APPLICATION COVER SHEET
Applicant: Applicant's Mailing Address:
RIO 00919-0759State Contact for the School Improvement GrantName: Lic.
CoordinatorContact's Mailing Address:Puerto Rico Department
00919-0759Telephone: 787-773-2015; 787-773-2003Fax: 787-751-6192Email address: firstname.lastname@example.org
Chief State School Officer (Printed Name): Telephone:Jesus M.
Sanchez, Ed. D 787-773-2004Signature
he Chief State School Officer: Date:
tate, through its authorized representative, agrees to comply with all requirements applicable to theSchool Improvement Grants program, including the assurances contained herein and the conditions that applyto any waivers that the State receives through this application.