Perkins Requisition Form School Year

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Perkins Requisition Form 2015-2016 School Year Houston ISD Perkins funding application period is open at this time The Carl Perkins act and the related funding stream seek to provide school districts with additional funds to support necessary career-related equipment and materials that could not otherwise be purchased by schools or school districts based on regular funding allotments As per federal requirement within the act, consumable products such as toner ink, paper or sheet metal cannot be purchased with Perkins funds As such, Houston ISD's Career and Technical Education department provides funding programmatically to ensure equity in programmatic funding as it relates to viable CTE programs that provide students with jobready skills in a high demand, high wage fields There are no overarching school allotments as these are not title funds The HISD CTE department aims to ensure that all CTE course instructors have a voice in determining how to best allocate Perkins funds at each campus in each career cluster Therefore, a representative (teacher) from each cluster should submit the form on behalf of and with the input from all teachers who comprise the career cluster Additionally, this requisition should be drafted with the input of your campus administration and your CTE program specialist Requests will be evaluated on the viability of the program to provide student success in an industry-related pathway and the financial need of the program(s) Decisions will be made after committee review of submitted applications Please be thinking strategically about how your program might benefit from funding for equipment and such other material that the Perkins funding might provide As you are planning, be mindful of the impending construction that your campus is or will soon be undergoing Employee and School Information Name * Title * Email * Phone Number * - - ### ### #### Fax ### - ### - #### School *

School Address * Street Address Address Line 2 City State / Province / Region United States Postal / Zip Code Country Department Chair Name * Department Chair Email * CTE Program Information Cluster * Career Pathyway * List the names of teachers who teach the courses that comprise this cluster * List the percent of projected job growth and associated potential occupation Click Here to View Job Growth Projection * Length of time in years that the campus-based coherent sequence has existed * Relevant Industry Certification offered by program *

Do you offer additional industry certification? * Yes Additional Certification offered by program Additional Certification offered by program Programmatic Work-Based Learning Offered * Does your program offer additional work-based learning opportunities? * Yes Programmatic Work-Based Learning Offered Programmatic Work-Based Learning Offered Programmatic Work-Based Learning Offered Postsecondary Opportunities Available (select all that apply) * Apprenticeship Articulated Credit Dual-Credit

n/a Does any member of your cluster sponsor a CTSO? * Yes Sponsored CTSO * CTSO Sponsor Additional CTSO Additional CTSO Sponsor Request Rationale Please provide a general statement of need for the requested items as they relate to the CTE program: * Describe how equipment/materials will be utilized in the class environment: * Please be specific about what the equipment/materials are as well as how it will be used Consider using TEKS to explain the utility of the equipment/materials Describe how the students will directly benefit from the purchased equipment/materials: *

How might the requested equipment/materials benefit students in a specific industry or with a specific skill? Describe how the purchased equipment/materials will contribute to your long term-vision for the program: * How will the requested equipment/materials affect the program in the long term? What difference will this equipment/materials make in the growth of the program in the future? Additional Unique Features or Program Innovations Did you submit an asset inventory for 2015-16? * Yes -year CTE Teacher Vendor Information Select an approved vendor, upload the vendor quote for items requested and list the total cost Vendor #1 Quote from Approved Vendor * * Are you requesting additional items from another approved vendor? *

Yes Add additional Vendor(s) You must complete each field and upload a quote for each additional vendor you add Vendor #2 Quote from Approved Vendor Vendor #3 Quote from Approved Vendor Vendor #4 Quote from Approved Vendor Vendor #5

Quote from Approved Vendor Confirmation Page Is your building principal aware of the items you are requesting? * Yes Principal Name * Principal Email * I understand that the information I have included and/or chosen not to include on this form will have an impact on the evaluation of my request * Yes Evaluation All requests are reviewed by committee on a case-by-case basis and approved or denied based on a strict department protocol including, but not limited to: -Department Criteria -Program Need Assessment -Student Impact -Cost Analysis -Labor Relevance -Department Objectives Designed