District Supervisor Collaboration Question Title * 1. District: Question Title * 2. Name and E-mail Address of District Contact: List the following information for the district staff who will attend the collaboration meetings as part of the district cohort. Question Title * 3. Name of Cohort Member 1: Question Title * 4. District Role of Cohort Member 1: Question Title * 5. E-mail Address for Cohort Member 1: Question Title * 6. Name of Cohort Member 2: Question Title * 7. District Role of Cohort Member 2: Question Title * 8. E-mail Address for Cohort Member 2: Question Title * 9. Name of Cohort Member 3: Question Title * 10. District Role of Cohort Member 3: Question Title * 11. E-mail Address for Cohort Member 3: Question Title * 12. Name of Cohort Member 4 (OPTIONAL): Question Title * 13. District Role of Cohort Member 4: Question Title * 14. E-mail Address for Cohort Member 4: Question Title * 15. Name of Cohort Member 5 (OPTIONAL): Question Title * 16. District Role of Cohort Member 5: Question Title * 17. E-mail Address for Cohort Member 5: Question Title * 18. Please rank your cohort preference in order from most preferred (1) to least preferred (6). 1 2 3 4 5 6 Cohort 1: Small to medium districts (Acadia Parish Educational Center, Crowley) 1 2 3 4 5 6 Cohort 2: Districts who receive SRCL funds and/or participate in LDC/MDC (Gladys Higdon Instructional Center, Alexandria) 1 2 3 4 5 6 Cohort 3: Medium to large districts (Bossier Instructional Center, Bossier) 1 2 3 4 5 6 Cohort 4: Rural districts (Richland Parish School Board Office, Rayville) 1 2 3 4 5 6 Cohort 5: Urban districts (Claiborne Building, Baton Rouge) 1 2 3 4 5 6 Cohort 6: Districts who receive SRCL funds and/or participate in LDC/MDC (Claiborne Building, Baton Rouge) Question Title * 19. What curriculum is being used in your district for the following content areas? Please provide the curriculum name and publisher (if applicable). If more than one curriculum is being used, be sure to include all titles. Math: English language arts: Question Title * 20. If any district-wide interim assessments are being administered, list the assessment name and the vendor (if applicable). Done