Illinois Success Sequence Program Documentation

1Site Agreement

2Implementation Plan

3Add Classrooms

Site Agreement for Paper/Workbooks or Digital/Online

This document provides terms and conditions for utilization of the Illinois Success Sequence Program (ISSP) in a school or other program setting. This agreement may be terminated upon request.

We have reviewed the Illinois Success Sequence Program (ISSP) materials Game Plan, Quest, Aspire, and/or Navigator and deemed the program(s) appropriate for implementation.

At least eight (8) classroom periods will be dedicated to implement the program with fidelity along with support services.

Performance measurement documents, including student enrollments and attendance, will be collected and provided to A&M Resources within 2 weeks of completing the program.

As part of a federally funded program, youth will be asked to complete voluntary, confidential surveys.

ISSP promotes optimal health by encouraging youth to embrace positive youth development and avoid risk behaviors.

The use of Game Plan, Quest, Aspire, or Navigator does not hold A&M Resources liable for any legal claims made against your school or agency.

Possible site visits from A&M Resources staff will be allowed.

School instructors will follow mandated reporting procedures as required by law.

A&M Resources agrees to:

Help identify support services as needed for vulnerable youth and their families.

Ensure program activities are age appropriate, trauma informed, medically accurate, inclusive, promote cultural sensitivity, and enforce anti-harassment protocols.

Collect and store participant demographic information and other reporting requirements in a secure database under restricted access policies.
• Parental Permission/Communication by site is provided accordingly:*
Select One
- I confirm that our site uses opt-out/passive parental permission for youth to participate in the SRAE program and will notify parents/guardians of the voluntary program and the surveys.
- I confirm that our site uses opt-in/active parental permission for youth to participate in the SRAE program and will secure permission for youth to participate in the voluntary program and surveys.
As a site that agrees to implement the Illinois Success Sequence Program, I agree to and will abide by the terms and conditions stated above.
Print Name (School/Site Representative)*
Signature (School/Site Representative)*

Name of Program Site:*
Address of Program Site (Include City):*
Street Address City State ZIP Code
County*
Program Site Contact:*
First Last
Contact Email:*
Contact Phone:*

Implementation Plan for Classrooms to Receive Programming

Class Name:	Estimated # of Youth to Serve:	Course(s):	Format:	Days of the Week and Exact Times Curriculum Will be Delivered:	Actions

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Illinois Success Sequence Program DOCUMENTATION

Site Agreement for Paper/Workbooks or Digital/Online

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