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of • 11111110 Type of Government Entity: Contact Information: Name of contact person in your department who is familiar with this grant application Sandy Shields E3 state D City ❑Town $X County L3 Village ❑Borough Q Township 0Territory ❑ Region ❑Council ❑Community Ll Pueblo Nation U School. District Title: r Telephone: 561/978-6254 11 Partner information Email: ashields@iresherif f . Fax:5611564-8037 Under the COPS in Schools grant program, applicants must enter into a partnership agreement with an official for a specific school or school district with general educational oversight authority in that jurisdiction. If there are going to be multiple partners involved in this project, please provide the following information for each of the partners on a separate piece of paper. However, you must designate one school official as the school representative under the grant program. Please provide the information for that individual in the space below. If the proposed project affects an entire school district, then the official with general educational oversight over the entire school district should complete the "information below. Name of Partner Agency or School District Indian River School Board School Official Name: Dr. Roger Dearing Title: Superintendent AAA—- 1990 25th 5t City: Vero Beach State: F. Zip Code: Phone: Fax: lition, at the time the application is submitted applicants for the COPS in. Schools program must include two written documents prepared in cooperation with the other :y, or agencies, involved in the program. a, a Memorandum of understanding (MOU) that details the roles and responsibilities of partners involved in this project. For additional information on the requirement, please !r to page 7 of this Application Form. a COPS in Schools. Narrative Addendum detailing, the proposed prpicct. For al information on the requirement, please refer to page 8 of tin. Application Form. All COPS in Schools awards will contain an "Additional Grant Condition" that mu+t he signed and returned to the COPS Office. This ,grant condition is contained in the a►►ard package. and requires the funded officrrisl and a school administrator t►o attend a COPS in Schixtls Training the COPS (Mice "Ill reimburse granters for the training, per deem, tra%cl. and 1s*dging fur atiend.once of rccli:ircd p.vticipsnts up It, the maximum of SI.ltltt per person attending- w COPS in schools ❑ Other (please specify): Title: r Telephone: 561/978-6254 11 Partner information Email: ashields@iresherif f . Fax:5611564-8037 Under the COPS in Schools grant program, applicants must enter into a partnership agreement with an official for a specific school or school district with general educational oversight authority in that jurisdiction. If there are going to be multiple partners involved in this project, please provide the following information for each of the partners on a separate piece of paper. However, you must designate one school official as the school representative under the grant program. Please provide the information for that individual in the space below. If the proposed project affects an entire school district, then the official with general educational oversight over the entire school district should complete the "information below. Name of Partner Agency or School District Indian River School Board School Official Name: Dr. Roger Dearing Title: Superintendent AAA—- 1990 25th 5t City: Vero Beach State: F. Zip Code: Phone: Fax: lition, at the time the application is submitted applicants for the COPS in. Schools program must include two written documents prepared in cooperation with the other :y, or agencies, involved in the program. a, a Memorandum of understanding (MOU) that details the roles and responsibilities of partners involved in this project. For additional information on the requirement, please !r to page 7 of this Application Form. a COPS in Schools. Narrative Addendum detailing, the proposed prpicct. For al information on the requirement, please refer to page 8 of tin. Application Form. All COPS in Schools awards will contain an "Additional Grant Condition" that mu+t he signed and returned to the COPS Office. This ,grant condition is contained in the a►►ard package. and requires the funded officrrisl and a school administrator t►o attend a COPS in Schixtls Training the COPS (Mice "Ill reimburse granters for the training, per deem, tra%cl. and 1s*dging fur atiend.once of rccli:ircd p.vticipsnts up It, the maximum of SI.ltltt per person attending- w COPS in schools