Adopt-A-School Annual Plan - DOC

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					                                                 Partners in Education
                                       Adopt-A-School Program Plan
Complete a separate form for each adopter. You may fill in this form on your computer by tabbing to each field (indicated with
gray shading) and typing your response. Save a copy to your computer by using the “File, Save As” command, and e-mail a copy to
the Partners in Education Office ( as an attachment.

Report Due Date(s): New School Year Plan – 1st Monday in October; Mid-Year Update – 1st Monday in February, Year-End
Report – last week of school. Reports are required to be eligible for the Golden Achievement Award.

School:                                                                                             Phone:
Campus Contact:                                                                                     Date:

When using this form to submit your New School Year Plan, fill in ONLY the “Description of Activity” section. When using this form
for Mid-Year Update and End-of-Year Report, type a date (mm/dd/yy) in the appropriate Program Areas box.

                                                                                             Program Areas
                                                           Required                                   Choose 3 or more
Description of Activity                                    Academic      Student        Career      Character     Teacher or     Community   School
                                                           Improvement   Incentives /   Awareness   Development   Adopter        Service     Improvement
                                                           Support       Recognition                              Appreciation               Plan
Ongoing Activities During Year

August – September








                                   School Partnership
                                   Annual Commitment



We hereby agree to:
    Interact at least once per month in pursuit of meeting the needs of students.
    Be represented at the four school partnership campus contacts meetings during this school year.
    Submit the Annual Plan and an End-of-the-Year Report regarding its implementation.

Signature of Adopter Coordinator                      Signature of Campus Contact

Names of Adopter Committee Members:                   Names of School Committee Members:



Adopter Executive Officer                             Principal

Adopt-A-School Program Plan                                                                    Page 2