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Note: Carefully read and follow the directions to complete the form and generate a PDF version that can be attached to the final application. All
narrative responses and PDF appendices must be submitted as one application.
As indicated by the signature of the Superintendent or authorized administrator, it is the intent of the institution identified below to apply for a School
Counselor Residency Implementation Grant to diversify the school counselor workforce to reflect the LEA’s community. The institution understands that submission of this optional
form does not require or otherwise
obligate the institution to submit an application to the Commission. Applications may be submitted to the Commission without submitting an intent form;
however, those who submit an intent form will be emailed any additional information regarding the application process that may become available. A scanned
copy of the signed Intent to Apply form may be emailed to
SchoolCounselorResGrants@ctc.ca.gov
*If Yes, indicate below all LEA consortium members and CD/CDS codes