##### U.S. Department of Education December 2000

Archived Information

2001-2002

Blue Ribbon Schools Program

Middle School and High School

Nomination Requirements

Introduction ii

Program Criteria
..................................................................iii

Eligibility Criteria v

Application Process and Review Calendar vi

Preparing the School Self-Assessment viii

2001-2002 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 -- School Self-Assessment Criteria 8

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-   Part VI \-- Previously Recognized Schools .......................18

-   Part VII \-- Special Emphasis Areas ..............................
    .18

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-   Part VIII \-- Private School Addendum ............................20

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-   Sample Formats for Displaying Assessment Data ...............22

OMB Control Number: 1850-0745

Expiration Date: October 31, 2003

**INTRODUCTION**

Since 1982 the U.S. Department of Education's Blue Ribbon Schools
Program has celebrated many of America's most successful schools. A Blue
Ribbon flag waving overhead has become a trademark of excellence, a
symbol of quality recognized by everyone from parents to policy-makers
in thousands of communities. The Department invites school communities
to use this nomination package to reflect on the quality and
effectiveness of their programs. The experience of answering the
questions and describing a school in terms of the Blue Ribbon criteria
could open the door to national recognition. All schools will find that
the Blue Ribbon criteria can be useful for ongoing school improvement
efforts, even if recognition is not the immediate goal. The criteria
provide a comprehensive framework for assessing school quality in all of
its dimensions.

### 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 that achieve to high
    academic standards or have shown significant academic improvement
    over five years;

(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 become 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 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 progress while overcoming serious obstacles.

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 average or have improved over time. The quality of
each school will be judged against the Blue Ribbon Schools criteria 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. The conceptual basis for the program criteria
is based on current research, state and national education reform goals,
and the expert opinions of practitioners nationwide.

Elementary and secondary schools (middle, junior high, and high schools)
are eligible to participate in alternate years. Schools also must meet
several other eligibility requirements as stated in the "Eligibility
Criteria" found on page v. 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.

# PROGRAM CRITERIA 

**Eligible Schools**

Only middle, junior high, and senior high schools are eligible for the
2001-2002 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. In acknowledgement of the research and
differing philosophies among middle, junior high, and high schools,
middle schools will be required to meet application requirements
consistent with developmentally appropriate middle school models.

Previously recognized schools may reapply for recognition after a
waiting period of five years. 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 sharing of best
practices. (See Previously Recognized Schools described below and Part
VI.)

**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 Academic 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 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.

**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 choose to 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 ought to do in the normal course
of their activities regardless of whether they choose to seek national
recognition.

Using the scoring guidelines, the National Review Panel will rate each
of the responses and overall criteria 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
nomination package. 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 or insufficient evidence ratings.

### 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 2001-2002, 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 VII. 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.

### Previously Recognized Schools

It is the Blue Ribbon Schools Program's philosophy that the
responsibility of public service accompanies the reward of national
recognition. 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 as a requirement for their application. State agency
officials and district superintendents are asked to facilitate sharing.
Additionally, the program expects that after recognition Blue Ribbon
Schools will continue to seek ways to further improve themselves.
Previously recognized schools need to complete Part VI indicating how
they are meeting the additional criteria as a previously recognized
school.

**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 homepage
address is case-sensitive and is: www.ed.gov/programs/nclbbrs/

**ELIGIBILITY CRITERIA**

1.  The school must be a middle school, a junior high school, or a
    senior high school. In PreK-12 schools, the middle school and high
    school components are eligible for consideration. Schools with some
    combination of grades 6-12 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 full year of operation when the
    application is submitted, that is, schools submitting nomination
    packages for the current year in the fall of 2001 must have been in
    continuous operation since September 1996.

3.  Previously recognized schools are eligible to reapply after a five
    year waiting period. Schools recognized in the 1996-1997 program or
    earlier are eligible to reapply in the current year.

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 PROCESS AND REVIEW CALENDAR**

October 2000 -- Fall 2002

#### 

#### September 21, 2000

***State liaison meeting***. Representatives of states and participating
organizations meet to plan for the new Blue Ribbon Schools nomination
cycle.

#### 

#### October 2000

*Publication of nomination requirements*. The U.S. Department of
Education publishes the nomination package and makes it available
on-line.

#### Ongoing

***Schools work on their nomination packages***, including answering the
School Self-Assessment Criteria questions, for forwarding to the
appropriate nominating agency in Fall, 2001. **Each nominating agency
determines its own deadline for application.** These agencies need time
to review submittals before sending those selected on for national
consideration.

Chief state school officers nominate public schools for consideration at
the national level. The Council for American Private Education (CAPE),
Bureau of Indian Affairs (BIA), and Department of Defense Education
Activity (DODEA) nominate their respective constituent schools. Each
nominating agency has a Blue Ribbon Schools Program liaison who can be
helpful to schools in preparing their nominations. A list of the BRS
liaisons can be found at
www.ed.gov/offices/OERI/BlueRibbonSchools/liaison.html.

#### October 8, 2001

***Deadline for private school nominations to The Council for American
Private Education**.*

#### November 21, 2001

***National deadline for both public and private nominations to the U.S.
Department of Education*.**

#### January 4 -- 9, 2002

***First National Review Panel Meeting**.* The National Review Panel,
composed of public and private school educators, meets to review all
nominations. The panel is culturally, ethnically, and geographically
diverse and includes persons with disabilities. The Council for American
Private Education recommends panel members from the private school
community. No U.S. Department of Education officials serve on the panel.
Panel members do not review schools from their own states or schools
with which they have had prior personal or professional involvement. At
this first panel meeting, panelists will recommend schools for site
visits. Stage I recommendations are based solely on the information in
the school's nomination package.

#### February 4, 2002

***Announcement of site visits.*** The U.S. Department of Education will
notify nominated schools whether or not they have been recommended for a
site visit.

#### February 15 -- 17, 2002

***Orientation of site visitors**.* In a meeting in Washington, D.C.,
site visitors will be prepared for their visits to schools. Site
visitors are educators with extensive public or private school
experience. No U.S. Department of Education officials serve as site
visitors.

#### February 25 -- April 19, 2002

***Site visits**.* Two-day visits are conducted at schools that have
been recommended for a site visit. The role of the site visitor is to
verify the accuracy of information in the nomination package and get
answers to specific questions posed by the National Review Panel. The
site visitor follows carefully prepared guidelines and criteria in
conducting the visit. 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.

#### April 23, 2002

***Site visit reports due to the U.S. Department of Education.***
Reports are due either two weeks from the time of the visit or by April
23, whichever comes first.

#### May 9 -- 11, 2002

***Second National Review Panel Meeting.*** The Panel meets a second
time to review the nomination packages of all schools that received site
visits and to recommend schools for national recognition. These Stage II
reviews consider site visitors' verification of the information in the
nomination package, the answers to specific panel questions, and site
visitors' first-hand reports on the quality of the instructional program
and school climate. The Panel recommends 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 have
been met. Once a decision has been reached, no appeals are permitted.

#### May 27, 2002

***Schools notified***. By May 27, notification of schools will be
complete.

#### Fall 2002

***National Recognition Ceremony.*** 2001-2002 Blue Ribbon Schools
celebrate their success at the annual recognition ceremony in
Washington, D. C. Three representatives of each school, usually the
principal and two others directly connected to the school, will be
invited to attend.

**PREPARING THE SCHOOL SELF-ASSESSMENT**

## Overview

This nomination package is designed to provide a profile of the school
and to offer an opportunity to highlight factors especially important to
the 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 eight 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.

**Part V** asks for responses to specific questions that reflect
learning-centered school criteria.

**Part VI** requires completion by previously recognized Blue Ribbon
Schools only.

**Part VII** provides the option for completing one of the special
emphasis areas.

**Part VIII** provides an addendum for private schools only.

Sample formats for displaying assessment data follow Part VIII.

**The quality of the written document** will have considerable influence
on how the review panel evaluates the 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 may 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 the school and should include the
school name, city, and state in the first sentence.

**Previously recognized Blue Ribbon Schools** seeking recognition again
are required to highlight changes and improvements since their last
award. They must also describe efforts to share their best practices
with other schools and provide explicit evidence throughout the School
Self-Assessment regarding changes, improvements, and outreach efforts to
share best practices. Prior nomination packages are not available to the
panel. Therefore, it is important for the school to document all
statements and claims as thoroughly as a school applying for the first
time.

**Technical Specifications**

Please keep the following in mind when completing the nomination
package. Failure to comply will result in the school\'s not being
reviewed.

-   **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.

-   **Copies**. Each school must submit four copies (the original plus
    three) of the completed School Self-Assessment. 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.

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-   **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, VI, and the assessment tables. Because
    the Department posts the entire nomination package of BRS on its
    website, the file must be written in Microsoft Word in PC format;
    the assessment tables may be in either Word or Excel. Otherwise, the
    formatting would be lost when the file is posted.

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-   **Cover Sheet**. Note that the cover sheet for the School
    Self-Assessment 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.)

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-   **Pagination**. Paginate the submittal and number all pages
    consecutively as follows:

> Cover sheets pp. 1‑2, 2a
>
> Part I pp. 3
>
> Part II pp. 4‑6
>
> Part III pp. 7‑8
>
> Part IV pp. 9
>
> Part V pp.10 up to 39
>
> Part VI in sequence, up to 2 additional pages
>
> Part VII in sequence, up to 3 additional pages
>
> Part VIII in sequence
>
> School assessment tables follow in sequence.

-   **Format**. Parts I and II and Part VIII, the Private School
    Addendum, must be completed without any reformatting. Do not retype
    pages 1‑6 or the first page of the Private School Addendum. Private
    schools must retype in bold and respond to the questions found in
    Part VII. Insert the questions and the responses after each
    corresponding question in Part V; for example, A2a would go after
    A2.

> The summary statement (pages 7‑8) is limited to two pages. Part V is
> limited to 30 pages *excluding* assessment tables. The 30-page
> limitation is a maximum, not a requirement. Previously recognized
> schools may have 2 extra pages for Part VI. Up to three additional
> pages may be used to complete Part VII, special emphasis area: special
> education or technology.

No attachments to the nomination package will be accepted except for the
school assessment tables and subgroup norms/standards supplied by
publishers needed to interpret assessment data in Part V, H4 and H5.

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

**Guidance in Completing Part V- School Self-Assessment Criteria**

-   **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 VII, Special Emphasis
    Areas, only the heading, that is, Special Education or Technology
    should be repeated and bolded.

> Question H4 requires that the response be formatted in a particular
> way. Adhere closely to the formatting guidelines for this question.
> 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, it is
> acceptable to reduce font/type size, though the final copy must be
> clearly legible.

-   **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 the school cross reference to conserve space and
    avoid repetition. However, the school should thoroughly answer the
    question before referring to any elaboration in related questions.

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-   **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 package is strongly discouraged.

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-   **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.

-   **Public Information.** Once Blue Ribbon Schools have been chosen,
    their nomination packages, site visit reports, and National Review
    Panel instruments become public information.

    **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 the 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 ONES THAT APPLY IN EACH GROUP:

  ---------------------- ------------------------ ------------------------
  \_\_\_\_ Middle School Previous National        Special Honors
                                                  Candidate:

  \_\_\_\_ Junior High   Blue Ribbon School:      \_\_\_\_ Special
  School                                          Education

  \_\_\_\_ High School   \_\_\_\_Yes \_\_\_\_No   \_\_\_\_ Technology

                         If yes, year(s)          
                         \_\_\_\_\_\_\_\_\_\_     
  ---------------------- ------------------------ ------------------------

**2001-2002 Blue Ribbon Schools Program Certification Sheet**

Name of Principal

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

Official School Name

(As it should appear 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, 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
each of the statements below concerning the 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 is true and correct. \[Include this page in the nomination
package as page 3.\]

> 1 . The school is a middle school, a junior high school, or a senior
> high school. Or the school is K-12 and the middle, junior high, and/or
> high school components are 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 October 1997.
>
> 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.

8.  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.

December 2000

**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 the 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
the school:

  ----------- --------- ----------- --------- -- ---------- ----------- --------- ----------- ---------
  **Grade**   **\# of   **\# of     **Grade                 **Grade**   **\# of   **\# of     **Grade
              Males**   Females**   Total**                             Males**   Females**   Total**

  **K**                                                     **7**                             

  **1**                                                     **8**                             

  **2**                                                     **9**                             

  **3**                                                     **10**                            

  **4**                                                     **11**                            

  **5**                                                     **12**                            

  **6**                                                     Other                             

                                                 **TOTAL                                      
                                                 STUDENTS                                     
                                                 IN                                           
                                                 SCHOOL**                                     
  ----------- --------- ----------- --------- -- ---------- ----------- --------- ----------- ---------

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

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

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

the students in the school: % Asian

\% Black or African American

\% Hispanic or Latino

\% Native Hawaiian or Other Pacific Islander

\% White

**100% Total**

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 the 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 priced meals:
\_\_\_\_\_\_\_\_%

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

> If this is not a reasonably accurate estimate of the percentage of
> students from low‑income families or the school does not participate
> in the federally‑supported lunch program, specify a more accurate
> estimate, tell why the school chose it, and explain how it 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 narrative snapshot of the school. If the
school is recognized, the summary statement will be made available to
the press. Although the National Review Panel will not rate the summary
statement, it will provide them with important background information
for understanding the school. Limit the summary statement to no more
than two pages.

Describe the school by highlighting its vision/mission, its tradition
and milestones, the nature of the community and students served, and its
facilities. Summarize the school\'s strengths and accomplishments
focusing on what makes the 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 the school, without references to how deserving the school
is of the award and without cross references.

Include the school name, city, and state in the first sentence.

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

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

Limit the statement to one page. The vision/mission statement will not
be rated separately, but it will provide the National Review Panel with
a context for rating the 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 the 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 package. Therefore, the answers should clearly
give evidence of the exemplary programs and practices at the building
level and the flexibility the 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 the
school has been successful in achieving both excellence and equity. In
describing the school\'s achievements, the nomination must convince the
review panel that all groups within the school have contributed to and
share in the school\'s success. Responses should show sensitivity to the
full range of special needs that exist in the community and school
population. For example, as the school responds 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 is the school\'s population best described? What are the
> students' needs?** **How does the school 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 the school integrates 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 the school ensures that it includes all students who need
> nonacademic services.*
>
> **A3**. **How does the school determine and address the developmental
> needs of** **students as they move from grade to grade?** *Explain how
> the school determines that programs and services are developmentally
> appropriate. Also, describe the 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 the school address the accessibility of its
> facilities to students and others with disabilities?** *Describe what
> the school has done or plans to do to improve the school\'s physical
> accessibility.*

**B. School Organization and Culture**

> **B1**. **How does the culture of the school support the learning of
> all its members and foster a caring community?** *Describe the 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 the
> school promote a healthy peer climate among the students?** *Explain
> how the school fosters positive interactions and respect between
> students and adults and how it promotes a healthy peer climate among
> students and student groups. Describe an instance when it remedied a
> situation where a student or group of students felt less than fully
> included*.
>
> **B3. How are teachers hired in the 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 the school's plan for school safety, discipline, and
> drug prevention? What is the record for the past five years?**
> *Describe the plan and create a set of behavioral categories that is
> consistent with the school\'s safety, discipline, and drug prevention
> policies and appropriate for describing incidents ranging from minor
> to serious that occur in the school. Show how the school maintains a
> safe, orderly, and drug-free environment.* *Report incidents in terms
> of percentages of students involved for each category identified and
> give evidence about any policy or practice that is effective.*

**C. Challenging Standards and Curriculum**

> **C1. How does the 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 does
> the school place on these goals in the curriculum?** *Give specific
> examples of how the curriculum addresses, and how much emphasis the
> school places on each of these objectives (including preparation for
> higher education for high schools): 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 the school's vision/mission.*
>
> **C2**. **How is the 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 the 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 does the school 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 the
> school? What questions about curriculum is the school currently
> addressing?** *Describe the process for continuous curriculum renewal,
> including the data and resources the school uses for evaluating and
> decision-making, the participants involved in the process, and the
> impact of its implementation on teachers and students. Discuss the
> plans for future curriculum renewal.*
>
> **C5. Successful schools offer all students opportunities to be
> engaged with significant content. How does the school ensure that
> students achieve at high levels in the core subjects?** *Include a
> 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; (4) any unique or unusually effective features of the
> curriculum; and (5) (high schools only) Advanced Placement or college
> courses offered, number of students taking the courses, and percentage
> of students scoring 3 or better or receiving college credit,
> disaggregated by gender, ethnic/racial, or socioeconomic groups that
> comprise 15 percent or more of the student body of the school.*
>
> Note: if the core curriculum is organized in a manner that would be
> better explained using a framework other than the traditional subject
> areas, substitute the framework for the one listed below. However, be
> sure to explain how the essential skills and core subjects relate to
> the curriculum framework.

a.  English (Language Arts)

b.  Mathematics

c.  Science

d.  Social Studies

e.  The Arts

f.  World Languages (other than English)

> **C6. What other content areas or programs play essential roles in the
> schoolwide curriculum goals?** *Select two additional content areas or
> programs that should be highlighted because of their central
> importance to the school\'s vision/mission and priorities or because
> of the high quality, uniqueness or special significance of the
> offering. These content areas may be subsets of the core curriculum,
> for example writing or biology. Provide the same kind of information
> 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.*
>
> **C8. (High Schools Only)** **What are the course requirements for
> graduation? What percentage of the last graduating class completed
> curriculum requirements typically required for college admission? What
> percentage of the last graduating class completed a course sequence
> designed to prepare them for transition to work? What percentage of
> the graduates completed some other sequence required for graduation?**
> *On the table below list the courses and the percentage of students
> for each category. Disaggregate the percentage data for any
> ethnic/racial or socioeconomic groups that comprise 15 percent or more
> of the student body of the school. Schools with greater than a 15
> percent mobility rate may also disaggregate data to show students who
> have attended the school for at least two years and those more
> recently arrived. Explain any disparity among subgroups and what the
> school is doing to close the gaps. This table may be placed at the end
> of the nomination package with the assessment tables.*

+-----------+------------+---------+-----+-------+-----+-------+---+---+
|           | **State    | **      |     | # C   |     | *     |   |   |
|           | High       | College |     | areer |     | *Othe |   |   |
|           | School**   | Prep**  |     |       |     | r\_\_ |   |   |
|           |            |         |     |       |     | \_\_\ |   |   |
|           |            |         |     |       |     | _\_** |   |   |
+-----------+------------+---------+-----+-------+-----+-------+---+---+
| # Courses | **         | \# of   | \%  | \# of | \%  | \# of | \ |   |
|           | Graduation | A       | of  | Aca   | of  | Aca   | % |   |
|           | Requ       | cademic | Gra | demic | Gra | demic | o |   |
|           | irements** | Years   | ds. | Years | ds. | Years | f |   |
|           |            |         |     |       |     |       | G |   |
|           |            |         |     |       |     |       | r |   |
|           |            |         |     |       |     |       | a |   |
|           |            |         |     |       |     |       | d |   |
|           |            |         |     |       |     |       | s |   |
|           |            |         |     |       |     |       | . |   |
+-----------+------------+---------+-----+-------+-----+-------+---+---+
| English   |            |         |     |       |     |       |   |   |
+-----------+------------+---------+-----+-------+-----+-------+---+---+
| Ma        |            |         |     |       |     |       |   |   |
| thematics |            |         |     |       |     |       |   |   |
+-----------+------------+---------+-----+-------+-----+-------+---+---+
| Algebra I |            |         |     |       |     |       |   |   |
+-----------+------------+---------+-----+-------+-----+-------+---+---+
| Geometry  |            |         |     |       |     |       |   |   |
+-----------+------------+---------+-----+-------+-----+-------+---+---+
| Algebra   |            |         |     |       |     |       |   |   |
| II        |            |         |     |       |     |       |   |   |
+-----------+------------+---------+-----+-------+-----+-------+---+---+
| Other     |            |         |     |       |     |       |   |   |
+-----------+------------+---------+-----+-------+-----+-------+---+---+
| Social    |            |         |     |       |     |       |   |   |
| Studies   |            |         |     |       |     |       |   |   |
+-----------+------------+---------+-----+-------+-----+-------+---+---+
| Science   |            |         |     |       |     |       |   |   |
+-----------+------------+---------+-----+-------+-----+-------+---+---+
| Lab       |            |         |     |       |     |       |   |   |
| Science   |            |         |     |       |     |       |   |   |
+-----------+------------+---------+-----+-------+-----+-------+---+---+
| World     |            |         |     |       |     |       |   |   |
| Language  |            |         |     |       |     |       |   |   |
+-----------+------------+---------+-----+-------+-----+-------+---+---+
| Arts      |            |         |     |       |     |       |   |   |
+-----------+------------+---------+-----+-------+-----+-------+---+---+
| Career    |            |         |     |       |     |       |   |   |
| Related   |            |         |     |       |     |       |   |   |
+-----------+------------+---------+-----+-------+-----+-------+---+---+
| Health/   |            |         |     |       |     |       |   |   |
| Physical  |            |         |     |       |     |       |   |   |
| Education |            |         |     |       |     |       |   |   |
+-----------+------------+---------+-----+-------+-----+-------+---+---+
| Other     |            |         |     |       |     |       |   |   |
+-----------+------------+---------+-----+-------+-----+-------+---+---+
| **% of    |            |         |     |       |     |       |   |   |
| Grad.     |            |         |     |       |     |       |   |   |
| Class**   |            |         |     |       |     |       |   |   |
+-----------+------------+---------+-----+-------+-----+-------+---+---+

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

> **D1. How are teaching practices and learning experiences in the
> school consistent with current knowledge about successful teaching and
> learning?** *Explain and illustrate through examples why the teaching
> practices are appropriate for the programs or subjects in the
> curriculum and for the students.*
>
> **D2. In what ways do teaching practices support student-initiated
> learning?** *Give evidence that the 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 the 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 and
> percentage of students using the library on a regular basis and the
> nature of media services in support of learning.*
>
> *.*
>
> **D4. What technology applications is the school using? How do they
> relate to the curricular goals and how do they support teaching and
> learning?** *Describe the approach to technology and how that approach
> enhances teaching and learning. Explain how the school ensures
> equitable access to and utilization of 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 the 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 does
> the school 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 the
> 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 the 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 the 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 the school
> recognizes excellent teaching.*

**F. Leadership and Educational Vitality**

> **F1**. **How does leadership move the 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
> the school. Describe the leadership role of the principal. Provide
> concrete examples of how the 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 the school and to themselves.*
>
> **F3**. **What kind of participatory school improvement process
> operates at the school? How did the 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 the
> efforts to effect school improvement, detailing the 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 the school leadership use the most current information
> about education to promote continuous improvement in the 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 the vision/mission and
> enhance student learning.*
>
> **F5. Reflecting on the last five years, what conditions or changes
> have contributed most to the overall success of the 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 the school uses technology. Describe also how the school
> insures 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 the school to develop and
> analyze data about the school and use it as a basis for important
> decisions.*
>
> **F7. What are the major educational challenges the school must face
> over the next five years, and how does the school plan to address
> them?** *Give specific examples.*

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

> **G1. What are the goals and priorities of the school, family, and
> community partnerships? How have the school and community both
> improved as a result of these partnerships and how did the school
> measure the improvements?** *Discuss how the 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 best exemplifies the partnerships
> and describe as specifically as possible the results achieved for each
> of the participating stakeholders.*
>
> **G2. How does the 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 the school determines 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 the school program. If appropriate,
> 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 Academic Success

> **H1. What is the school's overall approach to assessment? How do the
> methods align with the educational vision/mission and curriculum? What
> questions about assessment is the school currently addressing?**
> *Provide evidence and examples of a coherent school-wide assessment
> program tied to the school\'s mission. 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 through multiple measures that
> students achieve academically.*
>
> **H2. How does the school 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. Based
> on the assessment plan, give examples of how school administrators and
> teachers use assessment data to improve teaching and learning in core
> subjects.*
>
> **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 the 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-half standard deviation above the mean or a
> normal curve equivalent (NCE) of 61; (2) or to show significant
> improvement over the past five years, that is, at least a one-half
> standard deviation increase in achievement or an 11 NCE increase in
> achievement. Explain the results.*
>
> *Even if the entire school does not achieve at or above 61 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-half standard deviation above
> the mean or 61 NCEs and that other students have improved at least
> one-half 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 the
> school. If the school does not have five years of data, present at
> least three years of data and explain why there is no data for the
> other years. If at least 90 percent of the students take the test,
> high schools should include data on the PSAT, SAT, PLAN, and ACT. If
> fewer than 90 percent take the test, do not report the data.*
>
> *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, especially state tests, can interpret them. Use the
> sample tables as a guide. Graphs and charts are not accepted and will
> not be reviewed. Present the data for each test in the following
> ways:*

a.  *Clearly label and identify each table.*

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

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

d.  *Indicate the number of students and the percentage of students
    tested.*

e.  *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 national mean and the
    national standard deviation for the test and each subtest. Report
    the mean and standard deviation in the same metric as the scores. If
    the percent tested is below 90 percent on tests other than the PSAT,
    SAT, PLAN, and ACT, explain how the results can be validly
    interpreted A table for converting percentile scores into NCEs can
    be found on the Blue Ribbon School homepage.*

f.  *Disaggregate the data for any ethnic/racial or socioeconomic groups
    that comprise 15 percent or more of the student body of the 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 the school is
    doing to close the gaps.*

g.  *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.*

h.  *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.*

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

> **H5. What criterion-referenced tests does the school use? 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-half standard deviation above the mean; (2) or to show significant
> improvement over the past five years, that is, at least a one-half
> standard deviation increase in achievement. It is also 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.
> It is especially important that schools explain the meaning of the
> data provided by state standards-based or criterion-based tests.*
>
> *Use the sample tables as a guide. Graphs and charts are not accepted
> and will not be reviewed. Present the data for each test in the
> following ways:*

a.  *Clearly label and identify each table.*

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

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

d.  *Indicate the number of students and the percentage of students
    tested.*

e.  *Disaggregate the data for any ethnic/racial or socioeconomic groups
    that comprise 15 percent or more of the student body of the 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 the school is
    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 application, continuing to
    number the pages.*

> **H6. What alternative assessments of student performance does the
> school use?** *Describe the assessments 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. Alternative assessment may include such indicators as: a
> significant increase in the number of minority students taking and
> passing higher level courses such as AP courses; a significant
> increase over time of the number of low socioeconomic students
> attending college; tests developed and given across a department (for
> example, Algebra II final exam if the test is based on national
> standards), portfolios, performance-based assessments.*
>
> **H7. What are the data for the past five years in the following areas
> that serve as quantitative indicators of the school climate and
> engagement?** *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.*
>
> *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. School-related
> absences, such as field trips, should not be counted. Compute the
> drop-off rate by dividing the number of graduates (12^th^ grade
> graduates for high schools) by the number of students in that same
> class when they were in the entering grade of the school and
> multiplying that number 100 to get the percentage drop off rate.
> Explain any discrepancy greater than the reported dropout rate.*

  ------------------------ ----------- ----------- ----------- ----------- -----------
                           2000-2001   1999-2000   1998-1999   1997-1998   1996-1997

  Daily student attendance                                                 

  Daily teacher attendance                                                 

  Teacher turnover rate                                                    

  Student dropout rate                                                     

  Student drop-off rate                                                    
  ------------------------ ----------- ----------- ----------- ----------- -----------

> **H8. Which awards received by the school, staff, or students are most
> indicative of school success?** *Limit the description of awards to 10
> or fewer and explain the reasons for the choices. Give the year each
> award was received.*
>
> **H9. (*High Schools Only*) What were the students who graduated in
> Spring 2001 doing as of September 2001?** *Report student percentages
> as specified below. Explain how the school determined the results
> reported. If the pattern of student placements has changed
> significantly in the past five years, also provide data from an
> earlier comparison year and explain the changes.*

+-----------------------------------------------------+----------------+
| Graduating class size                               | > \_\_\_\_\_   |
+-----------------------------------------------------+----------------+
| Enrolled in a 4-year college or university          | > \_\_\_\_\_%  |
+-----------------------------------------------------+----------------+
| Enrolled in a community college                     | > \_\_\_\_\_%  |
+-----------------------------------------------------+----------------+
| Enrolled in vocational training                     | > \_\_\_\_\_%  |
+-----------------------------------------------------+----------------+
| Found employment                                    | > \_\_\_\_\_%  |
+-----------------------------------------------------+----------------+
| Military service                                    | > \_\_\_\_\_%  |
+-----------------------------------------------------+----------------+
| Other (travel, staying home, etc.)                  | > \_\_\_\_\_%  |
+-----------------------------------------------------+----------------+
| Unknown                                             | > \_\_\_\_\_%  |
+-----------------------------------------------------+----------------+

**PART VI - PREVIOUSLY RECOGNIZED SCHOOLS**

> Blue Ribbon Schools seeking recognition again must highlight
> throughout the nomination package changes and improvements 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, the school must take care to
> document all claims as thoroughly as if it were 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. Has the administration or staff had any interactions with other
> schools to share some of the successful strategies and practices? How
> has the staff been involved in leadership or training programs beyond
> the school to disseminate practices and programs?**

**Part VII - 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 or technology, limit the 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 the nomination package and extend the 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**

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.

**PART VIII - 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 the school have nonprofit, tax exempt (501(c)(3) status? Yes
\_\_\_\_\_\_

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

**Part II ‑ Demographics**

3\. What are the 2001-2002 tuition rates, by grade? (Do not include
room, board, or fees)

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

K 1^st^ 2^nd^ 3^rd^

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

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

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

8^th^ 9^th^ 10^th^ 11^th^

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

12^th^ Other

 What is the educational cost per student? \$\_\_\_\_\_\_

(School budget divided by enrollment)

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

 What percentage of the annual budget is devoted to \_\_\_\_\_\_%

scholarship assistance and/or tuition reduction?

-   What percentage of the student body receives

> scholarship assistance? (Including tuition reduction) \_\_\_\_\_\_%

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

Address each of the following questions. Retype and bold all questions.
Insert each question and the 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 does the school 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.**
>
> **H7a. What number and percentage of 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.**

**[SAMPLE FORMATS FOR DISPLAYING ASSESSMENT DATA]{.underline}**

**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?
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

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

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

Report results for at least two subtests that best reflect student
academic performance at the 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.

  -------------------------------------- ----------- ----------- ----------- ----------- -----------
                                         2000-2001   1999-2000   1998-1999   1997-1998   1996-1997

  Testing month                                                                          

  **SCHOOL SCORES**                                                                      

  Total or Composite Score                                                               

  Number of students tested                                                              

  Percent of total students tested                                                       

  Number of students excluded                                                            

  Percent of students excluded                                                           

  SUBTEST SCORES                                                                         

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

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

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

If the reports use scaled scores, provide the national score and
standard deviation for the total test and each subtest.

  -------------------------------------- ----------- ----------- ----------- ----------- -----------
                                         2000-2001   1999-2000   1998-1999   1997-1998   1996-1997

  **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?
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

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

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

Report results for at least two subtests that best reflects student
academic performance at the 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.

  -------------------------------------- ----------- ----------- ----------- ----------- -----------
                                         2000-2001   1999-2000   1998-1999   1997-1998   1996-1997

  Testing month                                                                          

  **SCHOOL SCORES**                                                                      

  Total or Composite Score                                                               

  Number of students tested                                                              

  Percent of total students tested                                                       

  Number of students excluded                                                            

  Percent of students excluded                                                           

  SUBTEST SCORES                                                                         

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

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

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

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

  -------------------------------------- ----------- ----------- ----------- ----------- -----------
                                         2000-2001   1999-2000   1998-1999   1997-1998   1996-1997

  **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 the 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
students are scoring at a significantly high level.

Explain the 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

  -------------------------------------- ----------- ----------- ----------- ----------- -----------
                                         2000-2001   1999-2000   1998-1999   1997-1998   1996-1997

  Testing month                                                                          

  **SCHOOL SCORES**                                                                      

  Total or Composite Score                                                               

  At or Above Proficient                                                                 

  At or Above Excellent                                                                  

  Number of students tested                                                              

  Percent of total students tested                                                       

  Number of students excluded                                                            

  Percent of students excluded                                                           

  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 when
reporting 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 when
reporting 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