PLANS Participant Agreement and Intake Form

Please complete and sign this agreement to confirm your role-specific participation in PLANS.

Purpose

The purpose of this Agreement between CLEE and the participant is to detail the commitment of each group to enter into a partnership to carry out the activities associated with the Plan, Lead, Act, Network, and Sustain (PLANS) for Equitable Outcomes. PLANS is funded through a Education and Innovation Research (EIR) grant from the US Department of Education for the year(s) a person participates.

Overview

PLANS is a professional learning program that implements evidence-based program components to deepen the implementation of a school’s improvement initiatives that aim to increase student outcomes. See the Overview for a description of the PLANS outcomes and research conducted by CLEE’s third-party evaluation partner, the American Institutes for Research (AIR).

Participants include:

Stakeholders	Students and families from the participating schools who attend the Community Assets and Needs Mapping Sessions.
Educators	All educators from the participating schools who attend the staff sessions.
School Leadership Team Members	Any educator or stakeholder serving as a member of a school’s leadership team (e.g. school improvement team).
School Leaders	Principals, assistant principals, and other leaders responsible for school-wide instructional improvements.
Principal Supervisors	District leaders responsible for providing guidance, mentoring and/or evaluation of school leaders.
District Leaders	Superintendents, assistant superintendents, and directors responsible for district-wide instructional improvements.

Please enter your full name(Required)

First Last

Please select your Participant role(Required)

If serving in multiple roles, please select the role with the highest data requirement (roles are listed in decreasing order)

School Leader

Principal Supervisor

District Leader

School Leadership Team Member

Stakeholder (student or family members)

Do you need translation for this form?(Required)

Yes

Do you need interpreter services for the sessions?(Required)

Yes

What language do you need translation / interpreter services in?(Required)

We will follow up via email within 1-3 business days.

Commitments

CLEE commits to all the following, pending continued funding from the U.S. Department of Education:

Implement PLANS experiences and activities, including Coaching, Multi-stakeholder Sessions, Group Sessions, Job-Embedded Support, and Asynchronous Modules and Resources (see overview of activities)
Provide a stipend once all commitments are fulfilled by the participants. Click here to see stipend information for each participant.
Ensure data collection and evaluation is streamlined and honors participants time. See below for details on data engagement expectations and permissions.
In storing PLANS data, CLEE and AIR will never share any data you submit with anyone outside of our teams and we will never use your name or the name of your school in any report.

Important Notes about the research design for School Leaders, Principal Supervisors, and District Leaders:

Every school admitted to engage in PLANS will receive the full PLANS programming and contribute to the study through data collection; however, the year each school engages in PLANS will depend on if they are randomly assigned to the treatment or control condition by AIR.
Schools assigned to the control condition will participate in PLANS the following year. This means that schools from the same LEA will likely participate in PLANS in different years.
Participants may be invited to join the Evaluation Advisory Council, facilitated by AIR, to provide insights that inform program improvements and research efforts. This voluntary opportunity allows stakeholders to contribute to the evaluation and refinement of PLANS.

School Leader commits to the following in the year they participate in PLANS.

Attend and engage in all sessions designated for your role, utilize resources and the learning management system (Canvas) to prepare for sessions and to deepen the implementation of your school’s improvement initiatives.
Support your School Leadership Team as they collaborate with you to implement your school’s improvement initiatives through regular meetings, modeling Core Leadership Practices, and regular feedback.
Identify and provide contact information for School Improvement Team participants and Stakeholder participants, and support their participation through communication of purpose and importance.
Fulfill all commitments and responsibilities within this agreement to receive the stipend (see stipend and in-kind details for all roles).
Allow CLEE to use photos, words, materials from discussions to share the learning and work on social media and elsewhere. We will always ask permission from participants via email before sharing materials, photos, or quotes with any names attached.
Complete PLANS participant data collection activities in a complete, consistent, and timely manner. Your participation in these activities will give you an opportunity to share your perspectives on PLANS and will inform your continued development while participating in PLANS. Your participation in these activities will not be used in any high-stakes decisions that affect your or another person’s livelihood. Your participation will include the following activities:
1. Reflections after each coaching and group session
2. Core Leadership Practices Self-Assessment
3. Pre-and post-surveys before and after PLANS participation
4. The Learning Community Survey in the spring before and after participation
  1. CLEE will guide you to send this survey to teachers in your school.
  2. Schools assigned to the control cohorts will administer the Learning Community Survey one extra time in the spring the year before they participate in PLANS.
5. You may also be randomly selected and invited to participate in focus groups, facilitated by AIR. Although voluntary, participation in these interviews will help gather further insight and feedback on how CLEE can further improve and refine the PLANS program.

Principal Supervisor commits to the following:

Attend and engage in all sessions designated for your role, utilize resources and the learning management system (Canvas) to prepare for sessions and strengthen your mentoring and supervisory practices in order to support the school leader.
Support your School Leader partner as they deepen the implementation of their school’s improvement initiatives through regular meetings, modeling Core Leadership Practices, and regular feedback.
Fulfill all commitments and responsibilities within this agreement to receive the stipend (see stipend and in-kind details for all roles).
Allow CLEE to use photos, words, materials from discussions to share the learning and work on social media and elsewhere. We will always ask permission from participants via email before sharing materials, photos, or quotes with any names attached.
Complete PLANS participant data collection activities in a complete, consistent, and timely manner. Your participation in these activities will give you an opportunity to share your perspectives on PLANS and will inform your continued development while participating in PLANS. Your participation in these activities will not be used in any high-stakes decisions that affect your or another person’s livelihood. Your participation will include the following activities:
1. Reflections after each coaching and group session
2. Pre-and post-surveys before and after PLANS participation
3. You may also be randomly selected and invited to participate in focus groups, facilitated by the PLANS evaluation team at the American Institutes for Research (AIR). Although voluntary, participation in these interviews will help gather further insight and feedback on how CLEE can further improve and refine the PLANS program.

District Leader commits to the following:

Attend and engage in all sessions designated for your role, utilize resources and the learning management system (Canvas) to prepare for sessions and support PLANS implementation.
Support School Leaders and all the other participants as they deepen the implementation of their school’s improvement initiatives..
Fulfill all commitments and responsibilities within this agreement to receive the stipend (see stipend and in-kind details for all roles).
Allow CLEE to use photos, words, materials from discussions to share the learning and work on social media and elsewhere. We will always ask permission from participants via email before sharing materials, photos, or quotes with any names attached.
Complete PLANS participant data collection activities in a complete, consistent, and timely manner. Your participation in these activities will give you an opportunity to share your perspectives on PLANS and will inform your continued development while participating in PLANS. Your participation in these activities will not be used in any high-stakes decisions that affect your or another person’s livelihood. Your participation will include the following activities:
1. Reflections after each coaching and group session
2. Pre-and post-surveys before and after PLANS participation
3. You may also be randomly selected and invited to participate in focus groups, facilitated by the PLANS evaluation team at the American Institutes for Research (AIR). Although voluntary, participation in these interviews will help gather further insight and feedback on how CLEE can further improve and refine the PLANS program.

School Leadership Team Member commits to the following:

Attend and engage in all sessions designated for your role, utilize resources and the learning management system (Canvas) to prepare for sessions and to deepen the implementation of your school’s improvement initiatives.
Fulfill all commitments and responsibilities within this agreement to receive the stipend (see stipend and in-kind details for all roles).
Allow CLEE to use photos, words, materials from discussions to share the learning and work on social media and elsewhere. We will always ask permission from participants via email before sharing materials, photos, or quotes with any names attached.
Complete PLANS participant data collection activities in a complete, consistent, and timely manner. Your participation in these activities will give you an opportunity to share your perspectives on PLANS and will inform your continued development while participating in PLANS. Your participation in these activities will not be used in any high-stakes decisions that affect your or another person’s livelihood. Your participation will include the following activities:
1. Reflections after each coaching and group session
2. Pre-and post-surveys before and after PLANS participation
3. The Learning Community Survey in the spring before and after participation
4. You may also be randomly selected and invited to participate in focus groups, facilitated by the PLANS evaluation team at the American Institutes for Research (AIR). Although voluntary, participation in these interviews will help gather further insight and feedback on how CLEE can further improve and refine the PLANS program.

School Stakeholders (family members, students) commits to the following:

Attend and engage in all sessions designated for your role to help improve your school’s ability to improve.
Fulfill all commitments and responsibilities within this agreement to receive the stipend (see stipend and in-kind details for all roles).
Allow CLEE to use photos, words, materials from discussions to share the learning and work on social media and elsewhere. We will always ask permission from participants via email before sharing materials, photos, or quotes with any names attached.
Complete PLANS participant data collection activities in a complete, consistent, and timely manner. Your participation in these activities will give you an opportunity to share your perspectives on PLANS and will inform your continued development while participating in PLANS. Your participation in these activities will not be used in any high-stakes decisions. Your participation will include the following activities:
1. Reflections after each group session
2. Pre-and post-surveys before and after PLANS participation
3. You may also be randomly selected and invited to participate in focus groups, facilitated by the PLANS evaluation team at the American Institutes for Research (AIR). Although voluntary, participation in these interviews will help gather further insight and feedback on how CLEE can further improve and refine the PLANS program.

Please complete the following information that will be kept confidential and allow CLEE and AIR to organize and disaggregate data meaningfully to meet the grant goals.

LEA / District Name(Required)

School Name(Required)

Approximate number of educators/staff members in your school(Required)

Please enter a number from 0 to 5000.

Current Role(Required)

Years of experience in current role(Required)

Report 0 if this is your first year

Please enter a number from 0 to 100.

Years of overall experience as a school and/or district administrator(Required)

Report 0 if this is your first year

Please enter a number from 0 to 100.

Please enter your grade(Required)

Student Consent for Participation in Community Assets and Needs Mapping Sessions

What is this about?
The Center for Leadership and Educational Equity (CLEE) is working with your school to guide improvement efforts. We are asking you to take part in two 90-minute sessions to discuss what is going well and what could be improved in your school with a group of students, families, teachers, and leaders. The sessions will be led by a trained CLEE facilitator and will take place at a date and time that CLEE will determine with your principal.

Will my information be private?
You will engage in group discussions and will fill out a reflection form at the end of each session. We will not use your name in any reports, and your answers will not be linked to you. But since there will be group discussions, we cannot promise full privacy, because other participants will also hear what is said. We ask that everyone respect each other’s privacy.

Do I have to participate?
No, it’s completely up to you. If you decide to join, you can choose to stop participating at any time. Your grades, school experience, or relationships with teachers and staff will not be affected if you choose not to participate.

What do I get for participating?
This is a chance to share your thoughts and help improve your school! Your voice matters, and your feedback will be used to help make positive changes. You will also receive a $150 stipend for attending both sessions.

What if I have questions?
If you have any questions before or after the focus group, you can contact Michelle Li, Program Director at CLEE, at michelleli@clee.org.

Do you agree to participate?
If you understand everything above and want to participate, please complete the following information that will be kept confidential and allow CLEE and AIR to organize and disaggregate data meaningfully to meet the grant goals, and sign below.

Student Signature(Required)

Pronouns(Required)

she / her(s)

he / him / his

they / them

Other

Gender(Required)

Female

Male

Nonbinary

Transgender female

Transgender male

Don't know or prefer not to answer

Other

Ethnicity / Race (select all that apply)(Required)

Black / African American

White

American Indian / Alaskan Native

Asian

Native Hawaiian / Pacific Islander

Hispanic

Latina / Latino / LatinX

prefer not to respond

Other

Age range(Required)

Personal Email Address or Student School Email(Required)

Please provide your email address for communication about your stipend If you are a STUDENT - please enter your school email address

Mobile Phone Number(Required)

This will be used to send text reminders

Emergency Contact Name(Required)

First Last

Emergency Contact Phone number(Required)

Emergency Contact Relationship to contact(Required)

If you are a student, please have your parent or guardian complete the section below:

Parent Consent Form for Student Participation in Community Assets and Needs Mapping Sessions

Purpose
The Center for Leadership and Educational Equity (CLEE) is working with your school to guide improvement efforts. We are requesting your permission for your child to take part in two 90-minute sessions to discuss what is going well and what could be improved in their school with a group of students, families, teachers, and leaders. The sessions will be led by a trained CLEE facilitator and will take place at a date and time that CLEE will determine with your principal.

Confidentiality and Privacy
Your child will engage in group discussions and will fill out a reflection form at the end of each session. We will not use your child’s name in any reports, and their answers will not be linked to them. But since there will be group discussions, we cannot promise full privacy, because other participants will also hear what is said. We ask that everyone respect each other’s privacy.

Freedom to Withdraw
Participation in the Mapping Sessions is completely voluntary. If your student decides to join, they can choose to stop participating at any time. Your child’s grades, school experience, or relationships with teachers and staff will not be affected if they choose not to participate.

Benefits
This is a chance for your child to share their thoughts and help improve your school! Their voice matters, and your feedback will be used to help make positive changes. Your child will also receive a $150 stipend for attending both sessions.

Risks
This Mapping Sessions poses minimal risks to participants. While the discussion is designed to be a respectful and supportive space, students may experience mild discomfort when sharing personal experiences.

What if I have questions?
If you have any questions before or after the focus group, you can contact Michelle Li, Program Director at CLEE, at michelleli@clee.org.

Informed Consent. I have read and understand the above information. I voluntarily consent to my child’s participation in the focus group.

Parent / Guardian Name

We will issue the stipend check to this name on behalf of the student participant

First Last

Parent / Guardian Personal Email Address

Home Address and / or preferred mailing address for stipend(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent Signature(Required)

Signature Agreement

Home Address and / or preferred mailing address for stipend(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

By signing this form, you understand and agree with the following:

to meet the program and data collection and commitments above
that CLEE and its external evaluator, AIR may store and use these data
that CLEE will meet all the commitments detailed above as long as the funding from the U.S. Department of Education continues for PLANS

Signature(Required)