<p>Name of Grant Program: Teen Pregnancy Prevention: Partners for Youth Success Fund Code: 716</p><p>Grant Assurances</p><p>The school district agrees to:</p><p>______Designate a Teen Pregnancy Prevention/STI/HIV Planning team of 2 -3 persons to fulfill the requirements of the grant.</p><p>______Allow the designated team to participate in required trainings sponsored by the Departments of Elementary and Secondary Education (Department) and Public Health (DPH). The PREP Kick-off meeting is tentatively scheduled for May 11, 2017 (Please save the date.) Additional dates will be forwarded as confirmed. </p><p>______Allow designated team to work through the Getting to Outcomes model or similar needs assessment process during the Spring of 2017 to select curriculum to be implemented.</p><p>______Allow designated teacher(s) to participate in up to 10 days of professional development (including a summer course) to acquire the requisite knowledge and skills to gain comfort in teaching selected curricula.  Sexuality Education Certification Series or equivalent  Curriculum Specific Training</p><p>______Participate in program evaluation activities. Evaluation of the program and program activities will occur in order to measure program effectiveness. Evaluation activities consist of the following components:  Administering pre/post assessments  Maintaining fidelity logs  Teacher observations during delivery of curriculum lessons</p><p>______Submit final summary reports to the Department according to written guidelines.</p><p>______Submit a written commitment to implement one of the selected evidence-based programs beginning, at the latest, in the 2017 - 2018 school year.</p><p>______Participate in any additional training or reporting required by the Department, DPH and/or the federal funders of this grant.</p><p>Signature of Staff Person Applying to be part of the Teen Date Pregnancy/STI/HIV Prevention Planning Team</p><p>Signature of Staff Person Applying to be part of the Teen Date Pregnancy/STI/HIV Prevention Planning Team</p><p>Signature of Staff Person Applying to be part of the Teen Date Pregnancy/STI/HIV Prevention Planning Team</p><p>Signature of Superintendent Date *Please add additional rows for team members as needed.</p>