NH Performance Assessment Network 2014-2015 APPLICATION

Thank you for your interest in the NH Performance Assessment Network.

The NH Performance Assessment Network aims to engage New Hampshire’s school districts in developing valid and reliable performance assessments to build and measure mastery of competencies in our local and state student assessment systems. We are seeking districts that wish to have their schools join a K-8, a high school, and North Country cohort beginning summer 2014, to undertake this work.

The application is due by Thursday June 19, 2014.

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* Thanks to a recent grant submission by Sanborn Regional School District, Center for Collaborative Education, Stanford University, and the Center for Assessment, we will be able to focus on Math and Science more than in previous years. If you are particularly interested in Math and Science, please indicate here.

Yes

No

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* School Information

District:

School:

Address:

Grades:

Student enrollment:

Size of faculty:

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* Lead contact

Name:

Position:

Email:

Phone:

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* Proposed Team Members:Teams should be 4-8 members and depending on your school or district's configuration should be comprised of the following. All team members are expected to attend all of the institute days.

• One principal or administrator (required)
• One additional member that works across grade levels (literacy coaches, curriculum directors, department chairs, instructional coaches, etc.)
• For HS and MS Teams: Schools should select the academic disciplines they seek to focus on first for this initiative and choose one to three teachers of each selected discipline.
• For K-8 Teams: Two to three self-contained general education teachers across grade levels, and if the middle grades are included, one to three teachers of each selected discipline.

Team Member 1:

Name:

Position (if teacher, indicate subject and grade levels):

Email:

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* Team Member 2:

Name:

Position (if teacher, indicate subject and grade levels):

Email:

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* Team Member 3:

Name:

Position (if teacher, indicate subject and grade levels):

Email:

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* Team Member 4:

Name:

Position (if teacher, indicate subject and grade levels):

Email:

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* Team Member 5:

Name:

Position (if teacher, indicate subject and grade levels):

Email:

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* Team Member 6:

Name:

Position (if teacher, indicate subject and grade levels):

Email:

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* Team Member 7:

Name:

Position (if teacher, indicate subject and grade levels):

Email:

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* Team Member 8:

Name:

Position (if teacher, indicate subject and grade levels):

Email:

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* Is this application for the K-8, High School, or North Country cohort?

K-8

High School (can include some Middle School representation)

North Country

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* Are you interested in hosting a fall or winter regional session (Institute Days 3 & 4) for 3-6 school teams (~18-40 people)?

Yes

No

Not Sure

Comments

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* Which sessions/months would you like to host?

Fall session: (October, November)

Winter session (January, February, March)

Please list the months or any specific dates that work well in your calendar:

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* Briefly describe the focus (2-3 key activities) of your school’s work to date with competencies and performance assessments.

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* Describe your school’s current use of performance assessment (e.g., list various subjects and grade levels).

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* Describe any continued or prior participation with outside experts, such as a performance assessment development network or organization.

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* What is at least one thing your school/district hope to gain though participation in the performance assessment initiative?

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* The Superintendent and the Principal(s) of the involved school(s) are familiar with this application and the following Statement of Commitment:

If selected to participate in the 2014-2015 Cohort for the Performance Assessment Network, our team will commit to attending all institute activities and contribute to the ongoing professional network for quality performance assessments.

Yes

No