responsible or for which it receives financial assistance from the U.S. Department of Education or the Michigan Department of Education. Certification for Participation as Grant Member Partnerships must consist of a local or intermediate school district, high school, early/middle college, a public community college or university, and a business and industry partner. List all participating partnership members below. Signature by the authorized representative indicates that the grant member will work cooperatively with the administrative and fiscal agent for this project. Certification of Agency Designated as Administrative and Fiscal Agent for this Project: (Local or Intermediate School District ONLY) Legal Name of Agency: District Code: Signature: (Name and Title of Authorized Representative): Mailing Address: Street: City, Zip: Signature: Date Signed: Telephone: Name and Title of Contact Peron: Mailing Address (if different from agency address) Certification of Participating Agency: Legal Name of Agency: District Code: Signature: (Name and Title of Authorized Representative): Mailing Address: Street: City, Zip: Signature: Date Signed: Telephone: Name and Title of Contact Peron: Mailing Address (if different from agency address) Certification of Participating Agency: Legal Name of Agency: District Code: Name and Title of Authorized Representative) Mailing Address: Street: City, Zip: Signature: Date Signed: Telephone: Name and Title of Contact Peron: Mailing Address (if different from agency address) Certification of Participating Agency: Legal Name of Agency: District Code: Name and Title of Authorized Representative) Mailing Address: Street: City, Zip: Signature: Date Signed: Telephone: Name and Title of Contact Peron: Mailing Address (if different from agency address) Certification of Participating Agency: Legal Name of Agency: District Code: Name and Title of Authorized Representative) Mailing Address: Street: City, Zip: Signature: Date Signed: Telephone: Name and Title of Contact Peron: Mailing Address (if different from agency address) Certification of Participating Agency: Legal Name of Agency: District Code: Name and Title of Authorized Representative) Mailing Address: Street: City, Zip: Signature: Date Signed: Telephone: Name and Title of Contact Peron: Mailing Address (if different from agency address) Certification of Participating Agency: Legal Name of Agency: District Code: Name and Title of Authorized Representative)
A description of the evaluation plan for each of the activities. Description of the metrics to measure the effectiveness of the project. Includes growth data on program improvement, retention, and development of student and adult learner skills. Budget and budget detail. 2017-2018 CTE Innovation and Equipment Competitive Grant Grant Budget Approval Form Instructions: The Budget Summary and the Budget Detail must be prepared by or with the cooperation the Business Office, using the School District Accounting Manual (Bulletin 1022 found at .) Budget Summary: Budget: Objects: Function Code*: Function Title: Salaries: Benefits: Purchased Services: Supplies & Materials: Capital Outlay Other Expenditures: Total Expenditures: 110 Instruction – Basic Programs 120 Instruction – Added Needs 130 Instruction – Adult/ Continuing Education 210 Pupil Support Services 220 Instructional Staff Services 230 General Administration 240 School Administration 253 Facility Acquisition & Construction Services 260 Operation & Maintenance 270 Pupil Transportation Services 280 Central Support Services 290 Other Support Services Subtotal: TOTAL: (*http://www.michigan.gov/documents/appendix_33974_7.pdf-go to page 23) Transaction Purpose: Original Amendment Date Fiscal Agent Contact Person Signature
Amount of Change: (use minus sign preceding decreases) $ Date Project Contact Person Signature Budget Detail: Explain each line item that appears on the Budget Summary, using the indicated function code and title (provide attachments as needed). Function Code*: Function Title: Budget Detail 110 Instruction – Basic Programs 120 Instruction – Added Needs 130 Instruction – Adult/ Continuing Education 210 Pupil Support Services 220 Instructional Staff Services 230 General Administration 240 School Administration 253 Facility Acquisition & Construction Services 260 Operation & Maintenance 270 Pupil Transportation Services 280 Central Support Services 290 Other Support Services (*http://www.michigan.gov/documents/appendix_33974_7.pdf-go to page 23)