AltEdApplication1.3.07

AltEdApplication1.3.07 - West Virginia Department of...

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Office of Healthy Schools Capitol Complex, Building 6, Room 309 1900 Kanawha Boulevard, East Charleston, WV 25305-0330 APPLICATION FOR STATE FUNDS FOR ALTERNATIVE EDUCATION PROGRAMS FOR DISRUPTIVE STUDENTS FY 2007-08 The application designated below hereby applies for funds under state account 0313 activity #143 to develop and operate alternative education programs for disruptive youth in accordance with State Board if Education Policy 2418: Regulations for Alternative Education Programs for Disruptive Students. The revenue source code and project code for these funds are 03211 and 1781X , respectively. PART I – GENERAL INFORMATION A. Applicant Information 1. County School District: 2. Address: 3. Telephone Number: 4. Superintendent’s Name: Date: B. Project Information 1. Alternative Education Programs: 2. Telephone Number: 3. Project Period From: to (Date) (Date 4. Project Director: (Name) (Title) (Telephone No./Ext.) 5. Fax Number: Email Address: Amount of Funds Requested $ C. Certification I, the undersigned county superintendent of schools have reviewed this application and hereby certify that: (1) to the best of my knowledge, the information contained herein is complete and correct; (2) funds provided to this agency will be used solely for the project as described in this application, or as amended; and (3) the county school district agrees to and will comply with the assurances in this application. Signature:
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AltEdApplication1.3.07 - West Virginia Department of...

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