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Schools for healthy lifestyles application packet

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Mac McCrory, Ed.D.

Executive Director
Lindsi Lemons, MPH
Program Director

Sherre James

Operations Director

500 N. Broadway, Suite 225

Oklahoma City, Oklahoma 73102

Phone: 405-606-8435

Fax: 405-606-8437


1. Review criteria and program requirements/grant spending guidelines (listed below).
2. Completed applications must be in the SHL office, 500 N. Broadway, Suite 225, Oklahoma City, OK, 73102, by Thursday, February 27, 2014 by 4:00 p.m. (Located in the Gaylord Building next to downtown YMCA; parking is available on southeast corner of 4th and Broadway.) Applications delivered by mail or hand after the deadline will not be accepted. Applications cannot be submitted by email or fax.
NOTE: You will be notified prior to the end of this school year whether or not your school has been selected.


  • Your school must be a public elementary school, grades K through 5/6. (Due to public funding, private schools cannot be approved for participation.)

  • Faxed or emailed applications will NOT be accepted.

  • Only typed proposals, which meet application criteria, will be considered.

  • Please do not include extra attachments (photos, brochures, etc.)

  • Do not bind original application (paperclip is fine).

Program Requirements/ Grant Spending Guidelines

  1. This application process is for a three-year tiered program. After the third year, and if your school meets all the requirements associated with each year, you will become a Senior/Certified school and be eligible for programs available only to Senior schools.

  1. If your school has more than 700 students, two coordinators must be selected.

  1. If your elementary is located on more than one campus, you must have principal approval from all campuses and each location must have a Coordinator.

  1. Attendance of your team at the Summer Health Institute. Your school must select a three-member team to attend the Summer Health Institute. Your team must consist of the Coordinator and/or the PE teacher. (If your school is located on more than one campus, PE teachers from all campuses must attend.) The same three-member team from your school MUST attend all sessions of the Summer Health Institute in order to receive the grant and participate in the SHL program. Principals are strongly encouraged to attend all sessions of the workshop and can also be counted as one of your team. Attendance will be monitored and participants will receive a certificate of attendance for professional development credits.

  1. Presentation of an SHL overview for your school staff. Each school will conduct the SHL orientation at the beginning of the school year to inform other staff members about the SHL program, available resources and curricula, their role in the project, etc. SHL staff is available to give these presentations.

  1. Schools will administer Fitnessgram physical fitness testing for 3rd through 6th graders (pre-test in fall; post-test in spring). Necessary materials, equipment, training and forms will be provided to perform and report the physical fitness testing. All five SHL required fitness tests must be completed: mile run or pacer, push-ups, sit and reach, trunk lift, and curl ups. Schools will input their own data by a specified deadline. In collaboration with the State Department of Health, each school will receive testing equipment and training for test administration and data entry.

  1. A health knowledge, attitudes, and behaviors online survey will be administered twice per year (pre-test in fall; post-test in spring). Grades to be tested will be decided at a later date. A parental permission form for each student is required to participate in the written survey. Permission forms must be given to the survey administrator to be returned to SHL. (Permission form will be provided by SHL.)

  1. SHL provided curriculum must be implemented in the year it is given (i.e., HealthTeacher in first year, Risk Watch in second year, etc.) and in all subsequent years.

  1. One activity or event (walking club, health fair, etc.) per semester is required. You might want to center activities on national campaigns (ex. Heart-Health Month in February or Nutrition Awareness Month in March).

  1. Submit required Mid-Year and End of Year report by deadline. Schools will submit a Mid-Year Report in January and an End of Year Report listing program accomplishments. A copy of all receipts for grant expenditures must be attached. Report forms will be provided by SHL.

  1. If a deadline cannot be met, you must notify the SHL office within 5 business days to request a time extension.

  1. Approved budget must include any items to be purchased including promotional items, professional development, transportation, equipment, etc.

  1. In general, grant funds can be spent for most equipment for PE classes, health curricula, and other teaching resources such as visual aids, education videos, etc. SHL discourages the purchase of consumable items unless being used for a nutrition lesson. During the first year in the SHL program, grant funds must be spent on materials/supplies for the two focus areas you will implement (physical activity and nutrition).

  1. Promotion items (t-shirts, hats, etc.) may be budgeted for purchase with grant funds if used as an incentive (weight loss or walking programs, etc.) for students or staff. A total of $100 per year can be spent for promotional items.

  1. Grants funds may be used to pay for appropriate professional development fees, or substitute fees for coordinators only if: 1) a specific request has been outlined in the school’s budget or with prior approval by SHL, and (2) the workshop/conference or special event directly relates to one of SHL’s five focus areas. A school’s total professional development costs should not exceed $100 per coordinator.

  1. Grant funds may be used for bus transportation to SHL sponsored events if:

  1. a specific request has been outlined in the school’s budget or by prior approval by SHL, and

  2. the event directly relates to one of the five focus areas.

Not more than $200 can be spent for transportation costs per year.

  1. Any changes to the approved budget must be submitted on Budget Change Request Form and approved by SHL staff prior to expenditures. (Form can be found on the flash drive given to you at the Summer Health Institute.)

  1. In subsequent years, carryover funds cannot total more than $2,250. A specific plan must be submitted and approved for projects that require more than $2,250.

  1. All SHL schools must apply for the Certified Healthy Schools program through the Oklahoma State Department of Health. SHL will send how-to information when available.

  1. New requirements can be added at any time, and each school will be responsible for making sure full compliance is met.

All non-compliance issues will be submitted to the Program Committee who will recommend appropriate action to the Board of Directors.

  1. If any of the above requirements cannot be met, you must notify SHL within 5 business days to explain your situation. SHL has the right to place your school on probation or (depending on the importance of the requirement) remove your school from the SHL program. (For example, a requirement that may result in removal is refusal to implement testing.) A probation period may last up to one year and may result in not being awarded the next year’s grant.

  2. If your school is placed on more than 2 probationary periods during your participation in the SHL program, it will result in immediate dismissal from the SHL program.

  3. If your school should leave (for any reason) the SHL program before your school is a senior/certified school, all equipment and unspent grant funds must be returned to SHL.

  4. All SHL schools are subject to a site visit by SHL staff and/or Program Committee member which will consist of an audit of equipment, finances, and use of SHL resources. If any equipment or grant funds cannot be accounted for, this will be reported to the Program Committee and your school will be responsible for replacing the missing equipment or funds.



  1. Freshmen (Year 1) – Five schools will be admitted to the SHL program. Grant amount - $1,000. These schools will implement two focus areas: Physical Activity and Nutrition. Schools will receive:

  • fitness testing equipment,

  • Physical Activity/Nutrition curriculum, and

  • Mileage Club materials.

  1. Sophomore (Year 2) – Grant amount - $750. Two more focus area will be added: Injury Prevention and Tobacco Use Prevention. Schools will receive:

  • Tobacco Use Prevention materials;

In addition, each school will receive:

  • Xbox Kinect;

  • Fat and sugar lipos and food models to supplement the Nutrition focus area.

  1. Junior (Year 3) – Grant amount - $500. One focus area will be added: Oral Health. Schools will receive:

  • Adopt-A-Dentist (if available) and dental health materials.

  • Adopt-A-Doc (if available) will also be added in this year.

  • Additional materials for all focus areas as determined by SHL staff.

If your school should leave the SHL program (for any reason) prior to becoming a Senior/Certified school, all equipment and unspent grant funds must be returned to SHL.

  1. Senior/Certified (Year 4+) - Grant amount – up to $500. (The grant award will be based on specific needs and carry over amounts.) Certified Schools will be eligible for SHL sponsored programs including:

  • Tasting Parties,

  • Wee Wahoo,

  • Wacky Water Wahoo,

  • Bike Rodeos,

  • Tar Wars presentations,

  • Peaceful Playgrounds,

  • SPARK, etc.



NAME OF SCHOOL__________________________________________________________


SCHOOL ADDRESS__________________________________________________________

CITY/ZIP ________________________________ COUNTY _________________________

TELEPHONE #________________________ FAX #__________________________
Grades Served __________ Number of Staff ______

Percent of Free and Reduced Lunch _____ Total Number of Students Served _________

Is your district a 24/7 Tobacco Free district? ______

How did you learn about the SHL program?

We, the undersigned, agree to follow each of the program requirements and spending guidelines as previously outlined.






Please list the SUMMER contact information for the coordinator(s) so we can keep him/her informed over the summer.

Name ________________________________________________________________________

Summer Address ______________________________________________________________

City/Zip ______________________________________________________________________

Phone __________________________________ Cell ________________________________

Email Address ________________________________________________________________
Please list the SUMMER contact information for the principal(s) so we can keep him/her informed over the summer.

Name ________________________________________________________________________

Summer Address ______________________________________________________________

City/Zip ______________________________________________________________________

Phone __________________________________ Cell ________________________________

Email Address ________________________________________________________________


Be sure to attach the Application Cover Sheet to the front of your responses. Please only use the space provided.

1. Explain why your school wants to become a part of SHL.

2. Describe what your school has already done to address school wellness.

3. Has your school previously applied for the Certified Healthy Schools program? If so, what level is your school?

4. Which community partners have you already worked with to promote school health?

5. After 3 years in the SHL program, what changes do you anticipate/hope to see in the overall health environment of your schools?




Example: Parachute, 24’ w/o handles from Gopher


To replace damaged parachute


6. Following the previously listed Grant Spending Guidelines, please list how you plan to spend your grant. (Your list must total $1,000.)

Please fill out the following form listing the SHL activities your school would complete to meet SHL program requirements.


Activities Completed


Ex. Fitnessgram testing










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