Statement of Intent

Statement of Interest - Peace Maker Foundation

Application for schools to be part of Peace Maker Foundation

Every school we help begins by filling out this Statement of Interest form.

What this Statement of Interest means

By signing this document, I state my interest in entering our school into an ongoing partnership with the Peace Maker Foundation.

I confirm that our school is dedicated to providing a safe learning environment for our students and / or to teaching conflict resolution skills. Upon entering into a partnership with the Peace Maker Foundation our school is willing to complete a Peace Maker Foundation report that can be used by the Foundation to:

1. Represent our violence prevention efforts for the purpose of raising contributions on behalf of Foundation Partner Schools. The Peace Maker Foundation raises money through workplace employee fund drives, grants, mailings, personal solicitations, etc.;

2. Assist other Peace Maker Partner Schools in the development of their peacemaking projects;

3. Inform the general public about the need and value of such programs.

I understand that this document is not a partnership agreement. The purpose of this document is to express our interest in becoming a Peace Maker Foundation Partner School and to provide the Foundation with information to:

1. Determine if the peacemaking topic described within fits with the priorities of the Foundation.

2. Raise contributions for our peacemaking work described within.

Today's Date

YYYY

School Name

Principal's Name

Principal's Signature (Full Name)

Name of Person Filling Out Form (if different)

School Address

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

Principal's Phone Number

###

####

School's Phone Number

###

####

Email

School District

County

Grade levels taught at your school:

Number of students attending your school:

Number of students expected to actively
participate in your violence prevention:

Number of students receiving a free or reduced
lunch:

Percentage of students receiving a free or reduced
lunch:

School Violence Prevention / Peace Making Budget

(Please include income and expenses for all of your peacemaking activities, not just those for which Peace Maker Foundation funding is requested)

INCOME

Amount Requested from Peace Maker Foundation

Amount Requested from Other Sources

Name of Source #2

Name of Source #1

TOTAL INCOME

EXPENSES

Amount for Purchasing a Curriculum:

Name of Curriculum:

Amount for Teaching Supplies (other than a
curriculum):

Type of Supplies

Amount for Staff Training:

Describe

Amount for Student Training:

Describe:

Amount for Consultant Services:

Describe:

Amount for Other:

Describe:

Amount for Other:

Describe:

TOTAL EXPENSES:

Part III - Project Description

In the box below, please describe the need, challenge or opportunity that your work will address.

In other words, what is the reason or motivation for undertaking the work that you would like Peace Maker Foundation to fund?

Complete this sentence, filling in the two boxes: in the box:

“With the funding we receive we would like to teach students:

[insert a peacemaking topic from 1-9 below]

by (doing what):

Peacemaking Topics:

1. Anger management

2. Bullying prevention

3. Conflict Resolution

4. Restorative practices

5. Peer mediation

6. Cooperation

7. Empathy

8. Listening / Communication

9. Respect / Tolerance

What measurable result do you want to achieve during the school-year that will demonstrate the value of your efforts to teach students conflict resolution skills or to maintain a safe learning environment. Your goal should indicate student knowledge, skills, behaviors or perceptions.

Your goal statement needs to include both numbers and a percentage and specify the target population to be measured (entire school, certain
grade levels or classrooms, etc.). Please refer to the Example Goal Statements found at the end of this document before writing your goal statement.

Please provide an outline of how you will go about teaching the peacemaking topic or topics that you identified above and how you will go about achieving your goal.

How might people connected with your school (parents, students, school staff, district administrators, etc.) be willing to help Peace Maker Foundation efforts to raise funds for your work?

Assistance provided by current Peace Maker Foundation schools includes: providing Peace Maker Foundation with a list of prospects (individuals or companies) to solicit, including Peace Maker Foundation and its Partner Schools as a giving option in the school district’s annual employee fund drive, distributing an email to parents about how contributions can be matched, organizing a student special event like a bowl-a-thon, parents hosting a house party, providing Table Captains for a Peace Maker Foundation organized fundraising event, hosting Peace Maker educational presentations about the need and value of your type of work, writing a letter of support for Peace Maker Foundation fundraising efforts, etc.

People at your school do not have to help Peace Maker Foundation fundraising efforts in order to receive funding. Your assistance, however, will likely increase the amount of contributions that are raised and make it likely that funding can be received during the Foundation’s next grant making round.

ADDENDUM: Examples of Goal Statements

Examples showing student knowledge:

84 out of 129 (65%) of 5th grade students surveyed will be able to list three things to try to calm one-self down.
(For students taught the Second Step program.)
84 out of ? 84 out of 129 (65%) of fourth graders will be able to identify two things to do the next time they felt bullied.
(For students participating in a Climb Theater Presentation.)

Example of a goal showing student skills:

18 of 24 (75%) third grade students will demonstrate the ability to use “I” statements appropriately when role playing conflict resolution exercises.

Examples showing student behavior skills:

Classroom removals for the entire school will drop by 15%, from 100 to 85. skills:
The number of students who report that they have been bullied 2-3 times per month will remain under 80, or 8% of the 6th, 7th & 8th graders at our school. (For schools using the Olweus Bullying Prevention Program.)

Examples showing student perceptions:

90% (450 out of 500) of our entire student body will report feeling safe at school. (For schools completing The Minnesota Student Survey.)
60% (300 of 500) of our entire student body will feel that teachers or other adults at school tried to put a stop to bullying when it was happening at school. (For schools using the Olweus Bullying Prevention Program.)

Please do not write an accomplishment statement that requires donors to be familiar with your program in order to understand its impact. For example, “76% of students surveyed could identify every C.A.R.E.S. value and its meaning.”

If you would like help developing a goal statement please call or email the Foundation.

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