**APPLICATION FOR FUNDING**

**UNDER THE**

**HOMELESS EDUCATION DISASTER ASSISTANCE PROGRAM**

![](media/image1.png)

> **CDFA Number: 84.383A**
>
> **Form Approved:**
>
> **OMB Number:**
>
> **Expiration Date:**

According to the Paperwork Reduction Act, 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 xxxx-xxxx. The time required to complete this
information collection is xx hours per LEA 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, DC 20202-4651. **If you have any comments or
concerns regarding the status of your individual submission of this
form, please write directly to:**

> Zollie Stevenson, Jr., Ph.D., Director
>
> Student Achievement and School Accountability Programs
>
> U.S. Department of Education
>
> 400 Maryland Ave. SW
>
> Washington, DC 20202-6132

GENERAL INSTRUCTIONS

[Application Information]{.underline}

Each local educational agency (LEA) or LEA consortium seeking funding
under the Homeless Education Disaster Assistance (HEDA) program must
submit an electronic application to the U.S. Department of Education
that includes the following information:

1.  The completed HEDA application cover page;

2.  The following assurances or certifications:

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

    -   Certification Regarding Lobbying (ED 80-0013 Form);

3.  A description of the LEA's (or lead LEA in an LEA consortium)
    compliance with the equitable access and participation requirements
    in section 427 of the General Education Provisions Act; and

4.  A completed HEDA Form A providing the number of enrolled students in
    kindergarten through grade twelve in your LEA or LEA consortium who
    became homeless as a result of a federally-declared natural
    disaster[^1] that occurred in calendar year 2008 (2008) and the
    applicable disaster identification numbers. In Form A provide:

-   the name of your LEA or, in the case of an LEA consortium, the
    designated lead LEA;

-   your LEA's (or, in the case of an LEA consortium, the designated
    lead LEA) Federal ID (NCES) number; and

-   the requested counts of students in Column 5.

5\. In the case of an LEA consortium, a completed HEDA Form B providing
the number of enrolled students in kindergarten through grade twelve in
all the LEAs that make up the consortium who became homeless as a result
of a federally-declared natural disaster ^1^ that occurred in calendar
year 2008 (2008) and the applicable disaster identification numbers. In
Form B provide:

-   the name of each LEA in the LEA consortium;

-   the Federal ID (NCES) number of each LEA in the LEA consortium; and

-   the counts of homeless students enrolled.

NOTE: Only an LEA or a consortium of LEAs that had a total of at least
fifty enrolled students in kindergarten through grade twelve who became
homeless as a result of a federally-declared major disaster that
occurred during 2008 is eligible for a grant under the HEDA program.
(For consortia of LEAs, each LEA in the consortium does not need to have
50 or more students; the combined total reported by the consortium must
be at least 50.)

[Application Due Date]{.underline}:

**HOMELESS EDUCATION DISASTER ASSISTANCE PROGRAM**

**APPLICATION COVER PAGE**

+----------------------------------+-----------------------------------+
| 1\. Legal Name of Applicant      | 2.  DUNS Identification Number:   |
| Local Educational Agency (LEA)   |                                   |
|                                  | 3.  Taxpayer Identification       |
|                                  |     Number:                       |
|                                  |                                   |
|                                  | 4.  Applicant LEA NCES ID Number: |
+----------------------------------+-----------------------------------+
| 5\. Applicant LEA Address        | 6\. Contact Person                |
| (including zip code)             |                                   |
|                                  | Name:                             |
|                                  |                                   |
|                                  | Position:                         |
|                                  |                                   |
|                                  | Telephone:                        |
|                                  |                                   |
|                                  | Fax:                              |
+----------------------------------+-----------------------------------+
| 7\. Is the applicant delinquent  | \_\_Yes, explanation attached     |
| of any Federal debt?             |                                   |
|                                  |                                   |
| \_\_\_No                         |                                   |
+----------------------------------+-----------------------------------+
| 8\. Is the application for a     |                                   |
| consortium of LEAs? \_\_\_Yes    |                                   |
| \_\_\_No                         |                                   |
+----------------------------------+-----------------------------------+
| 9\. If you answered "Yes" to     |                                   |
| Question 8, please list the      |                                   |
| legal names and NCES numbers for |                                   |
| all participating LEAs in the    |                                   |
| consortium:                      |                                   |
+----------------------------------+-----------------------------------+
| 10\. To the best of my knowledge |                                   |
| and belief, all data are true    |                                   |
| and correct. The document has    |                                   |
| been duly authorized by the      |                                   |
| governing body of the            |                                   |
|                                  |                                   |
| applicant and the applicant will |                                   |
| comply with the assurances       |                                   |
| provided in this package if the  |                                   |
| assistance is awarded.           |                                   |
+----------------------------------+-----------------------------------+
| .a. Typed Name and Title of      | b\. Telephone Number              |
| Authorized Representative        |                                   |
+----------------------------------+-----------------------------------+
| c\. Signature of Authorized      | d\. Date                          |
| Representative:                  |                                   |
+----------------------------------+-----------------------------------+

###  

### 

### INSTRUCTIONS FOR APPLICATION COVER PAGE

**1.** **Legal Name of LEA**. Enter the legal name of the applicant
local educational agency (LEA).

(For a consortium enter the legal name of the lead applicant LEA.)

**2. D-U-N-S Number**. Enter the applicant's D-U-N-S Number. If your
organization does not have a

D-U-N-S Number, you can obtain the number by calling 1-800-333-0505 or
by completing a D-U-N-S Number Request Form. The form can be obtained
via the Internet at the following URL: http://www.dnb.com

**3.** **Taxpayer Identification Number**. Enter the taxpayer's
identification number as assigned by the Internal Revenue Service. For a
consortium enter only the lead LEA's number.

**4.** **LEA NCES ID Number**: Enter the applicant's NCES number. The
NCES number can be obtained via the Internet at the following URL:
[[http://nces.ed.gov/globallocator/]{.underline}](http://nces.ed.gov/globallocator/)

**5.** **Address**. Address of the applicant LEA, or in the case of a
consortium the address of the lead LEA.

**6. Program Contact**. Name, address, telephone and fax numbers, and
email address of the person to be contacted on matters involving this
application.

**7. Federal Debt Delinquency**. Check "Yes" if the LEA is delinquent on
any Federal debt. (This question refers to the applicant's organization
and not to the person who signs as the authorized representative.
Categories of debt include delinquent audit disallowances, loans and
taxes.) Otherwise, check "No."

**8. Consortium:** Two or more LEAs who agree to apply for the grant and
distribute the funds together while managing their individual
responsibilities for maintaining auditable records for homeless student
identification and allowable expenditures.

**9. LEAs participating in a consortium:** List the name and information
for the lead LEA in #1-6 and then the legal name and NCES number for
each of the other participating LEAs in this text box.

**10. Certification**. To be signed by the authorized LEA representative
of the applicant LEA.

\[INSERT SF 424B Form\]

\[INSERT ED 80-0013 Form\]

\[INSERT Instructions for GEPA 427 Description\]

**HEDA Form A - Number of Homeless Students and Natural Disaster
Identifications^1^**

+------+----------------------------+-------+-----------+---+------------+
| LEA  |                            |       |           |   |            |
| (or, |                            |       |           |   |            |
| in   |                            |       |           |   |            |
| the  |                            |       |           |   |            |
| case |                            |       |           |   |            |
| of   |                            |       |           |   |            |
| an   |                            |       |           |   |            |
| LEA  |                            |       |           |   |            |
| con  |                            |       |           |   |            |
| sort |                            |       |           |   |            |
| ium, |                            |       |           |   |            |
| the  |                            |       |           |   |            |
| lead |                            |       |           |   |            |
| LEA) |                            |       |           |   |            |
| N    |                            |       |           |   |            |
| ame: |                            |       |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| Fed  |                            |       |           |   |            |
| eral |                            |       |           |   |            |
| ID   |                            |       |           |   |            |
| (N   |                            |       |           |   |            |
| CES) |                            |       |           |   |            |
| Num  |                            |       |           |   |            |
| ber: |                            |       |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| ^1^  | *For purposes of the HEDA  |       |           |   |            |
|      | program, a natural         |       |           |   |            |
|      | disaster is one for which  |       |           |   |            |
|      | the President declared a   |       |           |   |            |
|      | major disaster under title |       |           |   |            |
|      | IV of the Robert T.        |       |           |   |            |
|      | Stafford Disaster Relief   |       |           |   |            |
|      | and Emergency Assistance   |       |           |   |            |
|      | Act of 1974.*              |       |           |   |            |
|      |                            |       |           |   |            |
|      | *For a list of specific    |       |           |   |            |
|      | counties in which there    |       |           |   |            |
|      | has been a Federally       |       |           |   |            |
|      | declared disaster in 2008  |       |           |   |            |
|      | go to the Federal          |       |           |   |            |
|      | Emergency Management       |       |           |   |            |
|      | Agency\'s (FEMA) website   |       |           |   |            |
|      | at:                        |       |           |   |            |
|      | htt                        |       |           |   |            |
|      | p://www.fema.gov/news/disa |       |           |   |            |
|      | sters.fema?year=2008#sev1* |       |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| *    | ***Column (2)***           | ***C  | ***Column | * |            |
| **Co |                            | olumn | (4)***    | * |            |
| lumn | **Natural Disaster**       | (     |           | * |            |
| (1   |                            | 3)*** | **States  | C |            |
| )*** |                            |       | with      | o |            |
|      |                            | *     | Counties  | l |            |
| **   |                            | *Date | in Which  | u |            |
| Disa |                            | of**  | There Has | m |            |
| ster |                            |       | Been a    | n |            |
| Numb |                            | **    | Natural   | ( |            |
| er** |                            | Disas | D         | 5 |            |
|      |                            | ter** | isaster** | ) |            |
|      |                            |       |           | * |            |
|      |                            | **Dec |           | * |            |
|      |                            | larat |           | * |            |
|      |                            | ion** |           |   |            |
|      |                            |       |           | * |            |
|      |                            |       |           | * |            |
|      |                            |       |           | N |            |
|      |                            |       |           | u |            |
|      |                            |       |           | m |            |
|      |                            |       |           | b |            |
|      |                            |       |           | e |            |
|      |                            |       |           | r |            |
|      |                            |       |           | o |            |
|      |                            |       |           | f |            |
|      |                            |       |           | K |            |
|      |                            |       |           | - |            |
|      |                            |       |           | 1 |            |
|      |                            |       |           | 2 |            |
|      |                            |       |           | S |            |
|      |                            |       |           | t |            |
|      |                            |       |           | u |            |
|      |                            |       |           | d |            |
|      |                            |       |           | e |            |
|      |                            |       |           | n |            |
|      |                            |       |           | t |            |
|      |                            |       |           | s |            |
|      |                            |       |           | E |            |
|      |                            |       |           | n |            |
|      |                            |       |           | r |            |
|      |                            |       |           | o |            |
|      |                            |       |           | l |            |
|      |                            |       |           | l |            |
|      |                            |       |           | e |            |
|      |                            |       |           | d |            |
|      |                            |       |           | i |            |
|      |                            |       |           | n |            |
|      |                            |       |           | Y |            |
|      |                            |       |           | o |            |
|      |                            |       |           | u |            |
|      |                            |       |           | r |            |
|      |                            |       |           | L |            |
|      |                            |       |           | E |            |
|      |                            |       |           | A |            |
|      |                            |       |           | ( |            |
|      |                            |       |           | s |            |
|      |                            |       |           | ) |            |
|      |                            |       |           | M |            |
|      |                            |       |           | a |            |
|      |                            |       |           | d |            |
|      |                            |       |           | e |            |
|      |                            |       |           | H |            |
|      |                            |       |           | o |            |
|      |                            |       |           | m |            |
|      |                            |       |           | e |            |
|      |                            |       |           | l |            |
|      |                            |       |           | e |            |
|      |                            |       |           | s |            |
|      |                            |       |           | s |            |
|      |                            |       |           | b |            |
|      |                            |       |           | y |            |
|      |                            |       |           | a |            |
|      |                            |       |           | 2 |            |
|      |                            |       |           | 0 |            |
|      |                            |       |           | 0 |            |
|      |                            |       |           | 8 |            |
|      |                            |       |           | N |            |
|      |                            |       |           | a |            |
|      |                            |       |           | t |            |
|      |                            |       |           | u |            |
|      |                            |       |           | r |            |
|      |                            |       |           | a |            |
|      |                            |       |           | l |            |
|      |                            |       |           | D |            |
|      |                            |       |           | i |            |
|      |                            |       |           | s |            |
|      |                            |       |           | a |            |
|      |                            |       |           | s |            |
|      |                            |       |           | t |            |
|      |                            |       |           | e |            |
|      |                            |       |           | r |            |
|      |                            |       |           | L |            |
|      |                            |       |           | i |            |
|      |                            |       |           | s |            |
|      |                            |       |           | t |            |
|      |                            |       |           | e |            |
|      |                            |       |           | d |            |
|      |                            |       |           | i |            |
|      |                            |       |           | n |            |
|      |                            |       |           | C |            |
|      |                            |       |           | o |            |
|      |                            |       |           | l |            |
|      |                            |       |           | u |            |
|      |                            |       |           | m |            |
|      |                            |       |           | n |            |
|      |                            |       |           | ( |            |
|      |                            |       |           | 2 |            |
|      |                            |       |           | ) |            |
|      |                            |       |           | * |            |
|      |                            |       |           | * |            |
+------+----------------------------+-------+-----------+---+------------+
| 1789 | Hurricane Gustav           | 9/    | Alabama   |   |            |
|      |                            | 10/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1797 | Severe Storms and Flooding | 9/    | Alabama   |   |            |
|      | associated with Hurricane  | 26/08 |           |   |            |
|      | Ike                        |       |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1796 | Severe Storms, Flooding,   | 9/    | Alaska    |   |            |
|      | Landslides, and Mudslides  | 26/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1744 | Severe Storms, Tornadoes,  | 2     | Arkansas  |   |            |
|      | and Flooding               | /7/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1751 | Severe Storms, Tornadoes,  | 3/    | Arkansas  |   |            |
|      | and Flooding               | 26/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1758 | Severe Storms, Flooding,   | 5/    | Arkansas  |   |            |
|      | and Tornadoes              | 20/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1793 | Severe Storms and Flooding | 9/    | Arkansas  |   |            |
|      | associated with Hurricane  | 18/08 |           |   |            |
|      | Gustav                     |       |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1762 | Severe Storms and          | 5/    | Colorado  |   |            |
|      | Tornadoes                  | 26/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1785 | Tropical Storm Fay         | 8/    | Florida   |   |            |
|      |                            | 24/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1750 | Severe Storms and          | 3/    | Georgia   |   |            |
|      | Tornadoes                  | 20/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1761 | Severe Storms and Flooding | 5/    | Georgia   |   |            |
|      |                            | 23/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1743 | Severe Storms, High Surf,  | 2     | Hawaii    |   |            |
|      | Flooding, and Mudslides    | /6/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1781 | Flooding                   | 7/    | Idaho     |   |            |
|      |                            | 31/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1747 | Severe Storms and Flooding | 3     | Illinois  |   |            |
|      |                            | /7/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1771 | Severe Storms and Flooding | 6/    | Illinois  |   |            |
|      |                            | 24/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1800 | Severe Storms and Flooding | 10    | Illinois  |   |            |
|      |                            | /3/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1740 | Severe Storms and Flooding | 1/    | Indiana   |   |            |
|      |                            | 30/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1766 | Severe Storms and Flooding | 6     | Indiana   |   |            |
|      |                            | /8/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1795 | Severe Storms and Flooding | 9/    | Indiana   |   |            |
|      |                            | 23/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1737 | Severe Winter Storm        | 1     | Iowa      |   |            |
|      |                            | /4/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1763 | Severe Storms, Tornadoes,  | 5/    | Iowa      |   |            |
|      | and Flooding               | 27/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1741 | Severe Winter Storms       | 2     | Kansas    |   |            |
|      |                            | /1/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1776 | Severe Storms, Flooding,   | 7     | Kansas    |   |            |
|      | and Tornadoes              | /9/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1746 | Severe Storms, Tornadoes,  | 2/    | Kentucky  |   |            |
|      | Straight-line Winds, and   | 21/08 |           |   |            |
|      | Flooding                   |       |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1757 | Severe Storms, Tornadoes,  | 5/    | Kentucky  |   |            |
|      | Flooding, Mudslides, and   | 19/08 |           |   |            |
|      | Landslides                 |       |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1802 | Severe Wind Storm          | 10    | Kentucky  |   |            |
|      | associated with Tropical   | /9/08 |           |   |            |
|      | Depression Ike             |       |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1786 | Hurricane Gustav           | 9     | Louisiana |   |            |
|      |                            | /2/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| *    | ***Column (2)***           | ***C  | ***Column | * |            |
| **Co |                            | olumn | (4)***    | * |            |
| lumn | **Natural Disaster**       | (     |           | * |            |
| (1   |                            | 3)*** | **States  | C |            |
| )*** |                            |       | with      | o |            |
|      |                            | *     | Counties  | l |            |
| **   |                            | *Date | in Which  | u |            |
| Disa |                            | of**  | There Has | m |            |
| ster |                            |       | Been a    | n |            |
| Numb |                            | **    | Natural   | ( |            |
| er** |                            | Disas | D         | 5 |            |
|      |                            | ter** | isaster** | ) |            |
|      |                            |       |           | * |            |
|      |                            | **Dec |           | * |            |
|      |                            | larat |           | * |            |
|      |                            | ion** |           |   |            |
|      |                            |       |           | * |            |
|      |                            |       |           | * |            |
|      |                            |       |           | N |            |
|      |                            |       |           | u |            |
|      |                            |       |           | m |            |
|      |                            |       |           | b |            |
|      |                            |       |           | e |            |
|      |                            |       |           | r |            |
|      |                            |       |           | o |            |
|      |                            |       |           | f |            |
|      |                            |       |           | K |            |
|      |                            |       |           | - |            |
|      |                            |       |           | 1 |            |
|      |                            |       |           | 2 |            |
|      |                            |       |           | S |            |
|      |                            |       |           | t |            |
|      |                            |       |           | u |            |
|      |                            |       |           | d |            |
|      |                            |       |           | e |            |
|      |                            |       |           | n |            |
|      |                            |       |           | t |            |
|      |                            |       |           | s |            |
|      |                            |       |           | E |            |
|      |                            |       |           | n |            |
|      |                            |       |           | r |            |
|      |                            |       |           | o |            |
|      |                            |       |           | l |            |
|      |                            |       |           | l |            |
|      |                            |       |           | e |            |
|      |                            |       |           | d |            |
|      |                            |       |           | i |            |
|      |                            |       |           | n |            |
|      |                            |       |           | Y |            |
|      |                            |       |           | o |            |
|      |                            |       |           | u |            |
|      |                            |       |           | r |            |
|      |                            |       |           | L |            |
|      |                            |       |           | E |            |
|      |                            |       |           | A |            |
|      |                            |       |           | ( |            |
|      |                            |       |           | s |            |
|      |                            |       |           | ) |            |
|      |                            |       |           | M |            |
|      |                            |       |           | a |            |
|      |                            |       |           | d |            |
|      |                            |       |           | e |            |
|      |                            |       |           | H |            |
|      |                            |       |           | o |            |
|      |                            |       |           | m |            |
|      |                            |       |           | e |            |
|      |                            |       |           | l |            |
|      |                            |       |           | e |            |
|      |                            |       |           | s |            |
|      |                            |       |           | s |            |
|      |                            |       |           | b |            |
|      |                            |       |           | y |            |
|      |                            |       |           | a |            |
|      |                            |       |           | 2 |            |
|      |                            |       |           | 0 |            |
|      |                            |       |           | 0 |            |
|      |                            |       |           | 8 |            |
|      |                            |       |           | N |            |
|      |                            |       |           | a |            |
|      |                            |       |           | t |            |
|      |                            |       |           | u |            |
|      |                            |       |           | r |            |
|      |                            |       |           | a |            |
|      |                            |       |           | l |            |
|      |                            |       |           | D |            |
|      |                            |       |           | i |            |
|      |                            |       |           | s |            |
|      |                            |       |           | a |            |
|      |                            |       |           | s |            |
|      |                            |       |           | t |            |
|      |                            |       |           | e |            |
|      |                            |       |           | r |            |
|      |                            |       |           | L |            |
|      |                            |       |           | i |            |
|      |                            |       |           | s |            |
|      |                            |       |           | t |            |
|      |                            |       |           | e |            |
|      |                            |       |           | d |            |
|      |                            |       |           | i |            |
|      |                            |       |           | n |            |
|      |                            |       |           | C |            |
|      |                            |       |           | o |            |
|      |                            |       |           | l |            |
|      |                            |       |           | u |            |
|      |                            |       |           | m |            |
|      |                            |       |           | n |            |
|      |                            |       |           | ( |            |
|      |                            |       |           | 2 |            |
|      |                            |       |           | ) |            |
|      |                            |       |           | * |            |
|      |                            |       |           | * |            |
+------+----------------------------+-------+-----------+---+------------+
| 1792 | Hurricane Ike              | 9/    | Louisiana |   |            |
|      |                            | 13/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1755 | Severe Storms and Flooding | 5     | Maine     |   |            |
|      |                            | /9/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1788 | Severe Storms, Flooding,   | 9     | Maine     |   |            |
|      | and Tornadoes              | /9/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1777 | Severe Storms, Tornadoes,  | 7/    | Michigan  |   |            |
|      | and Flooding               | 14/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1772 | Severe Storms and Flooding | 6/    | Minnesota |   |            |
|      |                            | 25/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1753 | Severe Storms and Flooding | 5     | Mi        |   |            |
|      |                            | /8/08 | ssissippi |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1764 | Severe Storms and          | 5/    | Mi        |   |            |
|      | Tornadoes                  | 28/08 | ssissippi |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1794 | Hurricane Gustav           | 9/    | Mi        |   |            |
|      |                            | 22/08 | ssissippi |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1742 | Severe Storms, Tornadoes,  | 2     | Missouri  |   |            |
|      | and Flooding               | /5/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1748 | Severe Winter Storms and   | 3/    | Missouri  |   |            |
|      | Flooding                   | 12/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1749 | Severe Storms and Flooding | 3/    | Missouri  |   |            |
|      |                            | 19/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1760 | Severe Storms and          | 5/    | Missouri  |   |            |
|      | Tornadoes                  | 23/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1773 | Severe Storms and Flooding | 6/    | Missouri  |   |            |
|      |                            | 25/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1767 | Severe Winter Storm        | 6/    | Montana   |   |            |
|      |                            | 13/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1739 | Severe Winter Storm        | 1/    | Nebraska  |   |            |
|      |                            | 11/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1765 | Severe Storms, Tornadoes,  | 5/    | Nebraska  |   |            |
|      | and Flooding               | 30/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1770 | Severe Storms, Tornadoes,  | 6/    | Nebraska  |   |            |
|      | and Flooding               | 20/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1779 | Severe Storms,             | 7/    | Nebraska  |   |            |
|      | Straight-line winds, and   | 18/08 |           |   |            |
|      | Flooding                   |       |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1738 | Severe Winter Storms and   | 1     | Nevada    |   |            |
|      | Flooding                   | /8/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1782 | Severe Storms, Tornado,    | 8/    | New       |   |            |
|      | and Flooding               | 11/08 | Hampshire |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1787 | Severe Storms and Flooding | 9     | New       |   |            |
|      |                            | /5/08 | Hampshire |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1799 | Severe Storms and Flooding | 10    | New       |   |            |
|      |                            | /3/08 | Hampshire |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1783 | Severe Storms and Flooding | 8/    | New       |   |            |
|      |                            | 14/08 | Mexico    |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1801 | Tropical Storm Hanna       | 10    | North     |   |            |
|      |                            | /8/08 | Carolina  |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1752 | Severe Storms, Tornadoes,  | 5     | Oklahoma  |   |            |
|      | and Flooding               | /5/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1754 | Severe Storms, Tornadoes,  | 5     | Oklahoma  |   |            |
|      | and Flooding               | /9/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1756 | Severe Storms, Tornadoes,  | 5/    | Oklahoma  |   |            |
|      | and Flooding               | 14/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1775 | Severe Storms and Flooding | 7     | Oklahoma  |   |            |
|      |                            | /9/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1803 | Severe Storms, Tornadoes,  | 10    | Oklahoma  |   |            |
|      | and Flooding               | /9/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1798 | Severe Storms and Flooding | 10    | Puerto    |   |            |
|      |                            | /1/08 | Rico      |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1759 | Severe Winter Storm and    | 5/    | South     |   |            |
|      | Record and Near Record     | 22/08 | Dakota    |   |            |
|      | Snow                       |       |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1774 | Severe Storms and Flooding | 7     | South     |   |            |
|      |                            | /9/08 | Dakota    |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1745 | Severe Storms, Tornadoes,  | 2     | Tennessee |   |            |
|      | Straight-line Winds, and   | /7/08 |           |   |            |
|      | Flooding                   |       |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1780 | Hurricane Dolly            | 7/    | Texas     |   |            |
|      |                            | 24/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1791 | Hurricane Ike              | 9/    | Texas     |   |            |
|      |                            | 13/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1778 | Severe Storms and Flooding | 7/    | Vermont   |   |            |
|      |                            | 15/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1784 | Severe Storms, a Tornado,  | 8/    | Vermont   |   |            |
|      | and Flooding               | 15/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1790 | Severe Storms and Flooding | 9/    | Vermont   |   |            |
|      |                            | 12/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| 1769 | Severe Storms, Tornadoes,  | 6/    | West      |   |            |
|      | Flooding, Mudslides, and   | 19/08 | Virginia  |   |            |
|      | Landslides                 |       |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
| *    | ***Column (2)***           | ***C  | ***Column | * |            |
| **Co |                            | olumn | (4)***    | * |            |
| lumn | **Natural Disaster**       | (     |           | * |            |
| (1   |                            | 3)*** | **States  | C |            |
| )*** |                            |       | with      | o |            |
|      |                            | *     | Counties  | l |            |
| **   |                            | *Date | in Which  | u |            |
| Disa |                            | of**  | There Has | m |            |
| ster |                            |       | Been a    | n |            |
| Numb |                            | **    | Natural   | ( |            |
| er** |                            | Disas | D         | 5 |            |
|      |                            | ter** | isaster** | ) |            |
|      |                            |       |           | * |            |
|      |                            | **Dec |           | * |            |
|      |                            | larat |           | * |            |
|      |                            | ion** |           |   |            |
|      |                            |       |           | * |            |
|      |                            |       |           | * |            |
|      |                            |       |           | N |            |
|      |                            |       |           | u |            |
|      |                            |       |           | m |            |
|      |                            |       |           | b |            |
|      |                            |       |           | e |            |
|      |                            |       |           | r |            |
|      |                            |       |           | o |            |
|      |                            |       |           | f |            |
|      |                            |       |           | K |            |
|      |                            |       |           | - |            |
|      |                            |       |           | 1 |            |
|      |                            |       |           | 2 |            |
|      |                            |       |           | S |            |
|      |                            |       |           | t |            |
|      |                            |       |           | u |            |
|      |                            |       |           | d |            |
|      |                            |       |           | e |            |
|      |                            |       |           | n |            |
|      |                            |       |           | t |            |
|      |                            |       |           | s |            |
|      |                            |       |           | E |            |
|      |                            |       |           | n |            |
|      |                            |       |           | r |            |
|      |                            |       |           | o |            |
|      |                            |       |           | l |            |
|      |                            |       |           | l |            |
|      |                            |       |           | e |            |
|      |                            |       |           | d |            |
|      |                            |       |           | i |            |
|      |                            |       |           | n |            |
|      |                            |       |           | Y |            |
|      |                            |       |           | o |            |
|      |                            |       |           | u |            |
|      |                            |       |           | r |            |
|      |                            |       |           | L |            |
|      |                            |       |           | E |            |
|      |                            |       |           | A |            |
|      |                            |       |           | ( |            |
|      |                            |       |           | s |            |
|      |                            |       |           | ) |            |
|      |                            |       |           | M |            |
|      |                            |       |           | a |            |
|      |                            |       |           | d |            |
|      |                            |       |           | e |            |
|      |                            |       |           | H |            |
|      |                            |       |           | o |            |
|      |                            |       |           | m |            |
|      |                            |       |           | e |            |
|      |                            |       |           | l |            |
|      |                            |       |           | e |            |
|      |                            |       |           | s |            |
|      |                            |       |           | s |            |
|      |                            |       |           | b |            |
|      |                            |       |           | y |            |
|      |                            |       |           | a |            |
|      |                            |       |           | 2 |            |
|      |                            |       |           | 0 |            |
|      |                            |       |           | 0 |            |
|      |                            |       |           | 8 |            |
|      |                            |       |           | N |            |
|      |                            |       |           | a |            |
|      |                            |       |           | t |            |
|      |                            |       |           | u |            |
|      |                            |       |           | r |            |
|      |                            |       |           | a |            |
|      |                            |       |           | l |            |
|      |                            |       |           | D |            |
|      |                            |       |           | i |            |
|      |                            |       |           | s |            |
|      |                            |       |           | a |            |
|      |                            |       |           | s |            |
|      |                            |       |           | t |            |
|      |                            |       |           | e |            |
|      |                            |       |           | r |            |
|      |                            |       |           | L |            |
|      |                            |       |           | i |            |
|      |                            |       |           | s |            |
|      |                            |       |           | t |            |
|      |                            |       |           | e |            |
|      |                            |       |           | d |            |
|      |                            |       |           | i |            |
|      |                            |       |           | n |            |
|      |                            |       |           | C |            |
|      |                            |       |           | o |            |
|      |                            |       |           | l |            |
|      |                            |       |           | u |            |
|      |                            |       |           | m |            |
|      |                            |       |           | n |            |
|      |                            |       |           | ( |            |
|      |                            |       |           | 2 |            |
|      |                            |       |           | ) |            |
|      |                            |       |           | * |            |
|      |                            |       |           | * |            |
+------+----------------------------+-------+-----------+---+------------+
| 1768 | Severe Storms, Tornadoes,  | 6/    | Wisconsin |   |            |
|      | and Flooding               | 14/08 |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
|      | List of disasters is       |       |           |   |            |
|      | current as of November 20, |       |           |   |            |
|      | 2008. Additional disasters |       |           |   |            |
|      | for 2008 will be listed as |       |           |   |            |
|      | they are declared.         |       |           |   |            |
+------+----------------------------+-------+-----------+---+------------+
|      | LEA/Consortium Total       |       |           | E |            |
|      |                            |       |           | D |            |
|      |                            |       |           | s |            |
|      |                            |       |           | y |            |
|      |                            |       |           | s |            |
|      |                            |       |           | t |            |
|      |                            |       |           | e |            |
|      |                            |       |           | m |            |
|      |                            |       |           | w |            |
|      |                            |       |           | i |            |
|      |                            |       |           | l |            |
|      |                            |       |           | l |            |
|      |                            |       |           | a |            |
|      |                            |       |           | u |            |
|      |                            |       |           | t |            |
|      |                            |       |           | o |            |
|      |                            |       |           | - |            |
|      |                            |       |           | c |            |
|      |                            |       |           | a |            |
|      |                            |       |           | l |            |
|      |                            |       |           | c |            |
|      |                            |       |           | u |            |
|      |                            |       |           | l |            |
|      |                            |       |           | a |            |
|      |                            |       |           | t |            |
|      |                            |       |           | e |            |
|      |                            |       |           | t |            |
|      |                            |       |           | h |            |
|      |                            |       |           | e |            |
|      |                            |       |           | t |            |
|      |                            |       |           | o |            |
|      |                            |       |           | t |            |
|      |                            |       |           | a |            |
|      |                            |       |           | l |            |
+------+----------------------------+-------+-----------+---+------------+

> INSTRUCTIONS FOR HEDA FORM A

Number of Homeless Students and Natural Disaster Identifications

1.  Enter in Column 5 the number of enrolled K-12 students made homeless
    by any of the federally-declared natural disasters in 2008 listed by
    the Federal Emergency Management Agency (FEMA). For additional
    information and for the most up-to-date list of federally-declared
    natural disasters in 2008 listed by FEMA, see
    <http://www.fema.gov/news/disasters.fema#sev1>.

2.  An LEA should not count a student made homeless by a natural
    disaster in 2008 more than once. If a student was made homeless by
    more than one natural disaster, count the student for any one for
    which you have a verifiable and auditable record.

3.  Only students who were [enrolled]{.underline} by the LEA should be
    counted.

4.  You do not need to enter "0" next to the natural disasters for which
    no homeless student identification or enrollment resulted.

5.  Consortia should enter in Column 5 aggregate numbers for all
    participating LEAs.

6.  The total is auto-calculated. Check that the total number of
    students whose homelessness is tied to one of these natural
    disasters is 50 or higher to be eligible for a grant award.

> **HEDA FORM B**
>
> **Number of Homeless Students and Natural Disaster Identifications**
>
> (Required for Consortia Applicants Only)

  --------------------- --------------------- ----------------------------
  Column (1)            Column (2)            Column (3)

  Legal Name of each    NCES Identification   Number of K-12 Students in
  LEA in consortium     Number of each LEA in each LEA who were homeless
                        consortium            as a result of a natural
                                              disaster that occurred in
                                              2008

                                              

                                              

                                              
  --------------------- --------------------- ----------------------------

Will the lead LEA distribute funds under the HEDA program based on each
LEA's proportionate share of the total number of students made homeless
by natural disasters?

  -----------------------------------------------------------------------

  -----------------------------------------------------------------------

YES

  -----------------------------------------------------------------------

  -----------------------------------------------------------------------

NO

If no, describe the alternate needs-based method for distributing funds
among participating LEAs agreed upon in writing by all members of the
LEA consortium

> **INSTRUCTIONS FOR HEDA FORM B (REQUIRED FOR CONSORTIA ONLY)**

1.  Enter in Column (1) the full legal name of every LEA participating
    in the consortium.

2.  Enter in Column (2) the NCES number for each participating LEA.

3.  Enter in Column (3), for each participating LEA, the total number of
    enrolled K-12 students who were made homeless by a 2008 natural
    disaster. These students must be included in HEDA Form A in the
    aggregate count of students for the consortia who were made homeless
    by the specific natural disasters listed in that form.

NOTES:

-   It is the responsibility of both the lead LEA for the consortium and
    each participating LEA to have accurate data and auditable records
    on the numbers of homeless students enrolled who were made homeless
    by a natural disaster.

-   The total number of students made homeless by a natural disaster who
    are enrolled in all the LEAs participating in the consortium must
    equal the total number reported on HEDA Form A, which aggregates the
    data for all participating LEAs.

[^1]: For purposes of the HEDA program, a natural disaster is one for
    which the President declared a major disaster under Title IV of the
    Robert T. Stafford Disaster Relief and Emergency Assistance Act of
    1974.