Attachment D - Partnership Form.docx

DOCX document 20 KB Posted

Attached to
Grant Application for Immigrant/Refugee Student Success Plan
Solicitation number
S-58100-00012432
Issued by
Multnomah County, Oregon

About this file

This is a Partnership Form (Attachment D) for the Oregon Department of Education's (ODE) Student Success Plan (SSP) Grant RFA S-58100-00012432-ODE. The form is required documentation that must be completed for each partner contributing to the SSP Grant and submitted as a PDF along with the completed application by the specified due date. The form serves to document partner awareness and commitment to fulfilling the applicant's project plan under the SSP Grant program.

The form requires details about the lead applicant and partner organization, including descriptions of the partner's roles, activities, services, and deliverables, as well as their specific strengths and expertise. It also requires information about accountability structures between project partners, such as contracts, verbal agreements, MOUs, or letters of support. The form must be signed by authorized agents of both the partner organization and lead applicant to confirm participation in the SSP partnership.

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Text version

RFA S-58100-00012432–ODE IR SSP RFA 2024-25 Attachment D

Student Success Plan (SSP) Grant Partnership Form

INSTRUCTIONS: This form must be completed for each partner contributing to the SSP Grant. Forms must be submitted as a PDF attached to the completed application before the due date. The purpose of this form is to demonstrate that the Partner is aware of and committed to the partnership for the purposes of fulfilling the Applicant’s project plan as part of this SSP Grant.

Lead Applicant Name

Partner Organization Name

Describe the roles, activities, services, and/or deliverables the partner will provide for the grant Project.

What strengths or expertise does the partner named above contribute to the Project?

Describe the structures in place to ensure accountability among the Project partners (e.g., contract, verbal agreement, Memorandum of Understanding (MOU), letters of support from your Project partners, etc.). Note: if awarded, grantees may be asked to provide relevant documentation.

I confirm my organization’s participation in the SSP partnership named above for the purposes of fulfilling the Applicant’s Project Plan as part of the SSP Grant:

Name and Title of Authorized Agent of Partner: ______________________________________________________

Name and Title of Authorized Agent of Lead Applicant: ______________________________________________

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