Healthy Schools PA Recognition Program Application

Healthy Schools PA Recognition Program

Women for a Healthy Environment's program wants to help recognize and celebrate all schools and school district's actions that they take every day to improve the well-being of students and teachers. Just fill out the form below to see whether you qualify for an Emerging Schools, Honor Roll, High Honor Roll, or High Honor Roll with Distinction certification, which you will then be able to proudly display at your center. Please allow 10-20 minutes to fill out this form. We strive to get back to you as soon as possible, but please provide 3-5 business days for us to review your application.
Q.1 - Checkmark which applies to you:

Public SchoolPrivate SchoolCharter SchoolSchool District
Q. 2 - Name of School
Q. 3 - Facility Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Q. 4 - Contact Name*

First NameLast Name
Q. 5 - Contact Title/Position
Q. 6 - Contact E-mail*
Q. 7 - Phone Number*

Area CodePhone Number

Q. 9 - Checkmark which items from the Waste and Recycling section of the Checklist that your school has completed.*

Compost food and organic wasteWe implement waste-free lunch programRecycling program includes two or more of: office paper, plastic, metal cans, printer cartridges, newspapers/magazines, cell phones, cardboard, compact discs, video discs, glass, and implement zero-waste program for school-sponsored events
Please provide photographic or documented proof of your completion of these checklist items.

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Q. 10 - Checkmark which items from the Water section of the Checklist that your school has completed.*

Complete water assessment to learn where water comes from.Test quality of drinking water, including presence of lead.Conduct indoor water audit (gallons used, faucet flow, etc.)
Please provide photographic or documented proof of your completion of these checklist items.

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Q. 11 - Checkmark which items from the Energy section of the Checklist that your school has completed.*

Conduct building energy auditImplement a school-energy saving programUse alternative energy, renewable fuels, or specialized energy-efficient technologyEmpower students and staff to lower energy consumptionConvert lights to CFLs or LEDsEstablish an energy purchasing policyStart a WattWatchers program
Please provide photographic or documented proof of your completion of these checklist items.

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Q. 12 - Checkmark which items from the Health and Well-Being section of the Checklist that your school has completed.*

Purchase locally produced food items from vendor or farmerOffer salad bar dailyMaintain an onsite gardenProvide incentive for students to bring reusable water bottlesRemove vending machinesImplement policy to buy recycled, biodegradable, or less toxic school suppliesDevelop and enforce integrated pest management policy that includes: exploring alternative pest management methods; identifying least toxic, target-specific chemicals, preferably as baits and granules; using spot treatment and only treat obviously infested areas; testing for presence of PCBs in caulk and light fixtures; test for presence of lead in paint, dust and soil; ensuring vending machines contain only USDA certified Smart Snack options.
Please provide photographic or documented proof of your completion of these checklist items.

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Q. 8 - Checkmark which items from the Health and Well-Being section of the Checklist that your school has completed.

Purchase locally produced food items from vendor or farmerOffer salad bar dailyMaintain an onsite gardenProvide incentive for students to bring reusable water bottlesRemove vending machinesImplement policy to buy recycled, biodegradable, or less toxic school suppliesDevelop and enforce integrated pest management policy that includes: exploring alternative pest management methods; identifying least toxic, target-specific chemicals, preferably as baits and granules; using spot treatment and only treat obviously infested areas; testing for presence of PCBs in caulk and light fixtures; test for presence of lead in paint, dust and soil; ensuring vending machines contain only USDA certified Smart Snack options.
Please provide photographic or documented proof of your completion of these checklist items.

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Q. 15 - Checkmark which items from the Curriculum Integration section of the Checklist that your school has completed.*

Green School goals are developed and implemented in at least one grade level.Green School activities are planned by one or more teachers.Offer at least one teaching unit on an alternative energy or an environmental issue facing the state.Green School projects, such as air quality monitoring, are used to engage students and integrate sustainability principles into existing classroom curriculum.Schools hosts an environmental or energy speaker, event, or field trip.Establish a student organization that participates in environmental activities and issues.Establish an eco-reading program.Visit internet sites that educate about the environment and support endangered ecosystems.Maintain a natural surface playing area, rather than artificial turf.
Please provide photographic or documented proof of your completion of these checklist items.

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Q. 16 - Checkmark which items from the Community Engagement section of the Checklist that your school has completed.*

Establish or maintain a community natural area or garden.Include parents and community members on advancing the school's green initiatives.School engages with local community members on environmental issues through letter writing or attending public hearings etc.
Please provide photographic or documented proof of your completion of these checklist items.

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Q. 17 - Checkmark which items from the Professional Development section of the Checklist that your school has completed.*

Teachers voluntarily attend professional development on green school topics.Courses related to Green School initiatives are accepted as legitimate topics for professional development.Some school-wide training exists on topics supporting Green School projects.Planning time to enhance Green School goal is provided to teachers.Trainings to prepare teachers for Green School projects and strategies are provided and coordinated at the whole school level.
Please provide photographic or documented proof of your completion of these checklist items.

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Q. 18 - Checkmark which items from the Sharing Successes and Lessons Learned section of the Checklist that your school has completed.*

School's efforts to become green are known within the school.Signage and other educational displays make the green elements and practices of the school clear to visitors as well as students and staff.Projects and initiatives can be found on the school website.Results of the school's green projects and initiatives are published and shared at local community, state, and/or national level (e.g. documents showing how school has mentored other schools or received help, or student/faculty presentations at conferences).Trainings to prepare teachers for Green School projects and strategies are provided and coordinated at the whole school level.
Please provide photographic or documented proof of your completion of these checklist items.

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Q. 19 - Checkmark which items from the Category Planning section of the Checklist that your school has completed.*

School improvement plan identifies "green" strengths and weaknesses.School planning documents identify measurable and realistic Green School objectives.School and/or district level plans address Green School goals as a core component.Future plan exists (and is regularly updated) for implementing Green School activities.
Please provide photographic or documented proof of your completion of these checklist items.

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Q. 13 - Checkmark which items from the Transportation section of the Checklist that your school has completed.*

Complete a transportation assessment.Post "no-idling" signage that is visible to parents and bus drivers.Provide literature to parents about harms of diesel and car exhaust.Award preferential parking for carpooling vehicles.Utilize a bus company that has retrofitted their buses or uses propane.Create and promote safe and low exposure walking and biking routes.
Please provide photographic or documented proof of your completion of these checklist items.

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