Collaborate 21 - School Team Application

(The terms of the Institute of Museum and Library Services grant which funds Collaborate 21 stipulate that teams from schools serving remote or underserved populations be given priority for participation. In the event that the number of applications exceeds the number of spaces available, this demographic information will be used to prioritize schools for participation in the program.)

Distance of the school from Fargo or Bismarck (whichever is closer): miles

Percentage of students who qualify for the free and reduced lunch program: %

Percentage of minority population in the school: %

In signing this application, the team contact is stating that all team members listed above have agreed to:

• attend the Summer Training Academy June 16 - 19, 2013, at Valley City State University
• participate in the online support activities during the 2013-14 school year,
• collaborate to develop and implement an instructional project during the 2013-14 school year,
• attend the dissemination Academy meeting in spring, 2014 and a national conference (expenses paid by the grant) if your team is selected.

(Entering the following information online constitutes a signature)