Idaho Career & Technical Education

Idaho Career & Technical Education

Local Annual Application

Available: February 1st Due Date: April 1, 2017 Updated 2/1/2017

Directions: The Local Annual Application for state approved career & technical education (CTE) programs represents the local district’s request for state CTE funding for next year. The completed Local Annual Application will include:

Section 1 - General Information

Section 2 – Statement of Assurances and Certifications Regarding Lobbying; Debarment; and Drug-Free Workplace Requirements

Section 3 – CTE Program Information

Section 4 – Program Budget Request (Form 10F)

Section 1: General Information

District Information:

School District Name: / Click here to enter text.
School District Number: / Click here to enter text.

District CTEAdministrator Contact Information:

Name: / Click here to enter text.
Title: / Click here to enter text.
Mailing Address: / Click here to enter text.
Phone: / Click here to enter text.
Email: / Click here to enter text.

Section 2: Statement of Assurances and Certifications Regarding Lobbying; Debarment; and Drug-Free Workplace Requirements

The district is required to sign and return two documents: (1) The Statement of Assurances, and (2) Certifications Regarding Lobbying; Debarment; and Drug-Free Workplace Requirements. Both documents are available at Please note that both formsmust be completed on hard copy and returned to the IdahoCareer & Technical Education (ICTE) office with original signature(s) on or before April 1, 2017. Please return the signed forms to:

Donna Simpson, Admin. Assistant

Idaho Career & Technical Education

650 West State Street, Room 324

Boise, ID 83720-0095

(208) 429-5527 or

Through these documents, the school district certifies that the program requirements for state approved secondary CTE programs and CTE Programs of Study (including appropriate CTE endorsement for licensed teachers), and the rules and regulations for The Carl D. Perkins Career and Technical Education Improvement Act of 2006 (Public Law 109-270) will be met by the district or through contract between the district and other agencies, institutions, or individuals. The district agrees to furnish accurate fiscal and career & technical program data as requested by the Idaho Career & Technical Education office in a timely fashion. (check box belowto indicate your understanding of this requirement)

☐ Yes, I understand the Statement of Assurances and the Certifications Regarding Lobbying; Debarment; and Drug-Free Workplace Requirements must be submitted before any state or federal funds are released to the district.

Section 3: CTE Program Information

Please list all state-approved CTE programs currently being offered in the district and the status of each program

for the next school year. Please complete a Program Budget Request for each programcurrently active in the online CTE system.

CTE Program Name / Location of Program(School) / Lead Instructor (if known) / Status for Next Year
Click here to enter text. / Click here to enter text. / Click here to enter text. / Choose an item.
Click here to enter text. / Click here to enter text. / Click here to enter text. / Choose an item.
Click here to enter text. / Click here to enter text. / Click here to enter text. / Choose an item.
Click here to enter text. / Click here to enter text. / Click here to enter text. / Choose an item.
Click here to enter text. / Click here to enter text. / Click here to enter text. / Choose an item.
Click here to enter text. / Click here to enter text. / Click here to enter text. / Choose an item.
Click here to enter text. / Click here to enter text. / Click here to enter text. / Choose an item.
Click here to enter text. / Click here to enter text. / Click here to enter text. / Choose an item.
Click here to enter text. / Click here to enter text. / Click here to enter text. / Choose an item.
Click here to enter text. / Click here to enter text. / Click here to enter text. / Choose an item.
Click here to enter text. / Click here to enter text. / Click here to enter text. / Choose an item.
Click here to enter text. / Click here to enter text. / Click here to enter text. / Choose an item.
Click here to enter text. / Click here to enter text. / Click here to enter text. / Choose an item.
Click here to enter text. / Click here to enter text. / Click here to enter text. / Choose an item.
Click here to enter text. / Click here to enter text. / Click here to enter text. / Choose an item.
Click here to enter text. / Click here to enter text. / Click here to enter text. / Choose an item.
Click here to enter text. / Click here to enter text. / Click here to enter text. / Choose an item.
Click here to enter text. / Click here to enter text. / Click here to enter text. / Choose an item.

(NOTE: Please extend the table if the district has moreactive CTE programs than the number of rows available.)Contact Donna Simpson at 208.429.5527 or f you have questions.

Section 4: Program Budget Request

Please submit an online2018 Program Budget Request (Form 10F)for each currently active CTEprogram.Hard copies of the 10F form must be completed for newly approved and/orreinstated programs; one form must be completed for eachprogram.The completed forms should be faxed or emailed to the Program Quality Manager for the particular program requested.

Final Approval: Superintendent

Superintendents or their designee must approve the Local Annual Application. After reviewing the information on thisApplication, enter the superintendent or designee’s name or electronic signature in the space provided. A name or electronic signature in the space provided indicates the district consent in submitting the Local Plan and Application.

Superintendent or Designee Signature: / Position / Date

Application Submission

Submit Application Packet (Forms 10-A, 10-C, 10-F)on or before April 1stby post and/or e-mail to Donna Simpsonat . The Application Packetwill be reviewed by the state CTE staff and the school will be notified of this program’s status by May 15. District projected funding allocation letters will be sent by June 30th.

G:\Secondary Programs\SECONDARY\Secondary Forms\Local_Annual_Application_FY2018.doc