Building Tomorrow's Leaders (BTL) Program Application

Building Tomorrow's Leaders (BTL) Program Application
Name of School District*
Name of Participating School*
Address*

Street Address

CityState / Province

Postal / Zip Code
Name of Principal*
Principal Email Address*
example@example.com
Name of Facilitating Teacher *
Facilitating Teacher Email Address*
example@example.com
Facilitating Teacher Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Grade 6Grade 7Grade 8Grade 9Grade 10Grade 11Grade 12
Estimated Number of Students*
Fall SemesterSpring SemesterOther
Please explain how your school will incorporate the BTL program into its setting (suggested formats may include, but are not limited to, regular class periods, two-hour time slots, and half-day or full-day workshops). Note: While all eight modules are encouraged, a minimum of six modules is required for reimbursement.*
Please explain why your school needs the BTL program and how your students will benefit from it.*
Please explain how the school plans to advise students on utilizing and demonstrating their leadership skills beyond the classroom.*
Your signature below indicates your assurances to do the following:
- Complete Budget Application (SFN 52929) and fully justify how funds will be used in the Comments section.
- Submit the student and teacher evaluations upon completion of the program.
- Submit Completion Report upon completion of the program.
- Submit claim for funds in the North Dakota WebGrants system.
BTL Budget Application Form (please print, complete, and upload)

https://www.nd.gov/dpi/sites/www/files/documents/SFN%20Forms/SFN52929.pdf

Programming expenses may include:
- Cost per pupil ($40). The school must pay an Extension Agent $15 per student for the Real Colors book and presentation materials. The remaining $25 can be used for school expenses (e.g., ingredients for trail mix, printing, etc.).
- Stipends for speakers, mileage for Extension Agents, leadership visits, etc.
Upload Completed Budget Application

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School Administrator's Signature*

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