Application Form –Cohort 3

SECTION 1 – Partnership Details

Lead Applicant School

School Name:
School Phase/Sector:
DE No:
School Roll No:
Address:
Telephone No:
Email contact:
Principal Name:
Contact Teacher:
Management Type / Phase/
Sector / Total Enrolment / Community Background
C / P / O
NI: controlled/maintained/integrated/ special/ other: ______
ROI Border Counties: Voluntary Secondary/Vocational/Community and Comprehensive/Denominational Patronage/ Inter-Denominational Patronage/ Multi-Denominational Patronage/Gaelscoil
% / % / %

Partner School 2

School Name:
School Phase/Sector:
DE No:
School Roll No:
Address:
Telephone No:
Email contact:
Principal Name:
Contact Teacher
Management Type / Phase/
Sector / Total Enrolment / Community Background
C / P / O
NI: controlled/maintained/integrated/ special/ other: ______
ROI Border Counties: Voluntary Secondary/
Vocational/Community and Comprehensive/
Denominational Patronage/ Inter-Denominational Patronage/ Multi-Denominational Patronage/Gaelscoil
% / % / %

Partner School 3

School Name:
School Phase/Sector:
DE No:
School Roll No:
Address:
Telephone No:
Email contact:
Principal Name:
Contact Teacher
Management Type / Phase/
Sector / Total Enrolment / Community Background
C / P / O
NI: controlled/maintained/integrated/ special/ other: ______
ROI Border Counties: Voluntary Secondary/Vocational/Community and Comprehensive/Denominational Patronage/ Inter-Denominational Patronage/ Multi-Denominational Patronage/Gaelscoil
% / % / %

Partner School 4

School Name:
School Phase/Sector:
DE No:
School Roll No:
Address:
Telephone No:
Email contact:
Principal Name:
Contact Teacher
Management Type / Phase/
Sector / Total Enrolment / Community Background
C / P / O
NI: controlled/maintained/integrated/ special/ other: ______
ROI Border Counties: Voluntary Secondary/Vocational/Community and Comprehensive/Denominational Patronage/ Inter-Denominational Patronage/ Multi-Denominational Patronage/Gaelscoil
% / % / %

SECTION 2: Distance Between Participating Schools

Distance between participating schools / Less than 5 miles / Between 5 and 10 miles / Greater than 10 miles
Please indicate the maximum travel distance between the participating schools

SECTION 3: Funding from Other Sources

Are any of the schools in the partnership currently in receipt of or have outstanding applications for funding for Shared Education or school collaboration? If the answer is yes, please provide details:

Funding
Stream(s) / Source 1: / Source 2: / Source 3: / Total Additional Funds
Current Allocation:
Additional Information: / Summary detail of current funding or funding applied for:

SECTION 4 – Partnership self-evaluation

The CASE PEACE IV project is particularly aimed at those schools which have not had the opportunity to, or been in the position to deliver sustained shared education (as defined by the Shared Education Act 2016) to their pupils.

If the participating schools in your partnership do not have any history of working in shared education please tick the box below.

This partnership has no previous history of shared education

If the participating schools in your partnership have any previous history or experience of shared education please refer to the statements below and tick the one which best applies to your partnership at this time.

The statements have been adapted from the NI Education and Training Inspectorate’s self-evaluation tool Developing Shared Education: a Framework for School Partnerships

Statement
Some previous engagement in one-off shared events
Pupils in single class/year groups have been involved in sustained education activities
Pupils in more than one class/year group have been engaged in sustained shared education
Pupils in multiple class/year groups (and beyond the classroom) have been involved in sustained shared education activities

SECTION 5 - Project Summary

Please provide, in not more than 750 words, an overview of your project. This should include quantitative and qualitative outcomes. For example; the number and percentage of pupils that will be involved in shared classes, curricular areas to be shared and the number of staff, parents, Board of Governors/Management and the local community who will be involved.You should also include a short rationale for the composition of the partnership itself, making reference to the number and type of schools involved and the travelling distance between them.

If you intend to run projects in more than one curricular area, please describe each project separately.

SECTION6: Project Details

Please provide a brief overview of the proposed pupil activity, adding rows to the table where required. You must demonstrate clearly how 30 hours of contact time will be delivered to each individual pupil. A maximum of 20% (6 hours) may be delivered online.

Year Group / Curricular Area/s / No. of pupils from each participating school / Number of Meetings / Duration of Meeting
School 1 / School 2 / School 3 / School 4

SECTION7:

In this section please describe how the project relates to the School Development/ School Improvement Plans for each participating school:

SECTION 8:

Please describe briefly the strategies that the partnership will use to monitor and evaluate your project:

This project is supported by the European Union’s “PEACE IV Programme”, managed by the Special EU Programmes Body (SEUPB)

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CASE PEACE IV Project Proposed Action Plan

Please complete the Action Plan below. This should outline how the full programme will be delivered to all participating pupils and highlight the time, resources and staff support necessary to provide the required 30 hours of shared education per pupil.

Objectives / Targets / Actions / Success Criteria
(Qualitative & Quantitative) / Time/Resources/staff development (including Teacher Professional Learning) / Lead responsibility/ external support
Learner Centred
1.
2.
3.
High Quality Learning & Teaching / .
1.
2.
3.
Effective Leadership
1.
2.
3.
Community Connections
1.
2.
3.

Proposed Budget:

The maximum budget available to eligible partnerships is based on a Unit Cost of €84.28. For 2018/19 the project will also provide an allocation for transport, as well as partnership sub cover up to a maximum of 9 days per school.

Planned expenditure / Maximum available = €84.28 x No. of participating pupils across partnership
Additional sub cover
Coordination costs (if applicable)
Resources & Materials
Hire of facilities
Other (please specify)
Other (please specify)
Other (please specify)
TOTAL

Transport Budget

School to School Transport Costs
Additional transport requirements.
TOTAL

*Please note that a successful application does not imply full approval of the proposed action plan and budget. All partnership budgets must be approved by the CASE Programme Manager before any activity commences.

This project is supported by the European Union’s “PEACE IV Programme”, managed by the Special EU Programmes Body (SEUPB)

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SECTION 9 - Declaration & Undertaking

This declaration and undertaking should be completed by the Principal and Chairperson of the Board of Governors/Management from each school in the Partnership:

(i)We confirm that we are authorised to sign this declaration behalf of the schools named on page one.

(ii)We certify that the information provided in this application form is true and correct to the best of our knowledge and belief and undertake to notify any change to this information.

(iii)We understand that the provision of financial assistance will be subject to certain conditions which will be outlined fully in the letter of offer.

(iv)We confirm that this application does not duplicate or displace any existing funding.

Name of School 1: / Name of School 2:
Name of Chairperson:
(Block Capitals) / Name of Chairperson:
(Block Capitals)
Signature: / Signature:
Date: / Date:
Name of Principal:
(Block Capitals) / Name of Principal:
(Block Capitals)
Signature: / Signature:
Date: / Date:
Name of School 3: / Name of School 4:
Name of Chairperson:
(Block Capitals) / Name of Chairperson:
(Block Capitals)
Signature: / Signature:
Date: / Date:
Name of Principal:
(Block Capitals) / Name of Principal:
(Block Capitals)
Signature: / Signature:
Date: / Date:

Completed forms to be returned to

GDPR Notice:

The main purpose for which the CASE – PEACE IV Project requires the personal data provided by you is for contact purposes regarding the CASE Project and verification of funded projects, TPL and sub cover which is paid by the Department of Education & Skills. The personal data provided may be exchanged with Education Authority, NI as the Lead partner in the CASE Project and with SEUPB which is a North South funded body managing the PEACE IV Programme. The privacy notice outlining further information in relation to GDPR can be found at

This project is supported by the European Union’s “PEACE IV Programme”, managed by the Special EU Programmes Body (SEUPB)

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