FY Part I: Migrant Summer Program Intent to Participate Pre-K – Twelfth Grade and Part II: Migrant Summer Program Intent to Participate Birth to 2 County-District Code County-District Name Superintendent Name & Signature Date Yes, the district will provide a FY Summer Program for migrant students. Part I Part II No, the district will not provide a FY Summer Program for migrant students. Part I Part II Please do not complete the application(s) below, if responding NO to Part I and Part II. Part I: Migrant Summer Program Plan Pre-K through Twelfth Grade Summer Program Director or Contact Person: Phone Number: Email Address: Facility/Building where program will be held: Address: City: Zip Code: Anticipated total number of students to be served: Length of Program: DAYS: Hours: to Program Dates: START: END: Participating in Summer Food Program: Yes No Estimated cost of the instruction Migrant Summer Program (excluding transportation): $ Estimated cost of transportation for the Migrant Summer Program: $ Part I: Total Number of Students Served by Grade Levels Pre-K 4 year olds Fifth grade Pre-K 5 year olds Sixth grade Kindergarten Seventh grade First grade Eighth grade Second grade Ninth grade Third grade Eleventh grade Fourth grade Twelfth grade Oklahoma State Department of Education | Office of Federal Programs | June 2019 Page 1 of 4 Part I: Migrant Summer Program Intent to Participate Pre-K – Twelfth Grade and FY Part II: Migrant Summer Program Intent to Participate Birth to 2 Part I: Total Number of Students Served by Grade Levels 1. How will the District ensure that Identification and Recruitment remain a priority during the summer school session? 2. Identify staff that will provide services along with their qualifications. Please check all the apply for questions 3 through 6. 3. Which of the following will be used to identify eligible migrant children that have a “priority for service” and will be served in the Migrant Summer Program? Mobility (moved within the last 12 months) Grades Attendance records Teacher referral Test scores Limited English Proficient 4. Which of the following will the District use to communicate with parents about the Migrant Summer Program? Parent meeting Written notification Home visit(s) Other Oklahoma State Department of Education | Office of Federal Programs | June 2019 Page 2 of 4 Part I: Migrant Summer Program Intent to Participate Pre-K – Twelfth Grade and FY Part II: Migrant Summer Program Intent to Participate Birth to 2 5. Which of the following health care needs will the District coordinate with outside organizations or directly provide to participating migrant children? Schedule health checks Preschool information Immunization clinic Other 6. What evidence-based curriculum and effective instructional strategies will be used to teach the following academic areas? Please provide a detailed answer. Subject Description of Curriculum and Instructional Strategies Math Reading Language Arts English Language Development Early Childhood Secondary Credit Accrual 7. Describe below the Migrant Summer Program Performance target/objectives Measurable outcomes Key strategies to meet the performance target Evaluation process and the documentation that will be collected for the evaluation *Attach evidence of tools used for evaluation Oklahoma State Department of Education | Office of Federal Programs | June 2019 Page 3 of 4 Part I: Migrant Summer Program Intent to Participate Pre-K – Twelfth Grade and FY Part II: Migrant Summer Program Intent to Participate Birth to 2 Part II: Migrant Summer Program Plan Birth - Two Year Olds (Birth to 2) (If the information below is the same as in Part I’s application, please leave it blank.) Summer Program Director or Contact Person: Phone Number: Email Address: Facility/Building where program will be held: Address: City: Zip Code: Anticipated total number of students to be served: Length of Program: DAYS: Hours: to Program Dates: START: END: Participating in Summer Food Program: Yes No Estimated cost of the instruction Migrant Summer Program (excluding transportation): $ Estimated cost of transportation for the Migrant Summer Program: $ Part II: Total Number of Students Served Age Birth - Two Year Olds Newborn One year olds Six months Two year olds Nine months Part II: Migrant Summer Developmental Appropriate Program Birth – Two Year Olds 1. Social and Emotional Development 2. Physical Development 3. Cognitive (thinking) Skills 4. Language Development 5. Parent Engagement (Engagement & Communication) 6. Health Care Needs (Resources, Community Organizations) Oklahoma State Department of Education | Office of Federal Programs | June 2019 Page 4 of 4.