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					                  Wisconsin Department of Public Instruction                     INSTRUCTIONS: mail two (2) copies via U. S. mail to address
                  CARL PERKINS FORMULA ALLOCATION                                below. Also, submit two (2) original certification pages (Page 2) and
                  APPLICATION FOR CONSORTIUMS                                    contracts (Page 13 or 14) to:
                  Annual Request for Program of Study Funds                           WISCONSIN DEPARTMENT OF PUBLIC INSTRUCTION
                  PI-1303-F (Rev. 07-10)                                              ATTN: MARILYN BACHIM
                                                                                      CAREER AND TECHNICAL EDUCATION TEAM
                                                                                      P. O. BOX 7841
                                                                                       MADISON, WI 53707-7841
                                                                                 Electronically submit application (except POS Charts) through
                                                                                 Accellion secure file transfer:
Collection of this information is a requirement of PL 109-270.                   https://moveit.dpi.wi.gov/courier/1000@/mail_user_login.html
To assist an applicant when working with templates, activate the show/hide button located on the Standard Toolbar above [it looks
like a paragraph symbol (¶)]. When the show/hide button is activated, the applicant will see the areas on the template that need to be
completed. (°°°°°). The applicant needs to tab, rather than mouse, to move to the areas of the template that have been programmed
to receive information.

                                                     SECTION I—ADMINISTRATIVE PROVISIONS

PART A—Cover Sheet
Applicant Agency Name                                                                                                 District or CESA (4 Digit) Code

    Wisconsin School District                                                                                                         9999
LVEC/CTE Coordinator Name

    Bucky Badger
LVEC/CTE Coordinator Agency Address Building Name

    CTE Coordinator
Street Address                                                            City                                        State        Zip

    9999 University Avenue                                                    Heaven                                     WI                 99999
LVEC/CTE Coordinator Phone Area/No.           LVEC/CTE Coordinator Fax Area/No.          LVEC/CTE Coordinator E-Mail

    (608) 999-9999                                (608) 999-9990                             bbadger@heavenk12.wi.us

PART B—General Assurances
 1. The eligible recipient shall provide assurances that the eligible recipient will provide a program that is of such size, scope, and quality to bring about
    improvement in the quality of career and technical programs. (Fed. Req. #6)
 2. A DPI certified LVEC/CTE Coordinator shall be employed by the fiscal agent and shall fully oversee all aspects of the project—planning,
    evaluation, improvement, and implementation of the project.
 3. The district will require the entity and its principals involved in any sub-tier covered transaction paid through federal funds, that requires such
    certification, to ensure it/they are not debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation
    by a federal department or agency. (EDGAR-Part 85)
 4. The school board agrees to follow the Department of Public Instruction’s Fiscal Agent Policy.
 5. Administration of the program, activities, and services covered by this application will be in accordance with all applicable state and federal statutes,
    regulations, program plans, and the approved application.
 6. The school district will adopt and use proper methods of administering such program, including (a) the enforcement of any obligations imposed by
    law on agencies, institutions, organizations, and other recipients responsible for carrying out each program; or (b) the correction of deficiencies in
    program operations that are identified through audits, monitoring, or evaluation.
 7. No funds received under this Act may be used to provide programs to students prior to the seventh grade, except that equipment and facilities
    purchased with funds under this Act may be used by such students.
 8. No funds made available under this Act may be used (1) to require any secondary school student to choose or pursue a specific program of study
    or major; and (2) to mandate that any individual participate in a program, including a program that requires the attainment of a federally-funded skill
    level, standard, or certificate of mastery.
 9. None of the funds expended under any applicable program will be used to acquire equipment (including computer software) in any instance in
    which such acquisition results in a direct financial benefit to any organization representing the interests of the purchasing entity or its employees or
    any affiliate of such an organization.
10. The control of funds provided to the Local Educational Agency (LEA) under each program, and title to property acquired with those funds, will be in
    the public agency and that a public agency will administer those funds and property.
11. The LEA will provide reasonable opportunities for the participation by teachers, parents, and other interested agencies, organizations, and
    individuals in the planning for and operation of each program.
12. The LEA has adopted effective procedures for acquiring and disseminating to teachers and administrators participating in each program the
    significant information from educational research, demonstrations, and similar projects, and for adopting, where appropriate, promising educational
    practices developed through such projects.
Page 2                                                                                                                                          PI-1303-F
13. The programs and services provided under this grant will be used to address the needs set forth in the application and fiscal related information will
    be provided within the fiscal year timelines established for new, reapplying, and/or continuing programs.

                                                SECTION I—ADMINISTRATIVE PROVISIONS (cont’d.)
PART B—General Assurances (cont’d.)
14. No board or staff member of a LEA will participate in, or make recommendations with respect to, an administrative decision regarding a program or
    project if such decision can be expected to result in any benefit or remuneration, such as a royalty, commission, contingent fee, brokerage fee,
    consultant fee, or other benefit to him or her or any member of his/her immediate family.
15. Applicant shall comply with all federal and state reporting requirements, a year-end report, quarterly fiscal reports, and other data surveys
    conducted through federal and state resources.
16. The applicant will file financial reports and claims for reimbursement in accordance with procedures prescribed by the Department of Public
    Instruction.
17. The LEA will use fiscal control and fund accounting procedures that will ensure proper disbursement of, and accounting for, federal funds paid to
    that agency under each program.
18. The activities and programs that will be performed under this grant will be used to supplement services and not supplant funds from non-federal
    sources.
19. Each agency receiving funds under this grant shall use these funds only to supplement, and not to supplant state and local funds that, in the
    absence of such funds would otherwise be spent for activities under this section.
20. Each applicant shall develop and describe in the application the steps to ensure equitable access to, and equitable participation in, the project or
    activity to be conducted with such assistance, by addressing the special needs of students, teachers and other program beneficiaries in order to
    overcome barriers to equitable participation, including barriers based on gender, race, national origin (includes limited English proficiency), color,
    disability, and age. (Section 427 of GEPA)
21. The school district will comply with civil rights and nondiscrimination requirement provisions and equal opportunities to participate for all eligible
    students, teachers, and other program beneficiaries.
22. The programs and services provided with federal funds under this grant will be operated so as not to discriminate on the basis of age, gender, race,
    national origin, ancestry, religion, creed, pregnancy, marital or parental status, sexual orientation, or physical, mental, emotional, or learning
    disabilities.
23. Equal access to relevant training and activities shall be provided to meet the needs of males and females who desire to enter occupations that are
    not traditionally associated with their gender.
24. The LEA will evaluate its program periodically to assess its progress toward achieving its goals and objectives and use its evaluation results to
    refine, improve, and strengthen its program and to refine its goals and objectives as appropriate; and that any application, evaluation, periodic
    program plan or report relating to each program will be made readily available to parents and other members of the general public.
25. The school district will cooperate in carrying out any evaluation of this program conducted by or for the state educational agency, the secretary, or
    other federal officials.
26. The LEA will make reports to the state agency or board and to the Secretary as may reasonably be necessary to enable the state agency or board
    and the Secretary to perform their duties and that the local educational agency will maintain such records, including the records required under
    section 1232f of this title, and provide access to those records, as the state agency or board or the Secretary deem necessary to perform their
    duties.
27. Applicant shall adhere to the Stevens Amendment Disclosure (PL 102-141, Section 23, and PL 102-170, Section 511) when issuing statements,
    press releases, requests for proposals, bid solicitations, and other documents and products describing projects or programs funded in whole or in
    part with federal money, all grantees, including but not limited to state and local governments, shall clearly state: the percentage of the total cost of
    the program or project which will be financed with federal money and the dollar amount of federal funds awarded to the project or program.

 PART C—Certification and Signatures
 THE FOLLOWING SCHOOL OFFICIALS AND STAFF HEREBY AGREE to comply with federal and state regulations regarding maintenance and
 audits of records in such a way as a) to avoid commingling of CPA and other funds, b) to submit necessary reports and data; and certify that the
 information provided in this application is true and correct to the best of our knowledge, information, and belief, and that the required assurances are
 given. All approved programs, services, and activities will be conducted in accordance with state and federal laws, rules, and regulations and in
 accordance with Wisconsin Department of Public Instruction policies and program standards.
 Name and Title of Fiscal Agent Administrator for Project (District Administrator) Typed

     Cheesy Martinez O'Brien
 Signature of Fiscal Agent Administrator for Project (District Administrator)                                         Date Signed Mo./Day/Yr.

 
 Name and Title of Administrator Responsible for Project (LVEC/CTE Coordinator) Typed

     Bucky Badger, CTE Coordinator
 Signature of Administrator Responsible for Project (LVEC/CTE Coordinator)                                            Date Signed Mo./Day/Yr.

 
PI-1303-F                                                                                                                           Page 3

                                                     SECTION I—ADMINISTRATIVE PROVISIONS
PART D—Consortium Roster of LEA Designees Names identified below are automatically placed in the Secondary Leaders/Administrators in CTE
Directory. Copy using the embedded file below as many pages as needed.
1. Participating District List each individual LEA                                                             Telephone Area/No.
   District A                                                                                                      (608) 991-9999
   Name of LEA Designee                                               Position/Title                           Fax Area/No.
   Liliath Smith                                                      CTE Coordinator                              (608) 991-9998
   Address of LEA Designee Street, City, State, Zip                                          E-Mail Address
   902 Hitchcock Trail Little Trail WI 99999                                                 lsmith@districtA.k12.wi.us
2. Participating District List each individual LEA                                                             Telephone Area/No.
   District B                                                                                                      (608) 991-9989
   Name of LEA Designee                                               Position/Title                           Fax Area/No.
   Wayne Benson                                                       CTE Coordinator                              (608) 991-9988
   Address of LEA Designee Street, City, State, Zip                                          E-Mail Address
   110 Hiawatha Trail Highpoint WI 99998                                                     wbenson@districtB.k12.wi.us
3. Participating District List each individual LEA                                                             Telephone Area/No.
   District C                                                                                                      (608) 991-9979
   Name of LEA Designee                                               Position/Title                           Fax Area/No.
   Sven Hilgenson                                                     CTE Coordinator                              (608) 991-9978
   Address of LEA Designee Street, City, State, Zip                                          E-Mail Address
   9009 W Smith Avenue Arkansaw WI 99997                                                     hilgensons@districtC.k12.wi.us
4. Participating District List each individual LEA                                                             Telephone Area/No.
   District D                                                                                                      (608) 991-9969
   Name of LEA Designee                                               Position/Title                           Fax Area/No.
   Joseph Linz                                                        CTE Coordinator                              (608) 991-9968
   Address of LEA Designee Street, City, State, Zip                                          E-Mail Address
   10 Mercury Boulevard Yount WI 99996                                                       linz@districtD.k12.wi.us
5. Participating District List each individual LEA                                                             Telephone Area/No.
   District E                                                                                                      (608) 911-9999
   Name of LEA Designee                                               Position/Title                           Fax Area/No.
   Rosalind Kind                                                      CTE Coordinator                              (608) 911-9998
   Address of LEA Designee Street, City, State, Zip                                          E-Mail Address
   Fortune Square Hello WI 99995                                                             kind@districtE.k12.wi.us
6. Participating District List each individual LEA                                                             Telephone Area/No.
   District F                                                                                                      (608) 914-6700
   Name of LEA Designee                                               Position/Title                           Fax Area/No.
   Holly Albright                                                     CTE Coordinator                              (608) 914-6710
   Address of LEA Designee Street, City, State, Zip                                          E-Mail Address
   100 Main Street Gotcha WI 99988                                                           albright@districtF.k12.wi.us
7. Participating District List each individual LEA                                                             Telephone Area/No.
   District X                                                                                                      (608) 903-9111
   Name of LEA Designee                                               Position/Title                           Fax Area/No.
   June Audley                                                        CTE Coordinator                              (608) 903-9110
   Address of LEA Designee Street, City, State, Zip                                          E-Mail Address
   191 Packerland Juneau WI 99962                                                            jaudley@districtX.k12.wi.us
8. Participating District List each individual LEA                                                             Telephone Area/No.
   District Y                                                                                                      (608) 632-9990
   Name of LEA Designee                                               Position/Title                           Fax Area/No.
   Walker Bryant                                                      CTE Coordinator                              (608) 631-9998
   Address of LEA Designee Street, City, State, Zip                                          E-Mail Address
   10 Hopscotch Circle Battle Creek WI 99910                                                 wbryant@districtY.k12.wi.us
Page 4                                                                                                                                    PI-1303-F

                                              SECTION I—ADMINISTRATIVE PROVISIONS (cont’d.)

 If the applicant has more than eight districts in the consortium, identify additional LEA Designees by using the embedded
 file. Double-click to open and save file to desktop.
 The applicant must use the following format when naming the file:
          12 (applicant agency) Section I PART D—1
 For each additional file created, continue with this numbering sequence.
 Upon completion of the LEA Designee file, the applicant must mouse to PART E. Do not tab as this will create a new row.

 PART E—Justification
 LEA Designee must be a vocationally certified teacher and a member of the CPA consortium council. Written justification must be provided below for
 each LEA Designee who is not a vocationally certified teacher and a member of the CPA consortium council.
PI-1303-F                                                                                                                                            Page 5
                                              SECTION IX—COMPLIANCE WITH CORE INDICATORS
                                                          AND STATE INITIATIVES

 Compliance with CPA Federal Core Indicators and State Initiatives (Fed. Req. #2)
 The applicant completes Part A and Part B. The “source document” for compliance with federal CPA Core Indicators and State Initiatives is the FY
 ’09 District Profile. The report is available on the DPI website at http://www.dpi.wi.gov/cte/veersprofiles.html Using the coding on the ’09 District
 Profile; indicate compliance/non-compliance with each of the Federal Core Indicators and State Initiatives and Continuous Improvement compliance.
 In addition, each strategy to be used to bring a school district into compliance with the Federal Core Indicators and State Initiatives must be identified
 as an Activity in the Operational Plan (embedded Excel workbook, Section X). Enter the corresponding Section X, Part C, Activity Number in this
 chart.

  Complete a chart using the embedded file for each participating district in the consortium. Double-click to open and save file to
  desktop. The applicant must use the following format when naming the file and for each additional file created, continue with
  this naming sequence.
                                                                                                                                        PI-1303-F SECTION
            12 (school district name) Section IX
                                                                                                                                                IX
  For each additional file created, continue with this numbering sequence.
Page 6                                                                                                                       PI-1303-F

                                                        SECTION X—PROGRAMS OF STUDY

 PART A—Program of Study Chart [Fed. Req. #3 (A)]

 1.   The applicant completes a Program of Study Chart using the embedded Excel workbook for each selected Program of
      Study. Double-click to open workbook and save file to desktop.
      An applicant must use this chart or an applicant may submit a POS in a locally-developed format as long as the
      following criteria are met:



       Chart must label the Pathway name for each Program of Study,
       Chart must be at the Pathway level, not Cluster level,
       Chart must reflect both academic and Career and Technical Education courses critical to the Pathway, and
       Chart must reflect secondary sequences of coursework that results in a post-secondary industry related credential,
         certificate, associate or bachelor’s degree.
       Chart  must reflect post-secondary sequence of coursework that results in a post-secondary industry related
         credential, certificate, associate or bachelor’s degree or website address with post-secondary sequence of
         coursework.
      EXEMPTION—For a local school district which is at the “planning stage” for development of a Program of Study, a
      POS Chart does not need to be completed at this time.
      EXEMPTION—If the POS Chart has been published on the Wisconsin Career Pathways website,
      http://www.wicareerpathways.org/, the applicant is not required to submit a POS Chart with the 2011-12 application
      materials.
 Upon completion of the Excel workbook, the applicant must mouse to PART B. Do not tab as this will create a new row.
PI-1303-F                                                                                                                                      Page 7

                                                     SECTION X—PROGRAMS OF STUDY (cont’d.)

 PART B—Program of Study Description Complete one chart per Program of Study. Double-click to open the following field to allow selection of
 the Cluster Name and the associated Program of Study. If a security macro dialog box opens, click the enable macro button. [Fed. Req. #3 (A)]
 Applicant Agency Name

      Wisconsin School District

  Cluster                                                              Program_of_Study
  Health Science                                                       Therapeutic Services
 Upon completion of the Program of Study fields above, the applicant must mouse to question 1. Do not tab as this will create a new row.

 1.   This Program of Study prepares students for occupations that are: Check all that apply but a minimum of one.

            High Skill         High Wage              High Demand

 2.   Does labor market information (LMI) described in PI-1303-B, Section II.3 support the selection of the Program of Study?

            Yes                No


 3.   What other information was used in the selection of the Program of Study? Check all that apply.
                Advisory Committee Identified Need                               Strong Existing Articulation Agreements

                Community Priority                                               Student Interest

                Employer Identified Need                                         Teacher Identified Need

                Post-secondary partner                                           Tech Prep Consortia

                Other—Describe:


 4.   Who are the partners and how are they involved in the selection, development, implementation, and refinement of this Program of Study?

      The Administration within the consortium school districts have actively supported the development of Program of Study. The
      administration within the consortium schools have and continues to support the development of agreements with the technical
      college to offer students seamless transition options. The consortium districts this year have provided release time for staff
      development and collaboration on the Programs of Study. The consortium districts also support the development and
      curriculum writing time to support articulation agreements with the local technical college partners to strengthen the POS.
      School board members within the consortium schools are fully educated on the POS in all the districts. The BOE will continue
      to work with districts on the adoption of the knowledge and skills and alignment to the 21st Century skills as the POS moves
      further into implementation and refinment stages. The school boards also continue to learn about the blending of the Programs
      of Study with the School Counseling Model and academic courses. The school boards also recently approved the E4E plans
      for each of the districts which provided detail related to this POS and CTE programming.
      All consortium districts currently have an evaluation process for students within CTE and provide data related to the
      curriculum and career development. These evaluations will continue to be used as the POS model moves further into the
      implementation/refinment stage. As this model become further integrated into the school, students and parents will be used for
      further evaluation and additional benchmarks will be measured.
      The school counselors within each of the districts have completed Level I and Level II training. The school counselors have
      been exposed to career clusters and Programs of Study. The counselors have also been involved in networking events with
      other consortium schools and technical college partners. The school counselors are using career software progams and working
      on the implementation of ILPs for students. All districts utilize WISCareers. Next year the school counselors and CTE and
      academic instructors will be involved in pathway updates and refinment during in-service days and professional development
      provided through post-secondary partnerships.
      The Tech Prep coordinator has been working with instructors/districts to assist in the development and refinment of the courses
      that are offered for dual credit. There is more emphasis placed within the Tech Prep grant to support staff development and
      release time to create additional agreements with high school partners. The Technical College advisory board also drives
      program improvement at the secondary level and affects the sequencing in the POS. The techical college also supports the
      marketing of services and programming available to students as they move from high school into post-secondary education and
      works with families to seek scholarships, tutoring and financial aid options.
5.    Consortium’s Progress on Wisconsin POS Implementation Model
                                                                                Wisconsin POS Implementation Model Progress Rating*




                                                                                                                                                 and Continuous
                                                                                                Counseling and




                                                                                                                 Curriculum and




                                                                                                                                                 Accountability
                                                                                                School Career




                                                                                                                                  Planning and
                                                                                                Development




                                                                                                                                                 Improvement
                                                                                  Foundations




                                                                                                                 Instruction

                                                                                                                                  Transition
                                                                                                                 Rigorous
                                                                                  General




                                                                                                                 Quality
                                                                                                Career




                                                                                                                                  Policy
                                 Representative CTE        Representative CTE
     Participating District        Teacher Name               Teacher Title
District A                    Bear Bryant                 HS Teacher                D                D                D               D              D

District B                    Michael Jordan              HS Teacher                D                D                D               D              D

District D                    Joanne Nitschke             HS Teacher                D                D                D               D              D

District E                    Hope Wells                  HS Teacher                D                D                D               D              D

District F                    Tabitha Doche               HS Teacher                D                D                D               D              D

District X                    Elspeth Mynart              HS Teacher                D                D                D               D              D

District Y                    Jessica Elps                HS Teacher                D                D                D               D              D

District Z                    Nathaniel Doborowski        HS Teacher                D                D                D               D              D




*Progress Rating Key: D=Initial Development; I=Implementation; R=Refinement.
                                                  SECTION X—PROGRAMS OF STUDY (cont’d.)
6.   Summarize the progress/status on the five elements (Wisconsin POS Implementation Model) for this Program of Study prior to this application.

     6.a. General or Foundations Summarize what is in place to support this rating. Describe any differences among districts in the consortium.

          Leadership and stakeholder groups have been developed in all 8 districts. Business partnerships are being formed. There
          is support from administration and also the technical college system. A 5 year plan for development of this Program of
          Study was developed last year.
     6.b. School Counseling and Career Development Summarize what is in place to support this rating. Describe any differences among districts in
          the consortium.

          All 8 school districts have adopted and completed training in the WCSCM, Level 1 and 2. Further integration of the ILP
          process is being developed. School Counselors have been trained and provide support related to POS.
     6.c. Rigorous Curriculum and Quality Instruction Summarize what is in place to support this rating. Describe any differences among districts in
          the consortium.

          All 8 districts offer CNA training which increases Health options for students. Students also have the option to take
          courses through Youth Options offering seamless transition for students. The curriculum in all 8 districts is reinforced
          through application and practice. The 8 districts have or are developing a process to align programs to academic standards.
          6 districts will develop a crosswalk of Career Pathway knowledge and skills to the content of secondary and post-
          secondary programs/courses The other two districts did this last year.
     6.d. Transition Planning and Policy Summarize what is in place to support this rating.       Describe any differences among districts in the
          consortium.

          Career development is present in all 8 districts. Students have the opportunity to participate in WBL, Youth
          Apprenticeships and other student leadership activities. Articulation agreements are reviewed on an annual basis and staff
          attend Tech Prep meetings to learn more about post-secondary connections related to POS.
     6.e. Accountability and Continuous Improvement Summarize what is in place to support this rating. Describe any differences among districts in
          the consortium.

          Measures to evaluate CTE and POS are being identified. Districts have informal evaluation processes in place. More
          work will be done across the consortium and with the assistance from post-secondary to identify measure of success. All
          of the districts do have an understanding of the Perkins Core Indicators.
If the applicant has more than one Program of Study, use the embedded file to complete a Program of Study Description for
each selected Program of Study. Double-click to open and save file to desktop.
The applicant must use the following format when naming the file:
          12 (fiscal agent name) Section X PART B—POS abbreviate name of the Pathway
For each additional file created, continue with this naming sequence.
Upon completion of the Program of Study Description, the applicant must mouse to PART C. Do not tab as this will create a new row.
Page 10                                                                                                                                   PI-1303-F

                                                  SECTION X—PROGRAMS OF STUDY (cont’d.)

 PART C—Program of Study Operational Plan [Fed. Req. #3 (A)]
 1.   Provide a description using the embedded Excel workbook of how the applicant plans to budget CPA money for
      Programs of Study. Double-click to open workbook and save file to desktop.

                                                                                                                              SAMPLE 2011-12
                                                                                                                             CPA Operational Plan.xls

 Upon completion of the Excel workbook, the applicant must mouse to question 2. Do not tab as this will create a new row.

 2.   Provide a rationale for all budgeted items identified in Operational Plan. Organize by Program of Study and follow the same sequence as the
      tables on the Operational Plan. Identify each Participating District in the Program of Study and corresponding cost (a chart is an acceptable
      alternative).

      MULTIPLE PROGRAMS OF STUDY
      WCSCM and Special Needs Transition Training to _______(Rationale is "THE WHY")_______________________ Travel.
      School A=$450; School B= $450; School D=$450; and School E=$450.
      W1/Develoment of improved classroom teaching resources/strategies in CTE courses to________(Rationale is "THE WHY"--
      meet needs of special pops_________)/Released Time and Supplies. School A=$187.50; School B=$287.50; School
      C=$287.50=; School D=$287.50; School E=$287.50; School X=$287.50; School Y=$287.50; School Z=$387.50.
      Development of other career counseling training/Travel. School A=$400; School B=$100; School C=$245.
      NATURAL RESOURCE SYSTEMS
      Update natural resources instructional materials to ________(Rationale is "THE WHY")_____________________/Substitutes,
      Resources, and Travel Costs. School A=$500; School B=$600. and School C=$400.
      Development of articulation agreement with ____ technical college and ____ university to ____________(Rationale is "THE
      WHY")_____________/Substitutes and Travel Costs; School A=$150; School B=$200; School C=$150.
      Align instructional practices with 21st Century Skills to______(Rationale is "THE WHY")_________________/Substitutes
      and Training Costs; School A=$500; School B-$500, and School C=$500.
      THERAPEUTIC SERVICES
      Field trips to _____ and ____health care facilities for________(Rationale is "THE "WHY)______/Substitutes andTravels
      Costs. School D=$50; School E=$50; School F=$50; School X=$50; School Y=$50, and School Z=$50.
      Crosswalk of Knowledge and Skills between ____________________secondary courses and ___________ post-secondary __
      program to ______________(Rationale is T"HE WHY) ___________________/Substitutes and Travel Costs; School A=$200;
      School B=$300; School D=$100; School X=$100, School Y=$200; School Z=$300;
      _________ teachers and _______________ administrator attending conferences related to this POS to ________(Rationale is
      "THE WHY")_______________/Substitutes and Travel Costs; School A=$300, School B=$400, School D=$600; School
      X=$300, School Y=$200, and School Z=$200.
      Foster employer relationships to ___________________(Rationale is "THE WHY") __________________________/Extended
      Contract and Supplies. School A=$350; School B=$400; School D=$500, School X=$500; School Y=$250; and School
      Z=$500.
      MAINTENANCE, INSTALLATION, AND REPAIR
      Certification training to (_________________(Rationale is "THE WHY")--foster the teaching of industry standards in the
      classroom__________________)/Extended Contract, Registration, and Travel Costs. School A=$300; School B=$200; School
      C=$300; School D=$500, School E=$500; School F=$500; School X=$500; School Y=$500; and School Z=$500.
      Implement state-of-the art POS (_____________(Rationale is "THE WHY")--shared by all districts and supported by
      business/industry standards)_______________/Equipment and Resources. Host School A=$40,000. Anticipated equipment
      request includes ________________________________________________.
PI-1303-F                                                                                                                                   Page 11

                                                   SECTION XI—SUMMARY OF USE OF CPA FUNDS
Summary of Use of CPA Funds
Summarize costs by the following use of funds:
                                                                                                                           Federal Amount Budgeted
Program of Study: Required Uses of Funds
                                                                                                                                    FY ‘12

R1     “Integrate academics with CTE programs through a coherent sequence of courses                                               $2,700

R2     Link CTE at secondary level and CTE at post secondary level                                                                   $500

       Provide students with strong experience in and understanding of all aspects of an industry which may include
R3
       work-based learning experiences

R4     Develop, improve, or expand the use of technology in CTE

       Provide professional development programs to teachers, faculty, counselors, and administrators involved in                  $2,000
R5
       integrated CTE programs

       Develop and implement evaluations of CTE programs including an assessment of how the needs of special
R6
       populations are being met

R7     Initiate, improve, expand, and modernize quality CTE programs including relevant technology                                $40,000

R8     Provide services and activities that are of sufficient size, scope and quality to be effective

       Provide activities to prepare special populations for high skill, high wage, or high demand occupations that will
R9
       lead to self-sufficiency”

Program of Study: Permissible Uses of Funds

       “Involve parents, businesses, and labor organizations in the design, implementation, and evaluation of CTE                  $7,500
P1
       programs

       Provide career guidance and academic counseling for students participating in CTE programs that improves
P2     graduation rates and provides information on post-secondary career options (including baccalaureate degree                  $5,145
       programs)

       Local education and business (including small business) partnerships including work-related experience for
P3     students, (internships, co-op education, school-based enterprises, entrepreneurship, and job shadowing related
       to CTE), adjunct faculty arrangements for teachers and faculty, and industry experience for teachers and faculty

P4     Provide programs for special populations

P5     Assist CTE student organizations

P6     Provide mentoring and support services

       Leasing, purchasing, upgrading or adapting equipment, including instructional aides and publications designed to
P7
       strengthen and support academic and technical skill achievement

P8     Provide teacher preparation programs that address the integration of academic and CTE

       Develop/expand postsecondary program offerings and at times in formats accessible for students including
P9
       through distance learning

       Develop initiatives that facilitate the transition of sub-baccalaureate CTE students into baccalaureate degree
P10
       programs

P11    Improve or develop new CTE courses

P12    Develop and support small, personalized career-themed learning communities

P13    Provide support for family and consumer sciences programs
                                                    SECTION XI—SUMMARY OF USE OF CPA FUNDS
 Summary Of Use Of CPA Funds
 Summarize costs by the following use of funds:

 Program of Study: Permissible Uses of Funds

        Provide CTE programs for adults and school dropouts to complete secondary school education, or upgrade the
 P14
        technical skills, of the adults and school dropouts
        Provide assistance to individuals with previous participation in continuing education or training, or finding an
 P15
        appropriate job

 P16    Support training and activities in nontraditional fields

 P17    Provide support for training programs in automotive technologies

        Pool a portion of funds to not less than one other eligible recipient for innovative initiatives such as initial
 P18
        preparation and professional development, accountability systems, or technical assessments

 P19    Support other activities that are consistent with the purpose of this Act

 P20    Administrative Funds*                                                                                                $755

                                                                                    Total Requested for Application**      $58,600

* No more than 5 percent can be used for administrative costs.
** Sum must equal project request; i.e., total on PI-1303, Section X, Part .C and PI-1303-A, Section III.
PI-1303-F                                                                                                                                                 Page 13

                                                        SECTION XII—CONSORTIUM CONTRACTING
Part A—CESA Services Agreement Complete for each participating school district. Submit two originals of signed contract for one participating school
district. (Fiscal Agent locally retains one copy of signed contract for all participating districts.)

 Fiscal Agent CESA Name



 CESA Member Districts Include all members of the consortium.




 SAID SCHOOL DISTRICTS HEREBY MUTUALLY AGREE TO THE FOLLOWING CONDITIONS THAT
    said parties agree and contract for the cooperation of career and technical education programs, under the Carl D. Perkins Career and Technical
     Education Improvement Act of 2006 (PL 109-270);
    the CESA is to be the operator and fiscal agent of the Carl Perkins consortium;
    the annual budget for the cooperative program shall be approved by the school board of each participating school district prior to the beginning of
     the fiscal year.
    CESA Board of Control agrees to follow DPI’s Fiscal Agent Policy;
    the CESA agrees to file a Carl Perkins plan with an annual application and the required reports with the Department of Public Instruction;
    the CESA agrees to be prepared to assist school districts as requested and required with implementation of the Operational Plan;
    the CESA will utilize appropriate accounting procedures within Wisconsin Uniform Financial Accounting Requirements;
    all purchased resources will remain the property of the consortium;
    a plan for the final disposition of equipment, facilities, and materials that are purchased with CPA funds will be provided by the CESA;
    each school district will adhere to the CPA assurances as listed within the application and maintain records and other support materials to ensure
     all assurances are being met;
    student membership for state aid purposes be counted by the district of residence;
    transportation, if required, is to be furnished by the individual school district; special transportation aid shall also be claimed by the school district of
     residence;
    the budget and Operational Plan for this cooperative/consortium shall be developed by the CESA Fiscal Agent LVEC/CTE Coordinator and the
     Consortium Council;
    the CESA agrees to coordinate and/or maintain all materials and data to assure that the consortium and individual school districts are meeting
     federal and state requirements dealing with monitoring, fiscal reporting (including budget modifications), student reporting, and other related items
     that impact upon the requirements of the Carl D. Perkins Career and Technical Education Improvement Act of 2006 (PL 109-270).

 This agreement shall be effective for a          period for the school year(s)          .
 THE SCHOOL DISTRICT OF                  AGREES TO THE ABOVE TERMS, AND HEREBY AFFIXES THE APPROPRIATE SIGNATURE.

 District Administrator Signature                                                                                                     Date Signed Mo./Day/Yr.

 
 Board President Signature                                                                                                            Date Signed Mo./Day/Yr.

 
 Board Clerk Signature                                                                                                                Date Signed Mo./Day/Yr.

 
 CESA       AGREES TO THE ABOVE TERMS, AND HEREBY AFFIXES THE APPROPRIATE SIGNATURES
 CESA Board of Control Representative Signature                                                                                       Date Signed Mo./Day/Yr.

 
 CESA Administrator Signature                                                                                                         Date Signed Mo./Day/Yr.

 
 CESA LVEC/CTE Coordinator Signature                                                                                                  Date Signed Mo./Day/Yr.

 
Page 14                                                                                                                                         PI-1303-F

                                                 SECTION XII—CONSORTIUM CONTRACTING (cont’d.)
Part B—66.03 Agreement Complete for each participating school district. Submit two originals of signed contract for one participating school district.
(Fiscal Agent locally retains one copy of signed contract for all participating districts.)

 Fiscal Agent School District Name

      Wisconsin School District
 Consortium Member Districts Include all members of the consortium.

      District A, District B, District, C, District D, District E, District F, District X, District Y, District Z.




 SAID SCHOOL DISTRICTS HEREBY MUTUALLY AGREE, PURSUANT TO SECTION 66.03 OF THE WISCONSIN STATUTES, TO THE
 FOLLOWING CONDITIONS THAT:
   said parties agree and contract for the cooperation of CTE programs, under the Carl D. Perkins Career and Technical Education Improvement Act
    of 2006 (PL 109-270);
   the annual budget for the cooperative program shall be approved by the school board of each participating school district prior to the beginning of
    the fiscal year;
   the school district identified above is to be the operator and fiscal agent of the Carl Perkins consortium;
   school board has passed the Carl Perkins Cooperative resolution related to this 66.03 agreement;
   school board agrees to follow DPI’s Fiscal Agent Policy;
   the fiscal agent agrees to file a Carl Perkins Plan with an annual application and the required reports with the Department of Public Instruction;
   the fiscal agent agrees to be prepared to assist school districts as requested and required with implementation of the Operational Plan;
   the fiscal agent will utilize separate funding as provided in the Fund 90 series of the Wisconsin Uniform Financial Accounting Requirements;
   all purchased resources will remain the property of the consortium;
   a plan for the final disposition of equipment, facilities, and materials that are purchased with CPA funds will be provided by the fiscal agent;
   each school district will adhere to the CPA assurances as listed within the application and maintain records and other support materials to ensure
    all assurances are being met;
   student membership for state aid purposes be counted by the district of residence;
   transportation, if required, is to be furnished by the individual school district; special transportation aid shall also be claimed by the district of
    residence;
   the budget and Operational Plan for this cooperative/consortium shall be developed by the fiscal agent LVEC/CTE Coordinator and the
    Consortium Council;
   the fiscal agent agrees to coordinate and/or maintain all materials and data to assure that the consortium and individual school districts are
    meeting federal and state requirements dealing with monitoring, fiscal reporting (including budget modifications), student reporting, and other
    related items that impact upon the requirements of the Carl D. Perkins Career and Technical Education Improvement Act of 2006 (PL 109-270).

 This agreement shall be effective for a FIVE-YEAR period for the school year(s) 2008-13.

 THE SCHOOL DISTRICT OF Z AGREES TO THE ABOVE TERMS, AND HEREBY AFFIXES THE APPROPRIATE SIGNATURE.

 District Administrator Signature                                                                                              Date Signed Mo./Day/Yr.

 
 Board President Signature                                                                                                     Date Signed Mo./Day/Yr.

 
 Board Clerk Signature                                                                                                         Date Signed Mo./Day/Yr.

 
 THE FISCAL AGENT DISTRICT WISCONSIN SCHOOL DISTRICT AGREES TO THE ABOVE TERMS, AND HEREBY AFFIXES THE
 APPROPRIATE SIGNATURES.
 Fiscal Agent Administrator Signature                                                                                          Date Signed Mo./Day/Yr.

 
 Fiscal Agent LVEC/CTE Coordinator Signature                                                                                   Date Signed Mo./Day/Yr.

 
PI-1303-F                                                                                                                        Page 15

                                                SECTION XII—CONSORTIUM CONTRACTING (cont’d.)

 For additional copies of the contract, use the embedded file to complete a CESA Services Agreement for each district
 participating in the consortium. Double-click to open and save file to desktop.
 The applicant must use the following format when naming the file:
            12 (school district name) Section XII PART A—1
 For each additional file created, continue with this numbering sequence. (Mail signed contract to DPI—two copies of
 one participating district. Fiscal Agent locally retains one copy of signed contract for all participating districts.)

 For additional copies of the contract, use the embedded file to complete a 66.03 Agreement for each district participating in
 the consortium. Double-click to open and save file to desktop.
 The applicant must use the following format when naming the file:
            12 (school district name) Section XII PART B—1
 For each additional file created, continue with this numbering sequence. (Mail signed contract to DPI—two copies of
 one participating district. Fiscal Agent locally retains one copy of signed contract for all participating districts.)

				
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