##### U.S. Department of Education June 1, 1999

2000-2001

Blue Ribbon Schools Program

Elementary School

Nomination Requirements

Introduction ii

Eligibility Criteria v

Application and Review Process v

Timeline vii

Preparing the School Self-Assessment viii

2000-2001 School Self-Assessment

-   Certification Sheet 1

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-   Part I \-- Eligibility Certification 3

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-   Part II \-- Background and Demographic Data 4

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-   Part III \-- Summary 7

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-   Part IV \-- Vision/Mission Statement 7

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-   Part V \-- Learning-Centered Schools Criteria 8

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-   Part VI \-- Special Emphasis Areas 17

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-   Sample Formats for Displaying Assessment Data 19

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-   Private School Addendum 25

OMB Control Number: 1850-0745

Expiration Date: November 30, 2001

**INTRODUCTION**

### Program Purpose

The Blue Ribbon Schools Program (BRSP) was established by the Secretary
of Education in 1982. Its purpose is threefold: (1) to identify and give
public recognition to outstanding public and private schools across the
United States; (2) to make available a comprehensive framework of key
criteria for school effectiveness that can serve as a basis for
participatory self‑assessment and planning in schools; and (3) to
facilitate communication and sharing of best practices within and among
schools based on a common understanding of criteria related to success.
The program has developed into a national school improvement strategy
and many states now have related programs.

Blue Ribbon Schools model excellence and equity. They exhibit a strong
commitment to educational excellence for all students. The school\'s
success in furthering the intellectual, social, moral, and physical
growth of all its students, including students with disabilities and
limited English proficient students, is a basic consideration underlying
the recognition criteria. In seeking successful schools, the program
welcomes both schools that have demonstrated sustained success in
achieving these values and schools that have demonstrated significant
improvement by overcoming serious obstacles.

The quality of each school will be judged in the context of how
effectively it has defined and is meeting its own goals and how well it
serves students, their families, and the local community. Additionally,
for a school to be judged worthy of national recognition, it must show
significant progress in meeting State and/or national education goals.
Blue Ribbon Schools offer instructional programs that meet the highest
academic standards, have supportive and learning‑centered school
environments, and demonstrate student outcome results that are
significantly above the average for comparable schools.

Elementary and secondary schools are eligible to participate in
alternate years. Middle and junior high schools may only participate in
the secondary year. Schools also must meet several other eligibility
requirements as stated in the "Eligibility Criteria." Once a school\'s
eligibility to participate has been determined, information provided by
a school in response to the program criteria will guide the National
Review Panel's analysis regarding the school's possible designation as a
Blue Ribbon School.

**Conceptual Basis for the Program Criteria**

The Blue Ribbon Schools Program completed a two-year effort to update
its criteria to reflect current education research, reform goals, and
consensus views of best practice. The criteria published in this
nomination package were developed at a series of planning meetings held
during the summer of 1996 that included approximately 200 researchers,
practitioners, and staff from associations, foundations, state education
agencies, and the U.S. Department of Education. These criteria were
further refined based on the experience of their first use by schools in
1997-1998.

A series of commissioned research synthesis papers, as well as the
practical experience of the diverse participants, served as the basis
for reaching consensus on revised criteria. To receive draft copies of
these research papers, contact the Blue Ribbon Schools Program office at
202-219-2141.

Experience with school improvement and research indicates that no "quick
fixes" for school success exist. Schools are complex institutions.
Unusually successful schools have adopted a comprehensive and long-term
perspective dedicated to excellence and equity in all aspects of the
school program.

The very difficult goals of nurturing student learning and development
are at the heart of any school's vision/mission. Students are more
likely to learn and develop when the adults in the school not only
support them, but also continuously learn themselves. Learning-centered
school communities support the growth of all members. Since schools are
located within larger political, social, and economic environments that
may enable or constrain their progress, school success is often
dependent on developing partnerships for collaboration with the larger
community.

**Program Criteria**

**Overall Framework**

The overall framework of criteria used in the Blue Ribbon Schools
Program includes the following eight categories:

A.  Student Focus and Support

B.  School Organization and Culture

C.  Challenging Standards and Curriculum

D. Active Teaching and Learning

E. Professional Community

F. Leadership and Educational Vitality

G. School, Family, and Community Partnerships

H. Indicators of Success

Categories A, C, and D address the dynamic of student‑teacher‑content
interaction that is the central core of the education process. These
categories focus mainly on the classroom and its context. Categories B,
E, and F focus on elements of the context within schools that education
research suggests are conditions for success, including organizational,
cultural, and interpersonal factors. Category G covers the school\'s
relationships with significant external stakeholders. The emphasis in
category H shifts to results: the coherence of the school's overall
assessment system, the use of assessment data to inform decisions and
improve performance, and evidence of consistently outstanding or
significantly improved student and school performance outcomes.

### Special Emphasis Areas

Each year the Department of Education selects areas of high national
priority for special emphasis. Response to these areas of special
emphasis is optional. In 2000-2001, special emphasis is being given to
unusually effective programs in (1) special education and (2)
technology. A school may apply for special honors in either special
education or technology, but not both.

To apply for recognition in a special emphasis area, schools should
submit the information specified in Part VI. Only schools that receive
the Blue Ribbon Schools award are eligible to receive an additional
award in one of the special emphases. Failure to apply for honors in a
special emphasis area will not jeopardize a school\'s chances to be
recognized as a Blue Ribbon School.

### Characteristics and Use of Program Criteria

**The criteria are comprehensive**. The criteria are intended to address
all important aspects of school operations. Yet the criteria are broad
enough to suit diverse school contexts and to accommodate new or
changing goals and strategies within any particular school.

**The criteria are interrelated**. Addressing the multiple, embedded,
and interacting contexts of school life creates a dynamic linkage among
the criteria. The systematic use of a broad composite of criteria should
help schools to ensure that school improvement goals and strategies are
balanced.

**The criteria are nonprescriptive**. Wide latitude is intended and
accepted in how schools meet the criteria. The focus is on results
rather than on specific means or procedures. Schools often use the Blue
Ribbon criteria and process in conjunction with more targeted or
specific school improvement strategies.

**The criteria are a basis for collaborative self‑assessment**. School
responses to the overall framework should provide a profile of school
strengths and areas for improvement. The criteria are a useful tool for
self‑assessment, reflection, strategic planning, and involvement of all
relevant stakeholders in a common project.

**Self-assessment is an effective school improvement strategy**.
Research and experience suggest that self-assessment benefits schools
and fosters improvements in practice. Successful schools usually have a
process for reflection and planning. Thus, the criteria may assist
schools in accomplishing something they do in the normal course of their
activities regardless of whether they choose to seek national
recognition.

**Eligible Schools**

Only elementary schools are eligible for the 2000-2001 Blue Ribbon
Schools Program. If the highest grade in the school is grade six,
regardless of its name, the school may only apply during an elementary
year. The change in eligibility for middle schools is the result of a
comprehensive, external evaluation of the Blue Ribbon Schools Program by
Policy Studies Associates. This change helps assure equitable and
proportionate entry opportunities for all schools. In acknowledgement of
the research findings regarding differing philosophies among middle,
junior high, and secondary schools, middle schools will be required to
meet nomination requirements consistent with developmentally appropriate
middle school models.

### Previously Recognized Schools

It is the Blue Ribbon Schools Program's philosophy that the
responsibility of public service accompanies the reward of national
recognition. The program validates and spotlights educational successes
and offers to meritorious schools the opportunity for public praise for
their accomplishments. As models of excellence and equity, Blue Ribbon
Schools have much to share among themselves and with other schools that
aspire to similar success.

Blue Ribbon Schools recognized between 1983 and 1994 were encouraged to
take the initiative to share their best practices with other schools. As
a requirement for their nomination , schools recognized after 1994 are
required to show they have interacted with other schools. State agency
officials and district superintendents are asked to facilitate sharing.
The U.S. Department of Education expects to do more in the future to
promote formal and informal sharing. Additionally, the program expects
that after recognition Blue Ribbon Schools will continue to seek ways to
further improve themselves.

Previously recognized schools may reapply for recognition after a
waiting period of five years (See the eligibility criteria). Program
experience suggests that schools sometimes reapply because they find the
self-assessment process intrinsically beneficial as a school improvement
tool. In order to be recognized again, previously recognized schools
must meet additional criteria related to continuing improvement and the
sharing of best practices.

**ELIGIBILITY CRITERIA**

1.  The school must be an elementary school with some combination of
    grades K-8. In K-12 schools, the K-8 components are eligible for
    consideration. Schools with some combination of grades K-8 or 1-8
    must participate as an entire entity. Middle and intermediate
    schools that end with grade 6 may only apply during an elementary
    year.

2.  The minimum period of operation for public and private schools,
    including newly merged schools, is five full school years. The
    school must be in its sixth year of operation when the nomination is
    submitted, that is, schools submitting nomination s for the current
    year in the fall of 2000 must have been in continuous operation
    since September 1995.

3.  Previously recognized schools are eligible to reapply after a five
    year waiting period. Schools recognized in the 1994-1996 program
    cycle or earlier are eligible to apply.

4.  The nominated school must not be refusing the U.S. Department of
    Education, Office of Civil Rights (OCR) access to information
    necessary to investigate a civil rights complaint or to conduct a
    district‑wide compliance review.

5.  The OCR must not have issued a violation letter of findings to the
    school district concluding that the nominated school or the district
    as a whole has violated one or more of the civil rights statutes. A
    violation letter of findings will not be considered outstanding if
    OCR has accepted a corrective action plan from the district to
    remedy the violation.

6.  The U.S. Department of Justice must not have a pending suit against
    a school district alleging that the nominated school, or district as
    a whole, has violated one or more of the civil rights statutes or
    the Constitution's equal protection clause.

7.  The U.S. Department of Education must not have issued a monitoring
    report with findings of violations of the Individuals with
    Disabilities Education Act that apply to the school or school
    district in question. If there are such findings, for the school to
    be eligible, the state or district has corrected, or agreed to
    correct, the findings.

### 

### 

### APPLICATION AND REVIEW PROCESS

1\. Schools enter the program by completing a nomination package that
contains a School Self-Assessment and then forwarding it to the
appropriate nominating agency.

2\. Chief State School Officers nominate public schools for
consideration at the national level. (Each State is allowed a number of
nominations reflecting its student population and the number of schools
in the state.) Public schools must submit their nomination packages to
the appropriate State Education Agency according to the individual state
timelines. The Council for American Private Education (CAPE) nominates
private schools. Officials of the Bureau of Indian Affairs (BIA) and the
Department of Defense Education Activity (DODEA) nominate their schools.
Information on how to contact program liaisons for the states, CAPE,
BIA, and DODEA is available on the Blue Ribbon Schools home page at
www.ed.gov/programs/nclbbrs/.

3\. The U.S. Department of Education receives public and private school
nominations from the nominating agencies and examines them for
eligibility and completeness.

4 . A National Review Panel of public and private school educators
reviews school nomination packages. The U.S. Department of Education
seeks to form a panel that is culturally, ethnically, and geographically
diverse, and includes persons with disabilities. CAPE recommends panel
members representative of the private school community. Each year
experts in the special emphasis areas are also invited to serve as panel
members. No U.S. Department of Education officials serve on the panel.

5\. The National Review Panel meets initially to recommend schools for
site visits. Stage I recommendations are based solely on the information
in the school's nomination package. Attention is paid to assigning
schools, particularly private and special types of schools, to reviewers
with relevant experience. Panel members do not review schools from their
own states or schools with which they have had prior personal or
professional involvement.

6\. Two‑day visits are conducted at schools that have been recommended
for a site visit. Site visitors are educators with extensive public or
private school experience. No U.S. Department of Education officials
serve as site visitors.

The role of the site visitor is to verify the accuracy of information in
the nomination package and to get answers to specific questions posed by
the National Review Panel. The site visitor follows carefully prepared
guidelines and criteria in conducting on‑site visits. A substantial
portion of time is spent in classroom observations. The site visitor
also meets with school and district administrators, teachers, support
staff, students, parents, and community members. The site visitor
prepares a written report and forwards it to the U.S. Department of
Education.

7\. The National Review Panel meets a second time to review the
nomination packages of all the schools that received site visits and to
select from among them schools to recommend for National recognition.
These Stage II reviews consider site visitors\' verification of
information in the nomination package, the answers to specific panel
questions, and site visitors\' firsthand reports on the quality of the
instructional program and school climate. The select subpanel performs a
role similar to that described above.

8\. The National Review Panel recommends the schools for recognition by
the Secretary of Education. Schools recommended by the panel are cleared
by the Office of Civil Rights to ensure that eligibility requirements
are met. Once a decision has been reached, no appeals are permitted.

9\. Three representatives of each Blue Ribbon School, usually the
principal and two other people directly connected to the school, come to
Washington, D.C. for a Blue Ribbon Schools professional development and
recognition ceremony.

**TIMELINE**

## Event Date

+------------------------------------------------+---------------------+
| Publication of Nomination Requirements         | June 1999           |
+------------------------------------------------+---------------------+
| State Liaison Meeting                          | October, 1999       |
+------------------------------------------------+---------------------+
| Public School Nominations                      | As Determined       |
|                                                |                     |
| Due to State Education Agencies, BIA, and      | By Agencies         |
| DODEA                                          |                     |
|                                                |                     |
| All public school's must submit through the    |                     |
| states, BIA, or DODEA                          |                     |
+------------------------------------------------+---------------------+
| Private School Nominations                     | October 2, 2000     |
|                                                |                     |
| Must be received by CAPE by                    |                     |
+------------------------------------------------+---------------------+
| Public and Private School Nominations          | November 13, 2000   |
|                                                |                     |
| Must be received by U.S. Department of         |                     |
| Education by                                   |                     |
+------------------------------------------------+---------------------+
| First National Review Panel Meeting,           | January 5-10, 2001  |
| Washington, DC                                 |                     |
+------------------------------------------------+---------------------+
| Announcement of Site Visits                    | January 25, 2001    |
+------------------------------------------------+---------------------+
| Orientation of Site Visitors, Washington, DC   | February 16-17,     |
|                                                | 2001                |
+------------------------------------------------+---------------------+
| Site Visits                                    | February 21--April  |
|                                                | 13, 2001            |
+------------------------------------------------+---------------------+
| Site Visit Reports Due to U.S. Department of   | April 19, 2001      |
| Education                                      |                     |
|                                                |                     |
| (Two weeks from visit or by April 19,          |                     |
| whichever comes first)                         |                     |
+------------------------------------------------+---------------------+
| Second National Review Panel Meeting           | April 28-30, 2001   |
+------------------------------------------------+---------------------+
| Notification of Schools Completed              | May 23, 2001        |
+------------------------------------------------+---------------------+
| National Recognition Ceremony, Washington, DC  | Fall 2001           |
+------------------------------------------------+---------------------+

**PREPARING THE SCHOOL SELF-ASSESSMENT**

## Overview

This nomination package is designed to provide a profile of your school
and to offer you an opportunity to highlight factors especially
important to your local community. Completion of this nomination package
is required in order to be considered for the Blue Ribbon Schools award.
The package is divided into six parts.

**Part I** is used to determine whether the school meets the eligibility
criteria.

**Part II** seeks background and demographic information about the
school district and the school.

**Part III** provides a brief summary or \"snapshot\" of the school.

**Part IV** asks for a statement of the school's vision/mission or
philosophy.

The information in Parts II-IV is used by the National Review Panel to
understand the school context and, if the school is recognized by the
U.S. Department of Education, for public information purposes.

**Part V** invites descriptions of the school in response to specific
questions that reflect learning-centered school criteria.

**Part VI** is the optional section concerning special emphasis areas.

**The quality of the written document** will have considerable influence
on how the review panel evaluates your school. Complete descriptions of
school policies, programs, practices, and results are essential
ingredients of a successful school nomination. The School
Self-Assessment should, therefore, be well‑written and carefully
reviewed for content and style before being submitted. Failure to
address directly and concretely each question including the italicized
prompts can result in an unfavorable review even though the school\'s
programs and practices are, in reality, quite excellent.

**The Summary** section will be shared with other recognized schools,
members of Congress, and the press. It should be written as a
stand‑alone section, without reference to how deserving the school is of
national recognition and without cross references. It should be a
concise, accurate description of your school and should include the
school name, city, and state in the first sentence.

**Previously recognized Blue Ribbon Schools** seeking recognition again
must highlight changes and improvements since they were last honored.
Also, these schools are expected to describe efforts to share their best
practices with other schools.

Throughout the School Self-Assessment, schools previously recognized
must explicitly document their progress since the earlier award and note
any interactions with other schools in sharing their successful
strategies. Additionally, there is an addendum where previously
recognized schools must summarize relevant changes, improvements, and
efforts to share best practices. Prior nomination packages are not
available to the panel. Thus, you must take care to document all
statements and claims as thoroughly as a school applying for the first
time.

**TECHNICAL SPECIFICATIONS**

Please keep the following items in mind as you complete the nomination
package. If you fail to comply, your school may not be reviewed.

1.  **Paper, Spacing, and Type Size**. All responses must be typed on
    white paper, single spaced, with 1\" margins on right, left, top,
    and bottom. Use normal spacing between lines.

> Print size must not be reduced smaller than 11 point computer font,
> which is the type used in this box (for typewriters, 12‑pitch elite
> type is acceptable). Do not use compressed type and make sure that the
> font style used is easily reproducible.

Upon selection for submission to the U.S. Department of Education by the
nominating agency, each school will be assigned a unique identification
code by the agency's program liaison.

**Copies**. Each school must submit four copies (the original plus
three) of the completed nomination package. The original and copies must
be without any additional covers or folders and must be stapled in the
upper left-hand corner. The signed original must be printed on one side.
To minimize environmental impact, the three copies must be photocopied
on both sides of the paper.

**Electronic Files**. The school must submit a 3.5 inch floppy disk that
contains a file named "ID" that includes the name of the principal, the
name of the school, its address, and telephone number as on the cover
sheet, and a separate file named "BRSFORM" that includes the following
sections of the nomination form: the Summary, Part III, and Parts IV, V,
and VI. The file must be written in any version of WordPerfect,
Microsoft Word or Works in PC format. If it must be written on a
Macintosh or any format other than the three PC formats mentioned, it
must be written in ASCII.

It is imperative that the following information be provided on an
external label attached to the disk: the name of the school, the city
and state, the name and version of the word processing software package
used (for example, Word for Windows, ASCII on Mac), and the format of
the disk (PC or Mac).

2\. **Cover Sheet**. Note that the cover sheet for the nomination
package requires the signatures of the principal, the district
superintendent, and the president/chairperson of the local school board.
These signatures certify that each of the three individuals has reviewed
the content of the nomination package, including the statement of
eligibility, and has determined that it is accurate. (All of these
signatures may not be applicable for private schools; write N/A in the
space where the position or its equivalent is not applicable.)

3\. **Pagination**. Paginate your submittal and number all pages/sides
consecutively as follows:

> Cover sheets pp. 1‑2 or 2a
>
> Part I pp. 3
>
> Part II pp. 4‑6
>
> Part III pp. 7‑8
>
> Part IV pp. 9
>
> Part V pp.10+
>
> Part VI in sequence

4\. **Format**. Parts I and II and the Private School Addendum must be
completed without any reformatting. Do not retype pages 1‑6 or the
Private School Addendum page. (Private schools must retype and bold the
questions in the Private School Addendum. Insert the questions and your
responses after each corresponding question in Part V; for example, A3a
would go after A3.) The summary statement (pages 7‑8) is limited to two
pages. Part V is limited to 30 pages *excluding* assessment tables,
except that previously recognized schools may have 2 extra pages for
Section I. The 30-page limitation is a maximum, not a requirement. For
Part VI, special emphasis, up to three additional pages may be used for
special education and technology.

No attachments to the nomination package will be reviewed except for the
Private School Addendum the school assessment tables, and subgroup
norms/standards supplied by publishers needed to interpret assessment
data in Part V, H4 and H5. Assessment-related addenda should be limited.

5\. **Submission**. All nominations must be submitted through the
respective State education department, BIA, DODEA, or in the case of
private schools, through CAPE. There are no exceptions.

**Completing Part V**

6\. **Format**. The school must retype and bold each complete question
in Part V, together with its corresponding number, for example, A1, C3,
G2. Only the bold part of the question in the nomination form need be
repeated by the school; it must be repeated exactly as worded in the
nomination form and it must be bolded. The statements/prompts in italics
that accompany bold questions in the nomination are to guide responses
and need not be repeated. Pay special attention to any such italicized
requests for information, since reviewers will expect to find
information directly related to these structured queries. Note that in
Part VI, Special Emphasis Areas, only the heading, that is, Technology
or Special Education should be repeated and bolded.

Note also that question H4 requires that your response be formatted in a
particular way. Please adhere closely to the formatting guidelines for
these questions. For H4 provide all the relevant test details specified
in the italicized prompts. This nomination package provides samples of
suggested data display in Section H. In reporting test data, you may
reduce font/type size, though the final copy must be clearly legible.

7\. **Cross Referencing**. The school must decide how much space to
allocate to each response within the overall limitation of 30 pages for
Part V. Because many of the questions are closely related, it is
suggested that you cross reference to conserve space and avoid
repetition. However, you should thoroughly answer the question before
referring to an elaboration in related questions.

8\. **Participation**. Principals are expected to invite a team of
individuals, including teachers, staff, parents, students, and others,
to participate in the preparation of the nomination package. Many of the
questions will require reflection, research, discussion among the team,
and several attempts at formulating effective responses. Since
submitting a nomination is intended to stimulate and recognize school
improvement efforts, writing the nomination is ideally accomplished by
all of those stakeholders intimately involved in such efforts. The use
of a professional writer to draft the nomination is strongly
discouraged.

9\. **Editing**. The quality of the written presentation influences the
review panel\'s assessment. It is therefore important to designate a
competent editor to assist with the final document. Preparation of the
Self-Assessment section requests the names and titles of those who
participated (p. 2). Also, a description of the process is required and
scored as part of item F‑3.

The principal, however, is responsible for ensuring the accuracy and
completeness of the final document. The principal should personally
ensure that all nomination questions have been fully and accurately
answered, that formatting of the nomination complies with program
requirements, that photocopying has not resulted in missing or out of
sequence pages, and that proper shipment of all 4 copies occurs
according to the prescribed timeline.

10\. **Criteria**. The National Review Panel will rate each of the
responses and overall categories as follows: Exemplary, Strong,
Adequate, Inadequate, and Insufficient Evidence. Additionally, the panel
will judge whether the document makes sense as a whole. For example,
they will consider whether the vision, goals, practices, resources, and
results are aligned across the various sections of the School
Self-Assessment. For a school to receive a site visit, it must be judged
\"exemplary\" in two general categories, have no adequate general
categories, have no more than six adequate ratings in the individual
items, and have no inadequate ratings. Schools must meet the assessment
criteria in Section H.

### 

### Completing Part VI

Limit your descriptions of special emphasis in technology or special
education to no more than three pages. These pages are in addition to
the 30 pages allowed for Part V of the School Self-Assessment.

**Questions About the Nomination Package**

All questions concerning this nomination package should be addressed to
the appropriate program liaison in the states for public schools and to
CAPE for private schools. The answers to all questions the Department
receives from liaisons will be posted on the Blue Ribbon Schools home
page under Frequently Asked Questions as they are received. The Blue
Ribbon Schools Program homepage address is:
http://www.ed.gov/offices/OERI/BlueRibbonSchools/

**Paperwork Burden Statement**

According to the Paperwork Reduction Act of 1995, no persons are
required to respond to a collection of information unless such
collection displays a valid OMB control number. The valid OMB control
number for this information collection is **[1850-0745]{.underline}**.
The time required to complete this information collection is estimated
to average **50** hours per response, including the time to review
instructions, search existing data resources, gather the data needed,
and complete and review the information collection. **If you have any
comments concerning the accuracy of the time estimate(s) or suggestions
for improving this form, please write to:** U.S. Department of
Education, Washington, D.C. 20202-4651. **If you have comments or
concerns regarding the status of your individual submission of this
form, write directly to:** Blue Ribbon Schools Program, U.S. Department
of Education, 555 New Jersey Avenue NW, Room 508, Washington D.C.
20208-5643.

**Code**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

ASSIGNED BY NOMINATING AGENCY

CHECK THOSE THAT APPLY IN EACH GROUP:

  ---------------------------------------------------- -------------------
                                                       

  Previous National Blue Ribbon School:                Special Honors
                                                       Candidate:

  \_\_\_\_Yes \_\_\_\_No If yes, year(s)               \_\_\_\_ Special
  \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_   Education

                                                       \_\_\_\_ Technology
  ---------------------------------------------------- -------------------

**2000-2001 Blue Ribbon Schools Program Certification Sheet**

Name of Principal

(Specify: Ms., Miss, Mrs., Dr., Mr., Other) (As you wish it in the
official records)

Official School Name

(As you wish it in the official records)

School Mailing Tel. [( )]{.underline}

Street/P.O. Box

Address Fax [( )]{.underline}

> City State Zip Code+4 (9 digits)

Website/URL Email

County Nearest Major Airport/City, State

I have reviewed the information in this package, including the
eligibility requirements on page 3, and certify that to the best of my
knowledge all information is accurate.

Date\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

(Principal's Signature)

*Private Schools: If the information requested is not applicable to you,
write N/A in the space.*

Name of Superintendent

(Specify: Ms., Miss, Mrs., Dr., Mr., Other)

District Name Tel. [( )]{.underline}

District Mailing Fax [( )]{.underline}

> Street/P.O. Box

Address

> City State Zip Code

I have reviewed the information in this package, including the
eligibility requirements on page 3, and certify that to the best of my
knowledge it is accurate.

Date\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
(Superintendent's Signature)

Name of School Board

President/Chairperson

(Specify: Ms., Miss, Mrs., Dr., Mr., Other)

I have reviewed the information in this package, including the
eligibility requirements on page 3, and certify that to the best of my
knowledge it is accurate.

Date\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

(School Board President's/Chairperson's Signature)

**Preparation of School Self-Assessment**

Representatives of all relevant stakeholder groups (including
administrators, teachers, other school staff, students, parents, and
community representatives) should be involved in the preparation of the
School Self-Assessment. Information about its preparation is required
under F3 and is used in scoring that item in conjunction with the
information requested below. List the individuals involved in
preparation. If necessary, add an additional page numbered "2a."

**Name** **Position/Title**

(List Primary author/editor here)

**PART I ‑ ELIGIBILITY CERTIFICATION**

The signatures on the first page of this nomination package certify that
for each of the statements below concerning your school\'s eligibility,
previous recognition in the Blue Ribbon Schools Program, and compliance
with U.S. Department of Education, Office of Civil Rights (OCR)
requirements are true and correct. \[Include this page in the nomination
package as page 3.\]

> 1 . The school is an elementary school. Or the school is K-12 and the
> elementary component is applying. The entire school is applying,
> unless the school is K-12.
>
> 2\. The school has been in existence for five full years.
>
> 3\. The school has not received national recognition as a Blue Ribbon
> School since 1996.
>
> 4\. The nominated school or district is not refusing OCR access to
> information necessary to investigate a civil rights complaint or to
> conduct a district‑wide compliance review.
>
> 5\. The OCR has not issued a violation letter of findings to the
> school district concluding that the nominated school or the district
> as a whole has violated one or more of the civil rights statutes. A
> violation letter of findings will not be considered outstanding if OCR
> has accepted a corrective action plan from the district to remedy the
> violation.
>
> 6\. The U.S. Department of Justice does not have a pending suit
> alleging that the nominated school, or the school district as a whole,
> has violated one or more of the civil rights statutes or the
> Constitution\'s equal protection clause.
>
> 7\. There are no findings of violations of the Individuals with
> Disabilities Education Act in a U.S. Department of Education
> monitoring report that apply to the school or school district in
> question; and if there are such findings, the state or district has
> corrected, or agreed to correct, the findings.

**PART II ‑ BACKGROUND AND DEMOGRAPHIC DATA**

**DISTRICT** (Questions 1‑3 not applicable to private schools)

1\. Total number of students (PreK‑12)\* enrolled in the district:

2\. Number of schools in the district: Elementary schools

\_\_\_\_\_ Middle schools

\_\_\_\_\_ Junior high schools

\_\_\_\_\_ High schools

\_\_\_\_\_ TOTAL

3\. District Per Pupil Expenditure:

Average State Per Pupil Expenditure: \_\_\_\_\_\_

**SCHOOL** (To be completed by all schools)

4\. Category that best describes the area where your school is located:

> \[ \] Urban or large central city
>
> \[ \] Suburban school with characteristics typical of an urban school
>
> \[ \] Suburban
>
> \[ \] Small city or town in a rural area
>
> \[ \] Rural

5\. Number of years the principal has been in her/his position at this
school.

If less than three years, how long was the previous principal at this
school?

6\. Number of students enrolled at each grade level or its equivalent in
your school:

PreK\*\_\_\_\_\_ K \_\_\_\_\_ 1^st^ \_\_\_\_\_ 2^nd^ \_\_\_\_\_

3^rd^ \_\_\_\_\_ 4^th^ \_\_\_\_\_ 5^th^ \_\_\_\_\_ 6^th^ \_\_\_\_\_

7^th^ \_\_\_\_\_ 8^th^ \_\_\_\_\_ Other \_\_\_\_ Total
\_\_\_\_\_\_\_\_\_\_\_\_\_\_

7\. Racial/ethnic composition of % American Indian or Alaska Native

the students in your school: % Asian

\% Black or African American

\% Hispanic or Latino

\% Native Hawaiian or Other Pacific Islander

\% White

**100% Total**

\_\_\_\_\_\_\_\_\_\_\_\_\_

\* Include pre‑Kindergartners only if your school and/or district
operates PreK programs.

8\. Student turnover, or mobility rate, during the past year:
\_\_\_\_\_\_\_\_%

> (This rate should include the total number of students who transferred
> to or from different schools between October 1 and the end of the
> school year, divided by the total number of students in your school as
> of October 1, multiplied by 100.)

9\. Limited English proficient students in the school: \_\_\_\_\_\_\_\_%

\_\_\_\_\_\_\_\_Total Number

Number of languages represented: \_\_\_\_\_\_\_\_

Specify languages:

10\. Students who qualify for free/reduced price lunch:
\_\_\_\_\_\_\_\_%

\_\_\_\_\_\_\_\_Total Number

> If this is not a reasonably accurate estimate of the percentage of
> students from low‑income families or your school does not participate
> in the federally‑supported lunch program, specify a more accurate
> estimate, tell why you chose it, and explain how you arrived at this
> estimate.

11\. Students receiving special education services: \_\_\_\_\_\_\_\_%

\_\_\_\_\_\_\_\_ Number Served

> Indicate below the number of students with disabilities according to
> conditions designated in the Individuals with Disabilities Education
> Act.

\_\_\_\_Deaf \_\_\_\_Other Health Impaired

\_\_\_\_Deaf-Blind \_\_\_\_Seriously Emotionally Disturbed

\_\_\_\_Hard of Hearing \_\_\_\_Specific Learning Disability

\_\_\_\_Mentally Retarded \_\_\_\_Speech Impaired

\_\_\_\_Multihandicapped \_\_\_\_Visually Handicapped

\_\_\_\_Orthopedically Impaired

12\. Describe any significant changes in the data reported in items 4‑11
that have occurred during the past five years and explain why the
changes occurred.

13\. Indicate the full‑time and part‑time staff members in each of the
below categories.

**Number of Staff**

**[Full-time]{.underline}** **[Part-Time]{.underline}**

Administrator(s) \_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_

Classroom teachers \_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_

Special resource teachers/specialists \_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_

Paraprofessionals \_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_

> Support staff \_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_
>
> Total number \_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_

14\. Total number of classrooms in the school \_\_\_\_\_\_\_\_\_

15\. When was the school built? \_\_\_\_\_\_\_\_

Date(s) of any major renovation(s) \_\_\_\_\_\_\_\_

If the school has been renovated, briefly describe the nature of the
renovation.

**PART III ‑ SUMMARY**

Provide a brief, coherent snapshot of your school. If your school is
recognized, your summary statement will be made available to the press.
Also, it will become part of the Blue Ribbon Schools Program home page.
Although the National Review Panel will not rate the summary statement,
it will provide them with important background information for
understanding your school. Limit your summary statement to no more than
two pages.

Describe your school by highlighting its vision/mission, its tradition
and milestones, the nature of the community and students served, and its
facilities. Summarize your strengths and accomplishments focusing on
what makes your school a unique and successful place worthy of Blue
Ribbon School status. Using the main categories in Section V as a
general guide, selectively emphasize the key initiatives that
distinguish your school, without references to how deserving the school
is of the award and without cross references.

Please include your school name, city, and state in the first sentence.

**PART IV -- VISION/MISSION STATEMENT**

Successful organizations have a clearly articulated and commonly
understood vision and mission. Provide a brief statement of your
school's vision/mission or philosophy and state the school\'s goals that
reflect your vision/mission. Public schools may indicate how their
school vision/mission relates to district goals or policies.

Limit your statement to one page or less. Your vision/mission statement
will not be rated separately, but it will provide the National Review
Panel with a context for rating your responses in Part V.

**PART V ‑ LEARNING‑CENTERED SCHOOLS CRITERIA**

Note: In responding to the questions in Part V, provide specific
details, including especially illustrative examples and relevant data,
to maximize reviewers' understanding of your school. Public schools may
need to acknowledge the important role of state or district‑level
policies. Nevertheless, the individual school is the nominee for
recognition and is generally considered the action‑and-accountability
unit for this nomination. Therefore, your answers should clearly give
evidence of the exemplary programs and practices at your building level
and the flexibility your school deploys in developing and implementing
effective programs and policies. All schools, whether public or private
and regardless of grade span, must respond to all questions (unless
otherwise specified). The answers to individual questions will not
necessarily be of equal length. Cross‑reference answers when necessary
to avoid repetition.

Throughout Part V, the reviewers will be looking for evidence that your
school has been successful in achieving both excellence and equity. In
describing your achievements, you must convince the review panel that
all groups within the school have contributed to and share in your
success. Responses should show sensitivity to the full range of special
needs that exist in your community and school population. For example,
as you respond to questions in this section, consider the needs of
students with limited‑English proficiency, students with disabilities,
underachieving students and potential dropouts, students involved in
substance abuse, and gifted and talented students.

###### A. Student Focus and Support

> **A1**. **How would you describe your student population? What are
> your students' needs?** **How do you assure that the needs of all
> students are met?** *Explain how the school determines and meets the
> needs of diverse students.*
>
> **A2**. **What nonacademic services and programs are available to
> support students, and how do they relate to the student needs and
> school goals identified?** *Describe any counseling programs, health
> services, safety programs, tutoring or mentoring services, dropout
> prevention programs, or similar student support activities. Explain
> how you integrate student services with other components of the school
> program, including accessibility of students with disabilities to all
> programs. Indicate student participation rates and explain how you
> ensure that you include all students who need nonacademic services.*
>
> **A3**. **How does your school determine and address the developmental
> needs of** **students as they move from grade to grade?** *Explain how
> you determine that your programs and services are developmentally
> appropriate. Also, describe your strategies to ease transitions for
> first‑year students, transfer students entering other grades, and
> students leaving the school.*
>
> **A4**. **What cocurricular activities are available for students and
> how do those activities extend the academic curriculum?** *Indicate
> what cocurricular (extracurricular) opportunities are provided,
> including clubs and athletics. Indicate how participation is
> encouraged, what voice students have in planning cocurricular
> offerings, what percentage of students participate, and the extent to
> which participation represents the overall student body, both male and
> female.*
>
> **A5**. **How does your school address the accessibility of its
> facilities to students and others with disabilities?** *Describe what
> you have done or plan to do to improve the school\'s physical
> accessibility.*

**B. School Organization and Culture**

> **B1**. **How does the culture of your school support the learning of
> all its members and foster a caring community?** *Describe your school
> culture. Explain the process the school uses to engage all members in
> collective inquiry, reflection, and responsible decision‑making about
> their learning. Provide examples.*
>
> **B2**. **What opportunities do students have to build sustained and
> caring relationships with teachers and other adults?** **How does your
> school promote a healthy peer climate among the students?** *Explain
> how you foster positive interactions and respect between students and
> adults and how you promote a healthy peer climate among students and
> student groups. Describe an instance when you remedied a situation
> where a student or group of students felt less than fully included*.
>
> **B3. How are teachers hired in your school? How are teacher
> assignments made?** *Describe teacher recruitment and hiring standards
> and practices. Describe how teacher assignments are made. Give
> evidence that these assignments are made for the benefit of all
> students and that teacher strengths are matched to student needs.*
>
> **B4. What is your school's plan for school safety, discipline, and
> drug prevention? What is your record for the past five years?**
> *Describe your plan and create a set of behavioral categories that is
> consistent with your school safety, discipline, and drug prevention
> policies and appropriate for describing incidents ranging from minor
> to serious that occur in your school. Show how your school maintains a
> safe, orderly, and drug-free environment.* *Report incidents in terms
> of percentages of students involved for each category you identified
> and give evidence about any policy or practice that is effective.*

**C. Challenging Standards and Curriculum**

> **C1. How does your curriculum serve the broad goals for student
> learning and development that the public generally expects education
> to achieve: personal and intellectual growth, citizenship, and
> preparation for work and higher education? What relative emphasis do
> you place on these goals in your curriculum?** *Give specific examples
> of how your curriculum addresses, and how much emphasis you place on
> each of these objectives: basic skills; learning in the academic
> disciplines; character development and ethical judgment; preparation
> for life in a complex and diverse society; appreciation for democratic
> values; participation in the practices of democracy and community
> service; development of interpersonal, technological, and other skills
> valued in the workplace; and other broad goals and objectives
> consistent with your school's vision/mission.*
>
> **C2**. **How is your school organized to provide for differing
> student academic needs within the school\'s goals, priorities, and
> curriculum?** *Provide evidence that decisions about student grouping
> and scheduling are made with the benefit of all students as the
> primary goal. If student ability grouping exists at your school,
> describe under what conditions and how often students may move among
> groups. Provide data for the last academic year indicating how many
> students moved into groups with more challenging course work.*
>
> **C3. How do you ensure that diverse learners (for example, students
> with disabilities, gifted and talented students, students with limited
> English proficiency, migrant students, and students placed at risk)
> have the opportunity to learn challenging content and achieve at high
> levels?** *Describe any special programs or curricular offerings
> available for students with particular needs. Explain how these relate
> to the overall curriculum.*
>
> **C4. What is the process for continuous curriculum renewal at your
> school? What questions about curriculum is your school currently
> addressing?** *Describe your process for continuous curriculum
> renewal, including the data and resources you use for evaluating and
> decision-making, the participants involved in the process, and the
> impact of its implementation on teachers and students. Discuss your
> plans for future curriculum renewal.*
>
> **C5. Successful schools offer all students opportunities to be
> engaged with significant content. How does your school ensure that
> students achieve at high levels in the core subjects?** *Include a
> brief description of each subject area below, noting: (1) the general
> content and performance standards in each major subject area,
> including how essential skills such as, reading, writing, and thinking
> are addressed; (2) curriculum articulation throughout the content
> areas or across grades; (3) ways in which content areas are
> integrated; and (4) any unique or unusually effective features of your
> curriculum.*
>
> *Note: If your core curriculum is organized in a manner that would be
> better explained using a framework other than the traditional subject
> areas, you may substitute your framework for the one listed below.
> However, be sure to explain how the essential skills and core subjects
> relate to your curriculum framework.*
>
> *Although foreign language instruction is optional for elementary
> schools this year, no school will receive an exemplary rating in the
> overall \"C\" category unless it offers at least one foreign language
> as a part of the regular curriculum.*
>
> **a. English (Language Arts)**
>
> **b. Mathematics**
>
> **c. Science**

d.  **d. Social Studies**

> **e. The Arts**

**f. Foreign Languages (Optional)**

> **C6. What other content areas or programs play essential roles in
> your schoolwide curriculum goals?** *Select two content areas or
> programs that you think should be highlighted because of their central
> importance to your school\'s vision/mission and priorities or because
> of the high quality, uniqueness or special significance of the
> offering. Provide the same kind of information for these content areas
> as in item C5.*
>
> **C7. What requirements must be satisfied before a student is promoted
> to the next grade or level of schooling?** *Describe policies and
> practices related to promotion and eligibility for accelerated course
> work. Explain how these insure content mastery, appropriate student
> development, and challenge students beyond minimum standards.*

###### D. Active Teaching and Learning

> **D1. How are teaching practices and learning experiences in your
> school consistent with current knowledge about successful teaching and
> learning?** *Explain and illustrate through examples why your teaching
> practices are appropriate for the programs or subjects in your
> curriculum and for your students.*
>
> **D2. In what ways do your teaching practices support
> student-initiated learning?** *Give evidence that your classrooms are
> communities of learners and support student responsibility for
> contributing to individual and peer group learning and achievement.*
>
> **D3. How are resources made available to teachers and students for
> gathering information and sharing the results of their efforts?**
> *Describe your library, information, or media services and explain how
> these services support the curriculum and classroom instruction.
> Include any usage data available, for example, the number of students
> using the library.*
>
> *.*
>
> **D4. What technology applications are you using? How do they relate
> to your curricular goals and how do they support teaching and
> learning?** *Describe your approach to technology and how that
> approach enhances teaching and learning. Explain how you ensure
> equitable access to technology for students and teachers.*

**E. Professional Community**

> **E1**. **What opportunities do teachers and other staff have to build
> professional community that enhance their collective capacity to work
> together to support student learning?** *Describe the professional
> community in your school. Provide specific examples of how
> professional community builds a sense of collective responsibility for
> student outcomes, offers collegial support to develop and try out new
> ideas, solves problems collectively, seeks out information, provides a
> context for reflection, or enables staff to work together in other
> ways. Explain how such activities support student learning. How do you
> ensure adequate financial and time resources for professional
> development?*
>
> **E2. How does a coherent approach to professional development for
> teachers and other staff ensure their ability to implement effectively
> the school\'s curriculum, instructional strategies, and support
> system? How do organizational arrangements, such as time and teaching
> assignments, and school norms and culture, make professional
> development a priority?** *Describe professional development in your
> school and show how teachers are involved. Give examples of
> significant ongoing on‑site learning opportunities (such as mentoring,
> teacher research, teacher-led seminars) and school support for
> participation in out‑of‑school professional activities (such as
> networks, district workshops, professional associations, conferences,
> courses, links with higher education, cultural institutions, and
> businesses). Describe your long-term professional development plan and
> its relation to school goals*.
>
> **E3. How does the school tailor professional development and support
> to address the differences in career experience or professional
> responsibility?** *Describe the formal and informal support that the
> school provides for beginning teachers, newly hired teachers, and
> teachers undertaking a significant change in responsibilities.
> Describe opportunities for teacher leadership and provide examples of
> professional development opportunities for other staff (such as
> paraprofessionals, counselors or specialists, and administrators) and
> explain why these opportunities are appropriate.*
>
> **E4. How does your school use the processes and results of student
> assessment, staff evaluation, and school review to support
> professional growth?** **How has teacher professional development
> improved teaching and resulted in higher student achievement and
> success?** *Describe the opportunities that teachers and other staff
> have to obtain feedback on their own professional performance,
> including the role of formal staff evaluation. Provide any evidence
> available on the impact of professional development, especially on how
> this investment has improved teaching. Describe how your school
> recognizes excellent teaching.*

**F. Leadership and Educational Vitality**

> **F1**. **How does leadership move your school toward its
> vision/mission? How is the instructional leadership role defined and
> implemented? How are resources aligned with goals?** *Be specific
> about what leadership roles and functions are considered important in
> your school. Describe the leadership role of the principal. Provide
> concrete examples of how your school leadership ensures that policies,
> programs, relationships, and resources focus on the achievement of the
> school\'s vision/mission and promote learning.*
>
> **F2. How does the school engage its internal and external
> stakeholders in leadership and decision-making?** **What is the
> relationship between the principal and stakeholders?** *Explain how
> staff, teachers, students, parents, and the wider community have a
> voice in the formulation of the school\'s vision/mission, goals, and
> priorities. Explain how often and by whom long‑range goals and
> priorities are reviewed. Also, provide specific examples of how key
> stakeholders within the school have a voice in everyday decisions of
> critical importance to them.*
>
> **F3**. **What kind of participatory school improvement process
> operates at your school? How did your school prepare its
> Self‑Assessment for the Blue Ribbon Schools Program and how did this
> initiative relate to other school improvement and planning efforts?**
> *Describe your efforts to effect school improvement, detailing your
> progress to date. Specify the leadership roles in this process. In
> describing the preparation of this Self‑Assessment, explain the
> process, how internal and external stakeholder groups were involved,
> the time frame, and its relationship to ongoing school improvement
> efforts.*
>
> **F4. How does your school leadership use the most current information
> about education to promote continuous improvement in your school? How
> does such evidence influence decision‑making?** *Provide specific
> details about how the use of research findings, education reform
> reports, and/or the analysis of data (including data generated by the
> school) have fostered a deeper understanding of the school\'s goals,
> policies, and practices. Explain how this information has prompted
> specific improvements designed to achieve your vision/mission and
> enhance student learning.*
>
> **F5. As you reflect on the last five years, what conditions or
> changes have contributed most to the overall success of your school?**
> *Give specific examples**.***
>
> **F6**. **How has the school integrated technology to improve
> management and program efficiency and effectiveness?** *Assuming that
> educational applications of technology have been discussed in D,
> describe how you use technology in your school. Describe also how you
> insure that staff are trained in the use of technology and given the
> opportunity to use these resources effectively. Provide specific
> examples of how technology has enabled you to develop and analyze data
> about your school and use it as a basis for important decisions.*
>
> **F7. What do you consider the major educational challenges your
> school must face over the next five years, and how do you plan to
> address them?** *Give specific examples.*

**G. School, Family, and Community Partnerships**

> **G1. What are the goals and priorities of your school, family, and
> community partnerships? How have your school and community both
> improved as a result of these partnerships and how did you measure the
> improvements?** *Discuss how your school identifies these goals and
> priorities, who was involved in identifying them, and how they are
> related to the school\'s overall goals and activities. Provide
> specific examples of activities or projects conducted in collaboration
> with community institutions, agencies, and groups and show how these
> school-community partnerships benefit the community and the school.
> Describe an effort that you feel best exemplifies your partnerships
> and describe as specifically as possible the results achieved for each
> of the participating stakeholders.*
>
> **G2. How does your school involve families in their children\'s
> education?** *Discuss how, in partnership with families, the school:
> (1) supports and enhances the parenting role; (2) ensures effective
> two‑way communication; (3) recruits and encourages volunteers; (4)
> facilitates learning at home (including homework); and (5) involves
> families in decision making. Show data to indicate the extent of
> family involvement in these activities and the degree to which the
> families involved represent the overall student body.*
>
> **G3. How does the school support the needs and concerns of
> families?** *Discuss how you determine needs and concerns. Provide
> examples of school support, such as integrated health and social
> services at the school site, referrals to community services, before-
> and after-school child care, adult education, family counseling,
> nutrition education, times for parent meetings and conferences, and
> transportation options.*
>
> **G4. How are educational resources in the school and the community
> used to extend learning opportunities for students, teachers, and
> families?** *Provide specific examples of how community educational
> resources such as museums and performing arts institutions, public
> libraries, summer academic and athletic programs, study‑abroad
> programs, community enrichment programs, job training, internships and
> apprenticeship programs extend your school program. You may also
> discuss extended use of the school\'s own facilities, such as the
> media center, classrooms, gymnasium, and computer lab if programs
> provide reciprocal benefits to the community.*

# Indicators of Success

> **H1. What is your school's overall approach to assessment? How do
> your methods align with your educational vision/mission and
> curriculum? What questions about assessment is your school currently
> addressing?** *Provide evidence and examples of a coherent school-wide
> assessment program. Identify current issues and future directions. It
> is the school's responsibility to show sustained high achievement or
> significant improvement over five years through reports on
> norm-referenced tests, criterion-referenced tests, and/or alternative
> assessment. The school need not utilize any particular assessment
> method, but must show that students achieve academically.*
>
> **H2. How do you use assessment results to understand and improve
> student and school performance? How are data used to influence
> decision-making?** *Provide evidence that assessment data are used
> systematically in making decisions about programs and students. Give
> examples of how school administrators and teachers use assessment data
> to improve teaching and learning.*
>
> **H3. What assessment data are communicated to students, parents, and
> the community? What are the purposes of these communications? How does
> the school ensure that these stakeholders understand the standards for
> judgment and the meaning of the data?** *Show how the school keeps
> students, parents, and the community actively informed about the
> results of assessment.*
>
> **H4. What standardized norm-referenced tests developed on the
> national, state, or district level has your school given in the last
> five years? What are the results for the last five years?** *It is the
> responsibility of the school: (1) to show sustained high achievement,
> that is, at least one-third standard deviation above the mean or a
> normal curve equivalent (NCE) of 57; (2) or to show significant
> improvement over the past five years, that is, at least a one-third
> standard deviation increase in achievement or a 7 NCE increase in
> achievement.*
>
> *Even if the entire school does not achieve above 57 NCEs, a school
> may present itself as eligible for Blue Ribbon status by
> disaggregating data to show that the majority student group in the
> school achieves at a level at least one-third standard deviation above
> the mean or 57 NCEs and that other students have improved at least
> one-third of a standard deviation over five years. If a school has a
> significant number of students with low socioeconomic status or with
> other challenges, the school may show how these students have improved
> significantly because of the school\'s efforts. If the school has a
> high student turnover rate, it may also disaggregate the data to show
> the results for students who have attended the school for two years or
> more compared to those students with less than two years attendance.*
>
> *Present data from all standardized assessments administered by your
> school. If you do not have five years of data, present at least three
> years of data and explain why you do not have data for the other
> years. It is the school\'s responsibility to provide a sufficient
> explanation of the meaning of the scores so that someone not familiar
> with the tests can interpret them. Using the sample tables as a guide,
> present the data for each test in the following ways:*

a.  *Indicate the test name and edition/publication year.*

b.  *Specify the grade at which the test was administered.*

c.  *Indicate the number of students in the grade and the number and
    percentage of students tested.*

d.  *Using tables (no charts or graphs), report scores in terms of NCEs
    or standard scores. Do not report percentiles or stanines. For each
    grade (not for each classroom), report the mean and the standard
    deviation for the test and each subtest. Report the national mean
    and standard deviation in the same metric as the scores.*

e.  *Disaggregate the data for any ethnic/racial or socioeconomic groups
    that comprise 15 percent or more of the student body of your school.
    Show how all subgroups of students achieve at high levels or improve
    dramatically in achievement for at least two years and up to five
    years. Explain any disparity among subgroups and what you are doing
    to close the gaps.*

f.  *Specify which groups, if any, are excluded from a test, the reasons
    for the exclusion, as well as the number and percentage of students
    excluded. Describe how these students are assessed.*

g.  *Explain any patterns of increase or decline in test scores. Also,
    discuss the implications of any special circumstances that may
    affect student outcomes, such as an unusually high student mobility
    rate.*

h.  *Attach all test data to the end of this nomination package and
    continue numbering the pages consecutively.*

> **H5. What criterion-referenced tests do you use? What are the results
> for the last five years?** *Describe and report the data resulting
> from these tests using the appropriate prompts in H4, where
> applicable. It is the school\'s responsibility to provide sufficient
> explanation of the meaning of the scores so that someone not familiar
> with the tests can interpret them. Use the sample tables in the
> nomination package as a guide. Do not use graphs or charts.*
>
> **H6. What alternative assessments of student performance do you
> use?** *Describe the assessments you used, present the results, and
> provide sufficient explanation of the meaning of the results so that
> someone not familiar with these forms of assessment can interpret the
> results.*
>
> **H7. What are the data for the past five years in the following areas
> that serve as quantitative indicators of school climate and
> engagement?**
>
> 1999-2000 1998-1999 1997-1998 1996-1997 1995-1996
>
> **Daily student attendance** \_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_
> \_\_\_\_\_ \_\_\_\_\_
>
> **Daily teacher attendance** \_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_
> \_\_\_\_\_ \_\_\_\_\_
>
> **Teacher turnover rate** \_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_
> \_\_\_\_\_
>
> *Explain any patterns of increase or decrease as well as special
> circumstances that affected any of these indicators. Report in terms
> of percentages, listing each of the past five years under each
> category. If you use other indicators of school performance, you may
> add up to three additional indicators to this list.*
>
> *Note: In computing student attendance, both excused and unexcused
> absences should be tallied as absent. Similarly, any teacher out for
> personal or sick leave should be tallied as absent.*
>
> **H8. Which awards received by your school, staff, or students are
> most indicative of school success?** *Limit your description of awards
> to 10 or fewer and explain the reasons for your choices. Give the year
> each award was received.*

**I. Previously Recognized Schools**

> Blue Ribbon Schools seeking recognition again must highlight changes
> and improvements throughout the nomination package since they were
> last honored. Throughout the School Self-Assessment, schools
> previously recognized should explicitly document their progress since
> the earlier award and note any interactions with other schools in
> sharing their successful strategies. Previous nomination forms are not
> available to the review panel. Thus, you must take care to document
> all claims as thoroughly as a school applying for the first time.
>
> This section provides space for previously recognized schools to
> summarize their progress and accomplishments since the last
> recognition. Limit the summary statement to two pages.
>
> **I1. What major changes and improvements have taken place since the
> school was last recognized?**
>
> **I2. Have you had any interactions with other schools to share some
> of your successful strategies and practices? Has your staff been
> involved in leadership or training programs beyond your school to
> disseminate practices and programs? If so, please elaborate.**

**Part VI - Special Emphasis Areas (Optional)**

> Note: Schools may apply for special honors in one of the two following
> special emphasis areas: 1) special education or 2) technology. For
> special education and technology, limit your descriptions to no more
> than three pages. These pages are in addition to the 30 pages allowed
> for Part V.
>
> The criteria for special emphasis areas may overlap with some items in
> the basic School Self-Assessment. Be sure to address such items fully
> in the main body of your nomination package and extend your
> presentation here. In evaluating the special emphasis areas, the
> National Review Panel will be looking for programs that are creative,
> innovative and fully implemented. The panel will consider such equity
> concerns as the inclusion of students with disabilities and limited
> English proficiency. Summarize available program evaluation data.
> Desirable characteristics for particular special emphasis areas
> follow.

**J1. Special education**

a\. **Access:** The school community has identified potential barriers
to the parents' access to and participation in school wide activities,
including meetings, assemblies, counseling opportunities, graduation,
etc., and has proposed effective ways of overcoming these barriers.

b\. **Assessment:** The school community can demonstrate an effective
early identification and intervention system, especially designed for
students with potential reading or behavior concerns, and includes
preventative, instructional and supportive intervention for those
students and their parents.

c\. **Staff Development:** Training opportunities are designed to focus
on the students' unique needs and learning styles, and include
instructional strategies that enhance the student's ability to think,
understand, and apply learning to real-life situations in inclusive
settings.

d: **Resources:** The school community effectively utilizes external
resources to enhance and sustain the involvement of parents and students
with disabilities in activities and programs designed to improve the
quality of life as a member of the school community.

**J2. Technology**

Technology: The school's use of technology supports both instruction and
school management. It has the following characteristics:

a\. **Vision and Planning:** A long-range plan that is continually
updated supports a vision of technology for learning and school
management and was developed collaboratively by those who participate in
its implementation.

b\. **Instructional Integration:** The new technologies (for example,
multimedia computers, laptops, and hand held devices, web-based learning
resources, and distance learning) have been integrated into regular
classrooms and all teachers and students in the school have access to
the technology. There is a critical mass of users. The technology in the
school is used as a tool to support student learning and integration
into the curriculum. Emphasis is placed on students' developing higher
order thinking skills and information technology skills.

c\. **Professional Development:** There is high quality and continuous
professional development for all educational personnel with a focus on
integrating the technology into the curriculum and student learning.

d\. **Technical Assistance and Support:** Ongoing and accessible
technology technical assistance and support are available for teachers,
students, and other educational personnel.

e\. **Home and Community Connectivity:** Technology is used to support
interactive school connections with home and community, and to extend
opportunities for learning beyond the school day.

***SAMPLE FORMATS FOR DISPLAYING ASSESSMENT DATA***

**SAMPLE FOR NATIONAL NORM-REFERENCED TESTS ONLY**

Provide the following information for all tests. Complete a separate
form for each test and grade level.

Grade\_\_\_\_\_\_\_\_
Test\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Edition/publication year\_\_\_\_\_\_\_\_ Publisher
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

What groups were excluded from testing, why, and how were they assessed?
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Number excluded\_\_\_\_\_\_\_\_ Percent excluded\_\_\_\_\_\_\_\_

Scores are reported here as (check one): NCEs\_\_\_\_\_\_\_\_ Scaled
scores \_\_\_\_\_\_\_\_

Report results for at least two subtests that you believe best reflect
student academic performance at your school. Examples of subtest content
areas to be reported are: mathematics, language, reading comprehension.
Report number and percent tested for total score even if they differ
from the number and percent tested for subtests.

  -------------------------------------- ----------- ----------- ----------- ----------- -----------
                                         1999-2000   1998-1999   1997-1998   1996-1997   1995-1996

  Testing month                                                                          

  SCHOOL SCORES                                                                          

  Total or Composite Score                                                               

  Number tested                                                                          

  Percent tested                                                                         

  SUBTEST SCORES                                                                         

  1.\_\_\_\_\_\_\_\_\_\_ (specify                                                        
  subtest)                                                                               

  2.\_\_\_\_\_\_\_\_\_\_ (specify                                                        
  subtest)                                                                               

  3.\_\_\_\_\_\_\_\_\_\_ (specify                                                        
  subtest)                                                                               
  -------------------------------------- ----------- ----------- ----------- ----------- -----------

If you are reporting scaled scores, provide the national score and
standard deviation for the total test and each subtest.

  -------------------------------------- ----------- ----------- ----------- ----------- -----------
                                         1999-2000   1998-1999   1997-1998   1996-1997   1995-1996

  **NATIONAL SCORES**                                                                    

  Total or Composite Score                                                               

  SUBTEST SCORES                                                                         

  1.\_\_\_\_\_\_\_\_\_\_ (specify                                                        
  subtest)                                                                               

  2.\_\_\_\_\_\_\_\_\_\_ (specify                                                        
  subtest)                                                                               

  3.\_\_\_\_\_\_\_\_\_\_ (specify                                                        
  subtest)                                                                               

  **STANDARD DEVIATIONS**                                                                

  Total or Composite Standard Deviation                                                  

  SUBTEST STANDARD DEVIATIONS                                                            

  1.\_\_\_\_\_\_\_\_\_\_ (specify                                                        
  subtest)                                                                               

  2.\_\_\_\_\_\_\_\_\_\_ (specify                                                        
  subtest)                                                                               

  3.\_\_\_\_\_\_\_\_\_\_ (specify                                                        
  subtest)                                                                               
  -------------------------------------- ----------- ----------- ----------- ----------- -----------

In the narrative section of H4, note patterns of significant increase or
decline in scores and explain why they occurred. Also discuss the
implications of any special circumstances that may affect student
outcomes.

**SAMPLE FOR STATE OR DISTRICT NORM-REFERENCED TESTS ONLY**

Provide the following information for all tests. Complete a separate
form for each test and grade level.

Grade\_\_\_\_\_\_\_\_
Test\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Edition/publication year\_\_\_\_\_\_\_\_ Publisher
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

What groups were excluded from testing, why, and how were they assessed?
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Number excluded\_\_\_\_\_\_\_\_ Percent excluded\_\_\_\_\_\_\_\_

Scores are reported here as (check one): NCEs\_\_\_\_\_\_\_\_ Scaled
scores \_\_\_\_\_\_\_\_

Report results for at least two subtests that you believe best reflect
student academic performance at your school. Examples of subtest content
areas to be reported are: mathematics, language, reading comprehension.
Report number and percent tested for total score even if they differ
from the number and percent tested for subtests. In the narrative
section of H4, note patterns of significant increase or decline in
scores and explain why they occurred. Also discuss the implications of
any special circumstances that may affect student outcomes.

  -------------------------------------- ----------- ----------- ----------- ----------- -----------
                                         1999-2000   1998-1999   1997-1998   1996-1997   1995-1996

  Testing month                                                                          

  **SCHOOL SCORES**                                                                      

  Total or Composite Score                                                               

  Number tested                                                                          

  Percent tested                                                                         

  SUBTEST SCORES                                                                         

  1.\_\_\_\_\_\_\_\_\_\_ (specify                                                        
  subtest)                                                                               

  2.\_\_\_\_\_\_\_\_\_\_ (specify                                                        
  subtest)                                                                               

  3.\_\_\_\_\_\_\_\_\_\_ (specify                                                        
  subtest)                                                                               
  -------------------------------------- ----------- ----------- ----------- ----------- -----------

If you are reporting scaled scores, provide the state score, district
score, and the standard deviation for the total test and each subtest.

  -------------------------------------- ----------- ----------- ----------- ----------- -----------
                                         1999-2000   1998-1999   1997-1998   1996-1997   1995-1996

  **STATE SCORES**                                                                       

  Total or Composite Score                                                               

  SUBTEST SCORES                                                                         

  1.\_\_\_\_\_\_\_\_\_\_ (specify                                                        
  subtest)                                                                               

  2.\_\_\_\_\_\_\_\_\_\_ (specify                                                        
  subtest)                                                                               

  3.\_\_\_\_\_\_\_\_\_\_ (specify                                                        
  subtest)                                                                               

  **DISTRICT SCORES**                                                                    

  Total or Composite Score                                                               

  SUBTEST SCORES                                                                         

  1.\_\_\_\_\_\_\_\_\_\_ (specify                                                        
  subtest)                                                                               

  2.\_\_\_\_\_\_\_\_\_\_ (specify                                                        
  subtest)                                                                               

  3.\_\_\_\_\_\_\_\_\_\_ (specify                                                        
  subtest)                                                                               

  **STANDARD DEVIATIONS**                                                                

  Total or Composite Standard Deviation                                                  

  SUBTEST STANDARD DEVIATIONS                                                            

  1.\_\_\_\_\_\_\_\_\_\_ (specify                                                        
  subtest)                                                                               

  2.\_\_\_\_\_\_\_\_\_\_ (specify                                                        
  subtest)                                                                               

  3.\_\_\_\_\_\_\_\_\_\_ (specify                                                        
  subtest)                                                                               
  -------------------------------------- ----------- ----------- ----------- ----------- -----------

**SAMPLE FOR STATE OR DISTRICT CRITERION-REFERENCED TESTS ONLY**

The Data Display Table is illustrated on the following page.

Provide the following information for all tests. Complete a separate
form for each test and grade level.

Grade\_\_\_\_\_\_\_\_
Test\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Edition/publication year\_\_\_\_\_\_\_\_ Publisher
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

What groups were excluded from testing, why, and how were they assessed?
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Number excluded\_\_\_\_\_\_\_\_ Percent excluded\_\_\_\_\_\_\_\_

For your school, district, and state, report scores as the percent of
students tested whose performance was scored at or above the cutpoint
for 1) proficient and 2) at or above the cutpoint for excellent. Note
that the reported percentage of students scoring above the proficient
cutpoint should include students scoring above the excellent cutpoint.

Report number and percent tested for total score even if they differ
from the number and percent tested for subtests.

In the narrative section of H5, explain how these data show that your
students are scoring at a significantly high level.

Explain your standards for proficient and excellent and what the test
results mean in a way that someone unfamiliar with the test can
interpret the results. Note patterns of significant increase or decline
in scores and explain why they occurred. Also discuss the implications
of any special circumstances that may affect student outcomes.

**SAMPLE FOR STATE OR DISTRICT CRITERION-REFERENCED TESTS ONLY**

Data Display Table

  -------------------------------------- -- ----------- -- ----------- -- ----------- -- ----------- -- -----------
                                            1999-2000      1998-1999      1997-1998      1996-1997      1995-1996

  Testing month                                                                                         

  **SCHOOL SCORES**                                                                                     

  Total or Composite Score                                                                              

  At or Above Proficient                                                                                

  At or Above Excellent                                                                                 

  Number tested                                                                                         

  Percent tested                                                                                        

  SUBTEST SCORES                                                                                        

  1.\_\_\_\_\_\_\_\_\_\_ (specify                                                                       
  subtest)                                                                                              

  At or Above Proficient                                                                                

  At or Above Excellent                                                                                 

  2.\_\_\_\_\_\_\_\_\_\_ (specify                                                                       
  subtest)                                                                                              

  At or Above Proficient                                                                                

  At or Above Excellent                                                                                 

  3.\_\_\_\_\_\_\_\_\_\_ (specify                                                                       
  subtest)                                                                                              

  At or Above Proficient                                                                                

  At or Above Excellent                                                                                 

  **DISTRICT SCORES**                                                                                   

  Total or Composite Score                                                                              

  At or Above Proficient                                                                                

  At or Above Excellent                                                                                 

  SUBTEST SCORES                                                                                        

  1.\_\_\_\_\_\_\_\_\_\_ (specify                                                                       
  subtest)                                                                                              

  At or Above Proficient                                                                                

  At or Above Excellent                                                                                 

  2.\_\_\_\_\_\_\_\_\_\_ (specify                                                                       
  subtest)                                                                                              

  At or Above Proficient                                                                                

  At or Above Excellent                                                                                 

  3.\_\_\_\_\_\_\_\_\_\_ (specify                                                                       
  subtest)                                                                                              

  At or Above Proficient                                                                                

  At or Above Excellent                                                                                 

  **STATE SCORES (if applicable)**                                                                      

  Total or Composite Score                                                                              

  At or Above Proficient                                                                                

  At or Above Excellent                                                                                 

  SUBTEST SCORES                                                                                        

  1.\_\_\_\_\_\_\_\_\_\_ (specify                                                                       
  subtest)                                                                                              

  At or Above Proficient                                                                                

  At or Above Excellent                                                                                 

  2.\_\_\_\_\_\_\_\_\_\_ (specify                                                                       
  subtest)                                                                                              

  At or Above Proficient                                                                                

  At or Above Excellent                                                                                 

  3.\_\_\_\_\_\_\_\_\_\_ (specify                                                                       
  subtest)                                                                                              

  At or Above Proficient                                                                                

  At or Above Excellent                                                                                 
  -------------------------------------- -- ----------- -- ----------- -- ----------- -- ----------- -- -----------

**SAMPLE FOR SUBGROUP RESULTS: FORMAT ONE**

Complete a separate form for each test and each grade level. Present
[**at least**]{.underline} two years of data to show decreasing
disparity among subgroups. Some subgroup examples are:

> \(a\) Ethnicity (e.g., American Indian or Alaska Native, Asian, Black
> or African American, Hispanic or Latino, Native Hawaiian or Other
> Pacific Islander, White)
>
> \(b\) Language Status (e.g., Limited English proficient, Non-English
> speaker, English Fluent, English Only)
>
> \(c\) Socioeconomic Status (e.g., Eligible for free and reduced meals,
> not eligible for free and reduced meals)

Grade\_\_\_\_\_\_\_\_
Test\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Edition/publication year\_\_\_\_\_\_\_\_ Publisher
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Report subgroup results in the same way, using the same metric, as you
did when you reported school-wide results in H4 or H5 for this test
(e.g., scaled scores, NCEs, percent at or above proficient and
excellent).

Report number and percent tested for total score even if they differ
from the number and percent tested for subtests.

<table style="width:100%;">
<colgroup>
<col style="width: 44%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 0%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 0%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 5%" />
</colgroup>
<tbody>
<tr class="odd">
<td></td>
<td colspan="4"><p><em>(Specify Subgroup</em></p>
<p><em>below)</em></p></td>
<td colspan="4"></td>
<td colspan="5"></td>
</tr>
<tr class="even">
<td></td>
<td colspan="4"><em><strong>Ethnicity</strong></em></td>
<td colspan="4"><p><em><strong>Language</strong></em></p>
<p><em><strong>Status</strong></em></p></td>
<td colspan="5"><p><em><strong>Socioeconomic</strong></em></p>
<p><em><strong>Status</strong></em></p></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><strong>SUBGROUP SCORES</strong></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>Total Score, ______ (specify 1st year)</td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>Total Score,______ (specify 2nd year)</td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>No. tested, ______ (specify 1st year)</td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>No. tested, ______ (specify 2nd year)</td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>% tested, ______ (specify 1st year)</td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>% tested, ______ (specify 2nd year)</td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>SUBTEST SCORES</td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>1. ______­­­_____,____ (specify subtest &amp; 1st yr )</td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>1. ______­­­_____,____ (specify subtest &amp; 2nd yr )</td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>2. ______­­­_____,____ (specify subtest &amp; 1st yr )</td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>2. ______­­­_____,____ (specify subtest &amp; 2nd yr )</td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>3. ______­­­_____,____ (specify subtest &amp; 1st yr )</td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>3. ______­­­_____,____ (specify subtest &amp; 2nd yr )</td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
</tbody>
</table>

Note patterns of significant increase or decline in scores and explain
why they occurred. Also discuss the implications of any special
circumstances that may affect student outcomes.

**SAMPLE FOR SUBGROUP RESULTS: FORMAT TWO**

Complete a separate form for each year, each test, and each grade level.
Present **[at least]{.underline}** two years of data to show decreasing
disparity among subgroups. Some subgroup examples are:

> \(a\) Ethnicity (e.g., American Indian or Alaska Native, Asian, Black
> or African American, Hispanic or Latino, Native Hawaiian or Other
> Pacific Islander, White)
>
> \(b\) Language Status (e.g., Limited English proficient, Non-English
> speaker, English Fluent, English Only)
>
> \(c\) Socioeconomic Status (e.g., Eligible for free and reduced meals,
> not eligible for free and reduced meals)

Grade\_\_\_\_\_\_\_\_
Test\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Edition/publication year\_\_\_\_\_\_\_\_ Publisher
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Year Tested \_\_\_\_\_\_\_\_\_\_\_

Report subgroup results in the same way, using the same metric, as you
did when you reported school-wide results in H4 or H5 for this test
(e.g., scaled scores, NCEs, percent at or above proficient and
excellent).

Report number and percent tested for total score even if they differ
from the number and percent tested for subtests.

<table style="width:100%;">
<colgroup>
<col style="width: 35%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 0%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 0%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 5%" />
</colgroup>
<tbody>
<tr class="odd">
<td></td>
<td colspan="4"><p><em>(Specify Subgroup</em></p>
<p><em>below)</em></p></td>
<td colspan="4"></td>
<td colspan="5"></td>
</tr>
<tr class="even">
<td></td>
<td colspan="4"><em><strong>Ethnicity</strong></em></td>
<td colspan="4"><em><strong>Language Status</strong></em></td>
<td colspan="5"><em><strong>Socioeconomic Status</strong></em></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><strong>SUBGROUP SCORES</strong></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>Total or Composite Score</td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>Number tested</td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>Percent tested</td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>SUBTEST SCORES</td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>1. ____________ (specify subtest)</td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>2. ____________ (specify subtest)</td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>3. ____________ (specify subtest)</td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
</tbody>
</table>

Note patterns of significant increase or decline in scores and explain
why they occurred. Also discuss the implications of any special
circumstances that may affect student outcomes.

**PRIVATE SCHOOL ADDENDUM**

*The purpose of this addendum is to obtain additional information from
private schools relevant* *to the sections of the Self-Assessment noted
below. Attach the completed addendum to the end of the nomination
package, before the assessment data*

**Cover Sheet**

Date of Founding:

Private school association(s):

(Give primary religious or independent association only)

Does your school have nonprofit, tax exempt (501(c)(3) status? Yes
\_\_\_\_\_\_

No \_\_\_\_\_\_

##### Part II ‑ Demographics

3\. What are your 2000-2001 tuition rates, by grade? (Do not include
room, board, or fees)

\$\_\_\_\_\_\_ \$\_\_\_\_\_\_ \$\_\_\_\_\_\_ \$\_\_\_\_\_\_

PreK 1^st^ 2^nd^ 3^rd^

\$\_\_\_\_\_\_ \$\_\_\_\_\_\_ \$\_\_\_\_\_\_ \$\_\_\_\_\_\_

4^th^ 5^th^ 6^th^ 7^th^

\$\_\_\_\_\_\_ \$\_\_\_\_\_\_

8^th^ Other

-   What is your educational cost per student? \$\_\_\_\_\_\_

(School budget divided by enrollment)

-   What is the average financial aid per student? \$\_\_\_\_\_\_

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```
-   What percentage of your annual budget is devoted to \_\_\_\_\_\_%

scholarship assistance and/or tuition reduction?

-   What percentage of students receive scholarship assistance?

(Including tuition reduction) \_\_\_\_\_\_%

7\. Briefly describe your school\'s efforts to achieve a racially and
economically diverse, multicultural student enrollment. Include your
admissions criteria.

**Private School Addendum (Continued)**

Address each of the following questions. Retype and bold all questions.
Insert each question and your response after the corresponding question
in Part V (for example., A3a would follow A3).

**Part V ‑ Learning Centered Schools Criteria**

> **A2a. For special education schools, how do you assist in planning
> access to further services after students leave the school?**
>
> **F1a. Describe how the school develops its annual budget, and explain
> any special budgetary circumstances. Has the school operated on a
> balanced budget over the last three years? Indicate how the school
> communicates to parents, alumni and/or alumnae, and others the facts
> about its financial management.**
>
> **H6a. What number and percentage of your students have been expelled
> or asked to leave the school? Develop a categorization of reasons for
> involuntary departure and indicate the number of students in each
> category.**