Proposed Local Occupational Program Request

2a. Indicate standards to be used for proposed program*
2b. Upload document of all standards to be taught for the program*

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3: Teaches the identified program standards listed in the above that includes academic integration, AZ Professional Skills, CTSO integration and 51 % of program is lab time: examples of supporting evidence may include - Curriculum Maps, scope and sequence etc.
3. File Upload*

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Proposed Local Occupational Program Request
4. If a Community College Program, show the crosswalk of program standards to College outcomes
5: Taught by an appropriately certified instructor per CTE requirements for the proposed program
5. Identify the instructor/s and indicate the certification and credentials for the instruction of the proposed program or copy of District advertised for CTE certified Instructor*
6: Indicate how the program is inclusive for all students
6. Upload District Reports showing data to be gathered includes all populations as drafted in Perkins

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7: An industry or vocation has agreed to provide financial or technical support to the career technical education district for a specific career technical education district program…(which) includes in-kind contributions and donations.
7. List industry partners, company, and contact Info.*

Proposed Local Occupational Program Request
8: Requires student participation in Career Exploration for grades 5 - 9
8. Attach documentation of Career Exploration in grades 5-9*

Examples: Course catalog Listing, Career Center Lessons, District Documentation
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9. Specify and list the specialized equipment and specialized materials required for the instruction of the proposed program*

10. Indicate appropriate Career and technical Education Organization (CTSO)*

DECAFCCLAFBLAHOSAFFASkillsUSA

11. Upload work based learning opportunity documentation including, but not limited to Cooperative Education, Internship, Apprenticeship experiences.*

Example: District WBL guide, forms, course catalog, WBL
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12: Evaluates program performance annually and meets or exceeds established State Performance Measures
12. List how each state performance measure will be evaluated
1S1 Graduation Rate -   1s1*
S1 Reading/Language Proficiency -   2s1*
2S2 Mathematics Proficiency -   2s2*
2S3 Science Proficiency -   2s3*
3S1 Placement -   3s1*
4S1 Nontraditional -   4s1*
5S1 Industry Recognized Credential -   5s1*
5S4 Technical Skills Assessment -   5s4*
OR If a CTED Central program per 15-393.01A, how the CTED performance measure will be evaluated
Graduation Rate -    Grad Rate*
Completion Rate -   CR*
Technical Skills Assessment -    TSA*
Industry Credential or Community College Certificate earned - Cred*
Placement -   Place*
13. List industry credential(s) available for the proposed program. (Please note, if an industry credential is not currently on the approved Credential list, the CTED or District must submit a separate Industry credential application for each credential)*
14. Data to determine the need for the local program and/or rationale from the local governing board to start the program - Comprehensive Local Needs Assessment(CLNA), survey's, local data, focus groups, etc.*
Additional Comments

Proposed Local Occupational Program Request
Have you Completed Re-submitting Documentation?

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Is the information below complete and accurate?
Program	{lopRequest}
Carnegie Units	{carnegieUnits}
CTSO	{name255}
Credentials	{typeA304}
Coherent Sequence	{1List}

Program Specialist Review