**U.S. DEPARTMENT OF EDUCATION**

**Washington, DC 20202**

####### Archived Information

![](media/image1.wmf)

**FISCAL YEAR 2007**

**APPLICATION PACKAGE TO REQUEST**

**DESIGNATION AS AN ELIGIBLE INSTITUTION**

**UNDER THE TITLE III AND TITLE V PROGRAMS**

**AND TO REQUEST A WAIVER**

**OF THE NON-FEDERAL COST-SHARE REQUIREMENT**

CLOSING DATES:

March 9, 2007 for Eligibility Designation and

April 30, 2007 for Cost-Share Waiver

CFDA Number: 84:031H

OMB Number: 1840-0103, ED FORM 1049

EXPIRES: 1/31/2008

TABLE OF CONTENTS

Dear Applicant Letter................................................ 1
-- 3

Before You Get Started..........................................\... 4
-- 8

Instructions for Completing the Application................ 9-- 21

APPENDICES

[Federal Register]{.underline} Closing Date Notice Inviting Applications

Application For Designation As An Eligible Institution

(ED Form 1049)

Important Notice to Applicants

Dear Applicant:

We are pleased to provide the application package for fiscal year (FY)
2007 Designation as an Eligible Institution under the following Title
III, Part A, and Title V Programs of the Higher Education Act of 1965,
as amended:

-   STRENGTHENING INSTITUTIONS PROGRAM (SIP);

-   AMERICAN INDIAN TRIBALLY CONTROLLED COLLEGES AND UNIVERSITIES (TCCU)
    PROGRAM;

-   ALASKA NATIVE AND NATIVE HAWAIIAN-SERVING INSTITUTIONS (ANNH)
    PROGRAM; and the

-   DEVELOPING HISPANIC-SERVING INSTITUTIONS (HSI) PROGRAM.

This application package includes the information and instructions that
you need to apply for eligibility designation. Eligibility designation
qualifies an institution of higher education (IHE) to apply for grants
under the above Title III and Title V programs, provided they meet
certain additional program specific eligibility requirements.

The purpose of these programs is to provide funds to eligible
institutions of higher education to increase their self-sufficiency by
improving their academic programs, institutional management and fiscal
stability.

In addition, this application package may be used by IHEs to apply for a
waiver of certain non-Federal cost-share requirements under the
following programs:

-   FEDERAL WORK-STUDY (FWS) PROGRAM;

-   FEDERAL SUPPLEMENTAL EDUCATIONAL OPPORTUNITY GRANTS (FSEOG) PROGRAM;

-   TRIO STUDENT SUPPORT SERVICES (SSS) PROGRAM; and

-   UNDERGRADUATE INTERNATIONAL STUDIES AND FOREIGN LANGUAGE (UISFL)
    PROGRAM.

IMPORTANT INFORMATION: You must read this package in its entirety before
you begin to complete the application. Please make sure that you provide
sufficient responses to ALL applicable questions and that you enter the
correct data throughout the application. Providing accurate information
is essential in expediting the eligibility processes.

-   All institutions (including those designated as Tribally Controlled
    Colleges and Universities and Alaska Native and Native
    Hawaiian-Serving Institutions) interested in applying for a new FY
    2007 Title III or Title V grant MUST apply for eligibility
    designation by the established closing date. You must reapply for
    eligibility EACH year that you wish to apply for a new grant award.

-   IHEs currently receiving Title III, Part A, or Title V funds do not
    need to apply for eligibility designation unless they intend to
    apply for a new grant. *IHEs designated as Historically Black
    Colleges and Universities are statutorily exempt from the
    non-Federal cost-share match requirement and do not need to apply
    for eligibility designation.*

-   FY 2007 applicants will report their required student head count
    figures based solely on their 2004 fall semester enrollment.

-   To further assist you in determining the low-income levels of your
    students, we have included (in the [Federal]{.underline}
    [Register]{.underline} notice) the 2004 low-income figures, as
    determined by the Bureau of the Census.

-   To assist you with calculating your institution's average education
    and general (E&G) expenditures per FTE student, the ED Form 1049 has
    been improved to calculate your institution's E&G expenditures for
    you. See pages 12 and 13 for specific instructions.

-   [If you are interested only in obtaining a waiver]{.underline} of
    certain non-Federal cost-share requirements, you must apply for a
    waiver by the April 30, 2007 closing date.

-   If you are designated as an eligible institution, your waiver of the
    non-Federal cost-share requirement is effective for five consecutive
    years. You will need to request another waiver in 2012.

-   If you are a current Title III or Title V grant recipient, you are
    already entitled to the cost-share waiver.

For FY 2007, all applications must be submitted electronically as
described in this application package. If you wish to apply for a new
grant, please make sure you submit the application by the established
closing date.

**DO NOT WAIT FOR THE HARDCOPY RESULTS OF THE ELIGIBILITY APPLICATION TO
BEGIN THE APPLICATION PROCESS FOR NEW AWARDS IN 2007.** **ONCE YOU HAVE
SUBMITTED YOUR ELIGIBILITY APPLICATION USING THE CONTRACTOR'S WEB SITE,
PLEASE** **PRINT A COPY OF YOUR SUBMISSION FOR YOUR RECORDS. THE
DEPARTMENT WILL NOT BE ABLE TO PROVIDE COPIES.**

If you need further assistance, please contact us at the phone numbers
or e-mail addresses cited in this application package.

> Sincerely,

/signed/

> Susan E. Beaudoin
>
> Acting Deputy Assistant Secretary
>
> Higher Education Programs

**BEFORE YOU GET STARTED**

You must read this entire application package, study the eligibility
application face sheet (ED Form 1049) and collect the required data
before you attempt to complete the application on-line. This application
package may be obtained using the "eligibility 2007" link, at either of
the following Web sites:

[**http://www.ed.gov/programs/iduestitle3a/index.html**](http://www.ed.gov/programs/iduestitle3a/index.html)

> <http://www.ed.gov/hsi>
>
> <http://webprod.cbmiweb.com/title3and5/index.html>

You will need your institution\'s unique 8-digit identifier, referred to
as the Office of Postsecondary Education Identification (OPE ID) number,
in order to electronically retrieve and complete a valid eligibility
application form. If your institution's OPE ID number is not readily
available, your business office or student financial aid office should
have your OPE ID number**.** If not, contact our program office by
calling our main number at 202-502-7777 or any one of the individuals
listed below:

<Imogene.Byers@ed.gov> or 202-502-7672

<Kelley.Harris@ed.gov> or 202-219-7083

[Carnisia.Proctor@ed.gov](mailto:Team.C.rep@ed.gov) or 202-502-7606

Periodically throughout this application package 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/2001-4/121599a.html](http://www.ed.gov/legislation/FedRegister/finrule/1999-4/121599a.html)

Only **individual** accredited institutions, including eligible branch
campuses, may apply for designation as an eligible institution. The
regulations at 34 CFR Part 606.2(a)(6) and 607.2(a)(4) outline the
accrediting requirements. 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.

**[Designation As An Eligible Branch Campus]{.underline}**

To be designated as an eligible branch campus, the branch campus must
meet the needy student enrollment requirement, the educational and
general (E&G) expenditures requirement, and the definition of a branch
campus. The regulations at 34 CFR Part 606.7(b) and 34 CFR Part 607.7(e)
define "branch campus" to mean a unit of a college or university that is
geographically apart from the main campus and independent of that 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.

The Government Paperwork Elimination Act (GPEA) of 1998 (P. L. 105-277)
and the Federal Financial Assistance Management Improvement Act of 1999
(P. L. 106-107) encourage us to undertake initiatives to improve our
grant processes. Enhancing the ability of individuals and entities to
conduct business with us electronically is a major part of our response
to these Acts. Therefore, we are taking steps to adopt the Internet as
our chief means of conducting transactions in order to improve services
to our customers and to simplify and expedite our business processes.

[Note]{.underline}: Some of the procedures in these instructions for
transmitting applications differ from those in the Education Department
General Administrative Regulations (EDGAR) (34 CFR 75.102). Under the
Administrative Procedure Act (5 U.S.C. 553), the Department generally
offers interested parties the opportunity to comment on proposed
regulations. However, these amendments make procedural changes only and
do not establish new substantive policy. Therefore, under 5 U.S.C.
553(b)(A), the Secretary has determined that proposed rulemaking is not
required.

If your institution does **not** meet the needy student enrollment
requirement and/or the educational and general expenditures
requirement(s), and you wish to request a waiver of one or both of these
requirements, you must complete your designation application form and
your waiver request narrative electronically by the \[insert closing
date\] deadline if you are applying for a grant, and by the \[inset
closing date\] deadline if you are applying for a cost-share waiver.

We are requiring that all applications for institutional eligibility
designation for FY 2007 be submitted electronically by going on-line to:

<http://webprod.cbmiweb.com/title3and5/index.html>

You qualify for an exception to the electronic submission requirement,
and may submit your application in paper format, if you are unable to
submit an application electronically because --

-   You do not have access to the internet; or

-   You do not have the capacity to upload the data on-line; and

-   No later than two weeks before the application deadline date (14
    calendar days or, if the fourteenth calendar day before the
    application deadline date falls on a Federal holiday, the next
    business day following the Federal holiday), you mail or fax a
    written statement to the Department, explaining which of the two
    grounds for an exception prevent you from using the Internet to
    submit your application. If you mail your written statement to the
    Department, it must be postmarked no later than two weeks before the
    application deadline date. If you fax your written statement to the
    Department, we must receive the faxed statement no later than two
    weeks before the application deadline date.

Address and mail or fax your statement to: Dr. Maria E. Carrington, U.S.
Department of Education, 1990 K Street, N.W., room 6033, Washington, DC
20202-8513. FAX: (202) 502-7861. Your paper application must be
submitted in accordance with the mail or hand delivery instructions
provided in the official notice published in the [Federal
Register]{.underline}.

**IMPORTANT NOTE:** After completing the form electronically, double
check for accuracy and print a copy for yourself before submitting your
application. When you hit the submit button, the system will display a
message confirming that you have successfully submitted your
application. Save and print this confirmation as proof that you have
submitted your application electronically. If you do not receive this
confirmation, you should assume that we did not receive your
application. Please contact Mrs. Byers, Mrs. Harris or Ms. Proctor at
202-502-7777 or via email (<firstname.lastname@ed.gov>) immediately.
Please do not wait until the last hour to submit your application.

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

**INSTRUCTIONS FOR COMPLETING THE APPLICATION (ED Form 1049)**

**(ELECTRONIC SUBMISSION REQUIRED)**

## [PART I -- IDENTITY OF APPLICANT INSTITUTION]{.underline}

### ITEM 1. INSTITUTION/CAMPUS OPE ID NUMBER

You will need your institution\'s unique 8-digit identifier, referred to
as the Office of Postsecondary Education Identification (OPE ID) number,
in order to electronically retrieve and complete a valid eligibility
application form.

### ITEM 2. 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 (see definition of branch campus on page 5 of the
application package). For example, you would cite the State University
of New York, Brockport Campus.

Enter the name of the institution in the spaces provided.

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

ITEMS 3 THROUGH 6.

Self-explanatory.

**ITEM 7. 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. You may obtain the form using the following Web site:

[http://www.dnb.com](http://www.dnb.com/)

### ITEM 8. 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 the institution offers both undergraduate and graduate education,
identify it as a 4-year institution.

**ITEM 9. CONTROL OF INSTITUTION**

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

#### [PART II - INSTITUTIONAL ENROLLMENT]{.underline}

ITEM 1. TOTAL INSTITUTIONAL ENROLLMENT (Fall 2004 Head Count)

Determine the institution\'s **2004 fall semester** head count of
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 space provided.

ITEM 2. TOTAL MINORITY ENROLLMENT (Fall 2004 Head Count)

Determine the institution\'s **2004 fall semester** head count of
enrolled minority undergraduate and graduate 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(e) defines
minority student to mean a student who is Alaskan Native, American
Indian, Asian-American, Black (African-American), Hispanic American,
Native Hawaiian, or Pacific Islander.

Enter this number in the space provided.

#### [PART III - INSTITUTIONAL STATISTICS]{.underline}

### ITEM 1. NEEDY STUDENT REQUIREMENT

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

ITEM 1.A. FALL 2004 HEAD COUNT ENROLLMENT OF UNDERGRADUATE and GRADUATE
DEGREE STUDENTS

Determine the institution\'s total **2004 fall semester** head count of
undergraduate and graduate degree students who were enrolled in a
**degree** program. The regulations at 34 CFR Part 606.7(b) and at 34
CFR Part 607.7(e) 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 that 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 head count, 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 in the space provided under Part III, Item 1.A.

ITEM 1.B. FALL 2004 RECIPIENTS OF TITLE IV NEED-BASED FINANCIAL
ASSISTANCE

Determine the institution\'s total **2004 fall semester,**
**unduplicated** student head count of degree students who received any
of the following 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 head count, count each student who received Title
IV need-based assistance, regardless of the number of need-based
programs in which the student participated, **only once**.

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

**ITEM 1.C. FALL 2004 ENROLLMENT OF HALF TIME, UP TO AND INCLUDING
FULL-TIME, UNDERGRADUATE STUDENTS**

Determine the institution\'s total **2004-fall semester** undergraduate
head count of students who were enrolled at least **half time** in
degree programs at your institution.

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

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

### ITEM 1.D. FALL 2004 PELL GRANT RECIPIENTS ONLY

Determine your institution\'s total **2004 fall semester** undergraduate
head count of students who received **Pell Grants** for the 2004-2005
academic term. Include Pell Grant recipients who were enrolled in a
program on at least a half-time basis.

Enter the total undergraduate head count of Pell Grant recipients in the
space provided under Part III, Item 1.D.

**ITEM 2. EDUCATIONAL AND GENERAL (E&G) EXPENDITURES REQUIREMENT**

Use the following instructions to complete items 2.A through 2.D.

ITEM 2.A. UNDERGRADUATE FULL-TIME EQUIVALENT, FALL 2004 ENROLLMENT

Determine your institution\'s full-time equivalent (FTE) 2004 fall
semester enrollment of undergraduate students. The regulations at 34 CFR
Part 606.7(b) and 34 CFR Part 607.7(e) describe how you are to calculate
your full-time equivalent enrollment and the instructions below
paraphrase those regulations.

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

To determine the FTE for part-time undergraduate students, enter the
total number of credit hours of all part-time undergraduate students.
That number will automatically be divided by 12. The result is the FTE
for part-time undergraduate students.

The system will then add the total (full-time plus part-time)
undergraduate students. The result is the total number of undergraduate
FTE equivalent FY 2004 enrollment.

**\[NOTE: This number should not exceed the total institutional
enrollment entered under Part II, Item 1.\].**

ITEM 2.B. GRADUATE FULL-TIME EQUIVALENT 2004 FALL ENROLLMENT

Determine the institution\'s full-time equivalent **2004 fall semester**
enrollment of graduate students, if any, including both full-time and
part-time students, as explained here.

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

To determine the FTE for part-time graduate students, enter the total
number of credit hours of all part-time graduate students. That number
will automatically be divided by 12. The result is the FTE for part-time
graduate students.

The system will then add the total (full-time plus part-time) graduate
students. The result is the total number of graduate FTE equivalent FY
2004 enrollment.

### ITEM 2.C. TOTAL EDUCATIONAL AND GENERAL EXPENDITURES

Determine the institution\'s E&G expenditures for **2004-2005**. The
regulations at 34 CFR Part 606.7(b) and 34 CFR Part 607.7(e) define E&G
expenditures as the **total amount** expended by an institution of
higher education for: instruction, research, public service, academic
support (including library expenditures), student services,
institutional support, scholarships and fellowships, operation and
maintenance expenditures for physical plant, and any mandatory transfers
which 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.**

Enter the total 2004-2005 E&G expenditures in the space provided under
Part III, Item 2.C.

ITEM 2.D. AVERAGE EDUCATIONAL AND GENERAL EXPENDITURES PER FTE STUDENT

The system will calculate for you the institution\'s average E&G
expenditures per FTE for **2004-2005**.

> **[PART IV. SPECIFIC INSTITUTIONAL ELIGIBILITY
> REQUIREMENTS]{.underline}**

**ITEM 1. NEEDY STUDENT REQUIREMENTS.**

Use the following calculations 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 2004 fall semester, unduplicated student head
> count of 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 Programs. (Part III, 1B)
>
> Or
>
> B. The percentage of its 2004 fall semester, 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 III, 1D)

**ITEM 1. A. AT LEAST 50% OR MORE OF FALL 2004 DEGREE STUDENTS WERE
RECIPIENTS OF NEED-BASED FINANCIAL SUPPORT.**

If your institution **meets** the needy student requirement because **50
percent or more** of its 2004 fall semester, 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.**

+-----------------------------------------------------------------------+
| **EXAMPLE: Needy Student Calculation (Bubble A)**                     |
|                                                                       |
| To determine whether your institution meets the statutory needy       |
| student requirement for 2004-2005, divide the number of 2004-fall     |
| semester, Title IV recipients (Part III, Item 1.B) by the 2004 fall   |
| semester 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}**                                             |
|                                                                       |
| 2004 fall semester enrollment (Part III, 1.A) = 800 degree students   |
|                                                                       |
| 2004 fall semester 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 2004 fall semester degree students received |
| need-based financial support*.*                                       |
+=======================================================================+
+-----------------------------------------------------------------------+

### 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 2004 fall semester 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
bubble next to Part IV, Item 1.A only.**

+-----------------------------------------------------------------------+
| **EXAMPLE: Needy Student Calculation**                                |
|                                                                       |
| (Bubble B)                                                            |
|                                                                       |
| To determine if your institution meets the statutory needy student    |
| requirement for 2004, divide the number of 2004 fall semester Pell    |
| Grant recipients (Part III Item 1.D) by the 2004 fall semester        |
| 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}**                                             |
|                                                                       |
| 2004 fall semester enrollment of half-time to full-time degree        |
| students                                                              |
|                                                                       |
| (Part III, 1.C) = 600                                                 |
|                                                                       |
| 2004 fall semester Pell Grant recipients (Part III, 1.D) = 250)       |
|                                                                       |
| Fall Pell Grant percentage = 41.6% (250 divided by 600)               |
|                                                                       |
| Here are the median Federal Pell Grant percentages or thresholds for  |
| base year 2004-2005:                                                  |
|                                                                       |
| For 2-year public institutions, the median = **25.6%**                |
|                                                                       |
| For 2-year non-profit private institutions, the median = **39.7%**    |
|                                                                       |
| ##### For 4-year public institutions, the median = **25.8%**          |
|                                                                       |
| For 4-year non-profit private institutions, the median = **26.9%**    |
|                                                                       |
| 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.                                                  |
+-----------------------------------------------------------------------+

ITEM 1.C. 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.

**Prepare a separate narrative, providing the required evidence that
shows the chosen waiver option(s) does, indeed, apply to your particular
institution.** **Following the instructions detailed below, the
narrative must contain persuasive and compelling evidence. Mere
statements of fact may not be enough to support your request. Provide
supporting documentation (relevant studies, recent reports and/or data,
etc.) to justify your request for a waiver. It is okay to upload
photocopies of supporting documentation when addressing the waivers.**

**[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 2004-2005 base year,

## AND

Provide evidence that your institution charged **not more than**
**\$99.00 per student for tuition and fees for the 2004-2005 base
year.**

***To the extent possible, identify the resources provided by the state,
citing specific dollar amounts. Also, show actual tuition and fees
charged per student, and provide supporting documentation such as posted
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 2004-2005 base year **were students from
low-income families.**

The regulations at 34 CFR Part 606.7(c) and 34 CFR 607.7(e) 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 [Federal
Register]{.underline} Closing Date Notice inviting applications, we
stated the low-income figures for 2004.

*Support your request by providing documentation (statistical and whole
numbers baseline data) that verifies your claim that at least 30 percent
of your enrolled students were from low-income families.*

**[Needy Student Waiver Option #3,]{.underline} 34 CFR 606.3(b)(3) 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(e)
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
2004-2005 base year.

2\. The number of low-income students for the 2004-2005 base year that
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
2004-2005 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: 2000-2001, 2001-2002, 2002-2003, 2003-2004, and
2004-2005.

[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 2004-2005 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
2004-2005 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: 2000-2001, 2001-2002, 2002-2003, 2003-2004, and
2004-2005 who resided in areas [outside]{.underline} the boundaries of
an MSA.

[Needy Student Waiver Option #5,]{.underline} 34 CFR 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 2004-2005
base year and the two academic years following the base year (2005-2006
and 2006-2007). 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 2004-2005
base year and the two academic years following the base year (2005-2006
and 2006-2007) 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 (2007-2008, 2008-2009 and
2009-2010). Detail the institution\'s plans to meet these goals.

[Needy Student Waiver Option #6]{.underline}, 34 CFR 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.

**[Needy Student Waiver Option #7]{.underline}, 34 CFR 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 2004-2005
base year and the two academic years following the base year (2005-2006
and 2006-2007). 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 2004-2005
base year and the two academic years following the base year (2005-2006
and 2006-2007) 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
(2007-2008, 2008-2009 and 2009-2010). 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 2004-2005 E&G expenditures per FTE student
for each category of institution is the following:**

> **2- year public institution = \$ 9,320 per FTE student.**
>
> **2- year non-profit private = \$20,782 per FTE student.**
>
> **4- year public institution = \$23,553 per FTE student.**
>
> **4- year non-profit private = \$37,105 per FTE student.**

### PART IV, ITEM 2.A

Darken bubble 2.A only if your institution's 2004-2005 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 2.B if your institution [exceeded]{.underline} the E&G
expenditures threshold and you are requesting a waiver.

Write a justification for each waiver option you are requesting.

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 and
compelling evidence that the specific waiver condition exists. **Mere
statements of fact may not be enough to support your request. Provide
supporting documentation (relevant studies, recent reports and/or data,
etc.) to justify your request for a waiver. It is okay to upload
photocopies of supporting documentation when addressing the waivers.**

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

**Low student enrollment** in the Fall 2004 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,
and/or low relative to the enrollment after the base year.

***Provide detailed evidence that supports your claim that low student
enrollment in 2004 distorts you E&G expenditures. Show that enrollments
in the years prior to and after 2004 were greater, citing specific
numbers. Comparisons with similar IHEs could be helpful.***

**[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.
Provide documentation from a governmental source to substantiate the
high cost of living area.

***Cite recent statistics from local, state an/or national levels. When
possible, show comparisons.***

**[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. Provide documentation to substantiate the high costs.

***When possible, show comparisons and include supporting
documentation.***

**[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.

***Provide documentation to substantiate your request.***

**[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, or high cost programs, such as technology or health
science programs, 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.

***Provide documentation to substantiate your request. When possible,
show enrollment and cost comparisons.***

**[PART V. CERTIFICATION]{.underline}**

A duly authorized representative of the institution must check the box
in Part V to certify that to the best of their knowledge and belief, all
data in the application is true and correct and the applicant
institution will comply with the required assurances. By checking this
box and submitting this application, the applicant institution further
certifies that they meet the accrediting requirements and, if
applicable, meet the definition of a branch campus.

**APPENDICES**

-   **Federal Register Closing Date Notice Inviting Applications**

-   **Application For Designation As An Eligible Institution, (ED Form
    1049)**

4000-01-U

DEPARTMENT OF EDUCATION

(CFDA NO. 84.031H)

Office of Postsecondary Education.

Strengthening Institutions (SIP), American Indian Tribally Controlled
Colleges and Universities (TCCU), Alaska Native and Native
Hawaiian-Serving Institutions (ANNH) and Developing Hispanic-Serving
Institutions (HSI) programs; Notice Inviting Applications for
Designation as Eligible Institutions to apply for new awards under Title
III and Title V for Fiscal Year (FY) 2007.

[PURPOSE OF PROGRAMS]{.underline}: Under the SIP, TCCU, and ANNH
programs, (Title III, Part A programs) authorized under Part A of Title
III of the Higher Education Act of 1965, as amended (HEA), institutions
of higher education (IHEs or institutions) are eligible to apply for
grants if they meet specific statutory and regulatory eligibility
requirements. Similarly, IHEs are eligible to apply for grants under the
HSI program, authorized under Title V of the HEA, if they meet specific
statutory and regulatory requirements. In addition, an institution that
is designated as an eligible institution under those programs may also
receive a waiver of certain non-Federal cost-share requirements under
the Federal Supplemental Educational Opportunity Grant (FSEOG), the
Federal Work Study (FWS), the Student Support Services (SSS) and the
Undergraduate International Studies and Foreign Language (UISFL)
programs. The FSEOG, FWS, and SSS programs are authorized under Title IV
of the HEA; the UISFL program is authorized under Title VI of the HEA.

Qualified institutions may receive these waivers even if they are not
recipients of grant funds under the Title III, Part A programs or the
HSI program.

[SPECIAL NOTE]{.underline}: To qualify as an eligible institution under
the Title III, Part A programs or the HSI program, your institution must
satisfy several criteria, including one related to needy student
enrollment and one related to average educational and general (E&G)
expenditures for a particular base year. The most recent data available
for E&G expenditures are for base year 2004-2005. In order to award FY
2007 grants in a timely manner, we will use the most recent data
available. Therefore, we use E&G expenditure threshold data from the
base year 2004-2005. In completing your eligibility application, please
use E&G expenditure data from the base year 2004-2005.

If you are designated as an eligible institution and you do not receive
a new Title III or Title V award in FY 2007, your eligibility for the
non-Federal cost-share waiver under the FSEOG, the FWS, the SSS, and the
UISFL programs is valid for five consecutive years. You will not need to
reapply for eligibility until 2012, unless you wish to apply for a new
Title III or Title V grant. All institutions (including those designated
as TCCU and ANNH institutions) that are not designated as eligible
institutions and are interested in applying for a FY 2007
[new]{.underline} grant [or]{.underline} requesting a waiver of the
non-Federal cost share, must apply for eligibility designation in FY
2007.

[ELIGIBLE APPLICANTS]{.underline}: To qualify as an eligible institution
under the Title III, Part A programs or the HSI program, an accredited
institution must, among other requirements, have an enrollment of needy
students, and its average E&G expenditures per full-time equivalent
(FTE) undergraduate student must be low in comparison with the average
E&G expenditures per FTE undergraduate student of institutions that
offer similar instruction.

The complete eligibility requirements for the Title III, Part A programs
are found in 34 CFR 607.2 through 607.5. These regulations may be
accessed at the following Web site:
<http://www.access.gpo.gov/nara/cfr/waisidx_02/34cfr607_02.html>.

The complete eligibility requirements for the HSI program are found in
34 CFR 606.2 through 34 CFR 606.5. These regulations may be accessed at
the following Web site:
<http://www.access.gpo.gov/nara/cfr/waisidx_01/34cfr606_01.html>

[ENROLLMENT OF NEEDY STUDENTS]{.underline}: Under 34 CFR 606.3(a) and
607.3(a), an institution is considered to have an enrollment of needy
students if (1) at least 50 percent of its degree students received
financial assistance under one or more of the following programs:
Federal Pell Grant, FSEOG, FWS, and Federal Perkins Loan programs; or
(2) the percentage of its undergraduate degree students who were
enrolled on at least a half-time basis and received Federal Pell Grants
exceeded the median 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.

To qualify under this latter criterion, an institution's Federal Pell
Grant percentage for base year 2004-2005 must be more than the median
for its category of comparable institutions provided in the table in
this notice.

[EDUCATIONAL AND GENERAL EXPENDITURES PER FTE STUDENT]{.underline}: An
institution should compare its 2004-2005 average E&G expenditures per
FTE student to the average E&G expenditure per FTE student for its
category of comparable institutions contained in the table in this
notice. If the institution's average E&G expenditures for the 2004-2005
base year are less than the average for its category of comparable
institutions, the institution meets this eligibility requirement.

An institution's average E&G expenditures are the total amount it
expended during the base year for instruction, research, public service,
academic support, student services, institutional support including
library expenditures, operation and maintenance, scholarships and
fellowships, and mandatory transfers.

The following table identifies the relevant median Federal Pell Grant
percentages for the base year 2004-2005 and the relevant average E&G
expenditures per FTE student for the base year 2004-2005 for the four
categories of comparable institutions:

+----------------------------------+-----------------+----------------+
| Type of Institution              | 2004-2005       | 2004-2005      |
|                                  |                 |                |
|                                  | Median Pell     | Average        |
|                                  | Grant           |                |
|                                  | Percentage      | E&G            |
|                                  |                 | Expenditures   |
|                                  |                 | per FTE        |
|                                  |                 | Student        |
+----------------------------------+-----------------+----------------+
| 2-year Public Institutions       | 25.6            | 9,320          |
|                                  |                 |                |
| 2-year Non-profit Private        | 39.7            | 20,782         |
| Institutions                     |                 |                |
|                                  | 25.8            | 23,553         |
| 4-year Public Institutions       |                 |                |
|                                  | 26.9            | 37,105         |
| 4-year Non-profit Private        |                 |                |
| Institutions                     |                 |                |
+----------------------------------+-----------------+----------------+

Waiver Information: IHEs that are unable to meet the needy student
enrollment requirement or the average E&G expenditures requirement may
apply to the Secretary for waivers of these requirements, as described
in 34 CFR 606.3(b), 606.4(c) and (d), 607.3(b), and 607.4(c) and (d).
Institutions requesting a waiver of the needy student enrollment
requirement or the average E&G expenditures requirement must include in
their application detailed information supporting the waiver request, as
described in the instructions for completing the application.

The regulations governing the Secretary's authority to waive the needy
student requirement, 34 CFR 606.3(b)(2) and (3) and 607.3(b)(2) and (3),
refer to ''low-income'' students or families. The regulations define
''low-income'' as an amount that does not exceed 150 percent of the
amount equal to the poverty level, as established by the U.S. Bureau of
the Census, 34 CFR 606.3(c) and 607.3(c).

For the purposes of this waiver provision, the following table sets
forth the low-income levels for the various sizes of families:

# 2004 ANNUAL LOW-INCOME LEVELS

+------------------+--------------------+-------------+--------------+
| Size of Family   | Family Income for  | Family      | Family       |
|                  | the                | Income for  | Income for   |
| Unit             |                    |             |              |
|                  | 48 Contiguous      | Alaska      | Hawaii       |
|                  |                    |             |              |
|                  | States, D.C.,      |             |              |
|                  |                    |             |              |
|                  | and Outlying       |             |              |
|                  |                    |             |              |
|                  | Jurisdictions      |             |              |
+------------------+--------------------+-------------+--------------+
| 1                | \$ 13,965          | \$ 17,445   | \$ 16,050    |
|                  |                    |             |              |
| 2                | \$ 18,735          | \$ 23,415   | \$ 21,540    |
|                  |                    |             |              |
| 3                | \$ 23,505          | \$ 29,385   | \$ 27,030    |
|                  |                    |             |              |
| 4                | \$ 28,275          | \$ 35,355   | \$ 32,520    |
|                  |                    |             |              |
| 5                | \$ 33,045          | \$ 41,325   | \$ 38,010    |
|                  |                    |             |              |
| 6                | \$ 37,815          | \$ 47,295   | \$ 43,500    |
|                  |                    |             |              |
| 7                | \$ 42,585          | \$ 53,265   | \$ 48,990    |
|                  |                    |             |              |
| 8                | \$ 47,355          | \$ 59,235   | \$ 54,480    |
+------------------+--------------------+-------------+--------------+

Note: The 2004 annual low-income levels are being used because those are
the amounts that apply to the family income reported by students
enrolled for the Fall 2004 semester. For family units with more than
eight members, add the following amount for each additional family
member: \$4,770 for the contiguous 48 States, the District of Columbia
and outlying jurisdictions; \$5,970 for Alaska; and \$5,490 for Hawaii.

The figures shown under family income represent amounts equal to 150
percent of the family income levels established by the U.S. Bureau of
the Census for determining poverty status. The poverty guidelines were
published by the U.S. Department of Health and Human Services in the
[Federal Register]{.underline} on February 13, 2004 (69 FR. 7336).

The information about ''metropolitan statistical areas'' referenced in
34 CFR 606.3(b)(4) and 607.3(b)(4) may be obtained by requesting the
Metropolitan Statistical Areas, 1999 publication, order number
PB99--501538, from the National Technical Information Service, Document
Sales, 5285 Port Royal Road, Springfield, Virginia 22161, telephone
number 1--800--553--6847. There is a charge for this publication.

[APPLICATIONS AVAILABLE]{.underline}: January 8, 2007

[DEADLINE FOR TRANSMITTAL OF APPLICATIONS]{.underline}: March 9, 2007
for an applicant institution that wishes to be designated as eligible to
apply for a FY 2007 new grant under the Title III, Part A programs or
the HSI program; and April 30, 2007 for an applicant institution that
wishes to apply only for cost-sharing waivers under the FSEOG, FWS, SSS,
or UISFL programs.

[ELECTRONIC SUBMISSION OF APPLICATIONS]{.underline}:

Applications for designation of eligibility must be submitted
electronically using the following Web site:

[**http://webprod.cbmiweb.com/Title3and5/index.html**](http://webprod.cbmiweb.com/Title3and5/index.html)

To enter the Web site, you must use your institution's unique 8-digit
identifier, i.e., your Office of Postsecondary Education Identification
Number (OPE ID number). Your business office or student financial aid
office should have the OPE ID Number. If they do not, contact the
Department, using the e-mail addresses of the contact persons listed in
this notice under [FOR APPLICATIONS AND FURTHER INFORMATION
CONTACT]{.underline}.

You will find detailed instructions for completing the application form
electronically under the ''eligibility 2007'' link at either of the
following Web sites:

<http://www.ed.gov/programs/iduestitle3a/index.html>

or

[**http://www.ed.gov/hsi**](http://www.ed.gov/hsi)

If your institution is unable to meet the needy student enrollment
requirement or the average E&G expenditure requirement and wishes to
request a waiver of one or both of those requirements, you must complete
your designation application form electronically and transmit your
waiver request narrative document from the following Web site:

[**http://webprod.cbmiweb.com/Title3and5/index.html**](http://webprod.cbmiweb.com/Title3and5/index.html)

[EXCEPTION TO ELECTRONIC SUBMISSION REQUIREMENT]{.underline}: You may
qualify for an exception to the electronic submission requirement, and
may submit your application in paper format, if you are unable to submit
an application electronically because---

• you do not have access to the Internet; or

• you do not have the capacity to upload documents to the Web site;
[and]{.underline}

• No later than two weeks before the application deadline date (14
calendar days or, if the fourteenth calendar day before the application
deadline date falls on a Federal holiday, the next business day
following the Federal holiday), you mail or fax a written statement to
the Department, explaining which of the two grounds for an exception
prevent you from using the Internet to submit your application. If you
mail your written statement to the Department, it must be postmarked no
later than two weeks before the application deadline date. If you fax
your written statement to the Department, we must receive the faxed
statement no later than two weeks before the application deadline date.

Address and mail or fax your statement to: Dr. Maria Carrington, U.S.
Department of Education, 1990 K Street, N.W., room 6033, Washington, DC
20006-8513. Fax: (202) 502-7861.

Your paper application must be submitted in accordance with the mail or
hand delivery instructions described in this notice.

[SUBMISSION OF PAPER APPLICATIONS BY MAIL]{.underline}*.*

If you qualify for an exception to the electronic submission
requirement, you may mail (through the U.S. Postal Service or a
commercial carrier), your application to the Department. You must mail
the application, on or before the application deadline date, to the
Department at the following address:

[By mail through the U.S. Postal Service or commercial
carrier]{.underline}:

> Dr. Maria Carrington
>
> U.S. Department of Education
>
> 1990 K Street, N.W., Room 6033

Washington, DC 20006-8513

You must show proof of mailing consisting of one of the following:

\(1\) A legibly dated U.S. Postal Service postmark,

\(2\) A legible mail receipt with the date of mailing stamped by the
U.S. Postal Service,

\(3\) A dated shipping label, invoice, or receipt from a commercial
carrier, or

\(4\) Any other proof of mailing acceptable to the Secretary of the U.S.
Department of Education.

If you mail your application through the U.S. Postal Service, we do not
accept either of the following as proof of mailing:

\(1\) A private metered postmark, or

\(2\) A mail receipt that is not dated by the U.S. Postal Service.

If your application is postmarked after the application deadline date,
we will not consider your application***.***

[Note]{.underline}: The U.S. Postal Service does not uniformly provide a
dated postmark. Before relying on this method, you should check with
your local post office.

[SUBMISSION OF PAPER APPLICATIONS BY HAND DELIVERY]{.underline}.

If you qualify for an exception to the electronic submission
requirement, you (or a courier service) may deliver your paper
application to the Department by hand. You must deliver the application,
on or before the application deadline date, to the Department at the
following address:

> Dr. Maria Carrington
>
> U.S. Department of Education
>
> 1990 K Street, N.W., Room 6033

Washington, DC 20006-8513

Hand delivered applications will be accepted daily between 8:00 a.m. and
4:30 p.m., Washington, DC time, except Saturdays, Sundays and Federal
holidays.

[APPLICABLE REGULATIONS]{.underline}: (a) The Education Department
General Administrative Regulations in 34 CFR parts 74, 75, 77, 79, 82,
84, 85, 86, 97, 98, and 99. (b) The regulations for the Title III, Part
A programs in 34 CFR part 607, and for the HSI program in 34 CFR part
606.

[FOR APPLICATIONS AND FURTHER INFORMATION CONTACT]{.underline}: Imogene
Byers, Kelley Harris, or Carnisia Proctor, Institutional Development and
Undergraduate Education Service, U.S. Department of Education, 1990 K
Street, N.W., Room 6033, Request for Eligibility Designation,
Washington, DC 20202--8513.

You may contact these individuals at the following e-mail addresses or
phone numbers:

> <Imogene.Byers@ed.gov> 202-502-7672

<Kelley.Harris@ed.gov> 202-219-7083

<Carnisia.Proctor@ed.gov> 202-502-7606

If you use a telecommunications device for the deaf (TDD), you may call
the Federal Relay Service (FRS) at

1--800--877--8339.

Individuals with disabilities may obtain this document in an alternative
format (e.g., Braille, large print, audio tape, or computer diskette) on
request to the contact persons listed in this section**.**

Individuals with disabilities may obtain a copy of the application
package in an alternative format by contacting the persons listed in
this section.

## [Electronic Access to This Document]{.underline}:

You may view this document, as well as all other documents of this
Department published in the [Federal Register]{.underline}, in text or
Adobe Portable Document Format (PDF) on the Internet at the following
site:

[www.ed.gov/news/fedregister](http://www.ed.gov/news/fedregister)

To use PDF, you must have Adobe Acrobat Reader, which is available free
at this site. If you have questions about using PDF, call the U.S.
Government Printing Office (GPO) toll free, at 1--888--293--6498; or in
the Washington, DC area at (202) 512--1530.

[Note]{.underline}: The official version of this document is the
document published in the [Federal Register]{.underline}. Free Internet

access to the official edition of the [Federal Register]{.underline} and

the Code of Federal Regulations is available on GPO Access at:
<http://www.gpoaccess.gov/nara/index.html>

[Program Authority]{.underline}: 20 U.S.C. 1057--1059d, 1101--1103g.

Dated:

/signed/

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

> James F. Manning,
>
> [Delegated the Authority of Assistant Secretary for]{.underline}
>
> [Postsecondary Education]{.underline}.

**UNITED STATES DEPARTMENT OF EDUCATION**

**WASHINGTON, D.C. 20202**

**APPLICATION FOR DESIGNATION AS AN ELIGIBLE INSTITUTION**

**FISCAL YEAR 2007**

CFDA Number: 031H

To apply for grants under Title III, Part A, and Title V

Authority: 34 CFR Part 606 and 607 Programs

**Important: You are required to provide the information requested**

**in order to obtain or retain a benefit.**

According to the Paperwork reduction Act of 1995, no persons are
required to respond to a collection of information unless such
collection displays a valid OMB control number. The valid OMB control
number for this information collection is 1840-0103. The time required
to complete this information collection is estimated to average 7.00
hours (or minutes) per response, including the time to review
instructions, search existing data resources, gather the data needed,
and complete and review the information collection. If you have any
comments concerning the accuracy of the time estimate(s) or suggestions
for improving this form, please write to: U.S. Department of Education,
Washington, D.C. 20202-4561. If you have comments or concerns regarding
the status of your individual submission for this form, write directly
to: Institutional Development and Undergraduate Education Service, U.S.
Department of Education, 600 Independence Avenue, S.W., (1990 K Street,
N.W., 6th Floor), Washington, DC 20202-8513.

**\* This form must be completed electronically.**

# Part I. Identity of Applicant Institution

1\. Institution/Campus OPE ID Number:

2\. Name of Institution/Campus Requesting:

3\. Address (Street \# or P.O. Box and Street Name, City, State, Zip):

4\. Contact Person's Name: (Last Name, First Name, Middle Initial):

5\. Contact Person's Title, Phone Number, Extension:

6\. E-mail Address:

7\. Data Universal Numbering System (DUNS Number):

8\. Type (mark one): ( ) 2-Year Institution ( ) 4-Year Institution

9\. Control (mark one): ( ) Private Non-Profit Institution ( ) Public
Institution

# Part II. Institutional Enrollment

1\. Total Institutional Enrollment (Fall 2004 Head Count):

2\. Total Minority Enrollment (Fall 2004 Head Count):

# Part III. Institutional Statistics

1\. Needy Student Requirement

> A. Fall 2004 Head Count Enrollment of Undergraduate and Graduate
> Degree Students:
>
> B. Fall 2004 Recipients of Title IV Need-Based Financial Assistance:
>
> (Include Only Pell Grant, Supplemental Educational Opportunity Grant,
> College Work Study, and Perkins Loan)
>
> C. Fall 2004 Enrollment of Half-Time up to and including Full-Time
> Undergraduate Students:
>
> D. Fall 2004 Pell Grant Recipients:

**2. Educational & General Expenditures Requirement (E&G)**

> A. Undergraduate Full-Time Equivalent Fall 2004 Enrollment
>
> a\. Total Full-Time Undergraduate Students:
>
> b\. Total Number of Credit Hours for all Part-Time Undergraduate
> Students:
>
> B. Graduate Full-Time Equivalent Fall 2004 Enrollment:
>
> a\. Total Full-Time Graduate Students:
>
> b\. Total Number of Credit Hours for all Part-Time Graduate Students:
>
> C. Total 2004-2005 Educational & General Expenditures (E&G):
>
> D. Average 2004-2005 E&G per FTE = C/(A+B):

Part IV. Specific Institutional Eligibility Requirements

1\. Needy Student Requirement (mark A, B. or C)

> ( ) A. According to the result, after dividing item 1B by item 1A in
> Part III of this form, at least 50% of Degree Students are recipients
> of Need-Based Financial Support; or
>
> ( ) B. According to the result, after dividing item 1D by item 1C in
> Part III of this form, our enrollment exceeds the pertinent threshold
> for Substantial Percentage of Students Receiving Pell Grants for the
> 2004-2005 year.
>
> ( ) C. Requesting Waiver (Section 607.3(b) and Section 606.3(b)
> option(s):
>
> Fill in the bubble(s) needed and attach the narrative justification to
> this form.

AND

2\. Educational & General Expenditures Requirement (mark A or B)

> ( ) A. The E&G expenditures per FTE Student are less than the
> pertinent threshold for base year 2004-2005.
>
> ( ) B. Requesting Waiver (Section 607.4(c) and (d) and Section
> 606.4(c) and (d) option(s):
>
> Fill in the bubble(s) needed and attach the narrative justification to
> this form.

Part V. Certification

(Although this Certification requirement is waived for applicants
submitting through the Internet,

the Department reserves the right to require a signed form on request.)

To the best of my knowledge and belief, all data in this application are
true and correct. The governing body of the applicant has duly
authorized this document and the applicant will comply with the required
assurances. We meet the accrediting requirements and, if applicable, we
meet the definition of a branch campus as defined in 34 CFR Part
606.7(b) and 34 CFR 607.7(e).

Authorized Representative\'s Typed Name and Title Date Authorized
Representative\'s Signature

Phone Number Fax Number Former Name of Applicant Institution/Campus (if
applicable)

Form Approved - OMB No. 1340-0103 Expiration Date: 01/31/2008

ED Form 1049 (Revised 11/99), Replaces ED Form 1049, Revised 8/95 which
is obsolete.

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