----------------------- ----- ---- -------------- -------------- ------------- ------------ ------------------------- ------------- -----------------------------
  **General Information**                                                                                                             

  **School Name**                                                                **County**                                           

  **No. of                                          **No. of                     **No. of                                             
  Faculty/Staff**                                   Classrooms**                 Students**                                           

  **Primary Point of                                               **Secondary                                                        
  Contact**                                                        Point of                                                           
                                                                   Contact**                                                          

  **Name**                                                         **Name**                                                           

  **Title**                                                        **Title**                                                          

  **Mailing Address**                                              **Mailing                                                          
                                                                   Address**                                                          

  **City**                                                         **City**                                                           

  **State, ZIP**                                                   **State,                                                           
                                                                   ZIP**                                                              

  **Phone**                                                        **Phone**                                                          

  **e-mail**                                                       **e-mail**                                                         

  **Recognition                                                                                                                       
  Guidelines**                                                                                                                        

  **Guideline 1: All                 **- NWR                                                                            **Completed   
  Hazards NOAA Weather               located near                                                                       Yes:  No:    
  Radio (NWR) and                    the school's                                                                       **           
  Checklist**                        front office                                                                                     
                                     or                                                                                               
                                     supervisor's                                                                                     
                                     desk. Specific                                                                                   
                                     Area Message                                                                                     
                                     Encoder (SAME)                                                                                   
                                     NWR is highly                                                                                    
                                     recommended.                                                                                     
                                     It is also                                                                                       
                                     recommended                                                                                      
                                     that a                                                                                           
                                     checklist is                                                                                     
                                     maintained to                                                                                    
                                     insure the                                                                                       
                                     radio is                                                                                         
                                     operating                                                                                        
                                     properly.**                                                                                      

  **[Verification Team                                                                                                                
  General                                                                                                                             
  Notes:]{.underline}**                                                                                                               

                                                                                                                                      

                                                                                                                                      

                                                                                              **[Date:]{.underline}**                 **[Initials:]{.underline}**
  ----------------------- ----- ---- -------------- -------------- ------------- ------------ ------------------------- ------------- -----------------------------

  -------------------------- ------------------------------- ------------------------- ------------- -----------------------------
  **Guideline 2: Backup      **- Establish a backup method                             **Completed   
  Weather Information**      to receive weather information                            Yes:  No:    
                             (TV, EAS Radio Station,                                   **           
                             Internet, etc.) at the front                                            
                             office or supervisor's desk.**                                          

  **[Please                                                                                          
  Describe:]{.underline}**                                                                           

                                                                                                     

  **[Verification Team                                                                               
  General                                                                                            
  Notes:]{.underline}**                                                                              

                                                                                                     

                                                                                                     

                                                             **[Date:]{.underline}**                 **[Initials:]{.underline}**

  *Note: Please do not write                                                                         
  in shaded areas.*                                                                                  
  -------------------------- ------------------------------- ------------------------- ------------- -----------------------------

  ----------------------- ------------------------------- ------------------------- ------------- -----------------------------
  **Guideline 3: Review   **- Identify all potential                                **Completed   
  of Tornado Shelter      tornado shelter areas on the                              Yes:  No:    
  Areas**                 school grounds.**                                         **           

  **Make sure that                                                                                
  shelter areas are                                                                               
  located away from                                                                               
  windows and exterior                                                                            
  doors, are not part of                                                                          
  cafeterias or                                                                                   
  gymnasiums, and are not                                                                         
  part of temporary                                                                               
  buildings/trailers. The                                                                         
  shelter areas must be                                                                           
  part of the school's                                                                            
  emergency plan.**                                                                               

  **[Verification Team                                                                            
  General                                                                                         
  Notes:]{.underline}**                                                                           

                                                                                                  

                                                                                                  

                                                          **[Date:]{.underline}**                 **[Initials:]{.underline}**
  ----------------------- ------------------------------- ------------------------- ------------- -----------------------------

  ------------------------------ -------------- ---------------------- --------- ------------------------- ------------- -----------------------------
  **Guideline 4: Annual Tornado  **- The school                                                            **Completed   
  Drills**                       is required to                                                            Yes:  No:    
                                 hold a tornado                                                            **           
                                 drill at least                                                                          
                                 twice per year                                                                          
                                 (recommended                                                                            
                                 early in the                                                                            
                                 school year                                                                             
                                 and prior to                                                                            
                                 the start of                                                                            
                                 severe weather                                                                          
                                 season in                                                                               
                                 March).**                                                                               

  **[Dates tornado drills                       **Drill 1:**           **Drill                                           
  completed                                                            2:**                                              
  (dd/mm/yyyy):]{.underline}**                                                                                           

  **[Verification Team General                                                                                           
  Notes:]{.underline}**                                                                                                  

                                                                                                                         

                                                                                                                         

                                                                                 **[Date:]{.underline}**                 **[Initials:]{.underline}**
  ------------------------------ -------------- ---------------------- --------- ------------------------- ------------- -----------------------------

  -------------------------------------------------------------------------------------- -- ---------------- ----------- ---- --------------- ------------------------- ---- ------------- -----------------------------
  **Guideline 5: Basic Weather Training**                                                   **- Basic                                                                        **Completed   
                                                                                            weather training                                                                 Yes:  No:    
                                                                                            is required for                                                                  **           
                                                                                            a minimum of 10                                                                                
                                                                                            teachers/staff                                                                                 
                                                                                            per school. It                                                                                 
                                                                                            is required that                                                                               
                                                                                            the Principal                                                                                  
                                                                                            and Vice                                                                                       
                                                                                            Principal(s)                                                                                   
                                                                                            take this                                                                                      
                                                                                            training.**                                                                                    

  **Date completed (dd/mm/yyyy)**                                                                            **Number         **Presenter's                                                
                                                                                                             trained**        name**                                                       

  **The online training can be found at:                                                                                                                                                   
  http://www.weather.gov/ilm/stormready/Resources_files/teacherstraining/player.html**                                                                                                     

  **[Verification Team General Notes:]{.underline}**                                                                                                                                       

                                                                                                                                                                                           

                                                                                                                                                                                           

                                                                                                                                              **[Date:]{.underline}**                      **[Initials:]{.underline}**
  -------------------------------------------------------------------------------------- -- ---------------- ----------- ---- --------------- ------------------------- ---- ------------- -----------------------------

+--------------------+-----------------------------+----+---+---------+
| **Guideline 6:     | **- The HWO must be         |    | * |         |
| Hazardous Weather  | reviewed each morning by    |    | * |         |
| Outlook (HWO)      | the Principal, Vice         |    | C |         |
| Review**           | Principal, or by a          |    | o |         |
|                    | designated member in the    |    | m |         |
|                    | front office.**             |    | p |         |
|                    |                             |    | l |         |
|                    |                             |    | e |         |
|                    |                             |    | t |         |
|                    |                             |    | e |         |
|                    |                             |    | d |         |
|                    |                             |    | Y |         |
|                    |                             |    | e |         |
|                    |                             |    | s |         |
|                    |                             |    | : |         |
|                    |                             |    |  |         |
|                    |                             |    | N |         |
|                    |                             |    | o |         |
|                    |                             |    | : |         |
|                    |                             |    |  |         |
|                    |                             |    | * |         |
|                    |                             |    | * |         |
+--------------------+-----------------------------+----+---+---------+
| **If the HWO is    |                             |    |   |         |
| disseminated to    |                             |    |   |         |
| the staff other    |                             |    |   |         |
| than email please  |                             |    |   |         |
| explain:**         |                             |    |   |         |
+--------------------+-----------------------------+----+---+---------+
| **[Verification    |                             |    |   |         |
| Team General       |                             |    |   |         |
| Not                |                             |    |   |         |
| es:]{.underline}** |                             |    |   |         |
+--------------------+-----------------------------+----+---+---------+
|                    |                             |    |   |         |
+--------------------+-----------------------------+----+---+---------+
|                    |                             |    |   |         |
+--------------------+-----------------------------+----+---+---------+
| **Hazardous        |                             | *  |   | **[Ini  |
| Weather Outlook    |                             | *[ |   | tials:] |
| (HWO) -**          |                             | Da |   | {.under |
| [**http:           |                             | te |   | line}** |
| //www.weather.gov/ |                             | :] |   |         |
| ilm/products/hwo.s |                             | {. |   |         |
| html**](http://www |                             | un |   |         |
| .weather.gov/ilm/p |                             | de |   |         |
| roducts/hwo.shtml) |                             | rl |   |         |
|                    |                             | in |   |         |
| **Hazards Map -    |                             | e} |   |         |
| <http://www.       |                             | ** |   |         |
| weather.gov/ilm>** |                             |    |   |         |
+--------------------+-----------------------------+----+---+---------+
| *Note: Please do   |                             |    |   |         |
| not write in       |                             |    |   |         |
| shaded areas.*     |                             |    |   |         |
+--------------------+-----------------------------+----+---+---------+

+-------------------+---------------+--------------+----+---+---------+
| **Guideline 7:    | **- Each      |              |    | * |         |
| Severe Weather    | school must   |              |    | * |         |
| Emergency Plan    | d             |              |    | C |         |
| (SWEP)**          | evelop/review |              |    | o |         |
|                   | a SWEP or     |              |    | m |         |
|                   | incorporate   |              |    | p |         |
|                   | weather       |              |    | l |         |
|                   | hazards into  |              |    | e |         |
|                   | their overall |              |    | t |         |
|                   | Emergency     |              |    | e |         |
|                   | Action Plan.  |              |    | d |         |
|                   | The SWEP or   |              |    | Y |         |
|                   | related       |              |    | e |         |
|                   | portion of    |              |    | s |         |
|                   | the Emergency |              |    | : |         |
|                   | Action Plan   |              |    |  |         |
|                   | must be       |              |    | N |         |
|                   | reviewed by   |              |    | o |         |
|                   | all staff at  |              |    | : |         |
|                   | least once a  |              |    |  |         |
|                   | year.**       |              |    | * |         |
|                   |               |              |    | * |         |
+-------------------+---------------+--------------+----+---+---------+
| **Date plan       |               | **Month all  |    |   |         |
| completed         |               | staff        |    |   |         |
| (dd/mm/yyyy)**    |               | reviewed     |    |   |         |
|                   |               | (mm/yyyy)**  |    |   |         |
+-------------------+---------------+--------------+----+---+---------+
| **Please indicate |               |              |    |   |         |
| if the Severe     |               |              |    |   |         |
| Weather Emergency |               |              |    |   |         |
| Plan has been     |               |              |    |   |         |
| developed as a    |               |              |    |   |         |
| stand-alone or    |               |              |    |   |         |
| directly          |               |              |    |   |         |
| incorporated into |               |              |    |   |         |
| other operational |               |              |    |   |         |
| manuals.**        |               |              |    |   |         |
|                   |               |              |    |   |         |
| **Developed as a  |               |              |    |   |         |
| stand-alone plan: |               |              |    |   |         |
|  Incorporated    |               |              |    |   |         |
| into Emergency    |               |              |    |   |         |
| Action Plan: **  |               |              |    |   |         |
+-------------------+---------------+--------------+----+---+---------+
| **[Verification   |               |              |    |   |         |
| Team General      |               |              |    |   |         |
| Note              |               |              |    |   |         |
| s:]{.underline}** |               |              |    |   |         |
+-------------------+---------------+--------------+----+---+---------+
|                   |               |              |    |   |         |
+-------------------+---------------+--------------+----+---+---------+
|                   |               |              |    |   |         |
+-------------------+---------------+--------------+----+---+---------+
|                   |               |              | *  |   | **[Ini  |
|                   |               |              | *[ |   | tials:] |
|                   |               |              | Da |   | {.under |
|                   |               |              | te |   | line}** |
|                   |               |              | :] |   |         |
|                   |               |              | {. |   |         |
|                   |               |              | un |   |         |
|                   |               |              | de |   |         |
|                   |               |              | rl |   |         |
|                   |               |              | in |   |         |
|                   |               |              | e} |   |         |
|                   |               |              | ** |   |         |
+-------------------+---------------+--------------+----+---+---------+

  ----------------------- ------------------------------- ------------------------- ------------- -----------------------------
  **Guideline 8:          **- Annual review of the                                  **Completed   
  Lightning Safety        *Coaches & Sports Officials                               Yes:  No:    
  Review**                Guide to Lightning Safety* by                             **           
                          all of the coaches and/or P.E.                                          
                          teachers at the school**                                                

  **[Verification Team                                                                            
  General                                                                                         
  Notes:]{.underline}**                                                                           

                                                                                                  

                                                                                                  

                                                          **[Date:]{.underline}**                 **[Initials:]{.underline}**
  ----------------------- ------------------------------- ------------------------- ------------- -----------------------------

  --------------------------------------- -------------------------------
  **Signature of Applying Official**      

  **[Application Submitted by: (print     
  name):]{.underline}**                   

  **[School:]{.underline}**               **[Title:]{.underline}**

  **[Signature:]{.underline}**            **[Date:]{.underline}**

  **[NWS Personnel Receiving Application  
  (print name):]{.underline}**            

  **[Date Received:]{.underline}**        

  *Note: Please do not write in shaded    
  areas.*                                 
  --------------------------------------- -------------------------------