Missouri Green Schools Level I

To complete this form, type your answers in the boxes provided for each question. Do try and stick to the word limit. The box will expand to hold what you type. The number in parentheses corresponds to the number of the item in the USED GRS Nomination Form.

School Name:

Lead Name:

Email:

Sustainability

WATER AND GROUNDS

1 (6). Water Use - Can you demonstrate a reduction in your school's total water consumption?( ) Yes ( ) No

Baseline Year: / Water Use (gal / student / year):
Ending Year: / Water Use (gal / student / year):
Reduced Water Use: Baseline Water Use – Ending Water Use = gal / student /year
% Reduction: Reduced Water Use / Baseline Water Use = % gal / student
% Reduction per Year: % Water Use / (Ending Year – Baseline Year) = % gal / student / year
%Reduction Domestic Water Use: / % Reduction Irrigation Water Use:
How are these reductions documented (i.e. ENERGY STAR, utility bills, school district reports)?

2 (7). Landscaping – Does your school have water efficient or regionally appropriate ( ) Yes ( ) Nolandscaping (WERAL)?

Total Area: / WERAL Area: / % WERAL:
List Water Efficient Plants:
List Regionally Appropriate Plants:
In 50 words or less, describe WERAL Features:

3 (10). Ecology – Does your school have area(s) set aside for ecologically beneficial (EB) uses? ( ) Yes ( ) No

Total Area: / EB Area: / % EB Area
If yes, in100 words or less, describe the beneficial uses:

WASTE

4 (11) . Solid Waste – Has your school diverted some of its solid waste from a landfill( ) Yes ( ) No

through recycling and composting, and/or has it implemented practices to reduce

waste at the source (source reduction)?

A - Monthly garbage service in cubic yards (garbage dumpster size(s) x number of collections per month x percentage fulle when emptied or collected:
B - Monthy recycling volume in cubic yards (recycling dumpster size(s) x number of collections per month x percentage fulle when emptied or collected:
C - Monthy compostable materials volume in cubic yards (food scrap/food, soiled paper dumpster size(s) x number of collections per month x percentage fulle when emptied or collected:
Recycling Rate = ((B + C) / (A + B + C) x 100) =
Monthly waste generated per person = A / number of students and staff
In 50 words or less, describe any efforts at source reduction:

TRANSPORTATION

5 (16). Accommodations – Does your school accommodate alternative transportation by( ) Yes ( ) No

providing designated carpool parking stalls, bike racks for all ages, a Safe Pedestrian

Routes or Walking School Bus program, and/or other programs?

If yes, describe in 100 words or less:

Health

ENVIRONMENTAL HEALTH

7 (1). Water Sources - Is the school’s water source, whether municipal, on-site well, or other,( ) Yes ( ) No

protected from potential contaminants?

If yes, in 50 words or less describe your school’s source of water and efforts to protect it from contaminants :

8 (2).Drinking Water - Does your school have a program in place to test for and control lead ( ) Yes ( ) No

or other contaminants in drinking fountains and sinks?

If yes, in 50 words or less, describe the school’s program:

9 (4). Ventilation–What steps does your school take to maintain the ventilation system? ( )Yes ( )No

If yes, in 100 words or less, describe the school’spractices for:
inspecting and maintaining the ventilation system –
ensuring all unit ventilators are clean and operating properly –
ensuring that all spaces are adequately ventilated with outside air consistent with state or local codes or national standards -

10 (5). Airborne Contaminants - Has your school taken steps to control for specific airborne( )Yes ( )No

contaminants?

If yes, in 100 words or less, describe the school’s actions:
exhaust systems for heating systems, labs, and our other major airborne contaminant sources –
no idling policies for vehicles (including buses) –
vehicle loading/unloading zones at least ten feet from air intakes, doors and windows –
steps to prevent exposure to asthma triggers in and around the school -

11 (7). Chemical Management – Does your school have policies and procedures for identifying, ( )Yes ( )No

managing and or reducing student and staff exposure to chemical hazards.

If yes, describe the policies and procedures related to:
smoking on school grounds or buses -
mercury -
radon in frequently occupied rooms (should be below 4 pCI/L) -
playground structures that contain chromate-copper-arsenate treated wood -
implementing EPA’s IAQ for Schools and/or similar tools for periodic, comprehensive inspections to identify health and safety issues and take action -

NUTRITION AND FITNESS

12 (10). Fitness – How many minutes a week are spent on supervised P.E., and what % of that takes place outdoors?

minutes P.E.: / % outdoor P.E.: %
In 100 words or less, describe the outdoor P.E. activities:

COORDINATED SCHOOL HEALTH PROGRAM

13 (13). Health Education – Is education about exercise, nutrition and safety integrated( ) Yes ( ) No

into classroom assignments and assessed?

If yes, in 100 words or less, describe what is assessed and how:

14 (14). Health Services – Does your school have a school nurse or health center to provide ( ) Yes ( ) No

first aid, emergency care, assessment and planning management for chronic conditions

like asthma and management of health and emotional stressors for students and staff?

If yes, in 100 words or less, describe the health services:

Learning

CURRICULUM AND ASSESSMENT

15 (2). Lessons - To what extent are environmental and sustainability concepts integrated into the curriculum in each subject and each grade? In the table below, list each grade taught in your school. Then list at least one environmental and/or sustainability curriculum or lesson used in all classes in that grade and the specific subject standards covered (e.g. Science: geology, Math: geometry, English: technical writing, Social Studies: maps). If you need more lines, use the Table menu to add lines. If you have a grade in which no curriculum or lesson is used, put NA in the Curriculum or Lesson cell.

Grade / Curriculum or Lesson / Subjects

16 (3). Assessments - To what extent are environmental and sustainability concepts integrated into assessments in each subject and each grade? In the table below, list each grade taught in your school. Then list at least one environmental and/or sustainability curriculum or lesson used in all classes in that grade. You can use the same list as above. In the Assessment Tool cell, put the kind of assessment used (e.g. short answer quiz, multiple choice test, essay, on-line quiz, science fair project, etc.)

Grade / Curriculum or Lesson Assessed / Assessment Tool / Average Student Proficiency (%)

17 (4). STEM - To what extent are the environment and sustainability used as a context for learning STEM (Science, Technology, Engineering and Math) thinking skills and content knowledge? In the table below, list each grade taught in your school. Then list at least one environmental and/or sustainability curriculum or lesson used in all classes in that grade. You can use the same list as above. In the STEM Standard cell, put the standard addressed (e.g. critical thinking, … etc.)

Grade / Curriculum or Lesson / STEM Standard

PROFESSIONAL DEVELOPMENT

18 (8). Workshops Attended - In the table below, list workshops in which teachers participated in the last three years. Include the number of teachers, their grades and the year of participation. Add additional rows as needed. Categorize the workshops using the list provided in the directions. Webinars and online course will also count.

Workshops (Category 1, 2, or 3) / Grade (# Teachers) Year; Grade (# Teachers) Year:…

OUTDOOR LEARNING EXPERIENCES

19 (10). Outdoor Learning –In the table below, list each grade. For each grade briefly describe a meaningful outdoor experience and the subject standards to which it connects.

Grade / Outdoor Experience (Subject Standard)

1