Sample Application- Schools

Note to Nominating Authorities: This sample application is provided to assist you, but is not required. You are encouraged adapt to your jurisdiction’s needs in order to document how your nominees are high performing in every Pillar and Element.

Note to Nominating Authorities: This sample application is provided to assist you, but is not required. You are encouraged to adapt all of it to your jurisdiction’s needs. The overall aim is use a format that shows how your nominees’ are high performing in every Pillar and Element within the allowable page limit. How you achieve that is up to you. These are merely some suggestions offered as a starting place.

ED-GRS Sample Nominating Authority Application for Schools

Thank you for your interest in completing the (nominating authority name) application for nomination to U.S. Department of Education Green Ribbon Schools (ED-GRS). In order to complete this application, you will need to collect data about your school's facility, health, physical education and safety policies; food service; and environmental and sustainability curriculum.

ED-GRS recognizes schools taking a comprehensive approach to greening their school. A comprehensive approach incorporates environmental learning with improving environmental and health impacts. Becoming a U.S. Department of Education Green Ribbon School is a two-step process. The first step is to complete and submit this form to be selected as a nominee by an eligible nominating authority. Once selected as a nominee by your state or eligible nominating authority, the second step of the process requires signatures for the Nominee Presentation Form that will be sent to the U.S. Department of Education (ED) along with your application.

ED selects honorees from those presented by eligible nominating authorities nationwide. Selection will be based on documentation of the applicant's high achievement in the three ED-GRS Pillars:

Pillar I: Reduce environmental impact and costs.

Pillar II: Improve the health and wellness of students and staff.

Pillar III: Provide effective environmental and sustainability education, incorporating STEM, civic skills and green career pathways.

Schools demonstrating exemplary achievement in all three Pillars will receive highest rankings. It is important to document concrete achievement. It will help you to assemble a team to complete the application. This team might include: a facilities manager, physical education director, food services director, curriculum director, finance department representatives, teachers and students. You should consult the ED-GRS Green Strides Resources Page and Webinar Series for standards, programs and grants related to each Pillar, Element and question. This is an excellent clearinghouse of information for all schools, not only those who apply.

The questions in this application will help you demonstrate your high achievement in these Pillars as well as provide space for you to include pertinent documentation. Applications are due by xyz to xyz. We will select nominees and submit them to the U.S. Department of Education by February 1, 2015.

Note that if selected for nomination to ED-GRS, the school principal and district superintendent must be prepared to certify that each of the statements below concerning the school’s eligibility and compliance with the following requirements is true; however, in no case is a private school required to make any certification with regard to the public school district in which it is located.

1. The school has some configuration that includes one or more of grades Pre-K-12.

2. The school has been evaluated and selected from among schools within the Nominating Authority’s jurisdiction as highest achieving in the three ED-GRS Pillars: 1) reduced environmental impact and costs; 2) improved health and wellness; and 3) effective environmental and sustainability education.

3. Neither the nominated public school nor its public school district is refusing the U.S. Department of Education Office of Civil Rights (OCR) access to information necessary to investigate a civil rights complaint or to conduct a district wide compliance review.

4. OCR has not issued a violation letter of findings to the public school district concluding that the nominated public school or the public school district as a whole has violated one or more of the civil rights statutes. A violation letter of findings will not be considered outstanding if OCR has accepted a corrective action plan to remedy the violation.

5. The U.S. Department of Justice does not have a pending suit alleging that the public school or the public school district as a whole has violated one or more of the civil rights statutes or the Constitution’s equal protection clause.

6. There are no findings of violations of the Individuals with Disabilities Education Act in a U.S. Department of Education monitoring report that apply to the public school or public school district in question; or if there are such findings, the state or public school district has corrected, or agreed to correct, the findings.

7. The school meets all applicable federal, state, local and tribal health, environmental and safety requirements in law, regulations and policy and is willing to undergo EPA on-site verification.

School Contact Information

School Name: ____________________________________________

Street Address: ____________________________________________

City: ___________________________________________State: _______ Zip: _______________

Website: _______________________________Facebook page: ____________________________________________

Principal Name: ____________________________________________

Principal Email Address: _______________________________ Phone Number:_________________________________

Lead Applicant Name (if different): ____________________________________________

Lead Applicant Email: __________________________________ Phone Number:________________________________

Level [ ] Early Learning Center [ ] Elementary (PK - 5 or 6) [ ] K - 8 [ ] Middle (6 - 8 or 9) [ ] High (9 or 10 - 12)	School Type ( ) Public ( ) Private/Independent ( ) Charter ( ) Magnet	How would you describe your school? ( ) Urban ( ) Suburban ( ) Rural	District Name __________________ Is your school in one of the largest 50 districts in the nation? ( ) Yes ( ) No
			Total Enrolled: _________________
Does your school serve 40% or more students from disadvantaged households? ( ) Yes ( ) No	% receiving FRPL________________ % limited English proficient__________ Other measures__________________		Graduation rate:_____ Attendance rate: ____

Application Outline: State may wish to insert their scoring rubric here. This is but one example:

ED-GRS Pillars and Elements	Points
Cross-Cutting Question: Participation in green school programs	5 points
Pillar I: Reduce environmental impact and costs:  30%
Element 1A: Reduced or eliminated greenhouse gas (GHG) emissions                 Energy                 Buildings	15 points
Element 1B: Improved water quality, efficiency, and conservation                Water                Grounds	5 points
Element 1C: Reduced waste production                          Waste                Hazardous waste	5 points
Element 1D: Use of alternative transportation	5 points
Pillar II: Improve the health and wellness of students and staff: 30%
Element 2A: Integrated school environmental health program                 Integrated Pest Management                 Contaminant controls and Ventilation                 Asthma control                 Indoor air quality                 Moisture control                Chemical management	15 points
Element 2B: Health and Wellness Coordinated School Health Fitness and outdoor time Food and Nutrition	15 points
Pillar III: Provide effective environmental and sustainability education, incorporating STEM, civic skills and green career pathways: 35%
Element 3A: Interdisciplinary learning about the key relationships between dynamic environmental, energy and human systems	20 points
Element 3B: Use of the environment and sustainability to develop STEM content, knowledge, and thinking skills	5 points
Element 3C: Development and application of civic knowledge and skills	10 points
Total	100 points

Summary Narrative: Provide a narrative describing your school’s efforts to reduce environmental impact and costs; improve student and staff health; and provide effective environmental and sustainability education. Focus on unique and innovative practices and partnerships.

1. Is your school participating in a local, state or national school program, such as EPA ENERGY STAR Portfolio Manager, EcoSchools, Project Learning Tree, or others, which asks you to benchmark progress in some fashion in any or all of the Pillars? [State may wish to add other program names to this list]

( ) Yes ( ) No Program(s) and level(s) achieved: ____________________________________________

2. Has your school, staff or student body received any awards for facilities, health or environment?

( ) Yes ( ) No Award(s) and year(s) ____________________________________________

Pillar I: Reduced Environmental Impact and Costs

Energy

1. Can your school demonstrate a reduction in Greenhouse Gas emissions?

( ) Yes ( ) No Percentage reduction: _______________ Over (m/yy - m/yy): ____________________

Initial GHG emissions rate (MT eCO2/person): _________________________

Final GHG emissions rate (MT eCO2/person): _________________________

Offsets: ________________________How did you calculate the reduction? ______________________

2. Do you track resource use in EPA ENERGY STAR Portfolio Manager? ( ) Yes ( ) No

If yes, what is your score? ________ If score is above a 75, have you applied for and received ENERGY STAR certification? ( ) Yes ( ) No Year: ______

3. Has your school reduced its total non-transportation energy use from an initial baseline? ( ) Yes ( ) No

Current energy usage (kBTU/student/year):____________________

Current energy usage (kBTU/sq. ft./year):____________________

Percentage reduction: __________________over (m/yy - mm/yy): _________________________

How did you document this reduction?_________________________

4. What percentage of your school's energy is obtained from:

On-site renewable energy generation: ____________Type___________________

Purchased renewable energy: _________Type___________________

Participation in USDA Fuel for Schools, DOE Wind for Schools or other federal or state school energy program: __________________________________________________________________

5. In what year was your school originally constructed? ________________________

What is the total building area of your school? ____________________________________________

6. Has your school constructed or renovated building(s) in the past ten years? ( ) Yes ( ) No

For new building(s): Percentage building area that meets green building standards:________________

Certification and year received: ______________________Total constructed area:________________

For renovated building(s): Percentage of the building area that meets green building standards: _________Certification and year: _________________________Total renovated area: _____________

Water and Grounds

7. Can you demonstrate a reduction in your school's total water consumption from an initial baseline?

Average Baseline water use (gallons per occupant): ____________

Current water use (gallons per occupant): ____________________

Percentage reduction in domestic water use: _________________________

Percentage reduction in irrigation water use: _________________________

Time period measured (mm/yyyy - mm/yyyy): _________________________

How did you document this reduction (ie. ENERGY STAR Portfolio Manager, utility bills, school district reports)?: _________________________

8. What percentage or your landscaping is considered water-efficient and/or regionally appropriate?:__________Types of plants used and location: _________________________

9. Describe alternate water sources used for irrigation. (50 words max or whatever word max you indicate to your applicants)

__________________________________________________________________

10. Describe any efforts to reduce stormwater runoff and/or reduce impermeable surfaces. (50 words max)

__________________________________________________________________

11. Our school's drinking water comes from: ( ) Municipal water source ( ) Well on school property ( ) Other: __________________________________________________________________

12. Describe how the water source is protected from potential contaminants. (50 words max)

__________________________________________________________________

13. Describe the program you have in place to control lead in drinking water. (50 words max)

__________________________________________________________________

14. What percentage of the school grounds are devoted to ecologically beneficial uses?____________________________________________(50 word max)

Waste

15. What percentage of solid waste is diverted from landfilling or incinerating due to reduction, recycling and/or composting? Complete all the calculations below to receive points.

A - Monthly garbage service in cubic yards (garbage dumpster size(s) x number of collections per month x percentage full when emptied or collected): _________________________

B - Monthly recycling volume in cubic yards (recycling dumpster sizes(s) x number of collections per month x percentage full when emptied or collected): _________________________

C - Monthly compostable materials volume(s) in cubic yards (food scrap/food soiled paper dumpster size(s) x number of collections per month x percentage full when emptied or collected): _________________________

Recycling Rate = ((B + C) ÷ (A + B + C) x 100): _________________________

Monthly waste generated per person = (A/number of students and staff): _____________________

16. What percentage of your school's total office/classroom paper content is post-consumer material, fiber from forests certified as responsibly managed and/or chlorine-free? _______________________________

17. List the types and amounts of hazardous waste generated at your school:

Flammable liquids

Corrosive liquids

Toxics

Mercury

Other:

How is this measured?________________________________________________________________

How is hazardous waste disposal tracked? ____________________________________________

Describe other measures taken to reduce solid waste and eliminate hazardous waste. (100 word max)

_____________________________________________________________________________

18. Which green cleaning custodial standard is used? _________________________

What percentage of all products is certified? _________________________

What specific third party certified green cleaning product standard does your school use? ___________________________________

Alternative Transportation

19. What percentage of your students walk, bike, bus, or carpool (2 + student in the car) to/from school? (Note if your school does not use school buses) ____________________________________________

How is this data calculated? (50 word max)

________________________________________________________________

20. Has your school implemented?

[ ] designated carpool parking stalls.

[ ] a well-publicized no idling policy that applies to all vehicles (including school buses).

[ ] Vehicle loading/unloading areas are at least 25 feet from building air intakes, doors, and windows.

[ ] Safe Pedestrian Routes to school or Safe Routes to School

Describe activities in your safe routes program:_________________________________(50 word max)

21. Describe how your school transportation use is efficient and has reduced its environmental impact. (50 word max)__________________________________________________________________

22. Describe any other efforts toward reducing environmental impact, focusing on innovative or unique practices and partnerships. (100 word max)

__________________________________________________________________

Pillar 2: Improve the health and wellness of students and staff

Environmental Health

1. Describe your school’s Integrated Pest Management efforts, including IPM/green certifications earned, routine inspections, pest identification, monitoring, record-keeping, etc.:

_________________________________________________________________________________

2. What is the volume of your annual pesticide use (gal/student/year)? Describe efforts to reduce use: _____________________________________________________________________________________

3. Which of the following practices does your school employ to minimize exposure to hazardous contaminants? Provide specific examples of actions taken for each checked practice.

[ ] Our school prohibits smoking on campus and in public school buses.________________________________

[ ] Our school has identified and properly removed sources of elemental mercury and prohibits its purchase and use in the school. __________________________________

[ ] Our school uses fuel burning appliances and has taken steps to protect occupants from carbon monoxide (CO) __________________________________________

[ ] Our school does not have any fuel burning combustion appliances

[ ] Our school has tested all frequently occupied rooms at or below ground level for radon gas and has fixed and retested all rooms with levels that tested at or above 4 pCi/L OR our school was built with radon resistant construction features and tested to confirm levels below 4 pCi/L. __________________________________________

[ ] Our school has identified any wood playground or other structures that contain chromate copper arsenate and has taken steps to eliminate exposure. __________________________________________

4. Describe how your school controls and manages chemicals routinely used in the school to minimize student and staff exposure. (100 word max) ____________________________________________________________

5. Describe actions your school takes to prevent exposure to asthma triggers in and around the school. (100 word max)__________________________________________________________________

6. Describe actions your school takes to control moisture from leaks, condensation, and excess humidity and promptly cleanup mold or removes moldy materials when it is found. (100 word max)

________________________________________________________________

7. Our school has installed local exhaust systems for major airborne contaminant sources. ( )Yes ( )No

________________________________________________________________

8 Describe your school’s practices for inspecting and maintaining the building’s ventilation system and all unit ventilators to ensure they are clean and operating properly. (100 word max) ______________________________________________________________

9. Describe actions your school takes to ensure that all classrooms and other spaces are adequately ventilated with outside air, consistent with state or local codes, or national ventilation standards. (100 word max)____________________________________________________________

10. Describe other steps your school takes to protect indoor environmental quality such as implementing EPA IAQ Tools for Schools and/or conducting other periodic, comprehensive inspections of the school facility to identify environmental health and safety issues and take corrective action. (200 word max) ______________________________________________________________________________

Nutrition and Fitness

11. Which practices does your school employ to promote nutrition, physical activity and overall school health? Provide specific examples of actions taken for each checked practice, focusing on innovative or unique practices and partnerships. (100 word max each or whatever you choose to make them!)

[ ] Our school participates in the USDA's HeathierUS School Challenge. Level and year: _________________.

[ ] Our school participates in a Farm to School program to use local, fresh food.

[ ] Our school has an on-site food garden. _________________________________________________

[ ] Our school garden supplies food for our students in the cafeteria, a cooking or garden class or to the community. ________________________________________________________

[ ] Our students spent at least 120 minutes per week over the past year in school supervised physical education. ______________________________________________________________________________

[ ] At least 50% of our students' annual physical education takes place outdoors. _________________

[ ] Health measures are integrated into assessments.__________________________________________

[ ] At least 50% of our students have participated in the EPA's Sunwise (or equivalent program). ______________________________________

[ ] Food purchased by our school is certified as "environmentally preferable"

Percentage:_______ Type: ________________________________

12. Describe the type of outdoor education, exercise and recreation available. (100 word max)

______________________________________________________________________________

13. Describe any other efforts to improve nutrition and fitness, highlighting innovative or unique practices and partnerships. (100 word max)

______________________________________________________________________________

Coordinated School Health, Mental Health, School Climate, and Safety

14. Does your school use a Coordinated School Health approach or other health-related initiatives to address overall school health issues? ( ) Yes ( ) No

If yes, describe the health-related initiatives or approaches used by the school:

_____________________________________________________________________

14. Does your school partner with any postsecondary institutions, businesses, nonprofit organizations, or community groups to support student health and/or safety? ( ) Yes ( ) No

If yes, describe these partnerships:
_______________________________________________________________________

14. Does your school have a school nurse and/or a school-based health center? ( ) Yes ( ) No

15. Describe your school’s efforts to support student mental health and school climate (e.g. anti-bullying programs, peer counseling, etc.):

_______________________________________________________________________________

Pillar 3: Effective Environmental and Sustainability Education

1. Which practices does your school employ to help ensure effective environmental and sustainability education? Provide specific examples of actions taken for each checked practice, highlighting innovative or unique practices and partnerships.

[ ] Our school has an environmental or sustainability literacy requirement. (200 word max)

______________________________________________________________________

[ ] Environmental and sustainability concepts are integrated throughout the curriculum. (200 word max)

______________________________________________________________________

[ ] Environmental and sustainability concepts are integrated into assessments. (200 word max)

______________________________________________________________________

[ ] Students evidence high levels of proficiency in these assessments. (100 word max)

______________________________________________________________________

[ ] Professional development in environmental and sustainability education are provided to all teachers. (200 word max)

______________________________________________________________________

2. For schools serving grades 9-12, provide:

Percentage of last year's eligible graduates who completed the AP Environmental Science course during their high school career: ____________Percentage scoring a 3 or higher: _________________

3. How does your school use sustainability and the environment as a context for learning science, technology, engineering and mathematics thinking skills and content knowledge? (200 word max)

______________________________________________________________________

4. How does your school use sustainability and the environment as a context for learning green technologies and career pathways? (200 word max)

______________________________________________________________________

5. Describe students’ civic/community engagement projects integrating environment and sustainability topics. (200 word max)

______________________________________________________________________

6. Describe students’ meaningful outdoor learning experiences at every grade level. (200 word max)

______________________________________________________________________

7. Describe how outdoor learning is used to teach an array of subjects in context, engage the broader community, and develop civic skills. (200 word max)

______________________________________________________________________

8. Describe your partnerships to help your school and other schools achieve in the 3 Pillars. Include both the scope and impact of these partnerships. (Maximum 200 words)

______________________________________________________________________

9. Describe any other ways that your school integrates core environment, sustainability, STEM, green technology and civics into curricula to provide effective environmental and sustainability education, highlighting on innovative or unique practices and partnerships. (Maximum 200 words)

______________________________________________________________________

10. Submit xy number of photos (with appropriate permissions) or up to xy minutes of video content, as suits your competition. All of this, and everything in this application, is up to the state authority.

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