Clone of BASIC site Application

BASIC Project Application

Building Access for Students in Classrooms
**Please read all of the requirements and information in its entirety prior to completing the application.**

Programs will be considered upon demonstration of a commitment to a minimum of two years for the implementation of evidence-based practices designed to support children from birth to age five with unique learning and/or behavioral needs.

The program administrator and implementation team must also commit to learning and implementing Practice-Based Coaching strategies and tools to conduct coaching cycles with groups of general education teachers or individual teachers to improve outcomes for students ages three to five.

If you have questions about any portion of this application or process, please contact Fabiola Amburgy or Naiveen Wyatt in the Office of Special Education at 501-682-4221.
Instructions:

If you are unable to complete the application in one setting, simply click "SAVE" at the bottom of the page you were working on and it will save in "DRAFT" form. It will then provide you an option to "Receive an Email Reminder" or "Get Draft Link" to gain access to the application again.
Submission Deadline: Thursday, May 21, 2026

Program Readiness

Please answer the questions completely and thoroughly to determine your program's current readiness to implement the project's components.
35- Why is your program interested in participating in the BASIC project? How will the implementation of key practices, Practice-Based Coaching strategies, and resources assist your students' and teachers' growth?*
36- How does your program's infrastructure and stability allow you to commit to two years of this implementation?*
37- How does your program currently support children's interaction and behavior needs? This could include screeners, evaluations, curriculum, contacts and supports such as BehaviorHelp, Educational Cooperatives, school counselors, counseling programs, etc.*
38- Do you feel the staff (turnover rate) is stable enough to support a two-year commitment without sacrificing quality?*

YESNO
39- How is time scheduled in your program to allow for staff collaboration and planning (E.g. professional learning teams, team leadership meetings, data analysis meetings, and common planning time, etc.)?*
40- What evidence-based professional learning has your staff received?*

Pyramid ModelBASICCLASSOther
41- What data does your program use to determine the interaction skills, behavior needs, and/or school readiness skills of children enrolled in your program (include type of data and how it is used)?*
42-What other iniatives do you plan to be involved in the next two years?
43- How do you currently communicate with and support families from your program in dealing with challenging behaviors or unique educational needs?*
44- What is your site policy on suspension/expulsion of children?*
45- In what ways will participation in the BASIC Project increase your program’s ability to provide children with disabilities meaningful access to age-appropriate activities and learning opportunities alongside their non-disabled peers?*

Program Leadership Team

In order to participate in the project, each program must develop its own leadership team. This team will receive professional learning and guidance in how to sustain the implementation of evidence-based practices, plans for decreasing challenging behavior, and coaching strategies.
Who will serve as Program Director?
46- Program Director*

First NameLast Name
47- Email*
example@example.com
48- Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Who will serve as the Implementation Coach?
49- Implementation Coach*

First NameLast Name
50- Email*
example@example.com
51- Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Who will serve as the Behavior Support Personnel?
52- Behavior Support Personnel*

First NameLast Name
53- Email*
example@example.com
54- Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Who will serve as a Family Representative?
55- Family Representative*

First NameLast Name
56- Email*
example@example.com
57- Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.

Last Thoughts

Please give any additional information that may assist the team in making a final decision.
58- List any other program staff who will serve on your program's Leadership Team (Please include names, job titles, and contact information)?
59- What barriers, if any, do you predict may impact implementation efforts, and what is the program's ideas for addressing these barriers?*
60- Is there anything else you would like the Early Childhood Special Education staff to know about your program that we have not asked?

Signature*
Please verify that you are human.*
Should be Empty:

Rows	1	2	3	4	5	6	7	8	9	10+	N/A
Hispanic
American Indian or Native Alaskan
Asian
Black or African American
Native Hawaiian or Pacific Islander
White
Multiracial
Other

Rows	1	2	3	4	5	6	7	8	9	10+
Male
Female

BASIC Project Application

Submission Deadline: Thursday, May 21, 2026

Demographics

Program Readiness

Program Leadership Team

Last Thoughts