*Please confirm this form has been fully completed and reviewed by the JCSP Coordinator and Principal. Insert names below:


*Have all monies received for initiatives in the past year been spent on the initiatives and are receipts available? (Answer Yes/No) (If no, please contact the office at jcspresources@oide.ie)?

*Have all initiatives awarded in the past year been evaluated? (Answer Yes/No)

*Name (Coordinator)	

*Lead Teacher for the initiative (if not the coordinator)

*Email address

*Total number of students currently in JCSP	

*The year group(s) and number of students that you implemented the initiative with:

First Years (Male/Female)
Second Years (Male/Female)
Third Years (Male/Female)

*For DEIS schools answer the following questions		
The initiative proposal should link to the targets in the school’s DEIS Action Planning document. Please choose the DEIS theme which the initiative seeks to support (multiple choice)
Literacy
Numeracy
Attainment
Supporting Educational Transitions
Attendance
Retention
Partnership with Parents
Partnership with Others

*For non-DEIS schools, answer the following question:
Explain how the initiative proposal links with your school’s SSE Plan. (Four points minimum required).
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*Please describe the rationale for carrying out this initiative? (a minimum of four reasons required) For example, why you have chosen this specific cohort to engage in the initiative, background information on the cohort of students, information about how the initiative may link to teaching and learning, how the initiative may ignite student interest in a particular subject area, etc.

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*Please describe the anticipated improved learner outcomes after carrying out this initiative? (Four points minimum).
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*Please describe how you propose to implement this initiative? (Four points minimum)
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*List the JCSP statements (including cross curricular statements) you intend to use in conjunction with running this initiative? 

*Identify which domains of teaching and learning the initiative will impact on and explain how the initiative will achieve this. (Enter the domain number and give a reason for that domain. 

Domain 1: Learner Outcomes

Domain 2: Learning Experiences

Domain 3: Teacher’s Individual Practice

Domain 4: Teachers' Collective/Collaborative Practice

*Explain how you will evaluate the success of the initiative? For example, consider JCSP statements awarded. class assessments, feedback from students, student questionnaires / focus groups, teacher feedback and principal feedback.

*What will the initiative grant money be spent on?

*Other (details)