Governor's Shape Honor Roll-Elementary School Application

 

Questions 1-4 qualify schools for the Bronze Honor Roll distinction

1. All students in grades K-5 are required to have at least 90 hours of health and physical education instruction. Do all students in grades K-5 meet these requirements?
1. File
First select "choose file" to locate file and then select "upload" to attach to your application.
2. Physical Education teachers are required to assess and enter data for 100% of students in grades 4-5 for the full battery. Did your school enter the required data for 100% of the 4th & 5th grade students?
2. File
First select "choose file" to locate file and then select "upload" to attach to your application.
3. Physical Education teachers are required to assess and enter height and weight data for 100% of students in grades 1-3. Did your school enter the required data for 100% of the 1st-3rd grade students?
3. File
First select "choose file" to locate file and then select "upload" to attach to your application.
4. Please provide a verification statement signed by the principal and lead physical education teacher verifying all submitted information is correct.
First select "choose file" to locate file and then select "upload" to attach to your application.

 

Schools applying for the Silver Honor Roll distinction must answer questions 1-4 above in addition to question 5.

5. Does your school schedule and implement weekly recess and or physical activity time for all students in grades K-5?
5. File
First select "choose file" to locate file and then select "upload" to attach to your application.

 

Schools applying for the Gold Honor Roll distinction must answer questions 1-5 above in addition to the questions 6-10.

6. Does your school have an active Wellness Committee?
6. File
First select "choose file" to locate file and then select "upload" to attach to your application.
7. Does your school schedule and implement daily recess or physical activity time for all students in grades K-5?
7. File
First select "choose file" to locate file and then select "upload" to attach to your application.
8. Does your school participate in the Healthier US School Challenge or the Alliance for a Healthier Generation School Program?
8. File
First select "choose file" to locate file and then select "upload" to attach to your application.
9. Has your school signed the “Power Up for 30” Pledge?
9. File
First select "choose file" to locate file and then select "upload" to attach to your application.
10. Please submit a ONE page “Healthy School” success story
First select "choose file" to locate file and then select "upload" to attach to your application.

 

Schools applying for the Platinum Honor Roll distinction must answer questions 1-10 above in addition to the questions 11-12.

11. Did three representatives from your school attend a Power Up for 30 training?
11. File
First select "choose file" to locate file and then select "upload" to attach to your application.
12. Please submit a ONE page “Power Up for 30” success story
First select "choose file" to locate file and then select "upload" to attach to your application.