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<br />Application Form <br /> <br />Type of Government Entity: <br />a State ~ City <br />a Borough a Township <br />o Community 0 Pueblo <br />o Village 0 Council <br />o Other (please specify): <br /> <br />o Town <br />a Territory <br />o Nation <br /> <br />a County <br />a Region <br />o School District <br /> <br />Contact Information: <br /> <br />Name of contact person in your agency familiar with this grant application: <br />Lisa Wright <br /> <br />Title: Director of Community Development <br /> <br />Telephone: (903) 784-9203Fax:(903) 784-1798 <br />Email: l_wttght@cLparis.tx.us <br /> <br />III. Partner Information <br /> <br />Under the COPS in Schools grant program, applicants must enter into a <br />partnership agreement with an official for a specific school or school district <br />who has general educational oversight authority within that jurisdiction. **In <br />the space below, please provide the information of the school official with <br />general educational oversight who will be responsible for attending the <br />m~datory COPS in Schools Training. If the proposed project affects an entire <br />school district" then the official with general educational oversight over the <br />entire school district should be listed below. In addition, this individual will be <br />required to sign the attached COPS in Schools Training Requirement. <br /> <br />Name of Partner Agency or School District: Chisum Independent School District <br /> <br />School Official Name: Diane Steg;all <br /> <br />Title: Administrator <br />Address: 3250 Church Street <br /> <br />City: Paris State: TX Zip Code: 75460 <br /> <br />Telephone: (903) 737-2830 Fax: (903) 737-2831 <br /> <br />Email: steg;alld@chisum.esc8.net <br /> <br />**Jf there are multiple partners involved in this project, please provide the <br />information listed above for each of the partners on the attached "Additional <br />Partner Page" included with this application. At the present time, only one school <br />official per grant award will be permitted to attend the CIS Training due to <br />logistical constraints. <br /> <br />5 <br />