PI-9554Page 1

/ Wisconsin Department of Public Instruction
TITLE I, PART A, SECTION 1003(a)
SUPPLEMENTAL GRANT
INTERIM REPORT
PI-9554(Rev. 10-10) / INSTRUCTIONS: Submit this form along with the updated plans from the approved application by JANUARY 31, 2011, to:
WISCONSIN DEPARTMENT OF PUBLIC INSTRUCTION
TITLE I AND SCHOOL SUPPORT TEAM
ATTN: MACKENZIE DUNN
P.O. BOX 7841
MADISON, WI 53707-7841
I. GENERAL INFORMATION
Local Education Agency / Grant Contact Person or Grant Coordinator
E-mail Address / Telephone Area/No.
Ext.
Mailing Address Street, City, State, Zip
II. CERTIFICATION SIGNATURE
Signature of Grant Contact Person or Grant Coordinator
 / Date Signed
III. PROJECT IMPLEMENTATION
Part 1
  1. Complete the “Progress” column for Section VIII. School Plan in the approvedgrant application. Briefly describe the progress made to date in implementing the plan. Responses should reflect the evaluation methods and objectives. Include a summary of quantitative and qualitative data.
  2. Complete the “Progress” column for Section IX. District-Wide Plan (if applicable) in the approved grant application. Briefly describe the progress made to date in implementing the plan. Responses should reflect the evaluation methods and objectives. Include a summary of quantitative and qualitative data.
  3. If there is not enough space in the grant tables, you may provide DPI with attachments. However, limit attachments to four (4) pages total.
  4. Print only the pages for the Section VIII. School Plan and if applicable, the Section IX. District-Wide Plan and attach the plan(s) and any other appendices to this form.

Part 2
  1. In the space below, list the problems or obstacles you experienced, or anticipate, in implementing the plan. Briefly describe solutions or proposed solutions to overcome these problems.

IV. FUNDING
Do you anticipate having any funds unexpended or unencumbered by June 30, 2011? If yes, approximately how much money? Briefly describe the reasons for this projected balance.
V. REQUEST FOR ASSISTANCE
If the district needs some help in utilizing all available grant funds or needs any other technical assistance, please describe your needs below.
VI. SCHOOL SUPPORT TEAMS
Only grant recipients with Title I schools identified for improvement (SIFI) need to complete this section.
Describe each school support team’sactivities during the report period.

Be sure to attach this form to the updated plans from the approved application.