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 (firstname.lastname@example.org) 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.
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.
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
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