities.
Indicate what your program does if students attend the alternative education program for a period less than that required for a traditional instructional day by IC 20-30-2-2 (5 hours of instructional time for grades 1-6 and 6 hours for grades 7-12). Select all that apply.*

Return students to the traditional school for the remainder of the dayOffer post-secondary dual credit opportunitiesLink to an ICE program for work creditLink to required employment, no creditLink to service learningLink to internshipsLink to community service opportunitiesLink to CTE program

What is the student to teacher ratio for the Alternative Education Program? Please note the ratio for certified teachers is 15:1. Each non-certified aide adds capacity for 5 additional students.*

	Number of Students	Number of full-time certified teachers	Number of part-time certified teachers	Number of full-time non-certified aides	Number of part-time non-certified aides
Morning Session
Afternoon Session
Evening Session

What is the typical schedule for students in the Alternative Education Program? *

	5 Days/week	2-4 days/week	Less than 2 days/week	Saturday or summer program	Other
3-4 hours
5-6 hours
Extended Day
Other

Students typically remain in the program: Check the ONE that best applies.*

Less than 15 days15 days to 1 semester1 semester - 1 yearMore than 1 year
What type of curriculum, instructional materials, and assessments are used in the Alternative Education Program? Select all that apply.*

Core 40 optionAcademic Honors optionGeneral Diploma optionTraditional school curriculumCurriculum developed specifically for alternative educationVideo/audio recordingsCourse packetsPortfolio assessmentsHome based learningBlended learningISTEP+/GQE/ECAOther formal assessments (NWEA, TABE, etc)Classroom assessmentsBooks other than traditional textbooksMagazine/newspapersVirtual or distance educationPackaged programsComputer-based (courseware): If selected the type of courseware used must be specified below.
If computer-based was selected above, specify which type of courseware is used.
How does the Alternative Education Program meet the academic needs of the students? Check all that apply.*

Study skills trainingAcademic remediation/tutoringSelf-paced/accelerated instructionIndividualized instructionDifferentiated instructionReading developmentProject based learningCooperative learning/collaborative teamsPost-secondary dual enrollment opportunitiesHome based computer-assisted instructionSchool based computer-assisted instructionTechnology as a learning resourceService learning opportunitiesAuthentic instructionCareer/technical/vocational educationPeer tutoringBefore or after school academic assistanceField trips
How does the Alternative Education Program meet additional support services for students? Check all that apply.*

Level systemPoint systemBehavior management technique(s)Life skills trainingDrug testing or prevention groupsMentoringRequired employmentCommunity service opportunitiesAnger management coursesPregnancy prevention/parenting coursesSocial/emotional curriculumSchool counselor/social workerConflict resolution trainingViolence prevention trainingMental health servicesRestorative justice
How does the program meet the social/family-related needs of the students? Check all that apply.*

Child care availableLife skills trainingParenting programsHousing assistanceMedicaid/Hoosier HealthwiseMentoringFamily counselingFamily literacy programsJob assistance/Career explorationSNAP or Food assistanceMental health servicesVocational education

Indicate if the Alternative Education Program has the following processes.*

	Yes	No
The school/program has understandable, well-publicized processes for parents/guardians to influence decisions and raise issues or concerns.
The school/program has understandable, well-publicized processes for students to influence decisions and raise issues or concerns.
The school/program has understandable, well-publicized processes for community members and/or community partners to provide input and raise issues or concerns.

Student eligibility criteria. Check all that apply.*

Student intends to withdraw or has withdrawn before graduation.Student has not compiled academically and would benefit from alternative instruction.Student is a parent or an expectant parent unable to regularly attend traditional school.Student is employed and employment is necessary to support student or family.
Identify your program's measurable goals for SY 2022-2023.

Choose at least 2 goals (one of which must be academic) and record the data source, baseline, and target. On next year's grant, you will report if the goal was met and explain any shortfalls. Record actual outcome for targets set 2021-2022.*

	Goals (select at least one)	Goal Description	Data Source to quantifiably measure goal outcome	Quantifiable Data Target for 2021-2022	Quantifiable Baseline Data Point for 2021-2022	Quantifiable Data Target for 2022-2023
Goal 1
Goal 2
Goal 3 (optional)
Goal 4 (optional)
Goal 5 (optional)

Use this space to explain why any goals from academic year 2020-2021 were not achieved.
ASSURANCES
1. The project will be administered in accordance with all applicable statutes, regulations, and statements in the application.
2. The school corporation or program organizer will expend in the school year a matching amount of at least one third of the amount of the state grant per full-time equivalent student on alternative education programs.
3. The school corporation agrees to implement an objective, data-driven means of measuring the effectiveness of the program in achieving the goals set out in the application.
4. The school corporation is providing the alternative program on its own or in cooperation with other school corporations. If operating as a joint program, an agreement in compliance with IC 20-26-10 has been signed by participating corporations.
5. The school corporation will employ progressive disciplinary procedures designed to modify behavior in the regular school setting prior to admitting a disruptive student into an alternative educational program.
6. Each student will have an Individual Service Plan in accordance with IC 20-30-8-11.
7. The program will have a student to teacher ratio that does not exceed 15 students to 1 teacher.
8. The program will operate for a minimum of three hours per day and students must be enrolled and attending the program for a minimum of 10 consecutive days in order to be included in the grant reimbursement.
9. Program components have not changed significantly from the previous school year.
10. Each alternative education session (AM, PM or EVE) will operate for at least three continuous hours.
11. The school board has approved the alternative education program and curriculum. In the case of joint programs, the school board for each corporation has granted approval.
12. Grant recipients agree to maintain data and to ensure teacher access to historical student performance data.
  
  I CERTIFY that I am authorized to submit this application and that the information submitted in this application is, to the best of my knowledge, true and accurate.
Date*

MonthDayYear
Date
Alternative Education Program Contact*
Alternative Education Program Contact Signature*

Clear
Superintendent*
Superintendent Signature*

Clear
Should be Empty: