1. How I Won $11,500 for My School! Jennifer S. Duke Southeast Success Academy dukej@scsk12.org 901-416-1436 731-413-8815 (personal cell)

2. Why BCBSTN Is Involved Today approximately 24 percent of children are overweight, and another 18 percent are considered obese—placing them at a high risk for a variety of lasting health complications growing up. In Tennessee, about 4 in 10 children are overweight or obese, according to the Tennessee Department of Health. In an effort to promote better health for our state’s students, the BlueCross BlueShield of Tennessee Health Foundation will award up to 20 grants valued at $10,000 each to Tennessee middle schools as part of its Shape the State program. The grants will be used to purchase SPARK physical education curriculum, training and materials. SPARK is a research-based, public health organization dedicated to creating, implementing, and evaluating programs that promote lifelong wellness. 2013 Shape the State Grant Applicant Guidelines All applications must be received between Monday, April 15 and midnight on Friday, May 3. Late entries will not be considered. Previous grant recipients are not eligible to apply for the Shape the State grant. Grant finalists will be required to complete additional paperwork in order to receive the grant and all that it entails within two weeks of notification. The main contact person (submitted on the grant application) must be accessible year-round or updated information must be submitted as soon as anything changes during the grant year. Grant Recipient Calendar of Requirements: May 2013 – Complete confirmation paperwork within two weeks of notification Oct. 2013 – Participate in two-day training Oct. 2013 - Implement the program utilizing the curriculum and equipment immediately following training Oct. and Nov. 2013 – Participate in “Big” check presentation event held onsite at the winning schools Oct. and Nov. 2013 – Populate school site on the Shape the State official website for others to view On-going – Take photos and video to include with progress reports On-going – Participate in ongoing contests and opportunities in conjunction with Shape the State May 2014 – Program evaluation completed Website for application: http://shapethestate.com/content/program-overviewhttp://shapethestate.com/content/program-overview

3. Why for SPARK Countering Childhood Obesity Since 1989 SPARK is a research-based, public health organization dedicated to creating, implementing, and evaluating programs that promote lifelong wellness. SPARK strives to improve the health of children, adolescents, and adults by disseminating evidence-based Physical Education, After School, Early Childhood, and Coordinated School Health programs to teachers and recreation leaders serving Pre-K through 12th grade students.Physical EducationAfter SchoolEarly ChildhoodCoordinated School Health Each SPARK program fosters environmental and behavioral change by providing a coordinated package of highly active curriculum, on- site teacher training, extensive follow-up support, and content-matched equipment. Free Resources for You PE Lesson Plans Access a collection of research-based, highly active PE lesson plans. Each lesson shows alignment to NASPE National Standards. DetailsDetails Webinars Join us the 3rd Wednesday of each month for an interactive presentation on a timely topic. DetailsDetails Activity of the Month Each month we'll feature a SPARK activity and provide an instructional video, lesson plans and assessment tools to help you teach it! Details Details Standards Alignment See how SPARK aligns with national and state content standards. DetailsDetails Blog Our SPARK principals, Dr. Jim Sallis, Dr. Thom McKenzie and Mr. Paul Rosengard, are sharing their thoughts online each week. Join the conversation! Details Conference Handouts Did you attend a SPARK presentation at a local conference? Access the handouts online. DetailsDetails eNewsletter Sign up for SPARK's newsletter on their home page. DetailsDetails

4. Name of my grant: My 6 th graders, my homeroom, had to help me hold the GIANT check!

5. News Release for Grant BlueCross BlueShield of Tennessee grants will go to 20 more schools By Staff Report Published Friday, August 24th 2012 Twenty more Tennessee schools will soon receive a nationally acclaimed middle grades physical education program and exercise equipment—together valued at $10,000 for each school—from the BlueCross BlueShield of Tennessee Health Foundation. Applications for the second year of the foundation’s Shape the State grant program are being taken now through Sept. 4 from any public, private or parochial Tennessee school serving grades 6-8. Grant winners will be announced Sept. 12. The grant provides the curriculum, teacher training and equipment for each recipient school. “This program is an important tool in our efforts to combat childhood obesity in Tennessee,” said Calvin Anderson, BlueCross senior vice president of corporate affairs and executive director of the foundation. “The first Shape the State schools had a successful implementation last year, and we’re eager to see the next group join in.” According to the state Department of Health, about 40 percent of Tennessee children are overweight or obese. Children who are obese are more likely to grow into obese adults, studies show. Obesity dramatically increases a person’s risk for dangerous health conditions, such as Type 2 diabetes, heart disease and cancer, according to the Centers for Disease Control and Prevention. Shape the State brings the SPARK physical education program into schools and provides both training for PE teachers and exercise equipment for students. SPARK was launched in 1989 after being developed by researchers at San Diego State University. Since then, its evidence-based curriculum has been used in public schools, YMCAs and other settings across the nation. The foundation will also present winning schools an additional $1,000 to support PE, nutrition and wellness programs. Schools can apply online at http://shapethestate.com/overview or email shapethestate@bcbst.com for more information.http://shapethestate.com/overviewshapethestate@bcbst.com

6. Application Questions Shape the State www.surveymonkey.com/s/shapethestateapplication * 1. Name of person completing application (include first and last name). Note: Person completing this application will need to be available throughout the grant project (if awarded) to answer questions, provide information and make sure all paperwork is completed. * 2. Title of person completing application. * 3. Email address for person completing application. Note: Notification of award status will be sent to this email address on September 14, 2012. * 4. Phone number (XXX-XXX-XXXX) for person completing application. Note: We may contact this phone number during the review process if we have any questions about your application. * 5. Name of school applying. * 6. County school is located in. * 7. School Street Address. * 8. School City. * 9. School Zip Code. * 10. Name of school principal. * 11. Is the principal at this school aware of this application and if awarded one of the grants will be supportive of this project and allow staff (max 4) to attend one of the 2-day training sessions Travel expenses will be provided by Tennessee Health Foundation.

7. *12. How did you hear about this grant? Check all that apply. How did you hear about this grant? Check all that apply. BCBST mailing Shape the State email BCBST Shape the State site BCBST.com website SPARK email SPARK e-Newsletter SPARK website Colleague Word of mouth Other * 13. Please describe your students' current fitness scores (from Fitnessgram, Presidential and/or whatever fitness data you can provide). (150 words or less). Please describe your students' current fitness scores (from Fitnessgram, Presidential and/or whatever fitness data you can provide). (150 words or less). * 14. Describe any physical education, health, nutrition and/or wellness policies your school has in place. Describe any physical education, health, nutrition and/or wellness policies your school has in place. * 15. Tell us about your current PE/PA program STRENGTHS (200 words or less). Tell us about your current PE/PA program STRENGTHS (200 words or less). * 16. Tell us about your current PE/PA program CHALLENGES (200 words or less). Tell us about your current PE/PA program CHALLENGES (200 words or less). * 17. What do you hope to achieve by being awarded this grant? (200 words or less) What do you hope to achieve by being awarded this grant? (200 words or less) * 18. How will the staff at this school and administration support the successful implementation of the SPARK Program and contribute to program sustainability? (200 words or less). For more information about SPARK Middle School Program please visit: http://www.sparkpe.org/physical- education/middle-school/ How will the staff at this school and administration support the successful implementation of the SPARK Program and contribute to program sustainability? (200 words or less). For more information about SPARK Middle School Program please visit: http://www.sparkpe.org/physical- education/middle-school/ * 19. How will you evaluate the success of this program at your school? (250 words or less) How will you evaluate the success of this program at your school? (250 words or less) * 20. Why do you feel this school should be one of 20 in the state to receive this grant? (250 words or less) Why do you feel this school should be one of 20 in the state to receive this grant? (250 words or less)

8. 21. The SPARK workshop dates are scheduled for either October 15 & 16 (for East TN) or October 18 & 19 (for West TN). Staff from your school MUST attend one of these 2-day sessions. Note: Travel expenses, lunch, snacks and water will be provided by Tennessee Health Foundation. Knowing this, would your teacher(s) be able to travel to one of these 2-day training sessions? * 22. Which 2-day training session do you prefer for your staff? * 23. The SPARK Middle School Physical Education 2-day training session is for Middle School Physical Educators (they MUST attend). Visit http://www.sparkpe.org/physical-education/middle-school/training/ for more information about the SPARK training. How many Middle School Physical Education teachers would attend from this school (MAX 4)? * 24. You can send a maximum of 4 teachers (including the PE teacher(s) from question #23) from your school to attend the 2-day training. We highly encourage you to reach out to any other Middle School Physical Educators or teachers from within your school OR district OR community to attend (to make up the total of 4 people you can send). Please note: Your school will only receive 1 set of materials (if you are one of the grantees) so if you invite someone from another school/district, etc they will not receive curriculum or equipment. How many people (in addition to the number of PE teachers from question #23--if less than 4) will you be sending to the 2-day training? * 25. Would your school/district be willing to host one of the 2-day trainings? If NO, your application is complete. If YES, please complete questions #26 & #27. 26. If your school/district is interested in possibly hosting one of the 2-day trainings, please check the item(s) that your site would have available both days if hosting one of the trainings. Classroom close to gym OR we could use part of the Gym as classroom too Tables and Chairs for 40-45 people Screen (or blank white wall to project onto in Classroom or Gym if classroom isn't available) White board or easel/paper LCD projector for our trainer to use Would someone be available to let our trainer into your site at 6:30am so they can set-up/get ready the morning of the first day of training? 27. If you said YES, please select what date(s) you could host the training. Note: Answer should be same as Question #22.

9. Winners Announced! BlueCross Names Winners Of $10,000 Shape The State Grants Thursday, September 20, 2012 Twenty Tennessee middle schools have been awarded Shape the State grants to improve their physical education programs. The grants, valued at $10,000 each, are funded by the BlueCross BlueShield of Tennessee Health Foundation.Shape the State The grant provides the nationally acclaimed SPARK physical education curriculum, teacher training and equipment for each recipient school. In addition each school will receive $1,000 to spend on PE, nutrition and wellness efforts. This is the second year of the grant program. “We are happy to welcome these new Shape the State schools, and we’re impressed by their commitment to improving their students’ health,” said Calvin Anderson, BlueCross senior vice president of corporate affairs, and executive director of BlueCross’ Tennessee Health Foundation. According to the state Department of Health, about 40 percent of Tennessee children are overweight or obese. Obesity dramatically increases a person’s risk for dangerous health conditions, such as Type 2 diabetes, heart disease and cancer. The Shape the State grants continue a longstanding practice of BlueCross’ Tennessee Health Foundation’s supporting efforts to fight childhood obesity in the state.dangerous health conditions This fall, faculty and staff from the Shape the State schools will gather for training from SPARK professionals on using the program with their students. In addition, they will receive complete SPARK curriculum materials, as well as accompanying exercise equipment. SPARK was launched in 1989 after being developed by researchers at San Diego State University. Since then, its evidence-based curriculum has been used in public schools, YMCAs and other settings across the nation. The 2012 Shape the State grant winners are: American Way Middle School, Memphis Bachman Academy, McDonald Bledsoe County Middle School, Pikeville Cummings Middle School, Memphis Greeneville Middle School, Greeneville Heavenly Host Lutheran School, Cookeville Houston County Christian Academy, Erin H.Y. Livesay Middle School, Harrogate Lamplighter Montessori School, Cordova Lenoir City Middle School, Lenoir City Milan Middle School, Milan Mount Juliet Christian Academy, Mount Juliet Oneida Middle School, Oneida Powell Valley School, Speedwell Rock Springs Middle School, Smyrna Sharon School, Sharon Soldiers Memorial Middle School, New Tazewell Southeast Success School, Memphis Van Buren County Middle School, Spencer West Middle School, Denmark

10. District Notice Subject: BlueCross Names Winners of $10,000 Shape The State Grants Good afternoon. I trust all is well your way. I wanted to share some good news with you, in hopes of it (grant recipients) being articulated at the next board meeting! With the exception of Lamplighter Montessori, the other three schools are under your umbrella! Twenty Tennessee middle schools have been awarded “Shape the State” grants to improve their physical education programs. The grants, valued at $10,000 each, are funded by the BlueCross BlueShield of Tennessee Health Foundation. The grant provides the nationally acclaimed SPARK physical education curriculum, teacher training and equipment for each recipient school. In addition each school will receive $1,000 to spend on PE, nutrition and wellness efforts. This is the second year of the grant program. The winners throughout Shelby County are: American Way Middle School Cummings Middle School Southeast Success School Lamplighter Montessori School We are pleased with each respective schools commitment to health and wellness. Take care. Tavarski Hughes Division of Federal and Community Relations Federal Lobbyist and Public Policy Liaison BlueCross BlueShield of Tennessee

11. My Notices! From SHAPE/BCBSTN JENNIFER S. DUKE‎ Congratulations on being selected one of twenty 2012 Shape the State Grantees! Below outlines a timeline in order for us to make sure your teacher(s) can attend the SPARK Middle School training on October 18 & 19, 2012 (location TBD). We greatly appreciate your help expediting paperwork needed to receive this grant valued at $10,000 for your school. By September 28, 2012 · Submit Supplier Self-Certification form and W-9 to BCBST (blank forms attached to this email) · Submit Tax Exempt Certificate to SPARK and BCBST (this is needed so SPARK can ship equipment to you) · SPARK/BCBST to select school to host training · Submit names of teachers (max 4) attending training to SPARK October 18 & 19, 2012 · SPARK Middle School Workshop (you will receive your SPARK manual at this workshop) · Your school will receive equipment AFTER this workshop · Your school will be reimbursed for travel expenses related to attending the training (an expense report has been attached to this email for you to use for reimbursement following the training) Feel free to contact us if you have any questions: · For questions related to travel coverage/reimbursement, supplier self-certification form and/or W-9 contact Chelsea Johnson, BCBST Chelsea_Johnson@bcbst.com P: (423) 535-3240Chelsea_Johnson@bcbst.com · For questions related to SPARK workshop details and/or tax exempt certificate contact Julie Frank, SPARK Julie.frank@schoolspecialty.com P: 800-772-7573 ext. 2204. Julie.frank@schoolspecialty.com We look forward to working with you over the next year J Thanks!! Chelsea C. Johnson Community Relations Project Analyst BlueCross BlueShield of Tennessee 1 Cameron Hill Circle, 1.5 Chattanooga, TN 37402 P: (423) 535-3240 F: (423) 535-7173 C: (423) 290-6147 ----------------------------------------------------- Please see the following link for the BlueCross BlueShield of Tennessee E-mail disclaimer: http://www.bcbst.com/email_disclaimer.shtm FROM SPARK Congratulations! We are excited to “SPARK”-up your schools! Your SPARK workshop will take place Oct 18 & 19 at this location: LOCATION: Milan Middle School 4040 Middle Road Milan, TN 38358 TIME: 8:00am-3:00pm (1 hr break for lunch) I have attached a flyer which you can give to those who will be attending this training. Please make sure to send me a list of up to 4 teachers/people who will be attending by Sept 28 th. Julie Frank Director of Operations & Special Projects SPARK

12. Further Information JENNIFER S. DUKE‎ Congratulations on being selected one of twenty 2012 Shape the State Grantees! Below outlines a timeline in order for us to make sure your teacher(s) can attend the SPARK Middle School training on October 18 & 19, 2012 (location TBD). We greatly appreciate your help expediting paperwork needed to receive this grant valued at $10,000 for your school. By September 28, 2012 ************* REQUIRED SIGNATURES AND APPROVAL **************** · Submit Supplier Self-Certification form and W-9 to BCBST (blank forms attached to this email) · Submit Tax Exempt Certificate to SPARK and BCBST (this is needed so SPARK can ship equipment to you) · SPARK/BCBST to select school to host training · Submit names of teachers (max 4) attending training to SPARK October 18 & 19, 2012 · SPARK Middle School Workshop (you will receive your SPARK manual at this workshop) · Your school will receive equipment AFTER this workshop · Your school will be reimbursed for travel expenses related to attending the training (an expense report has been attached to this email for you to use for reimbursement following the training) Feel free to contact us if you have any questions: · For questions related to travel coverage/reimbursement, supplier self-certification form and/or W-9 contact Chelsea Johnson, BCBST Chelsea_Johnson@bcbst.com P: (423) 535-3240 Chelsea_Johnson@bcbst.com · For questions related to SPARK workshop details and/or tax exempt certificate contact Julie Frank, SPARK Julie.frank@schoolspecialty.com P: 800-772-7573 ext. 2204.Julie.frank@schoolspecialty.com We look forward to working with you over the next year J Thanks!! Chelsea C. Johnson Community Relations Project Analyst BlueCross BlueShield of Tennessee 1 Cameron Hill Circle, 1.5 Chattanooga, TN 37402 P: (423) 535-3240 F: (423) 535-7173 C: (423) 290-6147 ----------------------------------------------------- Please see the following link for the BlueCross BlueShield of Tennessee E-mail disclaimer: http://www.bcbst.com/email_disclaimer.shtm

13. Required Grant Forms AFTER I won the grant…

18. District Requirement Form MUST be completed for grant approval!

20. Partners (Who is involved, both within MCS and outside the district?) We will do our best to work with the Prep school here in the same facility so more lives are touched by a variety of opportunities to be active and have FUN!! To my knowledge, no one else will be involved. Evaluation (Including evaluator) We will report to BCBSTN at intervals during the year on how things are progressing. The P.E. department has several measures to use for demonstrating evidence of improvement in healthy lifestyles and choices. Grant Budget Categories ☐ Personnel ☐ Indirect costs ☐ Books X Supplies X Equipment ☐ Construction/Renovation ☐ Contracts X Resources X Professional Development ☐ Fringe benefits X Travel ☐ Other… New Personnel: N/A Amount allocated for evaluation: We were not given specifics of allocations for any one part of it, so I don't know. District match: X No ☐ Yes If yes, please describe:

21. We (teachers) participated in every unit they offer!

22. All equipment we used was included!

23. Can you imagine looking at a 10,000 item catalog and trying to select the best rubber basketball from 16 choices? You won’t have to. SPARK content experts have created equipment sets that match each item to an activity, saving teachers and administrators valuable time. Each set consists of quality Sportime equipment and includes all the items needed to instruct everything in a SPARK PE manual. - See more at: http://www.sparkpe.org/physical-education- resources/physical-education-equipment/#sthash.yPwArSVs.dpuf

24. A good PORTION of the equipment sent out!

25. Storage was included.

26. Storage SPACE was NOT!

27. 8 th graders creating a game using grant equipment.

28. 7 th graders creating their game.

29. Jennifer S. Duke Southeast Success School dukej@scsk12.org 901-416-1436 school 731-413-8815 personal cell (I usually do better with text than anything.)