U.S. Department of Education

Office of Postsecondary Education

Washington, DC 20202

![](media/image1.wmf)

Request for Fiscal Year 2003 Designation as an Eligible Institution

*for the*

Strengthening Institutions Program

American Indian Tribally Controlled Colleges and Universities Program

Alaska Native and Native Hawaiian-Serving Institutions Program

and the

Developing Hispanic-Serving Institutions Program

**(CFDA Number: 84.031 H)**

**Form Approved**

**OMB NO. 1840-0103, ED FORM 1049**

**Expiration Date: October 31, 2004**

Closing Dates: January 31, 2003 and May 23, 2003

**FISCAL YEAR 2003**

**DESIGNATION AS AN ELIGIBLE INSTITUTION**

**FOR THE**

**STRENGTHENING INSTITUTIONS PROGRAM**

**AMERICAN INDIAN TRIBALLY CONTROLLED COLLEGES AND UNIVERSITIES
PROGRAM**

**ALASKA NATIVE AND NATIVE HAWAIIAN-SERVING**

**INSTITUTIONS PROGRAM**

**AND THE**

**DEVELOPING HISPANIC-SERVING INSTITUTIONS PROGRAM**

**TABLE OF CONTENTS**

Dear Eligibility Applicant
Letter........................................................... Page
ii

Application for Designation as an Eligible Institution Form (ED Form
1049).. Page 3

Instructions for Completing the Application for Designation as an
Eligible Institution Form (ED Form
1049)...................................................................
Page 6 - 23

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## October, 2002

Dear Applicant:

We are pleased to provide the application for fiscal year (FY) 2003
designation as an eligible institution for programs funded under Title
III, Part A and Title V of the Higher Education Act of 1965, as amended.
This booklet includes the information, instructions and forms you need
to apply for eligibility designation.

Eligibility designation qualifies an institution of higher education
(IHE) to receive grants under the Title III, Part A and Title V
programs. Title III, Part A authorizes the Strengthening Institutions,
American Indian Tribally Controlled Colleges and Universities, and
Alaska Native and Native Hawaiian-Serving Institutions Programs. Title V
authorizes the Developing Hispanic-Serving Institutions Program. The
overall purpose of these programs is to assist eligible IHEs to improve
their academic programs, institutional management and fiscal stability.
To receive grants under these programs, an IHE also must meet
program-specific eligibility requirements.

In addition, eligibility designation allows IHEs to receive a waiver of
certain non-Federal share requirements under the Federal Work Study
Program, the Federal Supplemental Educational Opportunity Grants
Program, the Student Support Services Program and the Undergraduate
International Studies and Foreign Language Program.

All IHEs interested in applying for new FY 2003 Title III, Part A or
Title V grants, including IHEs currently receiving funds under Title
III, Part A or Title V, must apply for eligibility designation by the
January 31, 2003 deadline. IHEs interested only in obtaining a waiver of
certain cost-sharing requirements must apply for eligibility designation
by the May 23, 2003 deadline. IHEs interested in both applying for new
Title III, Part A or Title V grants, and obtaining a waiver of
cost-sharing, must apply for eligibility designation by the January 31,
2003 deadline.

# IHEs who are currently receiving Title III, Part A or Title V funds, but are not applying for new FY 2003 grants, and IHEs designated as Historically Black Colleges and Universities, do not need to apply for eligibility designation.

We strongly encourage you to complete the eligibility application early
and to submit it electronically. Please make sure you submit the
application by the pertinent deadline date. If we can be of help, please
contact us at the phone numbers or e-mail addresses cited in the
eligibility instructions.

Sincerely,

Wilbert Bryant

Deputy Assistant Secretary

for Higher Education Programs

**INSTRUCTIONS FOR COMPLETING THE**

**APPLICATION FOR DESIGNATION AS AN ELIGIBLE INSTITUTION**

**UNDER TITLE III AND TITLE V FORM (ED FORM 1049)**

-   **Study the eligibility application form (ED Form 1049) and the
    instructions for completing the form. Then go on to the Internet and
    access the same under the "eligibility 2003" link at either of the
    following web sites:**

> www.ed.gov/offices/OPE/HEP/idues/title3a.html
>
> www.ed.gov/hsi

-   Log on to the Internet after November 1, 2002 and **access the
    eligibility application form (ED Form 1049)** using the following
    site:

webprod.cbmiweb.com/title3and5/index.html

-   You will need your institution\'s unique 8-digit identifier,
    referred to as the OPE Identification (OPE ID) number, in order to
    electronically retrieve and complete a valid eligibility application
    form. If we sent you a hard copy of the eligibility booklet in the
    mail, we posted your institution's OPE ID number on the mailing
    label. If, for some reason, your institution's OPE ID number is not
    readily available, **check with your business officer or student
    financial aid officer as they will very likely have that OPE ID
    number**. If not, contact our program office by calling
    202-502-7777, 7577, 7580 or 7583 or e-mailing the eligibility
    contact persons:

> Thomas.Keyes@ed.gov
>
> Ellen.Sealey@ed.gov
>
> Margaret.Wheeler@ed.gov

-   Periodically in these instructions, we refer to certain sections of
    program regulations. We anticipate that you will [not]{.underline}
    need to read the program regulations because we have attempted to
    make these eligibility instructions all-inclusive. However, in the
    event you wish to check a

> regulation governing the Title III Part A Programs or the Title V
> Developing Hispanic-Serving Institutions Program, you may do so at the
> following web site:
>
> <http://www.ed.gov/legislation/FedRegister/finrule/1999-4/121599a.html>

-   Only **individual** institutions, including free-standing branch
    campuses, may apply for designation as an eligible institution. A
    higher education system, foundation or district may not apply on
    behalf of individual institutions.

-   Submit data pertinent solely to your institution, no matter whether
    your institution normally maintains and submits data to the U. S.
    Department of Education as part of a single filing by a higher
    education system for all institutions within that system or by a
    district for all institutions within that district.

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-   **To be designated as eligible as a branch campus**, an institution
    must meet the needy student enrollment requirement, the educational
    and general expenditures requirement, and the definition of a branch
    campus. The regulations at 34 CFR Part 606.7(b) and 34 CFR Part 607.
    7(c) define "branch campus" to mean a unit of a college or
    university that is geographically apart from the main campus. We
    consider a unit of a college or university to be independent of the
    main campus if the unit is permanent in nature, offers courses for
    credit and programs leading to an associate or bachelor's degree,
    and is autonomous to the extent that it has its own faculty and
    administrative or supervisory organization and its own budgetary and
    hiring authority. If your institution is applying for eligibility as
    a branch campus, provide the eligibility data pertinent only to that
    particular campus.

-   After completing the form electronically, double check to see that
    all of your figures are accurate, use the print button and only then
    use the submit button.

-   If your institution does **not** meet the needy student enrollment
    requirement and/or the educational and general expenditures
    requirement(s) and you need to include a narrative with your
    eligibility application form, complete your request for eligibility
    on-line, print the form, and press the submit button. On or before
    the appropriate closing date, e-mail your narrative waiver
    request(s) to the eligibility contact persons and, then, mail your
    signed narrative waiver request(s) with the printed eligibility
    application form to:

> **U.S. Department of Education**
>
> **Institutional Development and Undergraduate**
>
> **Education Service (IDUES)**
>
> **1990 K Street, N.W.**
>
> **Request for Eligibility Designation**
>
> **Attention: Thomas Keyes, Room 6048**
>
> **Washington, D.C. 20202-8513**

-   If you do not have internet access, study the hard copy eligibility
    application booklet with the instructions and form, complete the
    form, have the president or duly authorized representative sign it,
    complete your request for eligibility, and mail it, as soon as
    possible but no later than the appropriate closing date, to the
    address above. You may duplicate the form or construct the form on
    your computer.

-   You are responsible for verifying the accuracy and completeness of
    the data you submit. We are unable to notify institutions of errors
    or omissions in their data.

## PART I. IDENTITY OF APPLICANT

### Part I, Item 1. NAME OF INSTITUTION/CAMPUS

Use your institution\'s complete name. If your institution is a branch
campus, use the parent institution\'s name but follow it with the name
of the branch campus. E.g., You would identify the State University of
New York, Brockport campus as \"SUNY Brockport.\"

Enter the name of the institution in the spaces provided.

If your institution\'s name changed within the last 2 years, include the
former name on the appropriate line provided in Part V of the hardcopy
eligibility application form.

PART I, ITEMS 2 THROUGH 5.

Self explanatory.

**PART I, ITEM 6. DATA UNIVERSAL NUMBERING SYSTEM (DUNS) NUMBER**

**Enter your institution's DUNS number in the spaces provided.**

[DUNS Number]{.underline}: Dun and Bradstreet assigns your
institution\'s 9 digit DUNS number. Your business office will likely
know your institution's DUNS NUMBER. If not, you can obtain it at no
charge by calling 1-800-333-0505 or by completing a DUNS Number Request
Form. Obtain the form using the following web site:

<http://www.dnd.com/dnhome.htm>

### PART I, ITEM 7. TYPE OF INSTITUTION

Enter your institution\'s type: **Identify the institution as either a
2-year or 4-year institution of higher education.**

If your institution recently changed its status from 2-year to 4-year,
identify the institution as 4-year.

If your institution offers only a 2-year certificate program designed to
prepare a student to work as a technician, or at the semiprofessional
level in technological fields, identify it as a 2-year institution. On a
separate sheet of paper, briefly justify your institution's inclusion
within the regulatory definition of \"junior or community college\". The
regulations found at 34 CFR Part 606.7(b) and at 34 CFR Part 607.7(c)
define a junior or community college as an institution of higher
education that provides an educational program of not less than 2 years
that is acceptable for credit toward a bachelor's degree or that offers
a 2-year program in engineering, mathematics, or the physical or
biological sciences designed to prepare a student to work as a
technician or at the semiprofessional level in engineering, scientific,
or other technological fields requiring the understanding and
application of basic engineering, scientific, or mathematical principles
of knowledge.

If the institution offers both undergraduate and graduate education,
identify it as a 4-year institution.

If the institution operates a freestanding medical school, offering
graduate or postgraduate medical education, identify it as a medical
school. On a separate sheet of paper, explain how your educational
program makes a substantial contribution to providing opportunities for
minorities and economically disadvantaged students.

**PART I, ITEM 8. CONTROL OF INSTITUTION**

Identify the institution as either a private, nonprofit institution or a
public institution.

A private, non-profit institution is one that does not operate under
public or state, local or Indian tribal government supervision or
control.

A public institution is one that operates under the administrative
supervision or control of a government other than the Federal
Government.

#### PART II. INSTITUTIONAL ENROLLMENT

**PART II, ITEM 1. TOTAL INSTITUTIONAL FALL 1999 HEADCOUNT ENROLLMENT**

Determine the institution\'s opening **Fall 1999** academic term
**headcount for enrolled undergraduate and graduate students.**

Do not include foreign students who are not eligible to participate in
Title IV need-based financial assistance programs.

Enter this number in the spaces provided.

**PART II, ITEM 2. FALL 1999 MINORITY STUDENT HEADCOUNT ENROLLMENT**

Determine the institution\'s opening **Fall 1999** academic term
**headcount for enrolled undergraduate and graduate minority students.**

Do not include foreign students who are not eligible to participate in
Title IV need-based financial assistance programs.

The Regulations at 34 CFR Part 606.7(b) and Part 607.7(c) identify
minority groups to include individuals who are Alaska Natives, American
Indians, Asian-Americans, Blacks (African-Americans), Hispanic
Americans, Native Hawaiians, or Pacific Islanders.

Enter this number in the spaces provided.

#### PART III. INSTITUTIONAL STATISTICS

### ITEM 1. Needy Student Requirement

**Fill out Part III, Items 1A through 1D using the following
instructions.**

PART III, ITEM 1.A. Fall 1999 Headcount Enrollment of Undergraduate
Degree Students

Determine the institution\'s total opening **Fall 1999 academic term
headcount for undergraduate students who were enrolled** **in a degree
program**. The regulations at 34 CFR Part 606.7(b) and at 34 CFR Part
607.7(c) define "degree student" to mean a student who enrolls at an
institution for the purpose of obtaining the degree, certificate or
other recognized educational credential offered by the institution. We
consider the transcript that a student receives for the successful
completion of a two-year transfer program to be an "other recognized
educational credential."

Do not include foreign students who are not eligible to participate in
Title IV need-based assistance programs.

In determining the undergraduate student headcount, include all
undergraduate students who were enrolled in a program that results in
the award of a bachelor's degree, those enrolled in a two-year transfer
program, those enrolled in a two-year educational program that results
in the award of an associate degree and those enrolled in a vocational
or technical program of at least two years in length which results in
the award of a certificate that testifies the student qualifies to work
as a technician or at the semiprofessional level in technological
fields.

Enter the total headcount in the spaces provided under Part III, Item
1.A.

PART III, ITEM 1.B. Fall 1999 RECIPIENTS OF TITLE IV NEED-BASED
FINANCIAL ASSISTANCE

Determine the institution\'s total opening Fall 1999 academic term
**unduplicated** student headcount for **undergraduate** degree students
who received the following categories of Title IV need-based assistance:
**Federal Pell Grant, Federal College Work Study, Federal Perkins Loan
or Federal Supplemental** **Educational Opportunity Grant.** To compute
the unduplicated student headcount, [count only once]{.underline} each
student who received Title IV need-based assistance, regardless of the
number of need-based programs in which the student participated. In
determining the headcount, include all students who were enrolled in a
program that results in a bachelor's degree, those enrolled in a
two-year transfer program, those enrolled in a two-year education
program which results in the award of an associate degree, and those
enrolled in a vocational or technical program of at least two years in
length and which results in the award of a certificate that testifies
the student qualifies to work as a technician or at the semiprofessional
level in technological fields.

Enter the total headcount in the spaces provided under item Part III,
Item 1.B.

**PART III, ITEM 1.C. FALL 1999 ENROLLMENT OF HALF-TIME UP TO AND
INCLUDING FULL-TIME UNDERGRADUATE DEGREE STUDENTS**

Determine the institution\'s total opening **Fall 1999 academic term
undergraduate student headcount for students who were enrolled half-time
up to and including full-time in degree** **programs at your
institution**. Include only those students who were enrolled in a
program that results in the award of a bachelor's degree, those enrolled
in a two-year transfer program, those enrolled in a two-year educational
program that results in the award of an associate degree and those
enrolled in a vocational or technical program of at least 2-years in
length and which results in the award of a certificate that testifies
the student qualifies to work as a technician or at the semiprofessional
level in technological fields.

Do not include foreign students who are not eligible for Title IV
need-based financial assistance.

Enter the total headcount in the spaces provided under Part III, Item
1.C.

**PART III, ITEM 1.D. FALL 1999 PELL GRANT RECIPIENTS**

Determine your institution\'s total opening **Fall 1999 academic term
undergraduate headcount of students who received Pell grants for the
opening Fall 1999 academic term.**

Include Pell grant recipients who were enrolled in a program that
results in the award of a bachelor's degree, those enrolled in a
two-year transfer program, those enrolled in an educational program that
results in the award of an associate degree and those enrolled in a
vocational or technical program of at least two years in length and
which results in the award of a certificate that testifies the student
qualifies to work as a technician or at the semiprofessional level in
technological fields.

Enter the total undergraduate headcount of Pell grant recipients in the
boxes provided under Part III, Item 1.D.

**PART III, ITEM 2. EDUCATIONAL & GENERAL (E&G) EXPENDITURES
REQUIREMENT**

**Fill out PART III, Items 2.A through 2.D using the following
instructions.**

**PARTIII, ITEM 2.A. UNDERGRADUATE FULL-TIME EQUIVALENT FALL 1999
ENROLLMENT**

**Determine the institution\'s full-time equivalent (FTE) Fall 1999
enrollment of undergraduate students**, including both full-time
students and part-time students. The regulations at 34 CFR Part 606.7(b)
and 34 CFR Part 607.7(c) describe how you are to calculate your
full-time equivalent enrollment and the instructions below paraphrase
those regulations.

In determining the undergraduate FTE enrollment, do not include students
who were enrolled in an educational program of less than two years in
length and which do not result in the award of a certificate, an
associate degree or other recognized educational credential offered by
the institution. We consider the transcript that a student receives for
the successful completion of a two-year transfer program to be an "other
recognized educational credential".

Whatever the full-time load is at your institution, count a full-time
undergraduate degree student as one FTE.

To determine the FTE for part-time undergraduate students, total the
number of credit hours of all part-time undergraduate students. Include
both part-time degree students and part-time unclassified students. An
unclassified undergraduate student is one who is not a candidate for a
degree or other formal award, but is taking courses for credit in
regular classes with undergraduate degree students. However, both
classified and unclassified undergraduate students must be enrolled in a
program of at least two years in length that would result in the award
of a certificate, associate degree or other educational credential.

Divide the total number of credit hours for the part-time undergraduate
students by twelve. The result is the FTE for part-time undergraduate
students.

To calculate the total Fall 1999 undergraduate degree FTE: Add the FTE
of full-time undergraduate degree students and the FTE of part-time
undergraduate students enrolled at the institution in Fall 1999.
**\[NOTE: This number should not exceed the total institutional
enrollment entered under Part II, item 1.\].**

Enter the total Fall 1999 undergraduate degree FTE in the spaces
provided under Part III, Item 2.A.

**PART III, ITEM 2.B. GRADUATE FULL-TIME EQUIVALENT FALL 1999
ENROLLMENT**

**Determine the institution\'s full-time equivalent (FTE) Fall 1999
enrollment of graduate students, if any, including both full-time and
part-time students, as explained here.**

A full-time graduate degree student is one whose academic load, that is,
course work and other required activities, totals at least 9 credit
hours.

Count each full-time graduate degree student as one FTE student.

To determine the FTE of part-time graduate students, total the number of
credit hours of all part-time graduate students then divide the total by
nine. In totaling the number of credit hours of all part-time graduate
students, include both part-time degree students and part-time
unclassified students. An unclassified graduate student is one who is
not a candidate for a degree or other formal award, but is taking
courses for credit in regular classes with graduate degree students.

To calculate the total graduate degree FTE: Add the FTE of full-time
graduate degree students and the FTE of part-time graduate students,
then multiply this total by 2.5. This final figure is the graduate
degree FTE.

Enter the Fall 1999 total graduate degree FTE in the spaces provided
under Part III, Item 2.B.

**PART III, ITEM 2.C. TOTAL EDUCATIONAL AND GENERAL EXPENDITURES**

Determine the institution\'s E&G expenditures for the base year July 1,
1999-

June 30, 2000. The regulations at 34 CFR Part 606.7(b) and 34 CFR Part
607.7(c) define E&G expenditures as **the total amount expended by the
institution for: instruction, research, public service, academic support
including library expenditures, student services, institutional support,
scholarships and fellowships, operation and maintenance of physical
plant, and any mandatory transfers that the institution is required to
pay** **by law.** In determining the institution\'s E&G expenditures,
total these costs.

Do not include Federal Student Financial Aid. Exclude the total amount
*directly attributable* to students who are not eligible to participate
in Title IV need-based financial assistance as well as students in
vocational or technical programs of less than two years in length and
which do not result in the award of either a 2-year certificate or an
associate degree or other recognized educational credential such as the
transcript that a student receives for the successful completion of a
two-year transfer program.

Enter the total 1999-2000 E&G expenditures in the spaces provided under
Part III, Item 2.C.

**PART III, ITEM 2.D. AVERAGE EDUCATIONAL AND GENERAL EXPENDITURES PER
FTE STUDENT**

Determine the institution\'s average E&G expenditures per FTE for
1999-2000. To calculate this figure:

> **Add the Fall 1999 undergraduate FTE (Part III, Item 2.A) and the
> Fall 1999 graduate FTE, if any (Part III, Item 2.B). Then divide the
> institution\'s total E&G expenditures (Part III, Item 2.C) by the
> total FTE (Part III, Items 2.A + 2.B).** The result is your
> institution\'s average E&G expenditures for the 1999-2000 base year.
>
> Enter this number - rounded to the nearest dollar - in the spaces
> provided under Part III, Item 2.D.
>
> **[Example]{.underline}**
>
> Fall 1999 undergraduate FTE is 1000
>
> Fall 1999 graduate FTE is 250 (100 students X 2.5)
>
> TOTAL FALL 1999 FTE is 1,250
>
> Institution\'s total E&G expenditures are \$8,750,000
>
> Institution\'s average E&G expenditures for Fall 1999 is \$7,000 \-\--
> (\$8,750,000 divided by 1,250)

**PART IV. SPECIFIC INSTITUTIONAL**

####### ELIGIBILITY REQUIREMENTS

**Part IV, Item 1. NEEDY STUDENT REQUIREMENT.**

**Use the following instructions to determine whether your institution
meets the needy student requirement in [at least one of two possible
ways. ]{.underline}**

**YOUR INSTITUTION MEETS THE NEEDY STUDENT REQUIREMENT IF:**

> **A. At least 50% of its Fall 1999 unduplicated student headcount for
> undergraduate degree students received financial assistance under one
> or more of the following programs: Federal Pell Grant, Federal College
> Work Study, Federal Perkins Loan or Federal Supplemental Educational
> Opportunity Grant.**
>
> **Or**
>
> **B. The percentage of its Fall 1999 undergraduate degree students who
> were enrolled on at least a half-time basis and received Federal Pell
> grants [exceeded the median]{.underline} percentage of undergraduate
> degree students who were enrolled on at least a half-time basis and
> received Federal Pell Grants** at comparable institutions that offered
> similar instruction.

**Part IV, ITEM 1. A. At least 50% or more of Fall 1999 degree students
were recipients of need-based financial support.**

If your institution **meets** the needy student requirement because **50
percent or more** of its Fall 1999 enrolled degree students received the
above-mentioned Title IV need-based financial assistance, fill in the
bubble next to Part IV, Item 1.A. **If the percentage turns out to be
less than 50%, leave the bubble blank next to Part IV, Item 1.A.**

+-----------------------------------------------------------------------+
| ***Needy Student Calculation (EXAMPLE)***                             |
|                                                                       |
| ***(Bubble A)***                                                      |
|                                                                       |
| *To determine whether your institution meets the statutory needy      |
| student requirement for the base year 1999-2000, divide the number of |
| Fall 1999 Title IV recipients (Part III, Item 1.B) by the Fall 1999   |
| enrollment of degree students (Part III, Item 1.A). The result (Part  |
| III 1.B divided by Part III 1.A) is the percentage of needy students  |
| enrolled in the institution for the base year. If the result is [50   |
| percent or more]{.underline}, your institution meets the statutory    |
| needy student requirement threshold. The regulations at 34 CFR Part   |
| 606.3(a)(1) and at 34 CFR Part 607.3(a)(1) describe the needy student |
| requirement.*                                                         |
|                                                                       |
| *[Example]{.underline}*                                               |
|                                                                       |
| ‚ *Fall 1999 enrollment (Part III 1.A) = 800 degree students*         |
|                                                                       |
| ‚ *Fall 1999 Title IV recipients (Part III 1.B) = 600 students*       |
|                                                                       |
| ‚ *Percentage of recipients of need-based financial support*          |
|                                                                       |
| *= 75% (600 divided by 800)*                                          |
|                                                                       |
| *The example institution meets the needy student requirement because  |
| 50 percent or more of its Fall 1999 degree students received          |
| need-based financial support.*                                        |
+=======================================================================+
+-----------------------------------------------------------------------+

### Part IV, ITEM 1.B. The percentage of Federal Pell Grant recipients at the applicant institution exceeded the median percentage at similar institutions. 

If your institution **meets** the statutory needy student requirement
because the percentage of its Fall 1999 enrolled students that received
Pell grants [exceeded the median]{.underline} Federal Pell Grant
percentage for its category of institutions (see below), **fill in the
bubble** next to Part IV, Item 1.B. If your percentage **does not
exceed** the median Federal Pell Grant percentage for your category of
institution, **leave the bubble blank next to Part IV, Item** **1.B.**

**If the institution meets both Part IV, Items 1.A and 1.B, fill in the
bubbles next to [both]{.underline} Part IV, Item 1.A and Item 1.B.**

+-----------------------------------------------------------------------+
| ***Needy Student Calculation (EXAMPLE)***                             |
|                                                                       |
| (Bubble B)                                                            |
|                                                                       |
| *To determine if your institution meets the statutory needy student   |
| requirement for the 1999-2000 base year, **divide the number of Fall  |
| 1999 Pell grant recipients (Part III Item 1.D) by the Fall 1999       |
| enrollment of half-time up to and including** **full-time degree      |
| students (Part III Item 1.C).** The result (Part III 1.D divided by   |
| Part III 1.C) is the percentage of Pell grant recipients enrolled in  |
| the institution for the base year. If this result **exceeds** the     |
| \"Median Federal Pell Grant Percentage\" for your category of         |
| institution, your institution meets the statutory needy student       |
| requirement threshold.*                                               |
|                                                                       |
| *[Example]{.underline}*                                               |
|                                                                       |
| Fall 1999 enrollment of half-time to full-time degree students        |
|                                                                       |
| (Part III 1.C) = 750                                                  |
|                                                                       |
| *Fall 1999 Pell grant recipients (Part III 1.D) = 250)*               |
|                                                                       |
| *Fall Pell grant percentage = 33.33% (250 divided by 750)*            |
|                                                                       |
| Here are the median Federal Pell Grant percentages or thresholds for  |
| base year 1999-2000:                                                  |
|                                                                       |
| **For 2-year public institutions, the median = 18.9%**                |
|                                                                       |
| **For 2-year non-profit private institutions, the median = 31%.**     |
|                                                                       |
| ##### **For 4-year public institutions, the median = 23.5%**          |
|                                                                       |
| **For 4-year non-profit private institutions, the median = 23.4%.**   |
|                                                                       |
| *Since in our example, the institution's Pell Grant percentage is     |
| [greater]{.underline} than the median Pell grant percentage for any   |
| category of institution, the example institution meets the needy      |
| student requirement.*                                                 |
+-----------------------------------------------------------------------+

PART IV, ITEM 1.C. YOU ARE REQUESTING A WAIVER OF THE NEEDY STUDENT
REQUIREMENT.

If the institution **does not meet** the statutory needy student
requirement, **under either** the Title IV need-based financial
assistance 50% threshold **or** the appropriate Pell grant threshold,
you may request a waiver of this requirement. Before doing so, **study
below the seven possible options under which you may attempt to make
your case that we grant you a waiver**. These options correspond to the
seven options listed in the regulations at 34 CFR Part 606.3(b) and 34
CFR Part 607.3(b).

Fill in the bubble corresponding to Part IV, Item 1.C, denoting that you
are requesting a waiver.

After you review the seven possible options for requesting a waiver of
the needy student requirement, select the option(s) that applies to your
institution's particular case. [You may apply under more than one option
if you wish]{.underline}. Check the appropriate box(es) at Part IV, Item
1.C, \"(1)-(7)\",corresponding to the option(s) under which you are
applying for a waiver.

Prepare a narrative, on a separate sheet(s) of paper, providing the
required evidence that shows the chosen waiver option(s) does, indeed,
apply to your particular institution. **The narrative must contain
persuasive and compelling evidence [following the instructions detailed
below.]{.underline}**

***[Needy Student Waiver Option #1]{.underline}, 34 CFR 606.3(b)(1) and
607.3(b)(1)***

Provide evidence that the **State provided more than 30 percent of your
institution's budget** for the 1999-2000 base year.

## AND

Provide evidence that your institution charged **not more than**
\$**99.00 per student for the entire 1999-2000 academic year's tuition
and fees.**

[Needy Student Waiver Option #2]{.underline}, 34 CFR 606.3(b)(2) and
607.3(b)(2)

Provide evidence that **at least 30 percent** of the students served by
your institution in the 1999-2000 base year **were students from
low-income families.**

The regulations at 34 CFR Part 606.7(c) and 34 CFR 607.7(b) define a low
income individual to be one from a family whose taxable income for the
base year did not exceed 150% of an amount equal to the poverty level as
determined by the Bureau of the Census. In the Notice Inviting
Applications for eligibility included below, we stated the low-income
figures for the 1999-2000 base year.

***[Needy Student Waiver Option #3,]{.underline} 34 CFR 606.7(3)(b) and
607.3(b)(3)***

Provide evidence that your institution, in the base year,
**substantially increased the higher education opportunities for
low-income students who were also educationally disadvantaged, or from
groups underrepresented in postsecondary education, or were minority
students**. The program regulations at 34 CFR 606.7(b) and 607.7(c)
define \"*educationally disadvantaged*\", \"*minority student*\" and
\"*underrepresented*\"*.*

Include *ALL* the following information:

l\. A description of the student body characteristics, including the
racial/ethnic composition and the number of low-income students, for the
1999-2000 base year.

2\. The number of low-income students for the base year 1999-2000 who
were also educationally disadvantaged, from groups underrepresented in
postsecondary education, or minority students.

3\. A description of the programs and services in place during the
1999-2000 base year that were specifically designed to increase the
educational opportunities for the low income students who were also
educationally disadvantaged, from groups underrepresented in higher
education or minority students.

4\. A longitudinal progression detailing the number of these students
served by the institution's programs and services during the past five
academic periods: 1996-1997, 1997-1998, 1998-1999, 1999-2000, and
2000-2001.

[Needy Student Waiver Option #4,]{.underline} 34 CFR 606.3(b)(4) and
607.3(b)(4)

Provide evidence that your institution substantially increased the
higher education opportunities in the 1999-2000 base year **for
individuals who resided in an area that is not included in a
\"metropolitan statistical area**\" (MSA) as defined by the Office of
Management and Budget and who were unserved by other postsecondary
institutions.

Include *ALL* of the following information:

1\. The geographical areas of residence for enrolled students in the
1999-2000 base year including:

the percentage of enrolled students from MSAs; and

the percentage of enrolled students from locations [outside]{.underline}
an MSA.

2\. A map or scale drawing showing the geographically isolated or rural
nature of your institution's location. Include its geographic
relationship to the nearest other institution(s) of higher education and
nearest MSA; and the mileage between the institution and other
institutions and the nearest MSA.

3\. A description of the geographic barriers and climatic and other
conditions that limit the options of individuals to attend other
institutions.

4\. A brief longitudinal progression detailing the number of enrolled
students served by the applicant institution during the past five
academic periods: 1996-1997, 1997-1998, 1998-1999, 1999-2000, and
2000-2001 -- who resided in areas [outside]{.underline} the boundaries
of an MSA.

[Needy Student Waiver Option #5,]{.underline} 34 CFR 606.3(b)(5) and
607.3(b)(5)

Provide evidence that your institution is located **on or within 50
miles of an American Indian reservation or of a substantial population
of American Indians**, and that the institution will substantially
increase higher education opportunities for American Indians. In
addressing \"higher education opportunities for American Indians\"
include both student enrollment and retention.

Include *ALL* the following information:

1\. A map or scale drawing showing your institution\'s location in
relation to the American Indian reservation or population center.
Include the mileage between the institution and the reservation or
population center.

2\. A description of the student body characteristics for the 1999-2000
base year and the two academic years following the base year (2000-2001
and 2001-2002). Include the racial/ethnic composition, and specifically
identify the number and percentage of American Indian students by
full-time and part-time status.

3\. Describe the programs and services in place during the 1999-2000
base year and the two academic years following the base year (2000-2001
and 2001-2002) that were specifically designed to increase the higher
educational opportunities for American Indians.

4\. Describe your institution\'s plans to develop and implement programs
and services specifically designed to increase the higher educational
opportunities for American Indians.

5\. Describe the institution\'s enrollment goals for American Indian
students for the next three academic years (2003-2004, 2004-2005 and
2005-2006). Detail the institution\'s plans to meet these goals.

[Needy Student Waiver Option #6,]{.underline} 34 CFR 606.3(b)(6)
607.3(b)(6):

Your institution meets the definition of a **tribally controlled college
or university** as defined in section 2 of the Tribally Controlled
College or University Assistance Act of 1978. Please provide a
certification that supports your institution meets this definition.

***[Needy Student Waiver Option #7]{.underline}, 34 CFR 606.3(b)(7) and
607.3(b)(7):***

Provide evidence that your institution **will substantially increase
higher education opportunities for American Indians, Alaska Natives,
Black Americans, Hispanic Americans, Asian Americans, Pacific Islanders
or Native Hawaiians.** In addressing \"higher education opportunities\"
include both student enrollment and retention.

Include *ALL* of the following information:

1\. A description of the student body characteristics for the 1999-2000
base year and the two academic years following the base year (2000-2001
and 2001-2002). Include the racial/ethnic composition and specifically
identify the number and the percentage for each racial/ethnic group
listed above by full-time and part-time status.

2\. Describe the programs and services in place during the 1999-2000
base year and the two academic years following the base year (2000-2001
and 2001-2002) that were specifically designed to increase the higher
educational opportunities for one or more of the racial/ethnic groups
listed above.

3\. Describe the programs and services your institution [is currently
developing]{.underline} that are specifically designed to increase the
higher educational opportunities for one or more of the racial/ethnic
groups listed above. Include the projected date(s) for the
implementation of these programs and services.

4\. Describe your institution\'s enrollment goals for one or more of the
racial/ethnic groups listed above for the next three academic years
(2003-2004, 2004-2005 and 2005-2006). Explain in detail the
institution\'s plans to meet these goals.

**Part IV, Item 2. Education & General Expenditures** **Requirement**

> **Your institution meets the E&G expenditures requirement if its
> average E&G expenditures per FTE student cited in Part III Item 2.D.
> is [less than]{.underline} the average E&G per FTE for the same
> category of institution. The average 1999-2000 E&G expenditures per
> FTE student for each category of institution is the following:**
>
> **2 year public institution = \$ 8,348 per FTE student.**
>
> **2 year non-profit private = \$20,101 per FTE student.**
>
> **4 year public institution = \$19,516 per FTE student.**
>
> **4 year non-profit private = \$30,152 per FTE student.**

### Part IV, Item 2.A

Darken bubble 2.A only if your institution's 1999-2000 average E&G
expenditures per FTE is [less than]{.underline} the average E&G
expenditures per FTE student for its category of institution.

###### **Part IV, Item 2.B**

Darken bubble B if your institution [exceeded]{.underline} the E&G
expenditures threshold and you are requesting a waiver.

Put a check next to the number(s) 1 through 5 that corresponds with the
selected waiver option(s). Write a justification for each requested
waiver option.

Instructions for Selecting Waiver Option(s) for the E&G Expenditures
Requirement

Review all five waiver options provided below, and select the option(s)
that applies to your institution's particular case. [You may request
multiple options]{.underline}. You must submit a written justification
with the eligibility application form for each option requested. The
waiver option justification narrative must contain persuasive evidence
that the specific waiver condition exists.

***[E&G Waiver Option #1,]{.underline} 34 CFR 606.4(d)(1) and
607.4(d)(1)***

**Low student enrollment** in the Fall of 1999 distorted your
institution's E&G expenditures per FTE undergraduate student and the
institution's eligible designation is otherwise consistent with the
purposes of the Title III or Title V program. The institution may show
that its enrollment was low relative to the enrollment before the base
year, low relative to the enrollment after the base year, and/or low
relative to other similar institutions in the State.

***[E&G Waiver Option #2,]{.underline} 34 CFR 606.4(d)(2) and
607.4(d)(2)***

Location of the institution in **an unusually high cost-of-living area**
distorted your institution's E&G expenditures per FTE undergraduate
student and the institution's eligible designation is otherwise
consistent with the purposes of the Title III or Title V program.

***[E&G Waiver Option #3]{.underline}, 34 CFR 606.4(d)(3) and
607.4(d)(3)***

**High energy costs** distorted your institution's E&G expenditures per
FTE undergraduate student and the institution's eligible designation is
otherwise consistent with the purposes of the Title III or Title V
program.

***[E&G Waiver Option #4,]{.underline} 34 CFR 606.4(d)(4) and
607.4(d)(4)***

**An increase in State funding that was part of a desegregation plan**
for higher education distorted your institution's E&G expenditures per
FTE undergraduate student and the institution's eligible designation is
otherwise consistent with the purposes of the Title III or Title V
program.

***[E&G Waiver Option #5]{.underline}, 34 CFR 606.4(2)(5) and
607.4(d)(5)***

**Operation of high cost professional schools** such as medical or
dental schools distorted your institution's E&G expenditures per FTE
undergraduate student and the institution's eligible designation is
otherwise consistent with the purposes of the Title III or Title V
program.

For additional information, please refer to the Title III Eligibility
application Website at
www.ed.gov/offices/OPE/HEP/idues/eligibility2003.html.