Application Form

Please type over each asterisk to insert text. This form is ‘locked’ to enable checkboxes. If you experience problems, it can be unlocked without a password. Should your application be successful, all information from this form may be shown on the website and newsletter.

Section A: Contact information

Establishment name:
(in the case of network applications, all correspondence will be sent here for distribution to other members) / *
Lancashire establishment no:
(e.g. 02/013 or A1005) / *
Network name
(if applicable) / *
Headteacher’s/
Head of Centre’s name:
(of lead establishment in the case of networks) / *
Lead contact name:
(if not as above) / *
Email: (must be checked regularly) / *
Telephone no. (inc. area code) / *
Fax no. (inc. area code. Notifications and requests for evidence may be faxed to the establishment to ensure receipt) / * / If a phone-fax, check this box if we should ‘phone first
Network applications only: please list the names and establishment numbers of other members here: / Establishment name / Establishment no.
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Submission no. (office use only):
Project title (to be shown on certificate; maximum 15 words): / *
Award applied for:
(Select one option.
The accreditation panel may choose to award at a different level to that applied for)
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Best Practice Award (for long-established projects, embedded into the school's culture)
Good Practice Award (for established projects that have shown positive impact but are not yet fully embedded in the school's culture)
Innovative Practice Award (for recent projects)
Please read the application guidance notes on the Award website before completing the rest of this form.
Section B: About the project
Please summarise the project in no more than 200 words:
(if successful, this summary will appear in the newsletter and on the website as an article. Focus on what you did and what the impact was.)
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How would you categorise this project (check most appropriate box):
Assessment/target setting/tracking Culture and ethos
Behaviour and attendance Inclusion
Workforce reform Self evaluation
Professional development Performance management
Curriculum – Early Years Curriculum - Literacy
Curriculum – Numeracy Curriculum - MFL
Curriculum – ICT Curriculum – Boys Achievement
Curriculum – Innovative approaches Curriculum – Cross-curricular
Other (Please specify)
*
Section C: Leadership and Management of the Project
The Award is for the leadership and management of a particular project. Descriptive information about the project is required to provide a background context and it is also important that you provide sufficient information to allow the Panel to make a judgement about the origins, decisions, actions, and impact of your project. Applications that do not provide sufficient information do not allow the Panel to judge the application fully against the criteria for each award level and therefore will be rejected. Please see the guidance notes on the website for more information.
Specific aspect of practice to be accredited:
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What were you hoping to achieve? (initial success criteria):
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Please note that any evidence you cite in the following section may be requested by the accreditation panel. For your own convenience, do not cite evidence that you will be unwilling/unable to provide. However, you should cite at least two pieces of evidence for each section; applications without sufficient indication of evidence will be rejected. If you are offering bulky items, such as displays, as evidence please take a photograph and enclose with this application.
/ Source of evidence /
How did you identify the need for this practice? / ( e.g. OFSTED reports, SATs results, ECM audit, pupil survey, parent feedback)
* / *
Briefly describe the main characteristics of the school
e.g. pupil numbers, social and economic backgrounds, SEN profile. / NONE REQUIRED
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What did you do? What were the significant milestones and actions in development? Please provide dates, actions and rationale. We recommend that you do not apply for an award until a project has run for at least a year. / (E.g. action plans, evaluations, training records)
* / *
Which members of the establishment and/or wider community have been involved and what was their role? Describe how the people involved contributed to the positive outcomes of the project. / NONE REQUIRED
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How has the progress of the project been monitored and evaluated? / (e.g. monitoring reports)
* / *
How has the practice been modified or improved during development?
* / *
What has been the impact of the project on pupils’ learning, achievement or enjoyment and how was it measured? / (evidence e.g. changes pupils have experienced in the classroom or school, SATs results, pupil progress reports, school council minutes)
* / *
What are the next stages in the development process?
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What aspects of this practice may be useful for other establishments to consider?
What advice would you offer to establishments attempting a similar project?
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Any other comments you wish to add:
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Section C: Signatures and supporting comments
I fully support this application and can verify that the information provided is accurate.
Headteacher’s/Head of Centre’s signature:

Your application MUST be supported by your school adviser and you may wish to discuss it as part of an SSG visit. If your school does not participate in the SSG service you may buy in an adviser for a session to appraise your project and support your application if appropriate. Please call 01254 220740 if you would like to arrange this.

Supporting comment from School Adviser this text should demonstrate that the School Adviser has an understanding of the project and the impact of actions taken.)
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Name of School Adviser:
*
Date:
*

Checklist for Learning Excellence Award applications

Have you: Completed all sections?

Checked that the telephone, email and fax numbers are correct?

Obtained the Headteacher’s/Head of Centre’s signature?

Completed School Adviser's comments and date?

Enclosed photographs where appropriate?

Returning your form:
BY POST: / Learning Excellence Award Applications, Quality and Continuous Improvement, LPDS Centre, Southport Road, Chorley, Lancashire PR7 1NG
FAX: / 01254 220737
EMAIL: /
You should save this completed form to your computer before closing it.