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SpringBoard Essential Information


Please complete the following form to best support the implementation of SpringBoard in your school/district.


District Name____________________________________________________________


Address1:      ____________________________________________________________


Address2:      ____________________________________________________________


City & State: ____________________________________________________________


Zip Code:      ____________________________________________________________


Phone:  (____)___________________________________________________________




Superintendent:  _____________________


Phone Number:  _____________________


Email:  ____________________________


Contact Person:______________


Title:  _____________________________


Phone Number:  _____________________




Please mark clearly which apply to your school/district:

School Level Participation

1.  Name of High School (grades 9-12) will participate in SpringBoard?_____________


2.  How many Middle Schools (grades 6-8) will participate in SpringBoard?__________


Teacher level participation (Please include special education in these categories as well)


Middle School


# of English Teachers ____


# of Math Teachers ______


High School


# of English Teachers ____


# of Math Teachers ______


Projected Student Enrollment Participating in Springboard in 2005-2006:


Middle School______________________


High School________________________


Central Training dates this summer will be provided by the Maine Department of Education


Please send completed forms by fax or email to Wanda Monthey at 624-6821 or by March 21st, 2005.

Thank you.