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DC5-801 (Revised 6/14/19)
11. How will you monitor the outcomes and/or completion of the program? (e.g., surveys, pre/post-tests, and/or
escribe any benefits to the community, participant, and/or the Florida Department of Corrections.
13. Please list any other states or agencies that are currently (or previously) using this program.
s there any other pertinent information you wish to provide?
In the field below, please provide any/all citations of evaluation studies conducted specifically on the program currently
being applied. If you cannot provide evaluation studies, please explain.
SUBMISSION OF APPLICATION AND MATERIALS
Please ensure all supporting documentation and materials are included with the submission. Check any of the boxes below
to indicate what materials are being submitted.
Applications will only be reviewed once all applicable material is received.
Complete Application Curriculum or lesson plans Facilitator’s guide
Pre-test and/or Post-test Letter of support from institution Participant manual/guide
Credential, license, or training documentation for facilitator Fidelity monitoring tool
Other program materials. Please specify:
The completed application
and applicable materials can be emailed to:
OR sent by U.S. Mail to:
Florida Department of Corrections
Division of Development: Improvement and Readiness
Bureau of Applied Science, Research and Policy
501 South Calhoun Street
Tallahassee, FL 32399-2500
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