**05/27/2008**

**U.S. DEPARTMENT OF EDUCATION**

# OFFICE OF INNOVATION AND IMPROVEMENT

# WASHINGTON, D.C. 20202

**FY 2009**

**APPLICATION FOR GRANTS**

**UNDER THE STATE CHARTER SCHOOL FACILITIES INCENTIVE GRANTS PROGRAM**

# CFDA Number: 84.282D

# FORM APPROVED

# OMB No. 1855-0012, EXP. DATE XX/XX/20XX

![](media/image1.png){width="3.248611111111111in"
height="2.783333333333333in"}

**DATED MATERIAL - OPEN IMMEDIATELY**

**Closing Date: XXXX X, 200X**

> ![](media/image2.png){width="0.9173611111111111in"
> height="0.8993055555555556in"}**UNITED STATES DEPARTMENT OF
> EDUCATION**

Office of Innovation and Improvement

Dear Applicant:

Thank you for your interest in the State charter school facilities
incentive grants program administered by the U.S. Department of
Education's Office of Innovation and Improvement. I am pleased to
announce that approximately \$XX.X million will be available this year
to support an estimated X projects under this program.

Currently, about X,X00 charter schools operate around the country. These
public schools provide parents and students with options that can lead
to better student achievement. However, many charter schools face
significant challenges when trying to obtain facilities; insufficient
revenue and lack of access to private funding for facilities top the
list. The purpose of the State charter school facilities incentive
grants program (authorized by Title V, Part B, Subpart 1 of the
Elementary and Secondary Education Act (ESEA), as amended by the No
Child Left Behind Act) is to provide competitive incentive grants to
help States create new or enhance existing per-pupil facilities aid
programs.

Information to assist in preparing your application is found in the
Notice Inviting Applications (Section B) and in the Application Contents
section (Section C) of this application package.

Applications must be submitted electronically in accordance with the
section titled General Application Instructions and Information no later
than 4:30:00 p.m., Washington, DC time on XXXX X, 200X, for
consideration. An application that is not submitted by the deadline will
be returned to the applicant and will not be considered.

We expect to make awards under this program approximately two months
after the application deadline.

For further information, please contact XXX or XXX at (202) XXX-XXXX or
e-mail [charter.facilities@ed.gov]{.underline}.

Sincerely,

XXXX XXXXX\
Director

> Parental Options and Information

**[Table of Contents]{.smallcaps}**

A.  

**Section A.** General Application Instructions

-   Grants.gov Submission Procedures and Tips for Applicants

-   Instructions for Transmitting Instructions

-   Instructions for D-U-N-S Number

**Section B.** Application Notice, Program Statute, and Regulations

**Section C.** General Application Instructions and Information

-   General Instructions

-   Instructions for ED Abstract Narrative

-   Instructions for Project Narrative

-   Instructions for Budget Narrative

-   Instructions for Other Attachments

-   Priorities and Project Selection Criteria

-   Table 1- Per-Pupil Facilities Aid Paid by State

-   Table 2- Budget Form: Grant Funds Expenditures

-   Instructions for Table 2 \-- Budget Form: Grant Funds Expenditures

-   Table 3- Grant Funds as a Percentage of the Cost of Per-Pupil
    Facilities Aid

-   Program-Specific Assurance

-   General Education Provisions Act (GEPA) Section 427

-   Government Performance and Results Act (GPRA)

**Section D.** Standard Forms and Instructions

-   Application for Federal Assistance (SF 424)

-   Supplemental Information Required for Department of Education

-   Assurances -- Non-Construction Programs (SF 424B)

-   U. S. Department of Education Budget Information Non-Construction
    Programs

> Section A -- Budget Summary (ED 524)
>
> Section B -- Budget Summary Non-Federal Funds (ED 524)

-   Grants.Gov Lobbying Form

-   SF-LLL, Disclosure of Lobbying Activities

-   Survey on Ensuring Equal Opportunity for Applicants

**Section E.** Other Important Information and Notices

-   Executive Order 12372

-   Paperwork Burden Statement

-   Application Checklist

**SECTION A**

**GENERAL APPLICATION INSTRUCTIONS**

Insert most recent language for Grants.gov Submission Procedures and
Tips for Applicants, Instructions for Transmitting Instructions, and
Instructions for D-U-N-S Number

**SECTION B**

####### APPLICATION

**NOTICE, PROGRAM STATUTE, AND REGULATIONS**

Insert Application Notice here

**[Program Statute]{.smallcaps}**

+-----------------------------------------------------------------------+
| **Subpart 1 ---Charter School Programs**                              |
+-----------------------------------------------------------------------+
| > Section 5205 (b) PER-PUPIL FACILITIES AID PROGRAMS-                 |
| >                                                                     |
| > \(1\) DEFINITION OF PER-PUPIL FACILITIES AID PROGRAM- In this       |
| > subsection, the term per-pupil facilities aid program\' means a     |
| > program in which a State makes payments, on a per-pupil basis, to   |
| > charter schools to provide the schools with financing ---           |
| >                                                                     |
| > \(A\) that is dedicated solely for funding charter school           |
| > facilities; or                                                      |
| >                                                                     |
| > \(B\) a portion of which is dedicated for funding charter school    |
| > facilities.                                                         |
| >                                                                     |
| > \(2\) GRANTS-                                                       |
| >                                                                     |
| > \(A\) IN GENERAL- From the amount made available to carry out this  |
| > subsection under paragraphs (2) and (3)(B) of section 5211(b) for   |
| > any fiscal year, the Secretary shall make grants, on a competitive  |
| > basis, to States to pay for the Federal share of the cost of        |
| > establishing or enhancing, and administering per-pupil facilities   |
| > aid programs.                                                       |
| >                                                                     |
| > \(B\) PERIOD- The Secretary shall award grants under this           |
| > subsection for periods of not more than 5 years.                    |
| >                                                                     |
| > \(C\) FEDERAL SHARE- The Federal share of the cost described in     |
| > subparagraph (A) for a per-pupil facilities aid program shall be    |
| > not more than ---                                                   |
| >                                                                     |
| > \(i\) 90 percent of the cost, for the first fiscal year for which   |
| > the program receives assistance under this subsection;              |
| >                                                                     |
| > \(ii\) 80 percent in the second such year;                          |
| >                                                                     |
| > \(iii\) 60 percent in the third such year;                          |
| >                                                                     |
| > \(iv\) 40 percent in the fourth such year; and                      |
| >                                                                     |
| > \(v\) 20 percent in the fifth such year.                            |
| >                                                                     |
| > \(3\) USE OF FUNDS-                                                 |
| >                                                                     |
| > \(A\) IN GENERAL- A State that receives a grant under this          |
| > subsection shall use the funds made available through the grant to  |
| > establish or enhance, and administer, a per-pupil facilities aid    |
| > program for charter schools in the State.                           |
| >                                                                     |
| > \(B\) EVALUATIONS; TECHNICAL ASSISTANCE; DISSEMINATION- From the    |
| > amount made available to a State through a grant under this         |
| > subsection for a fiscal year, the State may reserve not more than 5 |
| > percent to carry out evaluations, to provide technical assistance,  |
| > and to disseminate information.                                     |
| >                                                                     |
| > \(C\) SUPPLEMENT, NOT SUPPLANT- Funds made available under this     |
| > subsection shall be used to supplement, and not supplant, State and |
| > local public funds expended to provide per pupil facilities aid     |
| > programs, operations financing programs, or other programs, for     |
| > charter schools.                                                    |
| >                                                                     |
| > \(4\) REQUIREMENTS-                                                 |
| >                                                                     |
| > \(A\) VOLUNTARY PARTICIPATION- No State may be required to          |
| > participate in a program carried out under this subsection.         |
| >                                                                     |
| > \(B\) STATE LAW- To be eligible to receive a grant under this       |
| > subsection, a State shall establish or enhance, and administer, a   |
| > per-pupil facilities aid program for charter schools in the State,  |
| > that ---                                                            |
| >                                                                     |
| > \(i\) is specified in State law; and                                |
| >                                                                     |
| > \(ii\) provides annual financing, on a per-pupil basis, for charter |
| > school facilities.                                                  |
| >                                                                     |
| > \(5\) APPLICATIONS- To be eligible to receive a grant under this    |
| > subsection, a State shall submit an application to the Secretary at |
| > such time, in such manner, and containing such information as the   |
| > Secretary may require.                                              |
| >                                                                     |
| > \(6\) PRIORITIES- In making grants under this subsection, the       |
| > Secretary shall give priority to States that meet the criteria      |
| > described in paragraph (2), and subparagraphs (A), (B), and (C) of  |
| > paragraph (3), of section 5202(e).                                  |
| >                                                                     |
| > \(c\) RULE OF CONSTRUCTION- Nothing in this section shall be        |
| > construed to require charter schools to collect any data described  |
| > in subsection (a).                                                  |
|                                                                       |
| Subsection cross-referenced under Section 5205(B)(6)                  |
+-----------------------------------------------------------------------+

Section 5202 (e) PRIORITY TREATMENT-

> \(1\) IN GENERAL- In awarding grants under this subpart for fiscal
> year 2002 or any succeeding fiscal year from any funds appropriated
> under section 5211 (other than funds reserved to carry out section
> 5205(b)), the Secretary shall give priority to States to the extent
> that the States meet the criteria described in paragraph (2) and one
> or more of the criteria described in subparagraph (A), (B), or (C) of
> paragraph (3).
>
> \(2\) REVIEW AND EVALUATION PRIORITY CRITERIA- The criteria referred
> to in paragraph (1) are that the State provides for periodic review
> and evaluation by the authorized public chartering agency of each
> charter school, at least once every 5 years unless required more
> frequently by State law, to determine whether the charter school is
> meeting the terms of the school\'s charter, and is meeting or
> exceeding the student academic achievement requirements and goals for
> charter schools as set forth under State law or the school\'s charter.
>
> \(3\) PRIORITY CRITERIA- The criteria referred to in paragraph (1) are
> the following:
>
> \(A\) The State has demonstrated progress, in increasing the number of
> high-quality charter schools that are held accountable in the terms of
> the schools\' charters for meeting clear and measurable objectives for
> the educational progress of the students attending the schools, in the
> period prior to the period for which a State educational agency or
> eligible applicant applies for a grant under this subpart.
>
> \(B\) The State ---
>
> \(i\) provides for one authorized public chartering agency that is not
> a local educational agency, such as a State chartering board, for each
> individual or entity seeking to operate a charter school pursuant to
> such State law; or
>
> \(ii\) in the case of a State in which local educational agencies are
> the only authorized public chartering agencies, allows for an appeals
> process for the denial of an application for a charter school.
>
> \(C\) The State ensures that each charter school has a high degree of
> autonomy over the charter school\'s budgets and expenditures.

**[Program Regulations]{.underline}**

PART 226\--STATE CHARTER SCHOOL FACILITIES INCENTIVE PROGRAM

Subpart A\--General

Sec.

226.1 What is the State Charter School Facilities Incentive program?

226.2 Who is eligible to receive a grant?

226.3 What regulations apply to the State Charter School Facilities
Incentive program?

226.4 What definitions apply to the State Charter School Facilities
Incentive program?

Subpart B\--How Does the Secretary Award a Grant?

226.11 How does the Secretary evaluate an application?

226.12 What selection criteria does the Secretary use in evaluating an
application for a State Charter School Facilities Incentive program
grant?

226.13 What statutory funding priority does the Secretary use in making
a grant award?

226.14 What other funding priorities may the Secretary use in making a
grant award?

Subpart C\--What Conditions Must Be Met by a Grantee?

226.21 How may charter schools use these funds?

226.22 May grantees use grant funds for administrative costs?

226.23 May charter schools use grant funds for administrative costs?

AUTHORITY: 20 U.S.C. 1221e-3; 7221d(b), unless otherwise noted.

Subpart A \-- General

[§226.1 What is the State Charter School Facilities Incentive
program]{.underline}?

\(a\) The State Charter School Facilities Incentive program provides
grants to States to help charter schools pay for facilities.

\(b\) Grantees must use these grants to\--

\(1\) Establish new per-pupil facilities aid programs for charter
schools;

\(2\) Enhance existing per-pupil facilities aid programs for charter
schools; or

\(3\) Administer programs described under paragraphs (b)(1) and (2) of
this section.

(Authority: 20 U.S.C. 7221d(b))

[§226.2 Who is eligible to receive a grant]{.underline}?

States are eligible to receive grants under this program.

(Authority: 20 U.S.C. 7221(b))

[§226.3 What regulations apply to the State Charter School Facilities
Incentive program]{.underline}?

The following regulations apply to the State Charter School Facilities
Incentive program:

\(a\) The Education Department General Administrative Regulations
(EDGAR) as follows:

\(1\) 34 CFR part 74 (Administration of Grants and Agreements with
Institutions of Higher Education, Hospitals, and other Non-Profit
Organizations).

\(2\) 34 CFR part 75 (Direct Grant Programs).

\(3\) 34 CFR part 77 (Definitions that Apply to Department Regulations).

\(4\) 34 CFR part 79 (Intergovernmental Review of Department of
Education Programs and Activities).

\(5\) 34 CFR part 80 (Uniform Administrative Requirements for Grants and
Cooperative Agreements to State and Local Governments).

\(6\) 34 CFR part 81 (General Education Provisions Act\--Enforcement).

\(7\) 34 CFR part 82 (New Restrictions on Lobbying).

\(8\) 34 CFR part 84 (Governmentwide Requirements for Drug-Free
Workplace (Financial Assistance)).

\(9\) 34 CFR part 85 (Governmentwide Debarment and Suspension
(Nonprocurement)).

\(10\) 34 CFR part 97 (Protection of Human Subjects).

\(11\) 34 CFR part 98 (Student Rights in Research, Experimental
Programs, and Testing).

\(12\) 34 CFR part 99 (Family Educational Rights and Privacy).

\(b\) The regulations in this part 226.

(Authority: 20 U.S.C. 1221e-3; 7221d(b))

[§226.4 What definitions apply to the State Charter School Facilities
Incentive program]{.underline}?

\(a\) [Definitions in the statute]{.underline}. The following term used
in this part is defined in section 5210 of the Elementary and Secondary
Education Act of 1965, as amended (ESEA):

Charter school

\(b\) [Definitions in EDGAR]{.underline}. The following terms used in
this part are defined in 34 CFR 77.1:

Applicant

Application

Award

Department

EDGAR

Facilities

Grant

Grantee

Project

Public

Secretary

\(c\) [Other definition]{.underline}. The following definition also
applies to this part:

[Construction]{.underline} means\--

\(1\) Preparing drawings and specifications for school facilities
projects;

\(2\) Repairing, renovating, or altering school facilities;

\(3\) Extending school facilities;

\(4\) Erecting or building school facilities; and

\(5\) Inspections or supervision related to school facilities.

(Authority: 20 U.S.C. 7221d(b); 7221i(1))

Subpart B --- How Does the Secretary Award a Grant?

[§226.11 How does the Secretary evaluate an application]{.underline}?

\(a\) The Secretary evaluates an application on the basis of the
criteria in §226.12 and the competitive preference priorities in §226.13
and §226.14.

\(b\) The Secretary informs applicants of the maximum possible score for
each criterion and competitive preference priority in the application
package or in a notice published in the [Federal Register]{.underline}.

(Authority: 20 U.S.C. 7221d(b))

[§226.12 What selection criteria does the Secretary use in evaluating an
application for a State Charter School Facilities Incentive program
grant]{.underline}?

The selection criteria for this program are as follows:

\(a\) [Need for facility funding]{.underline}. (1) The need for
per-pupil charter school facility funding in the State.

\(2\) The extent to which the proposal meets the need to fund charter
school facilities on a per-pupil basis.

\(b\) [Quality of plan]{.underline}. (1) The likelihood that the
proposed grant project will result in the State either retaining a new
per-pupil facilities aid program or continuing to enhance such a program
without the total amount of assistance (State and Federal) declining
over a five-year period.

\(2\) The flexibility charter schools have in their use of facility
funds for the various authorized purposes.

\(3\) The quality of the plan for identifying charter schools and
determining their eligibility to receive funds.

\(4\) The per-pupil facilities aid formula's ability to target resources
to charter schools with the greatest need and the highest proportions of
students in poverty.

\(5\) For projects that plan to reserve funds for evaluation, the
quality of the applicant's plan to use grant funds for this purpose.

\(6\) For projects that plan to reserve funds for technical assistance,
dissemination, or personnel, the quality of the applicant's plan to use
grant funds for these purposes.

\(c\) [The grant project team]{.underline}. (1) The qualifications,
including relevant training and experience, of the project manager and
other members of the grant project team, including employees not paid
with grant funds, consultants, and subcontractors.

\(2\) The adequacy and appropriateness of the applicant's staffing plan
for the grant project.

\(d\) [The budget]{.underline}. (1) The extent to which the requested
grant amount and the project costs are reasonable in relation to the
objectives, design, and potential significance of the proposed grant
project.

\(2\) The extent to which the costs are reasonable in relation to the
number of students served and to the anticipated results and benefits.

\(3\) The extent to which the non-Federal share exceeds the minimum
percentages (which are based on the percentages under section
5205(b)(2)(C) of the ESEA), particularly in the initial years of the
program.

\(e\) [State experience]{.underline}. The experience of the State in
addressing the facility needs of charter schools through various means,
including providing per-pupil aid, access to State loan or bonding
pools, and the use of Qualified Zone Academy Bonds.

(Approved by the Office of Management and Budget under control number
1855-0012)

(Authority: 20 U.S.C. 7221d(b))

[§226.13 What statutory funding priority does the Secretary use in
making a grant award]{.underline}?

The Secretary shall award additional points under a competitive
preference priority regarding:

\(a\) [Periodic Review and Evaluation]{.underline}. The State provides
for periodic review and evaluation by the authorized public chartering
agency of each charter school at least once every five years unless
required more frequently by State law, to determine whether the charter
school is meeting the terms of the school's charter and is meeting or
exceeding the student academic performance requirements and goals for
charter schools as set forth under State law or the school's charter.

\(b\) [Number of High-Quality Charter Schools]{.underline}. The State
has demonstrated progress in increasing the number of high-quality
charter schools that are held accountable in the terms of the schools'
charters for meeting clear and measurable objectives for the educational
progress of the students attending the schools, in the period prior to
the period for which the State applies for a grant under this
competition.

\(c\) [One Authorized Public Chartering Agency Other than an LEA, or an
Appeals Process]{.underline}. The State \--

\(1\) Provides for one authorized public chartering agency that is not a
local educational agency (LEA), such as a State chartering board, for
each individual or entity seeking to operate a charter school pursuant
to State law; or

\(2\) In the case of a State in which LEAs are the only authorized
public chartering agencies, allows for an appeals process for the denial
of an application for a charter school.

\(d\) [High Degree of Autonomy]{.underline}. The State ensures that each
charter school has a high degree of autonomy over the charter school's
budgets and expenditures.

(Approved by the Office of Management and Budget under control number
1855-0012)

(Authority: 20 U.S.C. 7221b; 7221d(b))

[§226.14 What other funding priorities may the Secretary use in making a
grant award]{.underline}?

\(a\) The Secretary may award points to an application under a
competitive preference priority regarding the capacity of charter
schools to offer public school choice in those communities with the
greatest need for this choice based on\--

\(1\) The extent to which the applicant would target services to
geographic areas in which a large proportion or number of public schools
have been identified for improvement, corrective action, or
restructuring under title I of the ESEA;

\(2\) The extent to which the applicant would target services to
geographic areas in which a large proportion of students perform poorly
on State academic assessments; and

\(3\) The extent to which the applicant would target services to
communities with large proportions of low-income students.

\(b\) The Secretary may award points to an application under a
competitive preference priority for applicants that have not previously
received a grant under the program.

\(c\) The Secretary may elect to consider the points awarded under these
priorities only for proposals that exhibit sufficient quality to warrant
funding under the selection criteria in §226.12 of this part.

(Approved by the Office of Management and Budget under control number
1855-0012)

(Authority: 20 U.S.C. 7221d(b))

Subpart C --- What Conditions Must Be Met by a Grantee?

[§226.21 How may charter schools use these funds]{.underline}?

\(a\) Charter schools that receive grant funds through their State must
use the funds for facilities. Except as provided in paragraph (b) of
this section, allowable expenditures include:

> \(1\) Rent.
>
> \(2\) Purchase of building or land.
>
> \(3\) Construction.
>
> \(4\) Renovation of an existing school facility.
>
> \(5\) Leasehold improvements.
>
> \(6\) Debt service on a school facility.

\(b\) Charter schools may not use these grant funds for purchasing land
when they have no immediate plans to construct a building on that land.

(Authority: 20 U.S.C. 7221d(b))

[§226.22 May grantees use grant funds for administrative
costs]{.underline}?

State grantees may use up to five percent of their grant award for
administrative expenses that include: indirect costs, evaluation,
technical assistance, dissemination, personnel costs, and any other
costs involved in administering the State's per-pupil facilities aid
program.

(Authority: 20 U.S.C. 7221d(b))

[§226.23 May charter schools use grant funds for administrative
costs]{.underline}?

\(a\) Except as provided in paragraph (b) of this section, charter
school subgrantees may use grant funds for administrative costs that are
necessary and reasonable for the proper and efficient performance and
administration of this Federal grant. This use of funds, as well as
indirect costs and rates, must comply with EDGAR and the Office of
Management and Budget Circular A-87 (Cost Principles for State, Local,
and Indian Tribal Governments).

\(b\) Consistent with the requirements in 34 CFR 75.564(c)(2), any
charter school subgrantees that use grant funds for construction
activities may not be reimbursed for indirect costs for those
activities.

(Authority: 20 U.S.C. 1221e-3; 7221d(b)

SECTION C

GENERAL APPLICATION INSTRUCTIONS AND INFORMATION

General Instructions

The 84.282D application consists of the following, as outlined in the
Federal Register Notice. All forms listed below are required. Please
review all instructions and the Federal Register Notice before
completing your application.

If you have received an exemption to the mandatory electronic submission
requirement and are submitting a hard copy application, you will not use
these forms, but will prepare a narrative incorporating each element.

[ED Abstract Form -]{.underline} The abstract is to be attached to the
"ED Abstract Form" in the application package in Grants.gov.

# [Project Narrative Attachment Form]{.underline} - (found in the Grants.gov application package) is where applicants will attach their narrative responses to the application requirements and selection criteria that will be used to evaluate applications submitted for this competition. Make sure that your narrative addresses all of the elements. We strongly recommend that the information be organized around and appear in the same sequence as the Project Selection Criteria. This section has a suggested page limit of 30 pages (not including the required forms and tables). 

Also included in this section, but not subject to the 30 page limit,
will be a table of contents and response to the invitation priority and
competitive priority.

[Budget Narrative Attachment Form]{.underline} - (found in the
Grants.gov application package) is where applicants will attach the ED
524 and Table 2 (Budget Form).

[Other Attachments Form]{.underline} - (found in the Grants.gov
application package) is where the applicant will attach additional
documents, including resumes/curriculum vitae and appendices. This is
also where the applicant will upload Table 1 (Charter School Aid Paid by
State) and Table 3 (Grant Funds as a Percentage of the Cost of Per-Pupil
Facilities Aid).

In this section, the applicant will also include the bill or enacted
statute (please specify which one it is) that authorizes per-pupil
facilities aid for charter schools. In the event it is a bill, please
indicate which hurdles it has passed towards enactment (e.g., passage by
a specified legislative body) and which hurdles remain (e.g., passage by
a specified legislative body and signature of a governor).

In addition, provide any available statutes regarding the appropriation
level for per-pupil facilities aid for charter schools since authorized
activities are not always funded. In the event that funding has not
already been enacted, please indicate which hurdles it has passed
towards enactment and which hurdles remain.

The Grants.gov system will allow applicants to attach as many as ten
separate appendices in this section. If the applicant has more than ten
separate appendices, it may be necessary for the applicant to
consolidate some of the attachments into just one attachment.

Electronic submission requires that narratives and other files be
attached to the following attachment forms as per the instruction in
this document such as:

> One page Abstract must be attached to the "Department of Education
> Abstract Form"
>
> Program Narratives must be attached to the "Program Narrative
> Attachment Form"
>
> Budget Narratives must be attached to the "Budget Narrative Attachment
> Form"
>
> All vitas, resumes, table of contents, letters, certifications,
> supplementary statements; and other requested appendices must be
> attached to the "Other Attachment Forms"

*Note: Please do not attach any narratives, supporting files, or
application components to the Standard Form (SF 424). Although this form
accepts attachments, the Department of Education will only review
materials/files attached to the attachment forms listed above.*

**Forms*,* Assurances, and Certifications**

Applicants must complete all forms included in the application package.
Instructions for the following forms are included in this document:

> SF 424
>
> Department of Education Supplemental Information for SF 424
>
> Assurance for Non-Construction Programs (SF 424B)
>
> Grants.gov Lobbying Form (Certification Regarding Lobbying ED 80-0013)
>
> SF-LLL, Disclosure of Lobbying Activities
>
> GEPA Statement

In order to submit your application through Grants.gov, you must
register with Grants.gov. The registration is a one-time process that
may take 5 days or more to complete. You may begin working on your
application while completing the registration process, but you cannot
submit an application until all of the registration steps are completed.
For detailed information on registering with Grants.gov, please go to:
[\<http://www.grants.gov/applicants/get_registered.jsp\>]{.underline}.

If you qualify for an exception to the mandatory electronic submission,
and have requested one no later than two weeks before the application
deadline date, please follow the instructions for submitting a hard copy
of the application in the Federal Register Notice. To help facilitate
the review of a hard copy application, please arrange the required
elements in the same order they are listed here.

When filling out the SF 424, you must use the same DUNS number that your
organization used when it registered with the Central Contractor
Registry, or Grants.gov will reject the application. Complete the SF 424
first; the information provided on the SF 424 will populate fields in
other application package forms.

> []{.mark}

**Instructions for ED Abstract Narrative**

[]{.mark}

The abstract is to be attached to the "ED Abstract Attachment Form" in
the application package in Grants.gov.

The abstract narrative must include the name and address of your
organization and the name, phone number, and e-mail address of the
contact person for this project.

The abstract narrative must not exceed one page and should use language
that will be understood by a range of audiences. For all projects,
include the project title (if applicable), goals, expected outcomes and
contributions for research, policy, practice, etc. Address how your
application meets the purpose of the State Charter School Facilities
Incentive Grants Program as stated in the Notice Inviting Applications
for New Awards.

**Instructions for Project Narrative**

Before preparing the project narrative, **applicants should review the
Federal Register notice**, the Dear Applicant Letter, and the program
statute for specific guidance and requirements. Note that applications
will be evaluated according to the specific selection criteria specified
in the Federal Register notice.

Please limit the Project Narrative to 30 pages, double-spaced, and
number the pages consecutively. Refer to the Federal Register notice for
additional application submission requirements.

This part of your application contains information responsive to the
Project Selection Criteria and the Application Content Requirements.
Make sure that your narrative addresses all of the elements. *We
strongly recommend that the information be organized around and appear
in the same sequence as the Project Selection Criteria*. Please upload
the program narrative as one document.

**Instructions for Budget Narrative**

This part of the application contains information about the Federal
funding you are requesting. You must fill in the ED 524 budget form.
Provide an itemized budget breakdown narrative, by project year, for
each budget category listed in Sections A and B of the ED 524 form. If
applicable to this program, provide the rate and base on which fringe
benefits are calculated.

If you are requesting reimbursement for indirect costs on line 10, this
information is to be completed by your Business Office. Specify the
estimated amount of the base to which the indirect cost rate is applied
and the total indirect expense. Please indicate which costs are included
and which costs are excluded from the base to which the indirect cost
rate is applied.

Each State educational agency receiving a grant pursuant to this subpart
may reserve not more than 5 percent of such grant funds for
administrative expenses associated with the charter school grant
program.

Provide other budget explanations or comments deemed necessary.

Applicants are also required to fill out Table 2 (Budget Form).

Both of these forms (the ED 524 and Table 2) will be uploaded in the
Budget Form Section.

**Instructions for Other Attachments**

Additional documents are to be attached to the "Other Attachments Form"
in the application package in Grants.gov. These would be supplementary
statements and other requested information.

In addition to the program narrative, applications should include
resumes for key personnel. Before preparing additional documentation,
**applicants should review the Federal Register notice**, the Dear
Applicant Letter, and the program statute for specific guidance and
requirements. Note that applications will be evaluated according to the
specific selection criteria specified in the Federal Register notice.

To facilitate the review of the application, please organize your
attachments in the following order:

1.  Table 1 - Charter School Aid Paid by State

2.  Table 3 - Grant Funds as a Percentage of the Cost of Per-Pupil
    Facilities Aid

3.  Bill or enacted statute

4.  Resumes/Curriculum Vitae

5.  Appendices

**Resumes/Curriculum Vitae**

Provide resumes/curriculum vitae for the project director as well as any
key personnel identified in the application.

**[Priorities and]{.smallcaps}** **[Project Selection
Criteria]{.smallcaps}**

**The Challenge: Helping Charter Schools and Promoting School Choice**

Charter schools have difficulty obtaining adequate facilities for
various reasons. One major obstacle is that charter schools that are
freestanding local educational agencies (LEAs) generally lack the
authority to raise property taxes. This inability to raise taxes,
combined with the inherent risk that charter schools need to renew their
charters to remain open, makes it difficult for investors to risk
financing the purchase of school facilities. A 2003 General Accounting
Office (GAO) publication, *Charter Schools: New Charter Schools Across
the Country and in the District of Columbia Face Similar Start-Up
Challenges*, details their difficulties obtaining facilities. This study
indicates that because financing a facility is difficult for charter
schools, many of them rely on their per-pupil operating allocations to
pay for their facility costs. These allocations are generally designed
to be large enough to just cover operating expenses, not capital
expanses such as facilities. GAO notes that of the 40 States, District
of Columbia and Puerto Rico that all have charter schools, only 6 offer
per-pupil facilities aid. Perhaps as a result, over half of the nation's
charter schools are in these six States.

The State Charter School Facilities Incentive Grants program is intended
to encourage States to develop per-pupil facilities aid programs and
share in the costs associated with charter schools facilities funding.

Charter schools serve as a key to providing meaningful public school
choice. In addition, the number of charter schools that grantees will be
able to serve with these funds is limited. Consequently, proposals that
focus funds on areas that need school choice the most will score higher
than other proposals.

The Secretary will select for funding under the State Charter School
Facilities Incentive Grants program those applications that are deemed
of highest overall quality. Experts in charter schools and education
finance will review the applications and assign to each application up
to XXX points using the Project Selection Criteria and corresponding
weights described in this section and the Competitive Priorities. Each
criterion includes factors the reviewers will consider in determining
how well an application meets the criterion.

Reviewers will use their own professional judgment to assess the quality
of each application against these criteria. To be competitive,
applicants must address each of the selection criteria fully and
clearly. We recommend that applicants organize their application
narrative around the Competitive Priorities and the Project Selection
Criteria.

***The Competitive Priority for applicants that propose a grant project
that increases the capacity of charter schools to offer school choice in
those communities with the greatest need for public school choice (XX
points):***

> This criterion focuses on the likelihood that the proposed project
> will increase the capacity of charter schools to provide public school
> choice in those geographic areas where school choice is needed most.
> Part of this need to provide public school choice is related to Title
> I of the Elementary and Secondary Act as amended by the No Child Left
> Behind (NCLB) Act. Under NCLB, school districts are required to
> provide public school choice to students in schools that have either
> (1) failed to make adequate yearly progress for two years, or (2) are
> considered to be persistently dangerous. School districts are already
> indicating that they are having difficulty finding sufficient space in
> schools so that students can transfer to quality schools that provide
> a safe learning environment.

Factors that will be considered in assessing the applicant's proposal to
address school facility capacity issues related to increasing the
capacity of charter schools to provide public school choice in those
communities with the greatest need for such choice, including:

-   The extent to which the applicant would target services to
    geographic areas in which a large proportion or number of public
    schools have been identified for improvement, corrective action, or
    restructuring under title I of the ESEA;

-   The extent to which the applicant would target services to
    geographic areas in which a large proportion of students perform
    poorly on State academic assessments; and

-   The extent to which the applicant would target services to
    communities with large proportions of low-income students.

***The Competitive Priority for new grantees (XX points):***

The Secretary awards XX points for applications from States that have
not previously received a grant under the program.

***The competitive priority for grant applicants with relatively strong
charter school programs.*** (XX points)

An applicant with a State educational agency (SEA) that does not meet
any one of the four statutory criteria will not receive any priority
points. In order to receive preference, an applicant must identify the
statutory criteria that it meets and provide documentation supporting
its claims.

Factors that will be considered in assessing the competitive priority
are:

-   [Periodic Review and Evaluation]{.underline}. The State provides for
    periodic review and evaluation by the authorized public chartering
    agency of each charter school at least once every 5 years unless
    required more frequently by State law, to determine whether the
    charter school is meeting the terms of the school's charter, and is
    meeting or exceeding the student academic performance requirements
    and goals for charter schools as provided under State law or the
    school's charter.

-   [Number of High-Quality Charter Schools]{.underline}. The State has
    demonstrated progress in increasing the number of high-quality
    charter schools that are held accountable in the terms of the
    schools' charters for meeting clear and measurable objectives for
    the educational progress of the students attending the schools, in
    the period prior to the period for which the State applies for a
    grant under this competition.

-   [One Authorized Public Chartering Agency Other than an LEA, or an
    Appeals Process]{.underline}. The State \--

> \(1\) Provides for one authorized public chartering agency that is not
> an local educational agency (LEA), such as a State chartering board,
> for each individual or entity seeking to operate a charter school
> pursuant to State law; or
>
> \(2\) In the case of a State in which LEAs are the only authorized
> public chartering agencies, allows for an appeals process for the
> denial of an application for a charter school.

-   [High Degree of Autonomy]{.underline}. The State ensures that each
    charter school has a high degree of autonomy over the charter
    school's budgets and expenditures.

**A. The selection criteria related to the applicant's capacity to carry
out the proposed grant project include:**

1\) Need for facility funding (XX points)

> This criterion rewards applicants that need the Federal funds to meet
> the facility needs of charter schools in the State. The materials that
> reviewers will take into account when rating against this selection
> criterion include:

-   State budget proposals and tables.

-   A description of how charter schools' costs in total (operating,
    capital, and interest costs) are financed in the State and the level
    of that funding.

-   A description of how public school facilities are financed within
    the State with a focus on a comparison between how facilities are
    financed for charter schools and regular public schools.

-   A description of what represents an adequate amount of facilities
    funding for charter schools in the State.

-   A description of the unmet need for charter school facility funding
    absent the assistance that would be provided under the proposal.

Factors that will be considered in assessing the adequacy of facility
funding include:

-   The need for per-pupil charter school facility funding in the State.

-   The extent to which the proposal meets the need to fund charter
    school facilities on a per-pupil basis.

2\) Quality of plan (XX points)

> This criterion focuses on the quality of the State's plan for
> delivering per-pupil facilities aid to charter schools.
>
> The materials that reviewers will take into account when rating
> against this selection criterion include:

-   Enabling statutes and other relevant legislation, such as
    appropriation legislation or tables.

-   Table 1 -- Per-Pupil Facilities Aid Paid by State.

-   Table 3 -- Grant Funds as a Percentage of the Cost of Per-Pupil
    Facilities Aid.

-   State budget proposals and tables.

-   A description of how charter schools' facility costs are financed in
    the State and the level of that funding, and how the distribution
    and level of funding would change under the plan.

-   A statement identifying the activities proposed to be undertaken
    with grant funds and the timeline for the activities, including the
    distribution of funds, and the procedures the applicant will use for
    documenting grant project procedures and results.

Factors that will be considered in assessing the quality of the plan
include:

-   The likelihood that the proposed grant project will result in the
    State either retaining a new per-pupil facilities aid program or
    continuing to enhance such a program without the total amount of
    assistance (State and Federal) declining over a five-year period.

-   The flexibility charter schools have in their use of facility funds
    for the various authorized purposes.

-   The quality of the plan for identifying charter schools and
    determining their eligibility to receive funds.

-   The per-pupil facilities aid formula's ability to target resources
    to charter schools with the greatest need and the highest
    proportions of students in poverty.

-   For projects that plan to reserve funds for evaluation, the quality
    of the applicant's plan to use grant funds for this purpose.

-   For projects that plan to reserve funds for technical assistance,
    dissemination, or personnel, the quality of the applicant's plan to
    use grant funds for these purposes.

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-   
-   

3\) The grant project team (XX points).

> This criterion focuses on the relevant training and experience of key
> grant project personnel, consultants, and subcontractors. Successful
> applicants will plan to use the services of individuals with
> substantial experience and expertise in education finance, charter
> schools, and other appropriate areas.
>
> The materials that reviewers will take into account when rating
> against this selection criterion include:

-   A description of current job responsibilities, the educational
    background, and the experience and skills of each member of the
    grant project team as described in current resumes. The resumes
    should pay particular attention to experience in the fields of
    education finance and charter schools. Position qualification
    statements should be provided for any staff, including through
    contracts, the applicant plans to hire for the project.

-   A staffing plan for the project, including a description of the
    assignments by activity or service.

> Factors used to assess the grant project team include:

-   The qualifications, including relevant training and experience, of
    the project manager and other members of the grant project team,
    including employees not paid with grant funds, consultants, and
    subcontractors.

-   The adequacy and appropriateness of the applicant's staffing plan
    for the grant project.

4\) The budget (XX points)

> This criterion focuses on the reasonableness of the budget.
>
> The materials reviewers will take into account when rating against
> this selection criterion include:

-   Table 2 \-- Budget Form

-   Table 3 \-- Grant Funds as a Percentage of the Cost of Per-Pupil
    Facilities Aid

-   State budget proposals and tables.

-   A description of how charter schools' costs in total (operating,
    capital, and interest costs) are financed in the State and the level
    of that funding.

-   A description of how public school facilities are financed within
    the State with focus on a comparison between how facilities are
    financed for charter schools and regular public schools.

-   A description of the unmet need for charter school facility funding
    absent the assistance that would be provided under the proposal.

> Factors used to assess the budget include:

-   The extent to which the requested grant amount and the project costs
    are reasonable in relation to the objectives, design, and potential
    significance of the proposed grant project.

-   The extent to which the costs are reasonable in relation to the
    number of students served and to the anticipated results and
    benefits.

-   The extent to which the non-Federal share exceeds the minimum
    percentages (which are based on the percentages under section
    5205(b)(2)(C) of the ESEA), particularly in the initial years of the
    program.

5\) State experience

> This criterion focuses on the experience the State has with helping
> charter schools meet their facility needs.
>
> The materials reviewers will take into account when rating against
> this selection criterion include:

-   State budget proposals and tables.

-   A description of how charter schools' costs in total (operating,
    capital, and interest costs) are financed in the State and the level
    of that funding.

-   Enabling statutes and other relevant legislation, such as
    appropriation legislation or tables.

-   A description of how public school facilities are financed within
    the State with focus on a comparison between how facilities are
    financed for charter schools and regular public schools.

> The factor used to assess the State's experience is:

-   The experience of the State in addressing the facility needs of
    charter schools through various means, including providing per-pupil
    aid, access to State loan or bonding pools, and the use of Qualified
    Zone Academy Bonds.

Table 1 -- Charter School Aid Paid by State

  ------------------- ---------- ---------- ---------- ----------- ---------- ---------- ---------- ---------- ----------
  **Source**          **Fiscal   **Fiscal   **Fiscal   **Fiscal    **Fiscal   **Fiscal   **Fiscal   **Fiscal   **Fiscal
                      year       year       year       year        year       year       year       year       year
                      20XX**     20XX**     20XX**     20XX^1^**   20XX**     20XX**     20XX**     20XX**     20XX**

  1\. Number of                                                                                                
  pupils in average                                                                                            
  daily attendance in                                                                                          
  charter schools                                                                                              

  2\. a. Per-pupil                                                                                             
  funding for charter                                                                                          
  school facilities                                                                                            
  in total ^2^                                                                                                 

  2\. b. Per-pupil                                                                                             
  funding for charter                                                                                          
  school facilities                                                                                            
  per charter school                                                                                           
  student in average                                                                                           
  daily attendance                                                                                             

  3\. a. Other                                                                                                 
  funding for charter                                                                                          
  schools ^3^                                                                                                  

  3\. b. Other                                                                                                 
  funding for charter                                                                                          
  schools per charter                                                                                          
  school student in                                                                                            
  average daily                                                                                                
  attendance                                                                                                   

  Total                                                                                                        
  ------------------- ---------- ---------- ---------- ----------- ---------- ---------- ---------- ---------- ----------

^1^ The State's fiscal year 20XX begins on \_\_\_\_\_\_\_\_\_\_\_ and
ends on \_\_\_\_\_\_\_\_\_. If the State has not yet made a decision
about the level of funding for these activities in Fiscal Year 20XX,
please indicate the status of funding for Fiscal Year 20XX in the State
for these activities. The purpose of this table is to determine total
amount of per-pupil facilities aid and assistance in general for charter
schools.

^2^ This funding includes funds that are distributed on a per-pupil
basis that are (1) dedicated solely for funding charter school
facilities and (2) the portion of funds that are dedicated for charter
school facilities that are part of a distribution of funds that may be
used for other purposes, such as operating expenses for charter schools
or facility funds for regular public schools.

^3^ These funds include operating funds for charter schools, per-pupil
allocations to charter schools that are not designated solely for
facilities, facilities funds that are not awarded to charter schools on
a per-pupil basis.

##  {#section .unnumbered}

## **Table 2 -Budget Form: Grant Funds Expenditures** {#table-2--budget-form-grant-funds-expenditures .unnumbered}

  ----------------- ----------- ----------- ----------- ----------- ----------- -----------
  **Budget          **Project   **Project   **Project   **Project   **Project   **Total**
  categories**      year 1**    year 2**    year 3**    year 4**    year 5**    

  A. Administrative                                                             
  funds (5%)                                                                    

  A.1. Indirect                                                                 
  costs                                                                         

  A.2. Evaluation                                                               

  A.3. Technical                                                                
  assistance                                                                    

  A.4.                                                                          
  Dissemination                                                                 

  A.5. Personnel                                                                
  costs not                                                                     
  associated with                                                               
  evaluation,                                                                   
  technical                                                                     
  assistance, or                                                                
  dissemination                                                                 

  A. Total                                                                      
  administrative                                                                
  costs                                                                         

  B. Per-pupil                                                                  
  facilities aid                                                                
  for charter                                                                   
  schools                                                                       

  Per-pupil funding                                                             
  for charter                                                                   
  school facilities                                                             

  C. Grand total --                                                             
  Federal grant                                                                 
  request                                                                       
  ----------------- ----------- ----------- ----------- ----------- ----------- -----------

[Instructions for Table 2 \-- Budget Form: Grant Funds
Expenditures]{.underline}

[A. Administrative funds:]{.underline}

> [A.1. Indirect costs:]{.underline} Many organizations have indirect
> cost rates established with the U.S. Department of Education which
> allow those organizations to spend a portion of their grant funds on a
> share of the total organization costs such as rent and utilities. For
> this grant you may choose to claim indirect costs, but the total
> amount may not exceed five percent. Also, if you choose to claim
> indirect costs, the sum of your indirect costs and your other
> administrative costs combined may not exceed five percent.

[A. Total administrative costs:]{.underline} The total for this line
should include the sum of lines A.1. through A.5. This line cannot
exceed five percent of the requested amount for any fiscal year.

[B. Per-pupil facilities aid for charter schools]{.underline}

This funding includes funds that are distributed on a per-pupil basis
that are (1) dedicated solely for funding charter school facilities and
(2) the portion of funds that are *dedicated for charter school
facilities* that are part of a distribution of funds that may be used
for other purposes, such as operating expenses for charter schools or
facility funds for regular public schools.

[C. Grand Total]{.underline}

The amount in the total column for this row should be the same as the
request on Form ED 424.

## **Table 3 - Grant Funds as a Percentage of the Cost of Per-Pupil Facilities Aid** {#table-3---grant-funds-as-a-percentage-of-the-cost-of-per-pupil-facilities-aid .unnumbered}

##  {#section-1 .unnumbered}

##  {#section-2 .unnumbered}

+----------------+--------+--------+--------+--------+--------+-------+
| #              | ## **  | ##     | ##     | ##     | ##     | ##    |
| # **Budget cat | Projec | **Proj | **Proj | **Proj | **Proj | **Tot |
| egories** {#bu | t year | ect ye | ect ye | ect ye | ect ye | al**  |
| dget-categorie |  1\*** | ar 2** | ar 3** | ar 4** | ar 5** | {#tot |
| s .unnumbered} |  {#pro |  {#pro |  {#pro |  {#pro |  {#pro | al .u |
|                | ject-y | ject-y | ject-y | ject-y | ject-y | nnumb |
|                | ear-1  | ear-2  | ear-3  | ear-4  | ear-5  | ered} |
|                | .unnum | .unnum | .unnum | .unnum | .unnum |       |
|                | bered} | bered} | bered} | bered} | bered} |       |
+----------------+--------+--------+--------+--------+--------+-------+
| ## **A.        | ##     | ##     | ##     | ##     | ##     | ##    |
| Line C, Grand  | {#sect | {#sect | {#sect | {#sect | {#sect |  {#se |
| total, from Ta | ion-3  | ion-4  | ion-5  | ion-6  | ion-7  | ction |
| ble 2 -- Budge | .unnum | .unnum | .unnum | .unnum | .unnum | -8 .u |
| t Form** {#a.- | bered} | bered} | bered} | bered} | bered} | nnumb |
| line-c-grand-t |        |        |        |        |        | ered} |
| otal-from-tabl |        |        |        |        |        |       |
| e-2-budget-for |        |        |        |        |        |       |
| m .unnumbered} |        |        |        |        |        |       |
+----------------+--------+--------+--------+--------+--------+-------+
| ##             | ##     | ##  {  | ##  {  | ##  {  | ##  {  | ##    |
|  **B. Line 1,  | {#sect | #secti | #secti | #secti | #secti | {#sec |
| State per-pupi | ion-9  | on-10  | on-11  | on-12  | on-13  | tion- |
| l funding for  | .unnum | .unnum | .unnum | .unnum | .unnum | 14 .u |
| charter school | bered} | bered} | bered} | bered} | bered} | nnumb |
|  facilities, f |        |        |        |        |        | ered} |
| rom Table 1 \- |        |        |        |        |        |       |
| -** **Charter  |        |        |        |        |        |       |
| School Aid Pai |        |        |        |        |        |       |
| d by State** { |        |        |        |        |        |       |
| #b.-line-1-sta |        |        |        |        |        |       |
| te-per-pupil-f |        |        |        |        |        |       |
| unding-for-cha |        |        |        |        |        |       |
| rter-school-fa |        |        |        |        |        |       |
| cilities-from- |        |        |        |        |        |       |
| table-1----cha |        |        |        |        |        |       |
| rter-school-ai |        |        |        |        |        |       |
| d-paid-by-stat |        |        |        |        |        |       |
| e .unnumbered} |        |        |        |        |        |       |
+----------------+--------+--------+--------+--------+--------+-------+
| ## **C. Tot    | ##  {  | ##  {  | ##  {  | ##  {  | ##  {  | ##    |
| al** {#c.-tota | #secti | #secti | #secti | #secti | #secti | {#sec |
| l .unnumbered} | on-15  | on-16  | on-17  | on-18  | on-19  | tion- |
|                | .unnum | .unnum | .unnum | .unnum | .unnum | 20 .u |
|                | bered} | bered} | bered} | bered} | bered} | nnumb |
|                |        |        |        |        |        | ered} |
+----------------+--------+--------+--------+--------+--------+-------+
| #              | ##  {  | ##  {  | ##  {  | ##  {  | ##  {  | ##    |
| # **D. Federal | #secti | #secti | #secti | #secti | #secti | {#sec |
|  grant request | on-21  | on-22  | on-23  | on-24  | on-25  | tion- |
|  (Line A., Tab | .unnum | .unnum | .unnum | .unnum | .unnum | 26 .u |
| le 3) as a per | bered} | bered} | bered} | bered} | bered} | nnumb |
| centage of the |        |        |        |        |        | ered} |
|  cost of per-p |        |        |        |        |        |       |
| upil facilitie |        |        |        |        |        |       |
| s aid (Line C. |        |        |        |        |        |       |
| , Table 3)** { |        |        |        |        |        |       |
| #d.-federal-gr |        |        |        |        |        |       |
| ant-request-li |        |        |        |        |        |       |
| ne-a.-table-3- |        |        |        |        |        |       |
| as-a-percentag |        |        |        |        |        |       |
| e-of-the-cost- |        |        |        |        |        |       |
| of-per-pupil-f |        |        |        |        |        |       |
| acilities-aid- |        |        |        |        |        |       |
| line-c.-table- |        |        |        |        |        |       |
| 3 .unnumbered} |        |        |        |        |        |       |
+----------------+--------+--------+--------+--------+--------+-------+

##  {#section-27 .unnumbered}

##  {#section-28 .unnumbered}

##  {#section-29 .unnumbered}

##  {#section-30 .unnumbered}

##  {#section-31 .unnumbered}

##  {#section-32 .unnumbered}

##  **\*Project Year 1 is the same as State fiscal year 20XX unless the applicant [explicitly]{.underline} notes and explains which project year maps to which State fiscal year.** {#project-year-1-is-the-same-as-state-fiscal-year-20xx-unless-the-applicant-explicitly-notes-and-explains-which-project-year-maps-to-which-state-fiscal-year. .unnumbered}

##  {#section-33 .unnumbered}

## Program-Specific Assurance {#program-specific-assurance .unnumbered}

######### 

######### 

######### 

######### 

######### I assure that my State intends to provide (either alone or with the assistance of other parties, such as foundations) annual funding, on a per-pupil basis, for charter school facilities. Furthermore, I am aware that the Federal share declines in accordance with the table below:

Matching Requirement for State charter school facilities incentive
grants program, by Grant Project Year

######### 

#########  Non-Federal share Federal share 

#########  (maximum)

######### 

######### Year 1 10% 90%

######### 

######### Year 2 20% 80%

######### 

######### Year 3 40% 60%

######### 

######### Year 4 60% 40%

######### 

######### Year 5 80% 20%

######### 

######### 

######### \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

######### 

######### Signature Title

######### 

####  

#### General Education Provisions Act (GEPA)

#### Section 427

**\*ALL APPLICANTS FOR NEW AWARDS [MUST]{.underline} INCLUDE INFORMATION
IN THEIR APPLICATIONS TO ADDRESS THIS PROVISION IN ORDER TO RECEIVE
FUNDING UNDER THIS PROGRAM.**

Section 427 requires each applicant to include in its application a
description of the steps the applicant proposes to take to ensure
equitable access to, and participation in, its federally-assisted
program for students, teachers, and other program beneficiaries with
special needs.

This provision allows applicants discretion in developing the required
description. The statute highlights six barriers that can impede
equitable access or participation: gender, race, national origin, color
disability, or age. Based on local circumstances, you should determine
whether these or other barriers may prevent your students, teachers,
etc. from such access or participation in the federally-funded project
or activity. The description in your application of steps to be taken to
overcome these barriers need not be lengthy; you may provide a clear and
succinct description of how you plan to address those barriers that are
applicable in your circumstances.

*A general statement of an applicant's nondiscriminatory hiring policy
is not sufficient to meet this requirement. Applicants must identify
potential barriers and explain steps they will take to overcome these
barriers.*

**\*Note: [Applicants are required to address this provision by
attaching a statement to the ED GEPA 427 Form that must be downloaded
from Grants.gov. ]{.underline}**

#### Government Performance and Results Act (GPRA)

**What is GPRA?**

The Government Performance and Results Act of 1993 (GPRA) is a
straightforward statute that requires all federal agencies to manage
their activities with attention to the consequences of those activities.
Each agency is to clearly state what it intends to accomplish, identify
the resources required, and periodically report their progress to the
Congress. In so doing, it is expected that the GPRA will contribute to
improve in accountability for the expenditures of public funds, improve
Congressional decision-making through more objective information on the
effectiveness of federal programs, and promote a new government focus on
results, service delivery, and customer satisfaction.

**How has the Department of Education Responded to the GPRA
Requirements?**

As required by GPRA, the Department of Education has prepared a
strategic plan for 2002-2007. This plan reflects the Department's
priorities and integrates them with its mission and program authorities
and describes how the Department will work to improve education for all
children and adults in the U.S. The Department's goals, as listed in the
plan, are:

*Goal 1: Create a Culture of Achievement*.

*Goal 2: Improve Student Achievement*

*Goal 3: Develop Safe Schools and Strong Character*

*Goal 4: Transform Education into an Evidence-based Field*

> *Goal 5: Enhance the Quality of and Access to Postsecondary and Adult
> Education*

*Goal 6: Establish Management Excellence*

The performance indicators for the State Charter School Facility
Incentive grants program are part of the Department's plan for meeting
Goal 5: Improve Student Achievement.

**What are the Performance Indicators for the State Charter School
Facility Incentive Grants program?**

The goal of the State Charter School Facility Incentive Grants program
is to support the creation of a large number of high-quality charter
schools. Under the Government Performance and Results Act, the
Department will use the following measure to evaluate the success of the
program in meeting this goal:

The ratio of funds leveraged by States for charter school facilities to
the combination of funds awarded by the Department under the State
Charter School Facility Incentive Grants program and funds leveraged by
States.

**SECTION D**

**INSTRUCTIONS TO STANDARD FORMS AND GRANT APPLICATION REQUIREMENTS**

**Forms*,* Assurances, and Certifications**

Applicants must complete all forms included in the application package.
Instructions for the following forms are included in this document:

-   SF 424

-   Department of Education Supplemental Information for SF 424

-   Instructions for ED 524

-   Assurance for Non-Construction Programs (SF 424B)

-   Grants.gov Lobbying Form (Certification Regarding Lobbying ED
    80-0013)

-   SF-LLL, Disclosure of Lobbying Activities

-   Survey Instructions on Ensuring Equal Opportunity for Applicants

## INSTRUCTIONS FOR THE SF-424

Public reporting burden for this collection of information is estimated
to average 60 minutes per response, including time for reviewing
instructions, searching existing data sources, gathering and maintaining
the data needed, and completing and reviewing the collection of
information. Send comments regarding the burden estimate or any other
aspect of this collection of information, including suggestions for
reducing this burden, to the Office of Management and Budget, Paperwork
Reduction Project (0348-0043), Washington, DC 20503.

**PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT
AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.**

> This is a standard form (including the continuation sheet) required
> for use as a cover sheet for submission of preapplications and
> applications and related information under discretionary programs.
> Some of the items are required and some are optional at the discretion
> of the applicant or the Federal agency (agency). Required items are
> identified with an asterisk on the form and are specified in the
> instructions below. In addition to the instructions provided below,
> applicants must consult agency instructions to determine specific
> requirements.

+---+-----------------+---------------+---+---------------------------+
| I | Entry:          |               | I | Entry:                    |
| t |                 |               | t |                           |
| e |                 |               | e |                           |
| m |                 |               | m |                           |
+---+-----------------+---------------+---+---------------------------+
| 1 | **Type of       |               | 1 | **Name Of Federal         |
| \ | Submission:**   |               | 0 | Agency**: (Required)      |
| . | (Required):     |               | \ | Enter the name of the     |
|   | Select one type |               | . | Federal agency from which |
|   | of submission   |               |   | assistance is being       |
|   | in accordance   |               |   | requested with this       |
|   | with agency     |               |   | application.              |
|   | instructions.   |               |   |                           |
|   |                 |               |   |                           |
|   | -               |               |   |                           |
|   |  Preapplication |               |   |                           |
|   |                 |               |   |                           |
|   | -   Application |               |   |                           |
|   |                 |               |   |                           |
|   | -   Ch          |               |   |                           |
|   | anged/Corrected |               |   |                           |
|   |     Application |               |   |                           |
|   |     -- If       |               |   |                           |
|   |     requested   |               |   |                           |
|   |     by the      |               |   |                           |
|   |     agency,     |               |   |                           |
|   |     check if    |               |   |                           |
|   |     this        |               |   |                           |
|   |     submission  |               |   |                           |
|   |     is to       |               |   |                           |
|   |     change or   |               |   |                           |
|   |     correct a   |               |   |                           |
|   |     previously  |               |   |                           |
|   |     submitted   |               |   |                           |
|   |                 |               |   |                           |
|   |    application. |               |   |                           |
|   |     Unless      |               |   |                           |
|   |     requested   |               |   |                           |
|   |     by the      |               |   |                           |
|   |     agency,     |               |   |                           |
|   |     applicants  |               |   |                           |
|   |     may not use |               |   |                           |
|   |     this to     |               |   |                           |
|   |     submit      |               |   |                           |
|   |     changes     |               |   |                           |
|   |     after the   |               |   |                           |
|   |     closing     |               |   |                           |
|   |     date.       |               |   |                           |
+---+-----------------+---------------+---+---------------------------+
|   |                 |               | 1 | **Catalog Of Federal      |
|   |                 |               | 1 | Domestic Assistance       |
|   |                 |               | \ | Number/Title:** Enter the |
|   |                 |               | . | Catalog of Federal        |
|   |                 |               |   | Domestic Assistance       |
|   |                 |               |   | number and title of the   |
|   |                 |               |   | program under which       |
|   |                 |               |   | assistance is requested,  |
|   |                 |               |   | as found in the program   |
|   |                 |               |   | announcement, if          |
|   |                 |               |   | applicable.               |
+---+-----------------+---------------+---+---------------------------+
|   |                 |               |   |                           |
+---+-----------------+---------------+---+---------------------------+
| 2 | **Type of       |               | 1 | **Funding Opportunity     |
| \ | Application**:  |               | 2 | Number/Title:**           |
| . | (Required)      |               | \ | (Required) Enter the      |
|   | Select one type |               | . | Funding Opportunity       |
|   | of application  |               |   | Number and title of the   |
|   | in accordance   |               |   | opportunity under which   |
|   | with agency     |               |   | assistance is requested,  |
|   | instructions.   |               |   | as found in the program   |
|   |                 |               |   | announcement.             |
|   | -   New -- An   |               |   |                           |
|   |     application |               |   |                           |
|   |     that is     |               |   |                           |
|   |     being       |               |   |                           |
|   |     submitted   |               |   |                           |
|   |     to an       |               |   |                           |
|   |     agency for  |               |   |                           |
|   |     the first   |               |   |                           |
|   |     time.       |               |   |                           |
|   |                 |               |   |                           |
|   | -               |               |   |                           |
|   |  Continuation - |               |   |                           |
|   |     An          |               |   |                           |
|   |     extension   |               |   |                           |
|   |     for an      |               |   |                           |
|   |     additional  |               |   |                           |
|   |                 |               |   |                           |
|   |  funding/budget |               |   |                           |
|   |     period for  |               |   |                           |
|   |     a project   |               |   |                           |
|   |     with a      |               |   |                           |
|   |     projected   |               |   |                           |
|   |     completion  |               |   |                           |
|   |     date. This  |               |   |                           |
|   |     can include |               |   |                           |
|   |     renewals.   |               |   |                           |
|   |                 |               |   |                           |
|   | ```{=html}      |               |   |                           |
|   | <!-- -->        |               |   |                           |
|   | ```             |               |   |                           |
|   | -   Revision -  |               |   |                           |
|   |     Any change  |               |   |                           |
|   |     in the      |               |   |                           |
|   |     Federal     |               |   |                           |
|   |                 |               |   |                           |
|   |    Government's |               |   |                           |
|   |     financial   |               |   |                           |
|   |     obligation  |               |   |                           |
|   |     or          |               |   |                           |
|   |     contingent  |               |   |                           |
|   |     liability   |               |   |                           |
|   |     from an     |               |   |                           |
|   |     existing    |               |   |                           |
|   |     obligation. |               |   |                           |
|   |     If a        |               |   |                           |
|   |     revision,   |               |   |                           |
|   |     enter the   |               |   |                           |
|   |     appropriate |               |   |                           |
|   |     letter(s).  |               |   |                           |
|   |     More than   |               |   |                           |
|   |     one may be  |               |   |                           |
|   |     selected.   |               |   |                           |
|   |     If          |               |   |                           |
|   |     \"Other\"   |               |   |                           |
|   |     is          |               |   |                           |
|   |     selected,   |               |   |                           |
|   |     please      |               |   |                           |
|   |     specify in  |               |   |                           |
|   |     text box    |               |   |                           |
|   |     provided.   |               |   |                           |
|   |                 |               |   |                           |
|   | > A. Increase   |               |   |                           |
|   | > Award B.      |               |   |                           |
|   | > Decrease      |               |   |                           |
|   | > Award         |               |   |                           |
|   |                 |               |   |                           |
|   | C. Increase     |               |   |                           |
|   | Duration D.     |               |   |                           |
|   | Decrease        |               |   |                           |
|   | Duration        |               |   |                           |
|   |                 |               |   |                           |
|   | E. Other        |               |   |                           |
|   | (specify)       |               |   |                           |
+---+-----------------+---------------+---+---------------------------+
|   |                 |               | 1 | **Competition             |
|   |                 |               | 3 | Identification            |
|   |                 |               | \ | Number/Title:** Enter the |
|   |                 |               | . | Competition               |
|   |                 |               |   | Identification Number and |
|   |                 |               |   | title of the competition  |
|   |                 |               |   | under which assistance is |
|   |                 |               |   | requested, if applicable. |
+---+-----------------+---------------+---+---------------------------+
|   |                 |               | 1 | **Areas Affected By       |
|   |                 |               | 4 | Project:** List the areas |
|   |                 |               | \ | or entities using the     |
|   |                 |               | . | categories (e.g., cities, |
|   |                 |               |   | counties, states, etc.)   |
|   |                 |               |   | specified in agency       |
|   |                 |               |   | instructions. Use the     |
|   |                 |               |   | continuation sheet to     |
|   |                 |               |   | enter additional areas,   |
|   |                 |               |   | if needed.                |
+---+-----------------+---------------+---+---------------------------+
| 3 | **Date          |               | 1 | **Descriptive Title of    |
| \ | Received:**     |               | 5 | Applicant's Project:**    |
| . | Leave this      |               | \ | (Required) Enter a brief  |
|   | field blank.    |               | . | descriptive title of the  |
|   | This date will  |               |   | project. If appropriate,  |
|   | be assigned by  |               |   | attach a map showing      |
|   | the Federal     |               |   | project location (e.g.,   |
|   | agency.         |               |   | construction or real      |
|   |                 |               |   | property projects). For   |
|   |                 |               |   | preapplications, attach a |
|   |                 |               |   | summary description of    |
|   |                 |               |   | the project.              |
+---+-----------------+---------------+---+---------------------------+
| 4 | **Applicant     |               |   |                           |
| \ | Identifier**:   |               |   |                           |
| . | Enter the       |               |   |                           |
|   | entity          |               |   |                           |
|   | identifier      |               |   |                           |
|   | assigned by the |               |   |                           |
|   | Federal agency, |               |   |                           |
|   | if any, or      |               |   |                           |
|   | applicant's     |               |   |                           |
|   | control number, |               |   |                           |
|   | if applicable.  |               |   |                           |
+---+-----------------+---------------+---+---------------------------+
| 5 | **Federal       |               | 1 | **Congressional Districts |
| a | Entity          |               | 6 | Of**: (Required) 16a.     |
|   | Identifier**:   |               | \ | Enter the applicant's     |
|   | Enter the       |               | . | Congressional District,   |
|   | number assigned |               |   | and 16b. Enter all        |
|   | to your         |               |   | District(s) affected by   |
|   | organization by |               |   | the program or project.   |
|   | the Federal     |               |   | Enter in the format: 2    |
|   | Agency, if any. |               |   | characters State          |
|   |                 |               |   | Abbreviation -- 2-3       |
|   |                 |               |   | characters District       |
|   |                 |               |   | Number, e.g., CA-12 for   |
|   |                 |               |   | California 12^th^         |
|   |                 |               |   | district, NC-103 for      |
|   |                 |               |   | North Carolina's 103^rd^  |
|   |                 |               |   | district.                 |
|   |                 |               |   |                           |
|   |                 |               |   | -   If all congressional  |
|   |                 |               |   |     districts in a state  |
|   |                 |               |   |     are affected, enter   |
|   |                 |               |   |     "all" for the         |
|   |                 |               |   |     district number,      |
|   |                 |               |   |     e.g., MD-all for all  |
|   |                 |               |   |     congressional         |
|   |                 |               |   |     districts in          |
|   |                 |               |   |     Maryland.             |
|   |                 |               |   |                           |
|   |                 |               |   | -   If nationwide, i.e.   |
|   |                 |               |   |     all districts within  |
|   |                 |               |   |     all states are        |
|   |                 |               |   |     affected, enter       |
|   |                 |               |   |     US-all.               |
|   |                 |               |   |                           |
|   |                 |               |   | -   If the                |
|   |                 |               |   |     program/project is    |
|   |                 |               |   |     outside the US, enter |
|   |                 |               |   |     00-000.               |
+---+-----------------+---------------+---+---------------------------+
| 5 | **Federal Award |               |   |                           |
| b | Identifier**:   |               |   |                           |
| . | For new         |               |   |                           |
|   | applications    |               |   |                           |
|   | leave blank.    |               |   |                           |
|   | For a           |               |   |                           |
|   | continuation or |               |   |                           |
|   | revision to an  |               |   |                           |
|   | existing award, |               |   |                           |
|   | enter the       |               |   |                           |
|   | previously      |               |   |                           |
|   | assigned        |               |   |                           |
|   | Federal award   |               |   |                           |
|   | identifier      |               |   |                           |
|   | number. If a    |               |   |                           |
|   | ch              |               |   |                           |
|   | anged/corrected |               |   |                           |
|   | application,    |               |   |                           |
|   | enter the       |               |   |                           |
|   | Federal         |               |   |                           |
|   | Identifier in   |               |   |                           |
|   | accordance with |               |   |                           |
|   | agency          |               |   |                           |
|   | instructions.   |               |   |                           |
+---+-----------------+---------------+---+---------------------------+
| 6 | **Date Received |               |   |                           |
| \ | by State:**     |               |   |                           |
| . | Leave this      |               |   |                           |
|   | field blank.    |               |   |                           |
|   | This date will  |               |   |                           |
|   | be assigned by  |               |   |                           |
|   | the State, if   |               |   |                           |
|   | applicable.     |               |   |                           |
+---+-----------------+---------------+---+---------------------------+
| 7 | **State         |               |   |                           |
| \ | Application     |               |   |                           |
| . | Identifier:**   |               |   |                           |
|   | Leave this      |               |   |                           |
|   | field blank.    |               |   |                           |
|   | This identifier |               |   |                           |
|   | will be         |               |   |                           |
|   | assigned by the |               |   |                           |
|   | State, if       |               |   |                           |
|   | applicable.     |               |   |                           |
+---+-----------------+---------------+---+---------------------------+
| 8 | **Applicant     |               |   |                           |
| \ | Information**:  |               |   |                           |
| . | Enter the       |               |   |                           |
|   | following in    |               |   |                           |
|   | accordance with |               |   |                           |
|   | agency          |               |   |                           |
|   | instructions:   |               |   |                           |
|   |                 |               |   |                           |
|   | **a. Legal      |               |   |                           |
|   | Name**:         |               |   |                           |
|   | (Required):     |               |   |                           |
|   | Enter the legal |               |   |                           |
|   | name of         |               |   |                           |
|   | applicant that  |               |   |                           |
|   | will undertake  |               |   |                           |
|   | the assistance  |               |   |                           |
|   | activity. This  |               |   |                           |
|   | is the name     |               |   |                           |
|   | that the        |               |   |                           |
|   | organization    |               |   |                           |
|   | has registered  |               |   |                           |
|   | with the        |               |   |                           |
|   | Central         |               |   |                           |
|   | Contractor      |               |   |                           |
|   | Registry.       |               |   |                           |
|   | Information on  |               |   |                           |
|   | registering     |               |   |                           |
|   | with CCR may be |               |   |                           |
|   | obtained by     |               |   |                           |
|   | visiting the    |               |   |                           |
|   | Grants.gov      |               |   |                           |
|   | website.        |               |   |                           |
+---+-----------------+---------------+---+---------------------------+
|   |                 |               |   |                           |
+---+-----------------+---------------+---+---------------------------+
|   |                 |               | 1 | **Proposed Project Start  |
|   |                 |               | 7 | and End Dates**:          |
|   |                 |               | \ | (Required) Enter the      |
|   |                 |               | . | proposed start date and   |
|   |                 |               |   | end date of the project.  |
+---+-----------------+---------------+---+---------------------------+
|   | **b.            |               |   |                           |
|   | Em              |               |   |                           |
|   | ployer/Taxpayer |               |   |                           |
|   | Number          |               |   |                           |
|   | (EIN/TIN):**    |               |   |                           |
|   | (Required):     |               |   |                           |
|   | Enter the       |               |   |                           |
|   | Employer or     |               |   |                           |
|   | Taxpayer        |               |   |                           |
|   | Identification  |               |   |                           |
|   | Number (EIN or  |               |   |                           |
|   | TIN) as         |               |   |                           |
|   | assigned by the |               |   |                           |
|   | Internal        |               |   |                           |
|   | Revenue         |               |   |                           |
|   | Service. If     |               |   |                           |
|   | your            |               |   |                           |
|   | organization is |               |   |                           |
|   | not in the US,  |               |   |                           |
|   | enter           |               |   |                           |
|   | 44-4444444.     |               |   |                           |
+---+-----------------+---------------+---+---------------------------+
|   |                 |               | 1 | **Estimated Funding:**    |
|   |                 |               | 8 | (Required) Enter the      |
|   |                 |               | \ | amount requested or to be |
|   |                 |               | . | contributed during the    |
|   |                 |               |   | first funding/budget      |
|   |                 |               |   | period by each            |
|   |                 |               |   | contributor. Value of     |
|   |                 |               |   | in-kind contributions     |
|   |                 |               |   | should be included on     |
|   |                 |               |   | appropriate lines, as     |
|   |                 |               |   | applicable. If the action |
|   |                 |               |   | will result in a dollar   |
|   |                 |               |   | change to an existing     |
|   |                 |               |   | award, indicate only the  |
|   |                 |               |   | amount of the change. For |
|   |                 |               |   | decreases, enclose the    |
|   |                 |               |   | amounts in parentheses.   |
+---+-----------------+---------------+---+---------------------------+
|   | **c.            |               |   |                           |
|   | Organizational  |               |   |                           |
|   | DUNS**:         |               |   |                           |
|   | (Required)      |               |   |                           |
|   | Enter the       |               |   |                           |
|   | organization's  |               |   |                           |
|   | DUNS or DUNS+4  |               |   |                           |
|   | number received |               |   |                           |
|   | from Dun and    |               |   |                           |
|   | Bradstreet.     |               |   |                           |
|   | Information on  |               |   |                           |
|   | obtaining a     |               |   |                           |
|   | DUNS number may |               |   |                           |
|   | be obtained by  |               |   |                           |
|   | visiting the    |               |   |                           |
|   | Grants.gov      |               |   |                           |
|   | website.        |               |   |                           |
+---+-----------------+---------------+---+---------------------------+
|   | **d. Address**: |               |   |                           |
|   | Enter the       |               |   |                           |
|   | complete        |               |   |                           |
|   | address as      |               |   |                           |
|   | follows: Street |               |   |                           |
|   | address (Line 1 |               |   |                           |
|   | required), City |               |   |                           |
|   | (Required),     |               |   |                           |
|   | County, State   |               |   |                           |
|   | (Required, if   |               |   |                           |
|   | country is US), |               |   |                           |
|   | Province,       |               |   |                           |
|   | Country         |               |   |                           |
|   | (Required),     |               |   |                           |
|   | Zip/Postal Code |               |   |                           |
|   | (Required, if   |               |   |                           |
|   | country is US). |               |   |                           |
+---+-----------------+---------------+---+---------------------------+
|   |                 |               | 1 | **Is Application Subject  |
|   |                 |               | 9 | to Review by State Under  |
|   |                 |               | \ | Executive Order 12372     |
|   |                 |               | . | Process?** Applicants     |
|   |                 |               |   | should contact the State  |
|   |                 |               |   | Single Point of Contact   |
|   |                 |               |   | (SPOC) for Federal        |
|   |                 |               |   | Executive Order 12372 to  |
|   |                 |               |   | determine whether the     |
|   |                 |               |   | application is subject to |
|   |                 |               |   | the State                 |
|   |                 |               |   | intergovernmental review  |
|   |                 |               |   | process. Select the       |
|   |                 |               |   | appropriate box. If "a."  |
|   |                 |               |   | is selected, enter the    |
|   |                 |               |   | date the application was  |
|   |                 |               |   | submitted to the State    |
+---+-----------------+---------------+---+---------------------------+
|   | **e.            |               |   |                           |
|   | Organizational  |               |   |                           |
|   | Unit:** Enter   |               |   |                           |
|   | the name of the |               |   |                           |
|   | primary         |               |   |                           |
|   | organizational  |               |   |                           |
|   | unit (and       |               |   |                           |
|   | department or   |               |   |                           |
|   | division, if    |               |   |                           |
|   | applicable**)** |               |   |                           |
|   | that will       |               |   |                           |
|   | undertake the   |               |   |                           |
|   | assistance      |               |   |                           |
|   | activity, if    |               |   |                           |
|   | applicable.     |               |   |                           |
+---+-----------------+---------------+---+---------------------------+
|   |                 |               |   |                           |
+---+-----------------+---------------+---+---------------------------+
|   |                 |               |   |                           |
+---+-----------------+---------------+---+---------------------------+
|   | **f. Name and   |               |   |                           |
|   | contact         |               |   |                           |
|   | information of  |               |   |                           |
|   | person to be    |               |   |                           |
|   | contacted on    |               |   |                           |
|   | matters         |               |   |                           |
|   | involving this  |               |   |                           |
|   | application**:  |               |   |                           |
|   | Enter the name  |               |   |                           |
|   | (First and last |               |   |                           |
|   | name required), |               |   |                           |
|   | organizational  |               |   |                           |
|   | affiliation (if |               |   |                           |
|   | affiliated with |               |   |                           |
|   | an organization |               |   |                           |
|   | other than the  |               |   |                           |
|   | applicant       |               |   |                           |
|   | organization),  |               |   |                           |
|   | telephone       |               |   |                           |
|   | number          |               |   |                           |
|   | (Required), fax |               |   |                           |
|   | number, and     |               |   |                           |
|   | email address   |               |   |                           |
|   | (Required) of   |               |   |                           |
|   | the person to   |               |   |                           |
|   | contact on      |               |   |                           |
|   | matters related |               |   |                           |
|   | to this         |               |   |                           |
|   | application.    |               |   |                           |
+---+-----------------+---------------+---+---------------------------+
|   |                 |               | 2 | **Is the Applicant        |
|   |                 |               | 0 | Delinquent on any Federal |
|   |                 |               | \ | Debt?** (Required) Select |
|   |                 |               | . | the appropriate box. This |
|   |                 |               |   | question applies to the   |
|   |                 |               |   | applicant organization,   |
|   |                 |               |   | not the person who signs  |
|   |                 |               |   | as the authorized         |
|   |                 |               |   | representative.           |
|   |                 |               |   | Categories of debt        |
|   |                 |               |   | include delinquent audit  |
|   |                 |               |   | disallowances, loans and  |
|   |                 |               |   | taxes.                    |
|   |                 |               |   |                           |
|   |                 |               |   | If yes, include an        |
|   |                 |               |   | explanation on the        |
|   |                 |               |   | continuation sheet.       |
+---+-----------------+---------------+---+---------------------------+
|   |                 |               |   |                           |
+---+-----------------+---------------+---+---------------------------+
| 9 | Type of         |               | 2 | **Authorized              |
| \ | Applicant:      |               | 1 | Representative**:         |
| . | (Required)      |               | \ | (Required) To be signed   |
|   |                 |               | . | and dated by the          |
|   | Select up to    |               |   | authorized representative |
|   | three applicant |               |   | of the applicant          |
|   | type(s) in      |               |   | organization. Enter the   |
|   | accordance with |               |   | name (First and last name |
|   | agency          |               |   | required) title           |
|   | instructions.   |               |   | (Required), telephone     |
|   |                 |               |   | number (Required), fax    |
|   |                 |               |   | number, and email address |
|   |                 |               |   | (Required) of the person  |
|   |                 |               |   | authorized to sign for    |
|   |                 |               |   | the applicant.            |
|   |                 |               |   |                           |
|   |                 |               |   | A copy of the governing   |
|   |                 |               |   | body's authorization for  |
|   |                 |               |   | you to sign this          |
|   |                 |               |   | application as the        |
|   |                 |               |   | official representative   |
|   |                 |               |   | must be on file in the    |
|   |                 |               |   | applicant's office.       |
|   |                 |               |   | (Certain Federal agencies |
|   |                 |               |   | may require that this     |
|   |                 |               |   | authorization be          |
|   |                 |               |   | submitted as part of the  |
|   |                 |               |   | application.)             |
+---+-----------------+---------------+---+---------------------------+
|   | A.  State       | L.  Nonprofit |   |                           |
|   |     Government  |     with      |   |                           |
|   |                 |     501C3 IRS |   |                           |
|   | ```{=html}      |     Status    |   |                           |
|   | <!-- -->        |     (Other    |   |                           |
|   | ```             |     than      |   |                           |
|   | A.  County      |               |   |                           |
|   |     Government  |   Institution |   |                           |
|   |                 |     of Higher |   |                           |
|   | B.  City or     |               |   |                           |
|   |     Township    |    Education) |   |                           |
|   |     Government  |               |   |                           |
|   |                 | M.  Nonprofit |   |                           |
|   | C.  Special     |     without   |   |                           |
|   |     District    |     501C3 IRS |   |                           |
|   |     Government  |     Status    |   |                           |
|   |                 |     (Other    |   |                           |
|   | D.  Regional    |     than      |   |                           |
|   |                 |               |   |                           |
|   |    Organization |   Institution |   |                           |
|   |                 |     of Higher |   |                           |
|   | E.  U.S.        |               |   |                           |
|   |     Territory   |    Education) |   |                           |
|   |     or          |               |   |                           |
|   |     Possession  | N.  Private   |   |                           |
|   |                 |               |   |                           |
|   | F.  Independent |   Institution |   |                           |
|   |     School      |     of Higher |   |                           |
|   |     District    |     Education |   |                           |
|   |                 |               |   |                           |
|   | G               | O             |   |                           |
|   | .  Public/State | .  Individual |   |                           |
|   |     Controlled  |               |   |                           |
|   |     Institution | P             |   |                           |
|   |     of Higher   | .  For-Profit |   |                           |
|   |     Education   |               |   |                           |
|   |                 |  Organization |   |                           |
|   | H.              |     (Other    |   |                           |
|   |   Indian/Native |     than      |   |                           |
|   |     American    |     Small     |   |                           |
|   |     Tribal      |     Business) |   |                           |
|   |     Government  |               |   |                           |
|   |     (Federally  | Q.  Small     |   |                           |
|   |     Recognized) |     Business  |   |                           |
|   |                 |               |   |                           |
|   | I.              | R.  His       |   |                           |
|   |   Indian/Native | panic-serving |   |                           |
|   |     American    |               |   |                           |
|   |     Tribal      |   Institution |   |                           |
|   |     Government  |               |   |                           |
|   |     (Other than | S.            |   |                           |
|   |     Federally   |  Historically |   |                           |
|   |     Recognized) |     Black     |   |                           |
|   |                 |     Colleges  |   |                           |
|   | J.              |     and       |   |                           |
|   |   Indian/Native |               |   |                           |
|   |     American    |  Universities |   |                           |
|   |     Tribally    |     (HBCUs)   |   |                           |
|   |     Designated  |               |   |                           |
|   |                 | T.  Tribally  |   |                           |
|   |    Organization |               |   |                           |
|   |                 |    Controlled |   |                           |
|   | K.              |     Colleges  |   |                           |
|   |   Public/Indian |     and       |   |                           |
|   |     Housing     |               |   |                           |
|   |     Authority   |  Universities |   |                           |
|   |                 |     (TCCUs)   |   |                           |
|   |                 |               |   |                           |
|   |                 | U.  Alaska    |   |                           |
|   |                 |     Native    |   |                           |
|   |                 |     and       |   |                           |
|   |                 |     Native    |   |                           |
|   |                 |     Hawaiian  |   |                           |
|   |                 |     Serving   |   |                           |
|   |                 |               |   |                           |
|   |                 |  Institutions |   |                           |
|   |                 |               |   |                           |
|   |                 | V.            |   |                           |
|   |                 |  Non-domestic |   |                           |
|   |                 |     (non-US)  |   |                           |
|   |                 |     Entity    |   |                           |
|   |                 |               |   |                           |
|   |                 | W.  Other     |   |                           |
|   |                 |     (specify) |   |                           |
+---+-----------------+---------------+---+---------------------------+
|   |                 |               |   |                           |
+---+-----------------+---------------+---+---------------------------+
|   |                 |               |   |                           |
+---+-----------------+---------------+---+---------------------------+
|   |                 |               |   |                           |
+---+-----------------+---------------+---+---------------------------+

# INSTRUCTIONS FOR

**DEPARTMENT OF EDUCATION SUPPLEMENTAL INFORMATION FOR SF 424**

a.  **Project Director.** Name, address, telephone and fax numbers, and
    e-mail address of the person to be contacted on matters involving
    this application.

**2. Novice Applicant.** Check **"Yes"** or "**No**" only if assistance
is being requested under a program that gives special consideration to
novice applicants. Otherwise, **leave blank.**

Check "**Yes"** if you meet the requirements for novice applicants
specified in the regulations in 34 CFR 75.225 and included on the
attached page entitled "Definitions for Department of Education
Supplemental Information for SF 424." By checking "Yes" the applicant
certifies that it meets these novice applicant requirements. Check
"**No**" if you do not meet the requirements for novice applicants**.**

**3. Human Subjects Research.** (See I. A. "Definitions" in attached
page entitled "Definitions for Department of Education Supplemental
Information For SF 424.")

**If Not Human Subjects Research.** Check "**No**" if research
activities involving human subjects are not planned at any time during
the proposed project period. The remaining parts of Item 3 are then not
applicable.

**If Human Subjects Research.** Check "**Yes**" if research activities
involving human subjects are planned at any time during the proposed
project period, either at the applicant organization or at any other
performance site or collaborating institution. Check "**Yes**" even if
the research is exempt from the regulations for the protection of human
subjects. (See I. B. "Exemptions" in attached page entitled "Definitions
for Department of Education Supplemental Information For SF 424.")

**3a. If Human Subjects Research is Exempt from the Human Subjects
Regulations.** Check "**Yes**" if all the research activities proposed
are designated to be exempt from the regulations. Insert the exemption
number(s) corresponding to one or more of the six exemption categories
listed in I. B. "Exemptions." In addition, follow the instructions in
II. A. "Exempt Research Narrative" in the attached page entitled
"Definitions for Department of Education Supplemental Information For SF
424."

**3a. If Human Subjects Research is Not Exempt from Human Subjects
Regulations.** Check "**No**" if some or all of the planned research
activities are covered (not exempt). In addition, follow the
instructions in II. B. "Nonexempt Research Narrative" in the page
entitled "Definitions for Department of Education Supplemental
Information For SF 424

**3a. Human Subjects Assurance Number.** If the applicant has an
approved Federal Wide (FWA) on file with the Office for Human Research
Protections (OHRP), U.S. Department of Health and Human Services, that
covers the specific activity, insert the number in the space provided.
If the applicant does not have an approved assurance on file with OHRP,
enter "None." In this case, the applicant, by signature on the SF-424,
is declaring that it will comply with 34 CFR 97 and proceed to obtain
the human subjects assurance upon request by the designated ED official.
If the application is recommended/selected for funding, the designated
ED official will request that the applicant obtain the assurance within
30 days after the specific formal request.

**Note about Institutional Review Board Approval.** ED does not require
certification of Institutional Review Board approval with the
application. However, if an application that involves non-exempt human
subjects research is recommended/selected for funding, the designated ED
official will request that the applicant obtain and send the
certification to ED within 30 days after the formal request.

## *Paperwork Burden Statement*. ***According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is 1890-0017. The time required to complete this information collection is estimated to average between 15 and 45 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have any comments concerning the accuracy of the estimate(s) or suggestions for improving this form, please write to: U.S. Department of Education, Washington, D.C. 20202-4700. If you have comments or concerns regarding the status of your individual submission of this form write directly to: Joyce I. Mays, Application Control Center, U.S. Department of Education, Potomac Center Plaza, 550 12^th^ Street, S.W. Room 7076, Washington, D.C. 20202-4260***. 

**DEFINITIONS FOR**

# DEPARTMENT OF EDUCATION SUPPLEMENTAL INFORMATION FOR SF 424

# (Attachment to Instructions for Supplemental Information for SF 424)

**Definitions:**

**Novice Applicant (See 34 CFR 75.225**). For discretionary grant
programs under which the Secretary gives special consideration to novice
applications, a novice applicant means any applicant for a grant from ED
that---

-   Has never received a grant or subgrant under the program from which
    it seeks funding;

-   Has never been a member of a group application, submitted in
    accordance with 34 CFR 75.127-75.129, that received a grant under
    the program from which it seeks funding; and

-   Has not had an active discretionary grant from the Federal
    government in the five years before the deadline date for
    applications under the program. For the purposes of this
    requirement, a grant is active until the end of the grant's project
    or funding period, including any extensions of those periods that
    extend the grantee's authority to obligate funds.

In the case of a group application submitted in accordance with 34 CFR
75.127-75.129, a group includes only parties that meet the requirements
listed above.

#### PROTECTION OF HUMAN SUBJECTS IN RESEARCH

**I. Definitions and Exemptions**

**A. Definitions.**

A research activity involves human subjects if the activity is research,
as defined in the Department's regulations, and the research activity
will involve use of human subjects, as defined in the regulations.

---**Research**

The ED Regulations for the Protection of Human Subjects, Title 34, Code
of Federal Regulations, Part 97, define research as "a systematic
investigation, including research development, testing and evaluation,
designed to develop or contribute to generalizable knowledge." *If an
activity follows a deliberate plan whose purpose is to develop or
contribute to generalizable knowledge it is research.* Activities which
meet this definition constitute research whether or not they are
conducted or supported under a program that is considered research for
other purposes. For example, some demonstration and service programs may
include research activities.

**---Human Subject**

The regulations define human subject as "a living individual about whom
an investigator (whether professional or student) conducting research
obtains (1) data through intervention or interaction with the
individual, or (2) identifiable private information." *(1) If an
activity involves obtaining information about a living person by
manipulating that person or that person's environment, as might occur
when a new instructional technique is tested, or by communicating or
interacting with the individual, as occurs with surveys and interviews,
the definition of human subject is met. (2) If an activity involves
obtaining private information about a living person in such a way that
the information can be linked to that individual (the identity of the
subject is or may be readily determined by the investigator or
associated with the information), the definition of human subject is
met.* \[Private information includes information about behavior that
occurs in a context in which an individual can reasonably expect that no
observation or recording is taking place, and information which has been
provided for specific purposes by an individual and which the individual
can reasonably expect will not be made public (for example, a school
health record).\]

**B. Exemptions.**

Research activities in which the **[only]{.underline}** involvement of
human subjects will be in one or more of the following six categories of
***exemptions*** are not covered by the regulations:

\(1\) Research conducted in established or commonly accepted educational
settings, involving normal educational practices, such as (a) research
on regular and special education instructional strategies, or (b)
research on the effectiveness of or the comparison among instructional
techniques, curricula, or classroom management methods.

\(2\) Research involving the use of educational tests (cognitive,
diagnostic, aptitude, achievement), survey procedures, interview
procedures or observation of public behavior, unless: (a) information
obtained is recorded in such a manner that human subjects can be
identified, directly or through identifiers linked to the subjects; and
(b) any disclosure of the human subjects' responses outside the research
could reasonably place the subjects at risk of criminal or civil
liability or be damaging to the subjects' financial standing,
employability, or reputation. ***If the subjects are children, exemption
2 applies only to research involving educational tests and observations
of public behavior when the investigator(s) do not participate in the
activities being observed. Exemption 2 does not apply if children are
surveyed or interviewed or if the research involves observation of
public behavior and the investigator(s) participate in the activities
being observed.*** \[Children are defined as persons who have not
attained the legal age for consent to treatments or procedures involved
in the research, under the applicable law or jurisdiction in which the
research will be conducted.\]

\(3\) Research involving the use of educational tests (cognitive,
diagnostic, aptitude, achievement), survey procedures, interview
procedures or observation of public behavior that is not exempt under
section (2) above, if the human subjects are elected or appointed public
officials or candidates for public office; or federal statute(s)
require(s) without exception that the confidentiality of the personally
identifiable information will be maintained throughout the research and
thereafter.

\(4\) Research involving the collection or study of existing data,
documents, records, pathological specimens, or diagnostic specimens, if
these sources are publicly available or if the information is recorded
by the investigator in a manner that subjects cannot be identified,
directly or through identifiers linked to the subjects.

\(5\) Research and demonstration projects which are conducted by or
subject to the approval of department or agency heads, and which are
designed to study, evaluate, or otherwise examine: (a) public benefit or
service programs; (b) procedures for obtaining benefits or services
under those programs; (c) possible changes in or alternatives to those
programs or procedures; or (d) possible changes in methods or levels of
payment for benefits or services under those programs.

\(6\) Taste and food quality evaluation and consumer acceptance studies,
(a) if wholesome foods without additives are consumed or (b) if a food
is consumed that contains a food ingredient at or below the level and
for a use found to be safe, or agricultural chemical or environmental
contaminant at or below the level found to be safe, by the Food and Drug
Administration or approved by the Environmental Protection Agency or the
Food Safety and Inspection Service of the U.S. Department of
Agriculture.

**II. Instructions for Exempt and Nonexempt Human Subjects Research
Narratives**

If the applicant marked "Yes" for Item 3 of Department of Education
Supplemental Information for SF 424, the applicant must provide a human
subjects "exempt research" or "nonexempt research" narrative. Insert the
narrative(s) in the space provided. If you have multiple projects and
need to provide more than one narrative, be sure to label each set of
responses as to the project they address.

**A. Exempt Research Narrative.**

If you marked "Yes" for item 3 a. and designated exemption numbers(s),
provide the "exempt research" narrative. The narrative must contain
sufficient information about the involvement of human subjects in the
proposed research to allow a determination by ED that the designated
exemption(s) are appropriate. The narrative must be succinct.

**B. Nonexempt Research Narrative.**

If you marked "No" for item 3 a. you must provide the "nonexempt
research" narrative. The narrative must address the following seven
points. Although no specific page limitation applies to this section of
the application, be succinct.

\(1\) **Human Subjects Involvement and Characteristics**: Provide a
detailed description of the proposed involvement of human subjects.
Describe the characteristics of the subject population, including their
anticipated number, age range, and health status. Identify the criteria
for inclusion or exclusion of any subpopulation. Explain the rationale
for the involvement of special classes of subjects, such as children,
children with disabilities, adults with disabilities, persons with
mental disabilities, pregnant women, prisoners, institutionalized
individuals, or others who are likely to be vulnerable

\(2\) **Sources of Materials**: Identify the sources of research
material obtained from individually identifiable living human subjects
in the form of specimens, records, or data. Indicate whether the
material or data will be obtained specifically for research purposes or
whether use will be made of existing specimens, records, or data.

\(3\) **Recruitment and Informed Consent**: Describe plans for the
recruitment of subjects and the consent procedures to be followed.
Include the circumstances under which consent will be sought and
obtained, who will seek it, the nature of the information to be provided
to prospective subjects, and the method of documenting consent. State if
the Institutional Review Board (IRB) has authorized a modification or
waiver of the elements of consent or the requirement for documentation
of consent.

\(4\) **Potential Risks**: Describe potential risks (physical,
psychological, social, legal, or other) and assess their likelihood and
seriousness. Where appropriate, describe alternative treatments and
procedures that might be advantageous to the subjects.

\(5\) **Protection Against Risk**: Describe the procedures for
protecting against or minimizing potential risks, including risks to
confidentiality, and assess their likely effectiveness. Where
appropriate, discuss provisions for ensuring necessary medical or
professional intervention in the event of adverse effects to the
subjects. Also, where appropriate, describe the provisions for
monitoring the data collected to ensure the safety of the subjects.

\(6\) **Importance of the Knowledge to be Gained**: Discuss the
importance of the knowledge gained or to be gained as a result of the
proposed research. Discuss why the risks to subjects are reasonable in
relation to the anticipated benefits to subjects and in relation to the
importance of the knowledge that may reasonably be expected to result.

\(7\) **Collaborating Site(s)**: If research involving human subjects
will take place at collaborating site(s) or other performance site(s),
name the sites and briefly describe their involvement or role in the
research.

***Copies of the Department of Education's Regulations for the
Protection of Human Subjects, 34 CFR Part 97 and other pertinent
materials on the protection of human subjects in research are available
from the Grants Policy and Oversight Staff, Office of the Chief
Financial Officer, U.S. Department of Education, Washington, D.C.
20202-4250, telephone: (202) 245-6120, and on the U.S. Department of
Education's Protection of Human Subjects in Research Web Site:
http://www.ed.gov/about/offices/list/OCFO/humansub.html***

NOTE: The **State Applicant Identifier** on the SF 424 is for State Use
only. Please complete it on the OMB Standard 424 in the upper right
corner of the form (if applicable).

ner of the form (if applicable).

![](media/image3.wmf)

**OMB Approval No. 0348-0040**

**ASSURANCES - NON-CONSTRUCTION PROGRAMS**

Public reporting burden for this collection of information is estimated
to average 15 minutes per response, including time for reviewing
instructions, searching existing data sources, gathering and maintaining
the data needed, and completing and reviewing the collection of
information. Send comments regarding the burden estimate or any other
aspect of this collection of information, including suggestions for
reducing this burden, to the Office of Management and Budget, Paperwork
Reduction Project (0348-0040), Washington, DC 20503

**PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT
AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.**

**Note:** Certain of these assurances may not be applicable to your
project or program. If you have questions, please contact the awarding
agency. Further, certain Federal awarding agencies may require
applicants to certify to additional assurances. If such is the case, you
will be notified.

As the duly authorized representative of the applicant I certify that
the applicant:

1\. Has the legal authority to apply for Federal assistance, and the
institutional, managerial and financial capability (including funds
sufficient to pay the non-Federal share of project cost) to ensure
proper planning, management, and completion of the project described in
this application.

2\. Will give the awarding agency, the Comptroller General of the United
States, and if appropriate, the State, through any authorized
representative, access to and the right to examine all records, books,
papers, or documents related to the award; and will establish a proper
accounting system in accordance with generally accepted accounting
standards or agency directives.

3\. Will establish safeguards to prohibit employees from using their
positions for a purpose that constitutes or presents the appearance of
personal or organizational conflict of interest, or personal gain.

4\. Will initiate and complete the work within the applicable time frame
after receipt of approval of the awarding agency.

5\. Will comply with the Intergovernmental Personnel Act of 1970 (42
U.S.C. 4728-4763) relating to prescribed standards for merit systems
for programs funded under one of the 19 statutes or regulations
specified in Appendix A of OPM\'s Standards for a Merit System of
Personnel Administration (5 C.F.R. 900, Subpart F).

6\. Will comply with all Federal statutes relating to nondiscrimination.
These include but are not limited to: (a) Title VI of the Civil Rights
Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of
race, color or national origin; (b) Title IX of the Education Amendments
of 1972, as amended (20 U.S.C. 1681-1683, and 1685-1686), which
prohibits discrimination on the basis of sex; (c) Section 504 of the
Rehabilitation Act of 1973, as amended (29 U.S.C. 794), which prohibits
discrimination on the basis of handicaps; (d) the Age Discrimination Act
of 1975, as amended (42 U.S.C.  6101-6107), which prohibits
discrimination on the basis of age; (e) the Drug Abuse Office and
Treatment Act of 1972 (P.L. 92-255), as amended, relating to
nondiscrimination on the basis of drug abuse; (f) the Comprehensive
Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation
Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on
the basis of alcohol abuse or alcoholism; (g)  523 and 527 of the
Public Health Service Act of 1912 (42 U.S.C.  290 dd-3 and 290 ee 3),
as amended, relating to confidentiality of alcohol and drug abuse
patient records; (h) Title VIII of the Civil Rights Act of 1968 (42
U.S.C.  3601 et seq.), as amended, relating to nondiscrimination in the
sale, rental or financing of housing; (i) any other nondiscrimination
provisions in the specific statute(s) under which application for
Federal assistance is being made; and (j) the requirements of any other
nondiscrimination statute(s) which may apply to the application.

7\. Will comply, or has already complied, with the requirements of
Titles II and III of the uniform Relocation Assistance and Real Property
Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair
and equitable treatment of persons displaced or whose property is
acquired as a result of Federal or federally assisted programs. These
requirements apply to all interests in real property acquired for
project purposes regardless of Federal participation in purchases.

8\. Will comply, as applicable, with the provisions of the Hatch Act (5
U.S.C. 1501-1508 and 7324-7328) which limit the political activities
of employees whose principal employment activities are funded in whole
or in part with Federal funds.

9\. Will comply, as applicable, with the provisions of the Davis-Bacon
Act (40 U.S.C. 276a to 276a-7), the Copeland Act (40 U.S.C. 276c and
18 U.S.C. 874) and the Contract Work Hours and Safety Standards Act
(40 U.S.C.  327-333), regarding labor standards for federally assisted
construction subagreements.

10\. Will comply, if applicable, with flood insurance purchase
requirements of Section 102(a) of the Flood Disaster Protection Act of
1973 (P.L. 93-234) which requires recipients in a special flood hazard
area to participate in the program and to purchase flood insurance if
the total cost of insurable construction and acquisition is \$10,000 or
more.

11\. Will comply with environmental standards which may be prescribed
pursuant to the following: (a) institution of environmental quality
control measures under the National Environmental Policy Act of 1969
(P.L. 91-190) and Executive Order (EO) 11514; (b) notification of
violating facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in
accordance with EO 11988; (e) assurance of project consistency with the
approved State management program developed under the Coastal Zone
Management Act of 1972 (16 U.S.C. 1451 et seq.); (f) conformity of
Federal actions to State (Clear Air) Implementation Plans under Section
176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. 7401 et
seq.); (g) protection of underground sources of drinking water under the
Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h)
protection of endangered species under the Endangered Species Act of
1973, as amended, (P.L. 93-205).

12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C.
1721 et seq.) related to protecting components or potential components
of the national wild and scenic rivers system.

13\. Will assist the awarding agency in assuring compliance with Section
106 of the National Historic Preservation Act of 1966, as amended (16
U.S.C. 470), EO 11593 (identification and protection of historic
properties), and the Archaeological and Historic Preservation Act of
1974 (16 U.S.C. 469a-1 et seq.).

14\. Will comply with P.L. 93-348 regarding the protection of human
subjects involved in research, development, and related activities
supported by this award of assistance.

15\. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L.
89-544, as amended, 7 U.S.C. 2131 et seq.) pertaining to the care,
handling, and treatment of warm blooded animals held for research,
teaching, or other activities supported by this award of assistance.

16\. Will comply with the Lead-Based Paint Poisoning Prevention Act (42
U.S.C. 4801 et seq.) which prohibits the use of lead- based paint in
construction or rehabilitation of residence structures.

17\. Will cause to be performed the required financial and compliance
audits in accordance with the Single Audit Act Amendments of 1996 and
OMB Circular No. A-133, Audits of States, Local Governments, and
Non-Profit Organizations.

18\. Will comply with all applicable requirements of all other Federal
laws, executive orders, regulations and policies governing this program.

  ----------------------------------------- -------- ---------------------
  SIGNATURE OF AUTHORIZED CERTIFYING        TITLE    
  OFFICIAL                                           

  APPLICANT ORGANIZATION                             DATE SUBMITTED
  ----------------------------------------- -------- ---------------------

**Standard Form 424B (Rev. 7-97) Back**

######### CERTIFICATION REGARDING LOBBYING

::: Definition-Term
Certification for Contracts, Grants, Loans, and Cooperative Agreements
:::

The undersigned certifies, to the best of his or her knowledge and
belief, that:

1.  No Federal appropriated funds have been paid or will be paid, by or
    on behalf of the undersigned, to any person for influencing or
    attempting to influence an officer or employee of an agency, a
    Member of Congress, an officer or employee of Congress, or an
    employee of a Member of Congress in connection with the awarding of
    any Federal contract, the making of any Federal grant, the making of
    any Federal loan, the entering into of any cooperative agreement,
    and the extension, continuation, renewal, amendment, or modification
    of any Federal contract, grant, loan, or cooperative agreement.

2.  If any funds other than Federal appropriated funds have been paid or
    will be paid to any person for influencing or attempting to
    influence an officer or employee of any agency, a Member of
    Congress, an officer or employee of Congress, or an employee of a
    Member of Congress in connection with this Federal contract, grant,
    loan, or cooperative agreement, the undersigned shall complete and
    submit Standard Form-LLL, "Disclosure of Lobbying Activities," in
    accordance with its instructions.

3.  The undersigned shall require that the language of this
    certification be included in the award documents for all subawards
    at all tiers (including subcontracts, subgrants, and contracts under
    grants, loans, and cooperative agreements) and that all
    subrecipients shall certify and disclose accordingly. This
    certification is a material representation of fact upon which
    reliance was placed when this transaction was made or entered into.
    Submission of this certification is a prerequisite for making or
    entering into this transaction imposed by section 1352, title 31,
    U.S. Code. Any person who fails to file the required certification
    shall be subject to a civil penalty of not less than \$10,000 and
    not more than \$100,000 for each such failure.

Statement for Loan Guarantees and Loan Insurance

The undersigned states, to the best of his or her knowledge and belief,
that:

If any funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any
agency, a Member of Congress, an officer or employee of Congress, or an
employee of a Member of Congress in connection with this commitment
providing for the United States to insure or guarantee a loan, the
undersigned shall complete and submit Standard Form-LLL, "Disclosure of
Lobbying Activities," in accordance with its instructions. Submission of
this statement is a prerequisite for making or entering into this
transaction imposed by section 1352, title 31, U.S. Code. Any person who
fails to file the required statement shall be subject to a civil penalty
of not less than \$10,000 and not more than \$100,000 for each such
failure.

**INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING
ACTIVITIES**

This disclosure form shall be completed by the reporting entity, whether
subawardee or prime Federal recipient, at the initiation or receipt of a
covered Federal action, or a material change to a previous filing,
pursuant to title 31 U.S.C. section 1352. The filing of a form is
required for each payment or agreement to make payment to any lobbying
entity for influencing or attempting to influence an officer or employee
of any agency, a Member of Congress, an officer or employee of Congress,
or an employee of a Member of Congress in connection with a covered
Federal action. Complete all items that apply for both the initial
filing and material change report. Refer to the implementing guidance
published by the Office of Management and Budget for additional
information.

**1. Identify the type of covered Federal action for which lobbying
activity is and/or has been secured to influence the outcome of a
covered Federal action.**

**2. Identify the status of the covered Federal action.**

**3. Identify the appropriate classification of this report. If this is
a follow up report caused by a material change to the information
previously reported, enter the year and quarter in which the change
occurred. Enter the date of the last previously submitted report by this
reporting entity for this covered Federal action.**

**4. Enter the full name, address, city, State and zip code of the
reporting entity. Include Congressional District, if known. Check the
appropriate classification of the reporting entity that designates if it
is, or expects to be, a prime or subaward recipient. Identify the tier
of the subawardee, e.g., the first subawardee of the prime is the 1st
tier. Subawards include but are not limited to subcontracts, subgrants
and contract awards under grants.**

**5. If the organization filing the report in item 4 checks
"Subawardee," then enter the full name, address, city, State and zip
code of the prime Federal recipient. Include Congressional District, if
known.**

**6. Enter the name of the federal agency making the award or loan
commitment. Include at least one organizational level below agency name,
if known. For example, Department of Transportation, United States Coast
Guard.**

**7. Enter the Federal program name or description for the covered
Federal action (item 1). If known, enter the full Catalog of Federal
Domestic Assistance (CFDA) number for grants, cooperative agreements,
loans, and loan commitments.**

**8. Enter the most appropriate Federal identifying number available for
the Federal action identified in item 1 (e.g., Request for Proposal
(RFP) number; Invitations for Bid (IFB) number; grant announcement
number; the contract, grant, or loan award number; the
application/proposal control number assigned by the Federal agency).
Included prefixes, e.g., "RFP-DE-90-001."**

**9. For a covered Federal action where there has been an award or loan
commitment by the Federal agency, enter the Federal amount of the
award/loan commitment for the prime entity identified in item 4 or 5.**

**10. (a) Enter the full name, address, city, State and zip code of the
lobbying registrant under the Lobbying Disclosure Act of 1995 engaged by
the reporting entity identified in item 4 to influence the covered
Federal action.**

> \(b\) **Enter the full names of the individual(s) performing services,
> and include full address if different from 10(a). Enter Last Name,
> First Name, and Middle Initial (MI).**

**11. The certifying official shall sign and date the form, print
his/her name, title, and telephone number.**

According to the Paperwork Reduction Act, as amended, no persons are
required to respond to a collection of information unless it displays a
valid OMB control Number. The valid OMB control number for this
information collection is OMB No. 0348-0046. Public reporting burden for
this collection of information is estimated to average 10 minutes per
response, including time for reviewing instructions, searching existing
data sources, gathering and maintaining the data needed, and completing
and reviewing the collection of information. Send comments regarding the
burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of
Management and Budget, Paperwork Reduction Project (0348-0046),
Washington, DC 20503

# Survey Instructions on Ensuring Equal Opportunity for Applicants

# 

> **Provide the applicant's (organization) name and DUNS number and the
> grant name and CFDA number.**

1\. 501(c)(3) status is a legal designation provided on application to
the Internal Revenue Service by eligible organizations. Some grant
programs may require nonprofit applicants to have 501(c)(3) status.
Other grant programs do not.

2\. For example, two part-time employees who each work half-time equal
one full-time equivalent employee. If the applicant is a local affiliate
of a national organization, the responses to survey questions 2 and 3
should reflect the staff and budget size of the local affiliate.

3\. Annual budget means the amount of money your organization spends
each year on all of its activities.

4\. Self-identify.

5\. An organization is considered a community-based organization if its
headquarters/service location shares the same zip code as the clients
you serve.

6\. An "intermediary" is an organization that enables a group of small
organizations to receive and manage government funds by administering
the grant on their behalf.

7.  Self-explanatory.

8.  Self-explanatory.

**\
**

**Paperwork Burden Statement**

According to the Paperwork Reduction Act of 1995, no persons are
required to respond to a collection of information unless such
collection displays a valid OMB control number. The valid OMB control
number for this information collection is 1890-0014. The time required
to complete this information collection is estimated to average five (5)
minutes per response, including the time to review instructions, search
existing data resources, gather the data needed, and complete and review
the information collection. **If you have any comments concerning the
accuracy of the time estimate(s) or suggestions for improving this form,
please write to:** U.S. Department of Education, Washington, D.C.
2202-4651.

**If you have comments or concerns regarding the status of your
individual submission of this form, write directly to:** Joyce I. Mays,
Application Control Center, U.S. Department of Education, 7^th^ and D
Streets, SW, ROB-3, Room 3671, Washington, D.C. 20202-4725

OMB No. 1890-0014 Exp. 1/31/2006

OMB Control No. 1890-0007 (Exp. 11/30/2007)

**NOTICE TO ALL APPLICANTS**

The purpose of this enclosure is to inform you about a new provision in
the Department of Education\'s General Education Provisions Act (GEPA)
that applies to applicants for new grant awards under Department
programs. This provision is Section 427 of GEPA, enacted as part of the
Improving America\'s Schools Act of 1994 (Public Law (P.L.) 103-382).

**To Whom Does This Provision Apply?**

Section 427 of GEPA affects applicants for new grant awards under this
program. **ALL APPLICANTS FOR NEW AWARDS MUST INCLUDE INFORMATION IN
THEIR APPLICATIONS TO ADDRESS THIS NEW PROVISION IN ORDER TO RECEIVE
FUNDING UNDER THIS PROGRAM.**

(If this program is a State-formula grant program, a State needs to
provide this description only for projects or activities that it carries
out with funds reserved for State-level uses. In addition, local school
districts or other eligible applicants that apply to the State for
funding need to provide this description in their applications to the
State for funding. The State would be responsible for ensuring that the
school district or other local entity has submitted a sufficient section
427 statement as described below.)

**What Does This Provision Require?**

Section 427 requires each applicant for funds (other than an individual
person) to include in its application a description of the steps the
applicant proposes to take to ensure equitable access to, and
participation in, its Federally-assisted program for students, teachers,
and other program beneficiaries with special needs. This provision
allows applicants discretion in developing the required description. The
statute highlights six types of barriers that can impede equitable
access or participation: gender, race, national origin, color,
disability, or age. Based on local circumstances, you should determine
whether these or other barriers may prevent your students, teachers,
etc. from such access or participation in, the Federally-funded project
or activity. The description in your application of steps to be taken to
overcome these barriers need not be lengthy; you may provide a clear and
succinct

description of how you plan to address those barriers that are
applicable to your circumstances. In addition, the information may be
provided in a single narrative, or, if appropriate, may be discussed in
connection with related topics in the application.

Section 427 is not intended to duplicate the requirements of civil
rights statutes, but rather to ensure that, in designing their projects,
applicants for Federal funds address equity concerns that may affect the
ability of certain potential beneficiaries to fully participate in the
project and to achieve to high standards. Consistent with program
requirements and its approved application, an applicant may use the
Federal funds awarded to it to eliminate barriers it identifies.

**What are Examples of How an Applicant Might Satisfy the Requirement of
This Provision?**

The following examples may help illustrate how an applicant may comply
with Section 427.

> \(1\) An applicant that proposes to carry out an adult literacy
> project serving, among others, adults with limited English
> proficiency, might describe in its application how it intends to
> distribute a brochure about the proposed project to such potential
> participants in their native language.
>
> \(2\) An applicant that proposes to develop instructional materials
> for classroom use might describe how it will make the materials
> available on audio tape or in braille for students who are blind.
>
> \(3\) An applicant that proposes to carry out a model science program
> for secondary students and is concerned that girls may be less likely
> than boys to enroll in the course, might indicate how it intends to
> conduct \"outreach\" efforts to girls, to encourage their enrollment.

We recognize that many applicants may already be implementing effective
steps to ensure equity of access and participation in their grant
programs, and we appreciate your cooperation in responding to the
requirements of this provision.

**SECTION E**

**OTHER**

**IMPORTANT**

**INFORMATION**

**AND NOTICES**

[Intergovernmental Review of Federal Programs]{.smallcaps}

#### Executive Order 12372

**This program is subject to the requirement of the Executive Order
12372 (Intergovernmental Review of Federal Programs) and the regulations
in 34 CFR Part 79. The objective of the Executive Order is to foster an
intergovernmental partnership and to strengthen federalism by relying on
State and local processes for Sate and local government coordination and
review of proposed Federal financial assistance. Applicants must contact
the appropriate State Single Point of Contact to find out about, and to
comply with, the State's process under Executive Order 12372.**

You may locate the name and contact information of State Single Points
of Contact at:

<http://www.whitehouse.gov/omb/grants/spoc.html>

[ESTIMATED PUBLIC REPORTING BURDEN]{.smallcaps}

# Paperwork Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are
required to respond to a collection of information unless such
collection displays a valid OMB control number. The valid OMB control
number for this information collection is 1855-0007. The time required
to complete this information collection is estimated to average 80 hours
per response, including the time to review instructions, search existing
data resources, gather the data needed, and complete and review the
information collection. **If you have any comments concerning the
accuracy of the time estimate(s) or suggestions for improving this form,
please write to:** U.S. Department of Education, Washington, D.C.
20202-4651. **If you have comments or concerns regarding the status of
your individual submission of this form, write directly to:** Credit
Enhancement for Charter School Facilities Program, U.S. Department of
Education, 400 Maryland Avenue, S.W., Room 4W245, Washington D.C.
20202-6140.

**[Application Checklist for Applicants]{.smallcaps}**

As discussed on the following pages, a complete application must include
all of the documents listed below.

\[ \] Cover page (SF 424 Form)

\[ \] ED Abstract Narrative Attachment Form

\[ \] Project Narrative Attachment Form

\[ \] Including responses to the selection criteria

\[ \] Budget Narrative Attachment Form

\[ \] ED 524

\[ \] Table 2 - Budget Form: Grant Funds Expenditures

\[ \] Other Attachments Form

\[ \] Program narrative, including responses to the selection criteria

\[ \] Enabling Statutes and Other Relevant Legislation

\[ \] Table 1- Charter School Aid Paid by State

\[ \] Table 3- Grant Funds as a Percentage of the Cost of Per-Pupil
Facilities Aid

\[ \] Resumes/Curriculum Vitae

\[ \] Assurances and Certifications

\[ \] Assurances──Non-Construction Programs

> \[ \] Certifications Regarding Lobbying

\[ \] SF-LLL Disclosure of Lobbying Activity

\[ \] Response to Section 427 of GEPA Guidance

\[ \] Did you submit a copy of the application to the State Single Point
of Contact (if applicable)?