2021-2022 RCN Application and Contract Forms

If you have any questions, or need assistance, please contact your START RCN Representative or Jana Benjamin, (616) 331-6482. Thank you for your leadership and everything you do to improve supports for students with ASD in Michigan.

RCN Updates

RCN Leadership Days

2020-2021 RCN Application and Contract Forms

3/29/2021 Update

We are excited to share that we are taking a little different approach to the RCN Contract Application for 2021-2022. This will involve a phased roll-out over the next two months to allow the RCN more time to identify priorities and select goals and activities that are meaningful for their schools, students, and families. This roll-out began in March, by asking RCN to explore the “Compelling Why” for their work during their March RCN meeting and to do some basic data mapping. START has provided guidance, including materials and videos to support this process.

In April, START will provide the RCN with more information about the contract requirements related to goals and activities. Although we will maintain some required components of the contract, RCN will be afforded flexibility in determining how to achieve the goals of each priority. At the Spring RCN Leadership Day, we will share more information about the goals, activities, and budgeting and provide you with time to work as an RCN team to create your plan for next year. We recommend scheduling at least 45 minutes at your April RCN meetings to work with your START representative to begin this process. If you have not scheduled an RCN meeting for April, you can review the information individually or in small groups. The submission deadline for the application will remain the end of June. To gain access to the 2021-2022 application preparation materials Google Folder, please contact your RCN leadership or your START RCN representative.

Please note: This page will be updated regularly as forms and links become available.


2021-2022 Reports and Applications

Reports 

Forms

Due Date

2021-2022 RCN Application

  • RCN Application

June 2021

2021-2022 Contract Requirements Worksheet

  • Contract Requirements Worksheet For Multi-County RCN - Word Document
  • Contract Requirements Worksheet For Multi-County RCN - Google Document
  • OR
  • Contract Requirements Worksheet For Single-County RCN - Word Document
  • Contract Requirements Worksheet For Single-County RCN - Google Document

TBD

Beginning of Year Target Student Reporting Form

  • K-12 Beginning of Year Target Student Reporting Form
    • K-12 Beginning of the Year Target Student Reporting Form - Word Document
    • K-12 Beginning of the Year Target Student Reporting Form - Fillable PDF
    • K-12 Beginning of the Year Target Student Reporting Form - Survey Link (enter data here
  • BYF Beginning of Year Target Student Reporting Form
    • BYF Beginning of the Year Target Student Reporting Form - Word Document
    • BYF Beginning of the Year Target Student Reporting Form - Fillable PDF
    • BYF Beginning of the Year Target Student Reporting Form - Survey Link (enter data here)
  • Target Student Parent Permission

TBD

2021-2022 Mid-Year Progress Report

  • Mid-Year Contract Progress Report - Word Document
  • Mid-Year Contract Progress Report - Google Document
  • Updated RCN Contract Requirements Worksheet
  • Peer to Peer Support Program Log (in your RCN Google folder) 
  • Financial Expenditure Report
  • Mid-year Invoice (if payment is sought)

TBD

End of Year Target Student Reporting Form

  • K-12 End of Year Target Student Reporting Form
    • K-12 End of Year Target Student Reporting Form - Word Document
    • K-12 End of Year Target Student Reporting Form - Fillable PDF
  • BYF End of Year Target Student Reporting Form
    • BYF End of Year Target Student Reporting Form - Word Document
    • BYF End of Year Target Student Reporting Form - Fillable PDF

TBD

2021-2022 End of Year Progress Report

  • End of Year Contract Progress Report - Word Document
  • End of Year Contract Progress Report - Google Document
    • RCN Trainings Report Form
    • RCN EPLI Trainers Report
    • EPLI Level 1 Individual Trainer Reports
  • Final RCN Contract Requirements Worksheet
  • Capacity Building Planning Tool
    • Capacity Building Tool - Sample
      • For your individual RCN Capacity Building Tool, contact START or your RCN Google folder
  • Secondary Transition Recommendations Implementation Checklist (0-1)
  • Completed Peer to Peer Fidelity Checklists (5)
  • Peer to Peer Innovation and Impact Site Data Set (1)
  • Financial Expenditure Report
  • Final Invoice

TBD