Archived Information

**U.S. DEPARTMENT OF EDUCATION**

**OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES**

**WASHINGTON, D.C. 20202-2575**

**2006 APPLICATION KIT FOR NEW GRANTS**

**UNDER**

**THE REHABILITATION SERVICES ADMINISTRATION**

####  VOCATIONAL REHABILITATION SERVICE PROJECTS

### FOR AMERICAN INDIANS WITH DISABILITIES

CFDA NUMBER 84.250B

![](media/image1.pct){width="1.5715277777777779in"
height="1.5715277777777779in"}

FORM APPROVED

OMB No. 1820-0018, EXP. DATE 02/28/2007

ED FORM 424, 04/30/2008

**DATED MATERIAL - OPEN IMMEDIATELY**

**CLOSING DATE: April 21, 2006**

# 

# TABLE OF CONTENTS

Dear Applicant Letter

Notice Inviting Applications for New Awards A

84.250B - Vocational Rehabilitation Service Projects for

> American Indians with Disabilities --
>
> Review Criteria B

Special Application Requirements C

Important Things To Remember D

Application Transmittal Instructions E

Rules and Regulations: Sec. 102(b)(c)(d) and 121 F

34 CFR 371

Instructions for Application for Federal Assistance G

> PART I Federal Assistance Face Sheet (Form 424)
>
> PART II Budget Information for Form 524
>
> PART III: Program Narrative

PART IV: Assurances, Certifications, and Disclosures

> o Assurances

o Certification Regarding Lobbying; Debarment,

Suspension and Other Responsibility Matters; and Drug-Free Workplace
Requirements

> o Certification Regarding
>
> Debarment, Suspension, and
>
> Voluntary Exclusion - Lower Tier
>
> Covered Transaction

o Disclosure of Lobbying Activities

o GEPA

o GPRA

**CLOSING DATE: April 21, 2006**

Dear Applicant:

The Secretary invites applications for new awards for fiscal year (FY)
2006 under the Vocational Rehabilitation Service Projects for American
Indians with Disabilities (CFDA 84.250B). This program is authorized by
Section 121 of the Rehabilitation Act of 1973, as amended (the Act), and
implemented by the subsequent program regulation at 34 CFR Part 371.

The purpose of this program is to provide vocational rehabilitation
services to American Indians with disabilities who reside on or near
Federal or State reservations, consistent with their individual
strengths, resources, priorities, concerns, abilities, capabilities, and
informed choice, so that they may prepare for and engage in gainful
employment, including self-employment, telecommuting and business
ownership.

This application package contains information and the required forms for
your use in applying and competing in the FY 2006 discretionary grant
award competition for the Vocational Rehabilitation Service Projects for
American Indians with Disabilities. Potential applicants are advised to
read all materials carefully, especially the **Federal Register Notice
(section A)**.

Please note the following:

-   **[APPLICATION SUBMISSION]{.underline}**. Based on the precautionary
    procedures the U.S. Postal Service is using to process mail, we are
    experiencing delays in the delivery of mail to the Department.
    Therefore, you may want to consider sending your application by
    overnight courier or submitting your application electronically. It
    will expedite the review process if three additional copies (for a
    total of six -- one original and five copies) are submitted to the
    Application Control Center in Washington, D.C.

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-   **[GRANTS.GOV APPLICATION SUBMISSION]{.underline}.** Applications
    for grants under this competition may be submitted electronically
    using the Grants.gov Apply site (www.Grants.gov). Please read
    carefully the document that is included immediately following this
    letter, which includes helpful tips about submitting electronically
    using the Grants.gov Apply site. Please note that you must follow
    the Application Procedures as described in the Federal Register
    notice announcing this grant competition. Information (including
    dates and times) about how to submit your application
    electronically, or by mail or hand delivery, can also be found in
    section E Application Transmittal Instructions of this application
    package.

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-   **[ELIGIBLE APPLICANT]{.underline}.** Applications may be made only
    by the governing bodies of Indian Tribes (or consortia of those
    governing bodies) located on Federal or state reservations.

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-   **[MAXIMUM AWARD]{.underline}.** There is no maximum award for the
    first project year. However, when preparing your submission,
    applicants should be aware that we anticipate an increase of about
    three percent in the award amounts for this program compared to
    FY 2005. (see section A)

-   **[ABSTRACT]{.underline}.** Each proposal MUST include a one page
    abstract. The abstract is a critical component of the proposal and
    it MUST highlight the purpose of the project, the proposed number of
    individuals to be served and the proposed number of individuals who
    will obtain employment outcomes during each year of the project,
    planned goals and objectives, innovative strategies utilized, and
    project outcomes.

-   **[SELECTION CRITERIA]{.underline}**. The program narrative MUST
    address the selection criteria shown following this letter (section
    B). [To facilitate the peer review process, the narrative should
    address the selection criteria in the order that the criteria are
    listed]{.underline}. An explanation of the selection criteria
    follows the criteria. Please be certain to carefully review this
    material and call for technical assistance if needed.

-   **[SPECIAL REQUIREMENTS]{.underline}**. In addition to the selection
    criteria, applicants [MUST]{.underline} address the special
    application requirements at 34 CFR 371.21 in a separate section of
    the application entitled "Special Application Requirements." If
    these special requirements are not addressed, the application [WILL
    NOT]{.underline} be reviewed for funding. An explanation of the
    special requirements also follows this letter (section C). Please be
    certain to carefully review this material and call for technical
    assistance if needed.

-   **[MATCH]{.underline}.** The Federal share may not be more than 90%
    of the total cost of the project. The local match may be in cash or
    in-kind. Please document the local match on Section B of the Budget
    Summary (Form 524) and provide a budget narrative to describe the
    local match. \*\*[Please remember]{.underline} that the 10% match is
    on the total cost of the project---the simplest way to compute the
    required match is to divide the requested Federal funds by 9. The
    result is the minimum required match.

-   **[BUDGET FORMS]{.underline}.** As a result of changes in the
    Department of Education's grants management process, all applicants
    for multi-year projects are required to provide detailed budget
    information for the total grant period requested (up to 60 months).
    At the time of the initial award, the Department will address the
    funding levels for each year of the grant award.

-   Applicants are reminded that the 1998 Amendments to the
    Rehabilitation Act require that all new applicants must describe how
    the needs of individuals with disabilities from minority backgrounds
    will be addressed. Applicants must also provide assurance that
    individuals provided services must be advised of the availability
    and purposes of the State's Client Assistance Program, including
    information on means of seeking assistance from that program.

# 

# **BONUS POINTS**. Previously funded tribal programs are entitled to receive 10 bonus points. To receive the points, the applicant MUST indicate that the governing body of the Tribe or the consortia of governing bodies had previously received an award under this program and MUST provide the date of the previous project period. Please clearly indicate this information in your application and list it in the Table of Contents so it is easily located.

# PROGRAM RULES AND REGULATIONS

The Federal regulations that apply to this competition can be found in
34 CFR Part 371. These grants are subject to the requirements of the
Education Department General Administrative Regulations (EDGAR), 34 CFR
75, 77, 80, 81, 82, 84, 85 and 97, which set forth general rules
affecting the submittal, review, grant awarding, and post-award
administration for Department of Education grant programs.

# TECHNICAL ASSISTANCE

If you have any questions about the information in this application kit,
please contact the RSA Competition Manager for Vocational Rehabilitation
Service Projects for American Indians with Disabilities, Alfreda Reeves
at (202) 245-7485. Individuals who use a telecommunications device (TDD)
may call the Federal Information Relay Services (FIRS) at 1-800-877-8330
between 8:00 am and 5:00 pm, Eastern time, Monday through Friday.

Thank you for your interest in these programs.

Sincerely,

Thomas E. Finch, Ph.D.

Unit Chief

Service Projects Unit

**IMPORTANT -- PLEASE READ FIRST**

**U.S. Department of Education**

***[Grants.gov Submission Procedures and Tips for
Applicants]{.underline}***

Please note that the Grants.gov site works differently than the U.S.
Department of Education's (Department) e-Application system. To
facilitate your use of Grants.gov, this document includes important
submission procedures you need to be aware of to ensure your application
is received in a timely manner and accepted by the Department of
Education.

1)  **REGISTER EARLY** -- Grants.gov registration is a one-time process
    that may take five or more days to complete. You may begin working
    on your application while completing the registration process, but
    you cannot submit an application until all of the Get Started steps
    are complete. For detailed information on the Get Started Steps,
    please go to: <http://www.grants.gov/GetStarted>.

2)  **SUBMIT EARLY** -- **We strongly recommend that you do not wait
    until the last day to submit your application. Grants.gov will put a
    date/time stamp on your application after it is fully uploaded.**
    The time it takes to upload an application will vary depending on a
    number of factors including the size of the application and the
    speed of your Internet connection. If you start uploading your
    application before 4:30 p.m. Washington, D.C. time on the
    application deadline date, and it does not finish uploading until
    after 4:30 p.m., your application will be marked late. If that
    happens, please see the section below on submission problems.

3)  **VERIFY SUBMISSION IS OK** -- You will want to verify that
    Grants.gov and the Department receive your Grants.gov submission
    timely and that it was validated successfully. To see the date/time
    your application was received, login to Grants.gov and click on the
    Check Application Status link. For a successful submission, the
    date/time received should be earlier than 4:30 p.m. on the deadline
    date, AND the application status should be: Validated, Received by
    Agency, or Agency Tracking Number Assigned.

> If the date/time received is later than 4:30 p.m. Washington, D.C.
> time, on the closing date, your application is late. If your
> application has a status of "Received" it is still awaiting validation
> by Grants.gov. Once validation is complete, the status will either
> change to "Validated" or "Rejected with Errors." If the status is
> "Rejected with Errors," your application has not been received
> successfully. Some of the reasons Grants.gov may reject an application
> can be found on the Grants.gov site:
> <http://www.grants.gov/assets/ApplicationErrorTips.doc>. If you
> discover your application is late or has been rejected, please see the
> instructions below. Note: You will receive a series of confirmations
> both online and via e-mail about the status of your application.
> Please do not rely solely on e-mail to confirm whether your
> application has been received timely and validated successfully.

# Submission Problems -- What should you do?

If you have problems submitting to Grants.gov before the closing date,
please contact Grants.gov Customer Support at 1-800-518-4726 or use the
customer support available on the Web site:
<http://www.grants.gov/CustomerSupport>.

If electronic submission is [optional]{.underline} and you have problems
that you are unable to resolve before the deadline date and time for
electronic applications, please follow the transmittal instructions for
hard copy applications in the Federal Register notice and get a hard
copy application postmarked by midnight on the deadline date.

If electronic submission is [required]{.underline}, you must submit an
electronic application before 4:30 p.m., unless you follow the
procedures in the Federal Register notice and qualify for one of the
exceptions to the electronic submission requirement [and]{.underline}
submit, no later than two weeks before the application deadline date, a
written statement to the Department that you qualify for one of these
exceptions. (See the Federal Register notice for detailed instructions.)

# 

# Helpful Hints When Working with Grants.gov

Please note, once you download an application from Grants.gov, you will
be working offline and saving data on your computer. Please be sure to
note where you are saving the Grants.gov file on your computer. You will
need to logon to Grants.gov to upload and submit the application. (This
is different from e-Application, where you are working online and saving
data to the Department's database.) You must provide on your application
the DUNS number that was used when your organization registered with the
Central Contractor Registry (CCR).

Please go to <http://www.grants.gov/ForApplicants> for help with
Grants.gov and click on the links in the lower right corner of the
screen under Applicant Tips and Tools. For additional tips related to
submitting grant applications, please refer to the Grants.gov Submit
Application Tips found on the Grants.gov homepage
[http://www.grants.gov](http://www.grants.gov/).

# Dial-Up Internet Connections

When using a dial up connection to upload and submit your application,
it can take significantly longer than when you are connected to the
Internet with a high-speed connection, e.g. cable modem/DSL/T1. While
times will vary depending upon the size of your application, it can take
a few minutes to a few hours to complete your grant submission using a
dial up connection. If you do not have access to a high-speed connection
and electronic submission is required, you may want to consider
following the instructions in the Federal Register notice to obtain an
exception to the electronic submission requirement no later than two
weeks before the application deadline date. (See the Federal Register
notice for detailed instructions.)

# 

# MAC Users

If you do not have a Windows operating System, you will need to use a
Windows Emulation program to submit an application using Grants.gov. For
additional information, review the PureEdge Support for Macintosh white
paper published by Pure Edge:
http://www.grants.gov/GrantsGov_UST_Grantee/!SSL!/WebHelp/MacSupportforPureEdge.pdf,
and/or contact Grants.gov Customer Support
(<http://www.grants.gov/CustomerSupport>) for more information. **If you
do not have a Windows emulation program and electronic submission is
required, please follow instructions in the Federal Register notice to
obtain an exception to the electronic submission requirement no later
than two weeks before the application deadline date.** (See the Federal
Register notice for detailed instructions.)

**[SECTION A]{.underline}**

**NOTICE INVITING APPLICATIONS FOR NEW AWARDS**

4000-01-U

DEPARTMENT OF EDUCATION

Office of Special Education and Rehabilitative Services

**Overview Information**

Vocational Rehabilitation Services Projects for American Indians With
Disabilities

Notice inviting applications for new awards for fiscal year (FY) 2006.

[Catalog of Federal Domestic Assistance (CFDA) Number]{.underline}:
84.250B

[Dates]{.underline}:

Applications Available: December 27, 2005.

Deadline for Transmittal of Applications: April 21, 2006.

[Eligible Applicants]{.underline}: The governing bodies of Indian tribes
(and consortia of those governing bodies) located on Federal and State
reservations.

[Estimated Available Funds]{.underline}: The Administration has plans to
set aside \$33,024,000 for the Vocational Rehabilitation Services
Projects for American Indians With Disabilities program for FY 2006, of
which we intend to use an estimated \$2,700,000 for this competition.
The actual level of funding, if any, depends on final congressional
action. However, we are inviting applications to allow enough time to
complete the grant process if Congress appropriates funds for this
program.

[Estimated Median Amount of Awards]{.underline}: The estimated median
amount of an award is \$500,000, which means that one-half of the awards
will be over \$500,000 and one-half of the awards will be under
\$500,000, with the majority of awards in the range of approximately
\$350,000 to \$575,000.

[Maximum Award]{.underline}: There is no maximum award amount for the
first project year. However, when preparing your submission, applicants
should be aware that we anticipate an increase of about three percent in
the award amounts for this program compared to FY 2005.

In addition, the Secretary may limit any proposed increases in funding
for project years two through five to the annual estimated percentage
change in the consumer price index for all urban consumers (CPIU). The
current estimated percentage increase in the CPIU over the prior year
for project years two through five is as follows: FY 2007 -- 2.9
percent, FY 2008 -- 2.4 percent, FY 2009 -- 2.4 percent, and FY 2010 --
2.4 percent.

[Estimated Number of Awards]{.underline}: 5.

[Note]{.underline}: The Department is not bound by any estimates in this
notice.

[Project Period]{.underline}: Up to 60 months.

Full Text of Announcement

I. Funding Opportunity Description

[Purpose of Program]{.underline}: The purpose of this program is to
provide vocational rehabilitation services to American Indians with
disabilities who reside on or near Federal or State reservations,
consistent with their individual strengths, resources, priorities,
concerns, abilities, capabilities, and informed choices, so that they
may prepare for and engage in gainful employment, including
self-employment, telecommuting, or business ownership.

[Priority]{.underline}: In accordance with 34 CFR 75.105(b)(2)(iv), this
priority is from section 121(b)(4) of the Rehabilitation Act of 1973, as
amended (29 U.S.C. 741).

[Competitive Preference Priority]{.underline}: For FY 2006 this priority
is a competitive preference priority. Under 34 CFR 75.105(c)(2)(i) we
award up to an additional 10 points to an application, depending on how
well the application meets this priority.

This priority is:

[Continuation of Previously Funded Tribal Programs]{.underline}

In making new awards under this program, we give priority consideration
to applications for the continuation of tribal programs that have been
funded under this program.

[Program Authority]{.underline}: 29 U.S.C. 741.

[Applicable Regulations]{.underline}: (a) The Education Department
General Administrative Regulations (EDGAR) in 34 CFR parts 75, 77, 80,
81, 82, 84, 85, and 97. (b) The regulations in 34 CFR parts 369 and 371.

II\. Award Information

[Type of Award]{.underline}: Discretionary grants.

[Estimated Available Funds]{.underline}: The Administration has plans to
set aside \$33,024,000 for the Vocational Rehabilitation Services
Projects for American Indians With Disabilities program for FY 2006, of
which we intend to use an estimated \$2,700,000 for this competition.
The actual level of funding, if any, depends on final congressional
action. However, we are inviting applications to allow enough time to
complete the grant process if Congress appropriates funds for this
program.

[Estimated Median Amount of Awards]{.underline}: The estimated median
amount of an award is \$500,000, which means that one-half of the awards
will be over \$500,000 and one-half of the awards will be under
\$500,000, with the majority of awards in the range of approximately
\$350,000 to \$575,000.

[Maximum Award]{.underline}: There is no maximum award amount for the
first project year. However, when preparing your submission, applicants
should be aware that we anticipate an increase of about three percent in
the award amounts for this program compared to FY 2005.

In addition, the Secretary may limit any proposed increases in funding
for project years two through five to the annual estimated percentage
change in the consumer price index for all urban consumers (CPIU). The
current estimated percentage increase in the CPIU over the prior year
for project years two through five is as follows: FY 2007 -- 2.9
percent, FY 2008 -- 2.4 percent, FY 2009 -- 2.4 percent, and FY 2010 --
2.4 percent.

[Estimated Number of Awards]{.underline}: 5.

[Note]{.underline}: The Department is not bound by any estimates in this
notice.

[Project Period]{.underline}: Up to 60 months.

III\. Eligibility Information

1\. [Eligible Applicants]{.underline}: The governing bodies of Indian
tribes (and consortia of those governing bodies) located on Federal and
State reservations.

2.  [Cost Sharing or Matching]{.underline}: See 34 CFR 371.40.

IV\. Application and Submission Information

1\. [Address to Request Application Package]{.underline}**:** Education
Publications Center (ED Pubs), P.O. Box 1398, Jessup, MD 20794-1398.
Telephone (toll free): 1-877-433-7827. FAX: (301) 470-1244. If you use a
telecommunications device for the deaf (TDD), you may call (toll free):
1-877-576-7734.

You may also contact ED Pubs at its Web site:
www.ed.gov/pubs/edpubs.html or you may contact ED Pubs at its e-mail
address: edpubs@inet.ed.gov

If you request an application from ED Pubs, be sure to identify this
competition as follows: CFDA number 84.250B.

Individuals with disabilities may obtain a copy of the application
package in an alternative format (e.g., Braille, large print, audiotape,
or computer diskette) by contacting the Grants and Contracts Services
Team, U.S. Department of Education, 400 Maryland Avenue, SW., room 5075,
Potomac Center Plaza, Washington, DC 20202-2550. Telephone: (202)
245-7363. If you use a telecommunications device for the deaf (TDD), you
may call the Federal Relay Service (FRS) at 1-800-877-8339.

2\. [Content and Form of Application Submission]{.underline}:
Requirements concerning the content of an application, together with the
forms you must submit, are in the application package for this
competition.

Page Limit: The application narrative (Part III of the application) is
where you, the applicant, address the selection criteria that reviewers
use to evaluate your application. It is suggested that you limit Part
III to the equivalent of no more than 35 pages, using the following
standards:

-   A "page" is 8.5" x 11", on one side only, with 1" margins at the
    top, bottom, and both sides.

-   Double space (no more than three lines per vertical inch) all text
    in the application narrative, including titles, headings, footnotes,
    quotations, references, and captions, as well as all text in charts,
    tables, figures, and graphs.

-   Use a font that is either 12 point or larger or no smaller than 10
    pitch (characters per inch).

The suggested page limit does not apply to Part I, the cover sheet; Part
II, the Budget section, including the narrative budget justification;
Part IV, the assurances and certifications; or the one-page abstract,
the resumes, the bibliography, or the letters of support.

3\. [Submission Dates and Times]{.underline}:

Applications Available: December 27, 2005

Deadline for Transmittal of Applications: April 21, 2006.

Applications for grants under this competition may be submitted
electronically using the Grants.gov Apply site (Grants.gov), or in paper
format by mail or hand delivery. For information (including dates and
times) about how to submit your application electronically, or by mail
or hand delivery, please refer to section IV. 6. [Other Submission
Requirements]{.underline} in this notice.

We do not consider an application that does not comply with the deadline
requirements.

4\. [Intergovernmental Review]{.underline}: This program is not subject
to Executive Order 12372 and the regulations in 34 CFR part 79.

5\. [Funding Restrictions]{.underline}: We reference regulations
outlining funding restrictions in the [Applicable
Regulations]{.underline} section of this notice.

6\. [Other Submission Requirements]{.underline}: Applications for grants
under this competition may be submitted electronically or in paper
format by mail or hand delivery.

a\. [Electronic Submission of Applications]{.underline}.

We have been accepting applications electronically through the
Department's e-Application system since FY 2000. In order to expand on
those efforts and comply with the President's Management Agenda, we are
continuing to participate as a partner in the new government wide
Grants.gov Apply site in FY 2006. Vocational Rehabilitation Services
Projects for American Indians With Disabilities\--CFDA Number 84.250B is
one of the programs included in this project. We request your
participation in Grants.gov.

If you choose to submit your application electronically, you must use
the Grants.gov Apply site at http://www.Grants.gov. Through this site,
you will be able to download a copy of the application package, complete
it offline, and then upload and submit your application. You may not
e-mail an electronic copy of a grant application to us.

You may access the electronic grant application for Vocational
Rehabilitation Services Projects for American Indians With
Disabilities---CFDA Number 84.250B competition at:
http://www.grants.gov. You must search for the downloadable application
package for this program by the CFDA number. Do not include the CFDA
number's alpha suffix in your search.

Please note the following:

• Your participation in Grants.gov is voluntary.

• When you enter the Grants.gov site, you will find information about
submitting an application electronically through the site, as well as
the hours of operation.

• Applications received by Grants.gov are time and date stamped. Your
application must be fully uploaded and submitted, and must be date/time
stamped by the Grants.gov system no later than 4:30 p.m., Washington, DC
time, on the application deadline date. Except as otherwise noted in
this section, we will not consider your application if it is date/time
stamped by the Grants.gov system later than 4:30 p.m., Washington, DC
time, on the application deadline date. When we retrieve your
application from Grants.gov, we will notify you if we are rejecting your
application because it was date/time stamped by the Grants.gov system
after 4:30 p.m., Washington, DC time, on the application deadline date.

• The amount of time it can take to upload an application will vary
depending on a variety of factors including the size of the application
and the speed of your Internet connection. Therefore, we strongly
recommend that you do not wait until the application deadline date to
begin the application process through Grants.gov.

• You should review and follow the Education Submission Procedures for
submitting an application through Grants.gov that are included in the
application package for this competition to ensure that you submit your
application in a timely manner to the Grants.gov system. You can also
find the Education Submission Procedures pertaining to Grants.gov at
http://e-grants.ed.gov/help/GrantsgovSubmissionProcedures.pdf

• To submit your application via Grants.gov, you must complete all of
the steps in the Grants.gov registration process (see
http://www.Grants.gov/GetStarted). These steps include (1) registering
your organization, (2) registering yourself as an Authorized
Organization Representative (AOR), and (3) getting authorized as an AOR
by your organization. Details on these steps are outlined in the
Grants.gov 3-Step Registration Guide (see
http://www.grants.gov/assets/GrantsgovCoBrandBrochure8X11.pdf). You also
must provide on your application the same D-U-N-S Number used with this
registration. Please note that the registration process may take five or
more business days to complete, and you must have completed all
registration steps to allow you to successfully submit an application
via Grants.gov.

• You will not receive additional point value because

you submit your application in electronic format, nor will we penalize
you if you submit your application in paper format.

• You may submit all documents electronically, including all information
typically included on the Application for Federal Education Assistance
(ED 424), Budget Information\--Non-Construction Programs (ED 524), and
all necessary assurances and certifications. If you choose to submit
your application electronically, you must attach any narrative sections
of your application as files in a .DOC (document), .RTF (rich text), or
.PDF (Portable Document) format. If you upload a file type other than
the three file types specified above or submit a password protected
file, we will not review that material.

• Your electronic application must comply with any page limit
requirements described in this notice.

• After you electronically submit your application, you will receive an
automatic acknowledgment from Grants.gov that contains a Grants.gov
tracking number. The Department will retrieve your application from
Grants.gov and send you a second confirmation by e-mail that will
include a PR/Award number (an ED-specified identifying number unique to
your application).

• We may request that you provide us original signatures on forms at a
later date.

Application Deadline Date Extension in Case of System Unavailability: If
you are prevented from electronically submitting your application on the
application deadline date because of technical problems with the
Grants.gov system, we will grant you an extension until 4:30 p.m.,
Washington, DC time, the following business day to enable you to
transmit your application electronically, or by hand delivery. You also
may mail your application by following the mailing instructions as
described elsewhere in this notice. If you submit an application after
4:30 p.m., Washington, DC time, on the deadline date, please contact the
person listed elsewhere in this notice under [For Further Information
Contact]{.underline}, and provide an explanation of the technical
problem you experienced with Grants.gov, along with the Grants.gov
Support Desk Case Number (if available). We will accept your application
if we can confirm that a technical problem occurred with the Grants.gov
system and that that problem affected your ability to submit your
application by 4:30 p.m., Washington, DC time, on the application
deadline date. The Department will contact you after a determination is
made on whether your application will be accepted.

[Note]{.underline}: Extensions referred to in this section apply only to
the unavailability of or technical problems with the Grants.gov system.
We will not grant you an extension if you failed to fully register to
submit your application to Grants.gov before the deadline date and time
or if the technical problem you experienced is unrelated to the
Grants.gov system.

b\. [Submission of Paper Applications by Mail]{.underline}.

If you submit your application in paper format by mail (through the U.S.
Postal Service or a commercial carrier), you must mail the original and
two copies of your application, on or before the application deadline
date, to the Department at the applicable following address:

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

> U.S. Department of Education
>
> Application Control Center

# Attention: (CFDA Number 84.250B)

# 400 Maryland Avenue, SW.

Washington, DC 20202-4260

or

[By mail through a commercial carrier]{.underline}:

U.S. Department of Education

Application Control Center -- Stop 4260

> Attention: (CFDA Number 84.250B)
>
> 7100 Old Landover Road

Landover, MD 20785-1506

Regardless of which address you use, 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.

c\. [Submission of Paper Applications by Hand Delivery]{.underline}.

If you submit your application in paper format by hand delivery, you (or
a courier service) must deliver the original and two copies of your
application by hand, on or before the application deadline date, to the
Department at the following address:

> U.S. Department of Education
>
> Application Control Center
>
> Attention: (CFDA Number 84.250B)
>
> 550 12th Street, SW.
>
> Room 7041, Potomac Center Plaza
>
> Washington, DC 20202-4260

The Application Control Center accepts hand deliveries daily between
8:00 a.m. and 4:30 p.m., Washington, DC time, except Saturdays, Sundays
and Federal holidays.

[Note for Mail or Hand Delivery of Paper Applications]{.underline}: If
you mail or hand deliver your application to the Department:

\(1\) You must indicate on the envelope and\--if not provided by the
Department\--in Item 4 of the Application for Federal Education
Assistance (ED 424) the CFDA number--- and suffix letter, if any---of
the competition under which you are submitting your application.

\(2\) The Application Control Center will mail a grant application
receipt acknowledgment to you. If you do not receive the grant
application receipt acknowledgment within 15 business days from the
application deadline date, you should call the U.S. Department of
Education Application Control Center at (202) 245-6288.

V. Application Review Information

####  [Selection Criteria]{.underline}: The selection criteria for this program are from 34 CFR 75.210 of EDGAR and are in the application package. The selection criteria may total 100 points, plus the 10 competitive preference priority points (see section I. [Competitive Preference Priority]{.underline}).

VI\. Award Administration Information

1\. [Award Notices]{.underline}: If your application is successful, we
notify your U.S. Representative and U.S. Senators and send you a Grant
Award Notification (GAN). We may also notify you informally.

If your application is not evaluated or not selected for funding, we
notify you.

> 2\. [Administrative and National Policy Requirements]{.underline}:

We identify administrative and national policy requirements in the
application package and reference these and other requirements in the
[Applicable Regulations]{.underline} section of this notice.

We reference the regulations outlining the terms and conditions of an
award in the [Applicable Regulations]{.underline} section of this notice
and include these and other specific conditions in the GAN. The GAN also
incorporates your approved application as part of your binding
commitments under the grant.

3\. [Reporting]{.underline}: At the end of your project period, you must
submit a final performance report, including financial information, as
directed by the Secretary. If you receive a multi-year award, you must
submit an annual performance report that provides the most current
performance and financial expenditure information as specified by the
Secretary in 34 CFR 75.118.

4\. [Performance Measures]{.underline}: Under the Government Performance
and Results Act of 1993 (GPRA), the Department has established two
performance measures for the Vocational Rehabilitation Services Projects
for American Indians with Disabilities program. The measures are the
percentage of individuals who leave the program with an employment
outcome and the cost per employment outcome. Each grantee must annually
report its performance on these measures through the Annual Progress
Reporting Form for the American Indian Vocational Rehabilitation
Services (AIVRS) Program.

In addition, this program is part of the Administration\'s job training
and employment common measures initiative.  The common measures for job
training and employment programs targeting adults are: entered
employment (percentage employed in the first quarter after program
exit); retention in employment (percentage of those employed in the
first quarter after exit that were still employed in the second and
third quarter after program exit); earnings increase (percentage change
in earnings pre-registration to post program and first quarter after
exit to third quarter after exit); and efficiency (annual cost per
participant). The Department is currently working toward implementation
of these common measures. Each grantee will be required to collect and
report data for the common measures when implemented.

#### VII. Agency Contact

[For Further Information Contact]{.underline}: Alfreda Reeves, U.S.
Department of Education, 400 Maryland Avenue, SW., room 5051, Potomac
Center Plaza, Washington, DC 20204-2800. Telephone: (202) 245-7485.

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, audiotape, or computer diskette) on
request by contacting the following office: The Grants and Contracts
Services Team, U.S. Department of Education, 400 Maryland Avenue, SW.,
Potomac Center Plaza, Washington, DC 20202-2550. Telephone: (202)
245-7363.

#### VIII. Other Information 

[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:
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:
www.gpoaccess.gov/nara/index.html

Dated:

> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

John H. Hager,

[Assistant Secretary]{.underline}

[for Special Education and]{.underline}

> [Rehabilitative Services]{.underline}.

**[SECTION B]{.underline}**

**APPLICATION REVIEW CRITERIA FOR VR SERVICE PROJECTS FOR AMERICAN
INDIANS WITH DISABILITIES (Section 121\--CFDA 84.250B)**

**The Peer Reviewers are asked to rate and award scores to the way an
application describes each of the following criteria. Based on the
quality of the responses, an application may receive up to 100 points
from each Reviewer. (Those applications eligible for the competitive
preference priority my receive up to 110 points per reviewer.)**

**(a) NEED FOR PROJECT\--5 POINTS.** The Secretary considers the need
for the proposed project, based on the following factors:

1\. The magnitude of the need for the services to be provided or the
activities to be carried out by the proposed project.

2\. The extent to which specific gaps or weaknesses in services,
infrastructure, or opportunities have been identified and will be
addressed by the proposed project, including the nature and magnitude of
those gaps or weaknesses.

**(b) SIGNIFICANCE\--10 POINTS.** The Secretary considers the
significance of the proposed project, based on the following factors:

1\. The potential contribution of the proposed project to increased
knowledge or understanding of rehabilitation problems, issues, or
effective strategies.

2\. The extent to which the proposed project is likely to build local
capacity to provide, improve, or expand services that address the needs
of the target population.

**(c) QUALITY OF THE PROJECT DESIGN\--15 POINTS.** The Secretary
considers the quality of the design of the proposed project, based on
the following factors:

1.  The extent to which the goals, objectives, and outcomes to be

achieved by the proposed project are clearly specified and measurable.

2\. The extent to which the design of the proposed project is
appropriate to, and will successfully address, the needs of the target
population or other identified needs.

3\. The extent to which the proposed project will be coordinated with
similar or related efforts, and with other appropriate community, State,
and Federal resources.

4\. The extent to which the proposed project encourages consumer
involvement.

5\. The quality of the methodology to be employed in the proposed
project.

**(d) QUALITY OF PROJECT SERVICES\--25 POINTS.** The Secretary considers
the quality of the services to be provided by the proposed project. The
application should include information on the following factors:

1\. The quality and sufficiency of strategies for ensuring equal access
and treatment for eligible project participants who are members of
groups that have traditionally been underrepresented based on race,
color, national origin, gender, age, or disability.

2\. The extent to which the services to be provided by the proposed
project are appropriate to the needs of the intended recipients or
beneficiaries of those services.

3\. The likely impact of the services to be provided by the proposed
project on the intended recipients of those services.

4\. The extent to which the services to be provided by the proposed
project involve the collaboration of appropriate partners for maximizing
the effectiveness of project services.

**(e) QUALITY OF PROJECT PERSONNEL\--15 POINTS.** The Secretary
considers the quality of the personnel who will carry out the

proposed project. All of the following factors are considered:

1\. The extent to which the applicant encourages applications for
employment from persons who are members of groups that have
traditionally been underrepresented based on race, color, national
origin, gender, age, or disability.

2\. The qualifications, including relevant training and experience, of
key project personnel.

**(f) ADEQUACY OF RESOURCES\--10 POINTS.** The Secretary considers the
adequacy of resources for the proposed project, including the following
factors:

1\. The adequacy of support, including facilities, equipment, supplies,
and other resources, from the applicant organization or the lead
applicant organization.

2\. The extent to which the costs are reasonable in relation to the
objectives, design, and potential significance of the proposed project.

3\. The extent to which the costs are reasonable in relation to the
number of persons to be served and to the anticipated results and
benefits.

**(g) QUALITY OF THE MANAGEMENT PLAN\--15 POINTS.** The Secretary
considers the quality of the management plan for the proposed project,
including the following factors:

1\. The adequacy of the management plan to achieve the objectives of the
proposed project on time and within budget, including clearly defined
responsibilities, timelines, and milestones for accomplishing project
tasks.

2\. The extent to which the time commitments of the project director and
principal investigator and other key project personnel are appropriate
and adequate to meet the objectives of the proposed project.

**(h) QUALITY OF THE PROJECT EVALUATION\--5 POINTS.** The Secretary
considers the quality of the evaluation to be conducted of the proposed
project. The Secretary looks for information that shows:

1\. The extent to which the methods of evaluation are thorough,
feasible, and appropriate to the goals, objectives, and outcomes of the
proposed project.

2\. The extent to which the methods of evaluation include the use of
objective performance measures that are clearly related to the intended
outcomes of the project and will produce quantitative and qualitative
data to the extent possible.

3.The extent to which the methods of evaluation will provide performance
feedback and permit periodic assessment of progress toward achieving
intended outcomes.

(Approved by the Office of Management and Budget under control number
1875‑0102)

(Authority: 20 U.S.C. 1221e‑3 and 3474)

**EXPLANATION OF REVIEW CRITERIA**

**Listed below are the review criteria (a) through (h) that will be used
by peer reviewers to rate and award scores to proposals for the American
Indian Vocational Rehabilitation Services Grants. Each review criteria
is accompanied by an explanation of terms and other information to
assist the applicant in developing the various sections of the proposal.
Proposals should address [all]{.underline} of the factors listed under
each criteria.**

**IMPORTANT: Traditionally, recipients of American Indian Vocational
Rehabilitation Services Grants have provided services to American
Indians with disabilities who reside [on]{.underline} reservations. The
1998 Amendments to section 121 of the Rehabilitation Act allow tribal
vocational rehabilitation programs to expand services to American
Indians with disabilities living [near]{.underline} the reservation, if
they choose to do so. Applicants should state whether they are planning
to provide services to individuals living on the reservation, or to
individuals living on or near the reservation. Applicants who choose to
provide service to individuals living on or near the reservation should
describe the geographic area to be served by the grant.**

**(a) NEED FOR PROJECT \-- 5 POINTS.** The Secretary considers the need
for the proposed project, based on the following factors:

> 1\. The magnitude of the need for the services to be provided or the
> activities to be carried out by the proposed project.
>
> 2\. The extent to which specific gaps or weaknesses in services,
> infrastructure, or opportunities have been identified and will be
> addressed by the proposed project, including the nature and magnitude
> of those gaps and weaknesses.

**EXPLANATION:** Descriptions of need should focus on the purpose for
which these projects are funded \-- to provide vocational rehabilitation
services that will enable American Indians with disabilities to achieve
employment outcomes. Barriers to the provision of vocational
rehabilitation services and achievement of employment outcomes can also
be described. In describing gaps in services, applicants may provide
information that shows the extent to which VR services are provided by
State VR agencies to American Indians with disabilities in the
geographic area to be served by the project. In addition to
reservations, the geographic area to be served can include areas near
the reservation, as described by the applicant.

**(b) SIGNIFICANCE\--10 POINTS.** The Secretary considers the
significance of the proposed project, based on the following factors:

> 1\. The potential contribution of the proposed project to increased
> knowledge or understanding of rehabilitation problems, issues, or
> effective strategies.
>
> 2\. The extent to which the proposed project is likely to build local
> capacity to provide, improve, or expand services that address the
> needs of the target population.

**EXPLANATION:** Describe the extent to which the proposed project will
expand or improve the practice of vocational rehabilitation for American
Indians with disabilities. Describe how proposed services and
strategies, including services traditionally used by Indian tribes, will
improve employment outcomes for American Indians with disabilities to be
served by the project.

**(c) QUALITY OF THE PROJECT DESIGN\--15 POINTS.** The Secretary
considers the quality of the design of the proposed project, based on
the following factors:

> 1\. The extent to which the goals, objectives, and outcomes to be
> achieved by the proposed project are clearly specified and measurable.
>
> 2\. The extent to which the design of the proposed project is
> appropriate to, and will successfully address, the needs of the target
> population or other identified needs.
>
> 3\. The extent to which the proposed project will be coordinated with
> similar or related efforts, and with other appropriate community,
> State, and Federal resources.
>
> 4\. The extent to which the proposed project encourages consumer
> involvement.
>
> 5\. The quality of the methodology to be employed in the proposed
> project.

**EXPLANATION:** Describe the overall plan for the project and how the
goals, objectives, outcomes, project design and methodology are directed
toward the provision of vocational rehabilitation services for the
achievement of employment outcomes. The overall project design should be
compatible with the assurance statements made in response to the special
application requirements at 34 CFR 371.21(a)-(j). Proposals should
identify the measurable results expected to be achieved during each year
of the project. In order to meet the needs of the target population,
proposals need to describe collaborative arrangements with State
vocational rehabilitation agencies (as required at 371.21(g)) and
linkages with other appropriate community, State, and Federal resources.
Commitments of other organizations should be clearly documented,
preferably in writing, and submitted with the application. Methods of
encouraging consumer involvement include providing opportunities for
input from American Indians with disabilities residing on or near the
reservation (as required at 371.21(f)), establishment of an advisory
committee as described at 34 CFR 369.45, or other approaches.

**(d) QUALITY OF PROJECT SERVICES\--25 POINTS.** The Secretary considers
the quality of the services to be provided by the proposed project. The
application should include information on the following factors:

> 1\. The quality and sufficiency of strategies for ensuring equal
> access and treatment for eligible project participants who are members
> of groups that have traditionally been underrepresented based on race,
> color, national origin, gender, age, or disability.
>
> 2\. The extent to which the services to be provided by the proposed
> project are appropriate to the needs of the intended recipients or
> beneficiaries of those services.
>
> 3\. The likely impact of the services to be provided by the proposed
> project on the intended recipients of those services.
>
> 4\. The extent to which the services to be provided by the proposed
> project involve the collaboration of appropriate partners for
> maximizing the effectiveness of project services.

**EXPLANATION:** Proposals should describe how the program will, to the
extent feasible, provide rehabilitation services that are comparable to
those provided by State VR agencies, including providing a broad variety
of vocational rehabilitation services as described in section 103 of the
Act. (See also Special Requirement 371.21(a)) Proposals may also
describe other aspects of service provision, including providing
services traditionally used by Indian tribes and providing traditional
VR services in a culturally appropriate manner. Proposals should
demonstrate that persons with disabilities will be able to access
services as required by the Americans with Disabilities Act.
Descriptions of the appropriateness and impact of services must relate
to the purpose of the program, which is the achievement of employment
outcomes by American Indians with disabilities. Proposals may also
describe other impacts of services to be provided by the project.
Proposals should include a description of how collaboration and linkages
described under "Quality of project design" contribute to the
effectiveness of project services.

**(e) QUALITY OF PROJECT PERSONNEL\--15 POINTS.** The Secretary
considers the quality of the personnel who will carry out the proposed
project. All of the following factors are considered:

> 1\. The extent to which the applicant encourages applications for
> employment from persons who are members of groups that have
> traditionally been underrepresented based on race, color, national
> origin, gender, age, or disability.
>
> 2\. The qualifications, including relevant training and experience, of
> key project personnel**.**

**EXPLANATION:** As stated at 34 CFR 371.43(b), preference in employment
must be given to American Indians, with a special priority being given
to American Indians with disabilities. Provide a resume for the project
director and other key project personnel, such as vocational
rehabilitation counselors. For each of the key personnel not identified
at the time of application, provide a job description or the
qualifications sought for the position. In addition to describing the
qualifications of key personnel, the applicant can also propose use of
training and other staff development activities to enhance these
qualifications. Program regulations at 34 CFR 371.41(a)(1) allow for
expenditures for staff development. Applicants may describe staff
development efforts that are funded by the grant or that are provided
through collaborative arrangements with any other appropriate resource,
including, but not limited to, the State vocational rehabilitation
agency and the Regional Rehabilitation Continuing Education Programs.

**(f) ADEQUACY OF RESOURCES\--10 POINTS.** The Secretary considers the
adequacy of resources for the proposed project, including the following
factors:

> 1\. The adequacy of support, including facilities, equipment,
> supplies, and other resources, from the applicant organization or the
> lead applicant organization.
>
> 2\. The extent to which the costs are reasonable in relation to the
> objectives, design, and potential significance of the proposed
> project.
>
> 3\. The extent to which the costs are reasonable in relation to the
> number of persons to be served and to the anticipated results and
> benefits.

**EXPLANATION:** Describe the facilities that will be used for the
project. When describing the adequacy of support for facilities,
equipment, etc. the proposal needs to consider how the applicant will
meet the requirements for confidentiality of information at 34 CFR
369.46 and the extent to which facilities and other resources are fully
accessible by individuals with disabilities. Identify specific
contributions to the project by the applicant and by collaborating
organizations, including in-kind contributions, cost sharing, donations,
etc. When describing the relationship of costs to objectives, design,
significance, and outcomes, the proposal can provide information about
any special factors that influence the cost.

**(g) QUALITY OF** **THE MANAGEMENT PLAN\--15 POINTS.** The Secretary
considers the quality of the management plan for the proposed project,
including the following factors:

> 1\. The adequacy of the management plan to achieve the objectives of
> the proposed project on time and within budget, including clearly
> defined responsibilities, timelines, and milestones for accomplishing
> project tasks.
>
> 2\. The extent to which the time commitments of the project director
> and principal investigator and other key project personnel are
> appropriate and adequate to meet the objectives of the proposed
> project.

**EXPLANATION:** The proposal should describe process by which the goals
and objectives will be met, such as the roles and responsibilities of
project staff, and when and how these will be achieved. Major tasks and
activities should be broken down into action steps to be completed by
specific dates. Applicants can use a timetable, GANT chart, or Pert
Chart to graphically present the sequence and relationship of project
activities to be included in the proposal.

**(h) QUALITY OF THE PROJECT EVALUATION\--5 POINTS.** The Secretary
considers the quality of the evaluation to be conducted of the proposed
project. The Secretary looks for information that shows:

> 1\. The extent to which the methods of evaluation are thorough,
> feasible, and appropriate to the goals, objectives, and outcomes of
> the proposed project.
>
> 2\. The extent to which the methods of evaluation include the use of
> objective performance measures that are clearly related to the
> intended outcomes of the project and will produce quantitative and
> qualitative data to the extent possible.
>
> 3\. The extent to which the methods of evaluation will provide
> performance feedback and permit periodic assessment of progress toward
> achieving intended outcomes.

**EXPLANATION:** Describe how appropriate and reliable data will be
obtained and evaluated. Proposals can consider use of external
evaluation methods. The evaluation plan should include a description of
how evaluation activities will be phased in with other project tasks to
ensure that periodic assessment provides performance feedback to project
staff in time to influence the conduct of the project. Evaluation
methods can include methods of gathering consumer input.

**[SECTION C]{.underline}**

**SPECIAL APPLICATION REQUIREMENTS FOR**

**VOCATIONAL REHABILITATION SERVICE PROJECTS**

**FOR AMERICAN INDIANS WITH DISABILITIES**

**Applicants for the Vocational Rehabilitation Service Projects for
American Indians with Disabilities must provide assurances that they
will meet the special application requirements stated at 34 CFR
371.21(a)-(j). Each application will be reviewed by the Department of
Education to determine whether the applicant has provided the required
assurances. Applications that do not include these assurances will be
returned and will not be submitted for the peer review process.**

**INSTRUCTIONS**

**Listed below are the special application requirements at 34 CFR
371.21(a)-(j), explanatory notes, and instructions for the content of
the required assurance statements. Provide the assurance statements in a
separate section of the application entitled \"Special Application
Requirements.\"**

371.21(a): Effort will be made to provide a broad scope of vocational
rehabilitation services in a manner and at a level of quality at least
comparable to those services provided by the designated State unit under
34 CFR part 361.

> **NOTE:** \"Vocational rehabilitation services\" are defined in
> section 103 of the Rehabilitation Act Amendments of 1998. (A copy of
> section 103 is enclosed.) Applicants should plan to provide those
> vocational rehabilitation services needed by the individuals
> identified in the proposal as part of the evidence of need for the
> project. Applicants are not required to provide every service listed.
> While efforts should be made to provide services that are comparable
> to those provided by the state vocational rehabilitation agency,
> services provided by tribal programs are not required to be identical
> to those provided by a state vocational rehabilitation agency.
>
> **[ASSURANCE STATEMENT]{.underline}:** A description of each of the
> vocational rehabilitation services planned by the applicant.

**371.21(b): Decisions affecting eligibility for and the nature and
scope of vocational rehabilitation services to be provided, and the
provision of these services, will be made by the tribal vocational
rehabilitation program through its vocational rehabilitation unit and
will not be delegated to another agency or individual.**

> **NOTE:** Decisions about the eligibility of American Indians with
> disabilities and the services that eligible individuals receive can be
> made only by the staff of the tribal
>
> vocational rehabilitation program. Staff of other tribal agencies and
> the project's advisory committee, if it has one, are not authorized to
> make these decisions.
>
> **[ASSURANCE STATEMENT]{.underline}:** An assurance statement that
> decisions about eligibility, the nature and scope of services, and the
> provision of services will be made only by the tribal vocational
> rehabilitation unit and not by any other entity.

371.21(c) and (d): An order of selection of individuals with
disabilities to be served under the program will be specified if
services cannot be provided to all eligible American Indians with
disabilities who apply. Priority in the delivery of vocational
rehabilitation services will be given to those American Indians with
disabilities who are the most severely disabled.

> **[ASSURANCE STATEMENT]{.underline}:** Depending on the applicant\'s
> situation, the application must include [one]{.underline} of the
> following:
>
> 1\. An assurance statement that the applicant expects to have enough
> resources to be able to serve all eligible American Indians with
> disabilities who are expected to apply.

OR

> 2\. A description of the order of selection, prioritized on the basis
> of severity of disability, and giving the highest priority to those
> who are most severely disabled.

371.21(e): All vocational rehabilitation services will be provided
according to an individualized plan of employment which has been
developed jointly by the representative of the service providing
organization and each American Indian with disabilities being served.

> **NOTE:** \"Service providing organization\" means the tribal
> vocational rehabilitation program. An individualized plan for
> employment is a written agreement between the tribal vocational
> rehabilitation program unit and the eligible American Indian with a
> disability. The individualized plan for employment specifies the
> individual\'s employment goal, the vocational rehabilitation services
> that will be provided to address the individual\'s disability and to
> achieve a vocational outcome, and how those services will be provided,
> including the entity providing the services and timelines for the
> provision of services.
>
> In addition, applicants for grants may choose to incorporate other
> requirements of section 102(b) of the Act that apply to State
> vocational rehabilitation agencies in the development of an
> individualized plan for employment. (A copy of section 102(b) is
> included in the application kit.)
>
> **[ASSURANCE STATEMENT]{.underline}:** An assurance statement that
> individualized plans for employment will be jointly developed for all
> eligible American Indians with disabilities.

371.21(f): American Indians with disabilities living on Federal or State
reservations where service programs are being carried out under this
part will have an opportunity to participate in matters of general
policy development and implementation affecting vocational
rehabilitation service delivery on the reservation.

> **NOTE:** In addition to providing services on the reservation, the
> Rehabilitation Act Amendments of 1998 allow applicants to determine
> whether they will also provide vocational rehabilitation services to
> American Indians with disabilities living [near]{.underline} the
> reservation. Applicants who decide to provide services to American
> Indians with disabilities living near the reservation will describe
> the geographic area in which the services will be provided.
> Opportunities for participation of American Indians with disabilities
> living on or near the reservation can be provided by establishment of
> an advisory committee as described at 34 CFR 369.45, or other
> approaches.
>
> **[ASSURANCE STATEMENT]{.underline}:** An assurance statement that the
> applicant will provide an opportunity for American Indians with
> disabilities living on or near the reservation, as described by the
> applicant, to participate in matters related to the development and
> implementation of general policies affecting the provision of
> vocational rehabilitation services under this grant.

371.21(g): Cooperative working arrangements will be developed with the
designated State unit, or designated State units, as appropriate, which
are providing vocational rehabilitation services to other individuals
with disabilities who reside in the State or States being served.

> **NOTE:** The 1998 Amendments to the Rehabilitation Act strengthened
> the requirement for collaboration between tribal and State vocational
> rehabilitation programs. Section 101(a)(11)(F) of the Act requires
> State vocational rehabilitation agencies to enter into formal
> cooperative agreements with each recipient of an American Indian
> vocational rehabilitation service project in the State. The agreement
> must describe strategies for collaboration and coordination in
> providing vocational rehabilitation services to American Indians who
> are individuals with disabilities, including \--
>
> \- strategies for interagency referral and information sharing that
> will assist in eligibility determinations and the development of
> individualized plans for employment;
>
> \- procedures for ensuring that American Indians who are individuals
> with disabilities and are living near a reservation or tribal service
> area are provided vocational rehabilitation services; and
>
> \- provisions for sharing resources in cooperative studies and
> assessments, joint training activities, and other collaborative
> activities designed to improve the provision of services to American
> Indians who are individuals with disabilities.
>
> **[ASSURANCE STATEMENT]{.underline}:** An assurance statement that the
> applicant has established or will establish a formal cooperative
> agreement, or agreements if appropriate, that include the required
> strategies for collaboration and coordination of service provision.

371.21(h): Any comparable services and benefits available to American
Indians with disabilities under any other program which might meet in
whole or in part the cost of any vocational rehabilitation service will
be fully considered in the provision of vocational rehabilitation
services in accordance with 34 CFR part 361.

> **NOTE:** As defined in 34 CFR 361, "comparable services and
> benefits\" means services and benefits that are: 1) provided or paid
> for, in whole or in part, by other Federal, State, or local public
> agencies, by health insurance, or by employee benefits; 2) available
> to the individual at the time needed to achieve the goals of the
> individualized plan for employment; and 3) commensurate to the
> services the individual would otherwise receive from the vocational
> rehabilitation program.
>
> **[ASSURANCE STATEMENT]{.underline}:** An assurance statement that the
> applicant will assist individuals with disabilities to fully consider
> the appropriate use of all comparable services and benefits available
> through other sources.

**371.21(I): Any American Indian with disabilities who is an applicant
or recipient of services, and who is dissatisfied with a determination
made by a counselor or coordinator under this program and files a
request for a review, will be afforded a review under procedures
developed by the grantee comparable to those under the provisions of
section 102(c)(5)(A)-(I) of the Act.**

> **NOTE:** Applicants for grants must develop due process procedures by
> which an American Indian with a disability is provided an opportunity
> to have his/her grievance reviewed at levels above that at which the
> original decision was made. Applicants may model their due process
> procedures on those described in section 102(c)(5)(A)-(I) of the Act.
> Applicants may use tribal courts, impartial hearing officers from the
> list developed by the State vocational rehabilitation agency, or other
> methods. (A copy of section 102(c)(5)(A)-(I) is enclosed.)
>
> **[ASSURANCE STATEMENT]{.underline}:** An assurance that due process
> procedures have been developed or will be developed, with an early
> time line for that development.

371.21(j): Minimum standards will be established for community
rehabilitation programs and providers of services which will be
comparable to the standards set by the designated State unit and
designated State units in the State or States in which the program is to
be provided.

> **NOTE:** \"Community rehabilitation programs\" are defined at 34 CFR
> 369.4. Applicants may choose to adopt State agency standards or they
> may modify State agency standards. At a minimum, community
> rehabilitation programs and other service providers should be
> accessible to individuals with disabilities. Other standards to
> consider include the qualifications of the personnel providing the
> requested service, the extent to which an individual's special
> communication needs can be met, and the existence of procedures to
> prevent fraud, waste and abuse.
>
> **[ASSURANCE STATEMENT]{.underline}:** A description of how the
> applicant will assure use of qualified service providers.

For more information, please contact:

Alfreda Reeves RSA, Wash. DC 202-245-7485

Dr. Thomas E. Finch RSA, Wash. DC 202-245-7343

**ELIGIBLE APPLICANT FOR SUBMITTING A PROPOSAL FOR A SECTION 121 GRANT**

American Indian tribes may submit applications for American Indian
Vocational Rehabilitation (VR) Services Projects funded under section
121 of the Rehabilitation Act of 1973, as amended, using one of the
following options.

> 1\) An Indian tribe may submit a 121 proposal to provide VR services
> only to American Indians with disabilities living on its own
> reservation.
>
> 2\) An Indian tribe may submit a 121 proposal to provide VR services
> to American Indians with disabilities living on its own reservation
> and to American Indians with disabilities living on the reservations
> of other Indian tribes, under an inter-tribal arrangement as
> referenced in 34 CFR 371.42(b). **Such a proposal must include a
> written authorization from the governing bodies of the other Indian
> tribes that allows VR services to be provided by the Indian tribe
> receiving the 121 grant.** An example of a suitable written
> authorization is provided in Sample #1.
>
> 3\) A consortium of Indian tribes may submit a 121 proposal. As
> defined in 34 CFR 371.4, a consortium means "two or more eligible
> governing bodies of Indian tribes that make application as a single
> applicant under an agreement whereby each governing body is legally
> responsible for carrying out all of the activities in the
> application." **Such a proposal must include written authorizations
> from the governing bodies of all the tribes who are members of the
> consortium, acknowledging this legal responsibility.** An example of a
> suitable written authorization is provided in Sample #2.

SAMPLE #1

Inter-tribal Arrangement

> Section 34 CFR 371.42(b) provides that a section 121 grantee may enter
> into an inter-tribal arrangement with governing bodies of other Indian
> tribes for carrying out a project that serves more than one tribe. An
> American Indian Tribe may submit a proposal for a section 121 project
> to provide services to American Indians with disabilities living on
> its reservation and on the reservations of other Indian tribes, so
> long as the governing bodies of the other Indian tribes provide
> written authorization allowing for the provision of such services. The
> written Dear (**official name of the governing body of the Indian
> Tribe submitting the application**):
>
> (Whatever opening statements the writer deems appropriate.)
>
> Pursuant to 34 CFR § 371.42(b), the (*official name of the governing
> body of the Indian Tribe supporting the application*) agrees to enter
> into an arrangement whereby the (**Indian Tribe submitting the
> application**) will carry out a vocational rehabilitation (VR) project
> authorized under section 121 of the Rehabilitation Act of 1973. This
> arrangement authorizes the (**Indian Tribe submitting the
> application**) to submit an application for a grant pursuant to 34 CFR
> § 371.42(b) to fund a VR project that will include the provision of VR
> services to American Indians with disabilities residing on the
> reservation of the (*Indian tribe supporting the application*).
>
> (Whatever justification of the need for the project the writer deems
> appropriate.)
>
> (Whatever closing statements the writer deems appropriate.)
>
> Sincerely,
>
> (Name of official authorized to sign this letter)
>
> (Name of Indian Tribe)

SAMPLE #2

Consortium

A consortium of Indian tribes may submit a proposal for a section 121
project. As defined under 34 CFR 371.4, a consortium means "two or more
eligible governing bodies of Indian tribes that make application as a
single applicant under an agreement whereby each governing body is
legally responsible for carrying out all of the activities in the
application." A single application from a consortium of Indian Tribes
must include the following statement (or something similar that has the
same legal effect) from each of the tribes that is included in the
consortium.

> The (**the official name of each governing body of the Indian Tribe
> that is included in the consortium**) submits this application as a
> member of the consortium that is submitting an application for a grant
> under section 121 of the Rehabilitation Act of 1973 (the Act) to carry
> out an American Indian vocational rehabilitation (VR) project. The VR
> project will be carried out by the (*the official name of the
> governing body of the Indian Tribe or Tribes that will be actually
> carrying out the project*). However, the (**Tribe included in the
> consortium**) understands and agrees that, in the event that the
> (*Tribe or Tribes carrying out the project*) or any other Indian Tribe
> that is a member of this consortium is unable to carry out this
> project, the (**Tribe included in the consortium**) alone will be held
> legally responsible to ensure that the VR project to be funded under
> section 121 of the Act is carried out. The VR project to be carried
> out under this grant will provide services to American Indians with
> disabilities who reside on the reservation of each of the Indian
> Tribes included in this consortium.

This statement from each of the Indian Tribes included in the consortium
must be signed by a Tribal official authorized to sign such a statement
and submit an application for funds under section 121 of the Act.

**[SECTION D]{.underline}**

######## GENERAL INFORMATION ON COMPLETING AN APPLICATION

1\. The purpose and goal of the project is to provide vocational
rehabilitation services to enable consumers to prepare for and obtain
gainful employment.

2\. Applicants **MUST** address the Special Requirements\--applications
will be returned if they are not addressed! In your application, include
these assurances in a separate section titled "Special Requirements".

3\. The 121 projects MUST deliver a wide variety of vocational
rehabilitation services to meet the needs of consumers with
disabilities.

4\. Make it [easy]{.underline} for the reviewers to appropriately rate
your application. The application narrative (Part III of this
application form) should be organized to follow the exact sequence of
the components in the selection criteria used to evaluate applications.

> [Please number ALL pages\--including the Appendices.]{.underline}
>
> [Remember to cross-reference the narrative sections of your
> application ,if you are including further information in the
> appendix.]{.underline}
>
> [Include a Table of Contents.]{.underline}
>
> [Include a one-page single-spaced abstract.]{.underline}
>
> [Do not bound applications.]{.underline}
>
> [Try to keep the narrative to 35 pages, double-spaced.]{.underline}

5\. Definitions/Information for preparing the Budget:

> [Equipment]{.underline}-Tangible, nonexpendable property having a
> useful life of more than one year and an acquisition cost of \$5,000
> or more per unit. However, consistent with YOUR institutional policy,
> lower limits may be established.
>
> [Supplies]{.underline}-Direct materials and supplies that are
> consumable, expendable or of a relatively low unit cost.
>
> [Personnel]{.underline}-All project staff who are paid for by the
> grant or whose time is used to meet the match requirement.
>
> [Match]{.underline}-The match is computed on the TOTAL cost of the
> project (both Federal and applicant contributions). The easiest way to
> compute the correct local match is to divide the requested Federal
> funds by 9. Example: \$100,000 requested Federal funds per year/9 =
> [\$11,111]{.underline} required match per year.
>
> [Other]{.underline}-This is the place for all direct costs that are
> not clearly covered by the other direct cost categories. It is a
> catch-all category that could include a wide variety of costs that do
> not seem to \"fit\" elsewhere in the budget. For instance, postage and
> copying; as well as all Client services including training and
> stipends, etc. listed in this category.

[Staff training costs]{.underline} ARE allowable expenses.

6\. There is a maximum award amount specified for the competition
included in the Federal Register Notice.

7\. Include a multi-year budget breakdown.

8\. KEY PERSONNEL are defined as the Project Director, Principle
Investigator and/or the Project Coordinator. Please provide a resume or
a job description for all key personnel and other staff members.

9\. If you are eligible for the 10 bonus points as a continuation of a
previously funded 121 project,

provide the name of the Tribe or Consortia and the dates of the project
period.

NOTIFICTION OF FUNDING

The time to complete the evaluation of applications is variable. Once
applications have been received staff must appropriately evaluate the
applications, identify and contact potential reviewers, convene peer
review panels, and summarize and review the recommendations of the
review panels. The recommendation package then enters a departmental
review. You may receive notification within 3 months of the application
closing date, depending on the number of applications received.

MAKING SURE APPLICATION IS ASSIGNED TO THE CORRECT COMPETITION

Applicants should clearly indicate in Item 3 on the application (ED Form
424) the CFDA number of the program priority (e.g., 84.250B)
representing the competition in which the application should be
considered. If this information is not provided, your application may
inadvertently be assigned and reviewed under a different competition
from the one you intended.

DELIVERING/SENDING APPLICATIONS

Applications can be hand delivered, submitted electronically
(www.Grants.gov), or mailed but in either case [must]{.underline} go to
the Application Control Center at the address listed in the [Application
Transmittal Instructions]{.underline}. Delivering or sending the
application to the competition manager in the program office may prevent
if from being logged in on time to the appropriate competition and may
results in the application not being reviewed.

**[SECTION E]{.underline}**

Application Transmittal Instructions

##### ATTENTION ELECTRONIC APPLICANTS: Please note that you must follow the Application Procedures as described in the Federal Register notice announcing the grant competition. Some programs may require electronic submission of applications, and those programs will have specific requirements and waiver instructions in the Federal Register notice. 

An original and two copies of an application for an award must be mailed
or hand-delivered by the application deadline date unless it is
submitted electronically. To help expedite our review process, we would
appreciate your voluntarily including an additional 3 copies of your
applications.

### Applications Submitted Electronically

You must submit your grant application through the Internet using the
software provided on the Grants.gov Web site
([http://www.grants.gov](http://www.grants.gov/)) by 4:30 p.m.
(Washington, DC time) on the application deadline date.

If you submit your application through the Internet via the Grants.gov
Web site, you will receive an automatic acknowledgment when we receive
your application.

For more information on using Grants.gov, please refer to the Notice
Inviting Applications that was published in the Federal Register, the
Grants.gov Submission Procedures and Tips document found in the
application package instructions, and visit http://www.grants.gov.

## **Applications Delivered by Mail**

Applications sent by mail must be addressed to:

> U.S. Department of Education
>
> Application Control Center
>
> [Attention: (84.250B CFDA Number)]{.underline}

400 Maryland Avenue, SW.

####  Washington, D.C. 20202-4260

Applicants 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

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

If an application is sent through the U.S. Postal Service, the Secretary
does 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

Applicants should note that 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.

If you send your application by mail or if you or you courier deliver it
by hand, the Application Control Center will mail a Grant Application
Receipt Acknowledgment to you. If you do not receive the notification of
application receipt within 15 days from the mailing of the application,
you should call the U.S. Department of Education Application Control
Center at (202) 245-6288.

You must indicate on the envelope and---if not provided by the
Department---in Item 4 of the Application for Federal Education
Assistance (ED 424 (exp. 04/30/08)) the CFDA number -- and suffix
letter, if any -- of the competition under which you are submitting your
application.

If your application is late, we will notify you that we will not
consider the application.

### Applications Delivered by Commercial Carrier/Hand

Special Note: Due to recent disruptions to normal mail delivery, the
Department encourages you to consider using an alternative delivery
method (for example, a commercial carrier, such as Federal Express or
United Parcel Service; or U.S. Postal Services Express Mail) to transmit
your application for this competition to the Department. If you use an
alternative delivery method, please obtain the appropriate proof of
mailing under "Applications Sent by Mail," then follow the mailing
instructions under the appropriate delivery method.

Applications that are delivered by commercial carrier, such as Federal
Express, United Parcel Service, etc. should be mailed to the:

**U. S. Department of Education**

**Application Control Center -- Stop 4260**

**Attention: CFDA #84.250B**

**7100 Old Landover Road**

**Landover, MD 20785-1506**

Applications Delivered by Hand

You or your courier must hand deliver the original and number of copies
requested of the application by 4:30 p.m. (Washington, DC time) on or
before the deadline date. Please hand deliver copies to:

> **U.S. Department of Education**
>
> **Application Control Center**
>
> **Attention: CFDA #84.250B**
>
> **Room 7041**
>
> **Potomac Center Plaza**
>
> **550 12th Street, SW.**
>
> **Washington, D.C. 20202**

The Application Control Center accepts deliveries daily between 8:00
a.m. and 4:30 p.m. (Washington, D.C. time), except Saturdays, Sundays
and Federal holidays.

**[SECTION F]{.underline}**

RULES AND REGULATIONS

SECTION 121: AMERICAN INDIAN VOCATIONAL

REHABILITATION SERVICES

SECTION 102(b)-(c): INDIVIDUALIZED PLAN OF

EMPLOYMENT

SECTION 103: VOCATIONAL REHABILITATION

SERVICES

34 CFR PART 371

Section 121 American Indian Vocational Rehabilitation Services

**[Sec. 121(a)]{.underline}:** The Commissioner, in accordance with the
provisions of this part, may make grants to the governing bodies of
Indian tribes located on Federal and State reservations (and consortia
of such governing bodies) to pay 90 percent of the costs of vocational
rehabilitation services for American Indians who are individuals with
disabilities residing on or near such reservations. The non‑Federal
share of such costs may be in cash or in kind, fairly valued, and the
Commissioner may waive such non‑Federal share requirement in order to
carry out the purposes of this Act.

> **(b)(1)** No grant may be made under this part for any fiscal year
> unless an application therefor has been submitted to and approved by
> the Commissioner. The Commissioner may not approve an application
> unless the application‑‑
>
> **(A)** is made at such time, in such manner, and contains such
> information as the Commissioner may require;
>
> **(B)** contains assurances that the rehabilitation services provided
> under this part to American Indians who are individuals with
> disabilities residing on or near a reservation in a State shall be, to
> the maximum extent feasible, comparable to rehabilitation services
> provided under this title to other individuals with disabilities
> residing in the State and that, where appropriate, may include
> services traditionally used by Indian tribes; and
>
> **(C)** contains assurances that the application was developed in
> consultation with the designated State unit of the State.
>
> **(2)** The provisions of sections 5, 6, 7, and 102(a) of the Indian
> Self‑Determination and Education Assistance Act shall be applicable to
> any application submitted under this part. For purposes of this
> paragraph, any reference in any such provision to the Secretary of
> Education or to the Secretary of the Interior shall be considered to
> be a reference to the Commissioner.
>
> **(3)** Any application approved under this part shall be effective
> for not more than 60 months, except as determined otherwise by the
> Commissioner pursuant to prescribed regulations. The State shall
> continue to provide vocational rehabilitation services under its State
> plan to American Indians residing on or near a reservation whenever
> such State includes any such American Indians in its State population
> under section 110(a)(1).
>
> **(4)** In making grants under this part, the Secretary shall give
> priority consideration to applications for the continuation of
> programs which have been funded under this part.

**(5)** Nothing in this section may be construed to authorize a separate
service delivery system for Indian residents of a State who reside in
non‑reservation areas.

> **(c)** The term *\"reservation\"* includes Indian reservations,
> public domain Indian allotments, former Indian reservations in
> Oklahoma, and land held by incorporated Native groups, regional
> corporations, and village corporations under the provisions of the
> Alaska Native Claims Settlement Act.

**Sec. 102(b)** **Individualized Plan for Employment**

**(1)** **Options for developing an individualized plan for employment**

> If an individual is determined to be eligible for vocational
> rehabilitation services as described in subsection (a), the designated
> State unit shall complete the assessment for determining eligibility
> and vocational rehabilitation needs, as appropriate, and shall provide
> the eligible individual or the individual\'s representative, in
> writing and in an appropriate mode of communication, with information
> on the individual\'s options for developing an individualized plan for
> employment, including‑‑
>
> **(A)** information on the availability of assistance, to the extent
> determined to be appropriate by the eligible individual, from a
> qualified vocational rehabilitation counselor in developing all or
> part of the individualized plan for employment for the individual, and
> the availability of technical assistance in developing all or part of
> the individualized plan for employment for the individual;
>
> **(B)** a description of the full range of components that shall be
> included in an individualized plan for employment;

**(C)** as appropriate‑‑

> **(i)** an explanation of agency guidelines and criteria associated
> with financial commitments concerning an individualized plan for
> employment;
>
> **(ii)** additional information the eligible individual requests or
> the designated State unit determines to be necessary; and
>
> **(iii)** information on the availability of assistance in completing
> designated State agency forms required in developing an individualized
> plan for employment; and

**(D)(i)** a description of the rights and remedies available to such an
individual including, if appropriate, recourse to the processes set
forth in subsection (c); and

**(ii)** a description of the availability of a client assistance
program established pursuant to section 112 and information about how to
contact the client assistance program.

**(2)** **Mandatory procedures**

**(A)** **Written document**

> An individualized plan for employment shall be a written document.

**(B)** **Informed choice**

> An individualized plan for employment shall be developed and
> implemented in a manner that affords eligible individuals the
> opportunity to exercise informed choice in selecting an employment
> outcome, the specific vocational rehabilitation services to be
> provided under the plan, the entity that will provide the vocational
> rehabilitation services, and the methods used to procure the services,
> consistent with subsection (d).

**(C)** **Signatories**

> An individualized plan for employment shall be‑‑

**(i)** agreed to, and signed by, such eligible individual or, as
appropriate, the individual\'s representative; and

**(ii)** approved and signed by a qualified vocational rehabilitation
counselor employed by the designated State unit.

**(D)** **Copy**

> A copy of the individualized plan for employment for an eligible
> individual shall be provided to the individual or, as appropriate, to
> the individual\'s representative, in writing and, if appropriate, in
> the native language or mode of communication of the individual or, as
> appropriate, of the individual\'s representative.

**(E)** **Review and amendment**

> The individualized plan for employment shall be‑‑

**(i)** reviewed at least annually by‑‑

> **(I)** a qualified vocational rehabilitation counselor; and
>
> **(II)** the eligible individual or, as appropriate, the individual\'s
> representative; and

**(ii)** amended, as necessary, by the individual or, as appropriate,
the individual\'s representative, in collaboration with a representative
of the designated State agency or a qualified vocational rehabilitation
counselor (to the extent determined to be appropriate by the
individual), if there are substantive changes in the employment outcome,
the vocational rehabilitation services to be provided, or the service
providers of the services (which amendments shall not take effect until
agreed to and signed by the eligible individual or, as appropriate, the
individual\'s representative, and by a qualified vocational
rehabilitation counselor employed by the designated State unit).

**(3)** **Mandatory components of an individualized plan for
employment**

> Regardless of the approach selected by an eligible individual to
> develop an individualized plan for employment, an individualized plan
> for employment shall, at a minimum, contain mandatory components
> consisting of‑‑
>
> **(A)** a description of the specific employment outcome that is
> chosen by the eligible individual, consistent with the unique
> strengths, resources, priorities, concerns, abilities, capabilities,
> interests, and informed choice of the eligible individual, and, to the
> maximum extent appropriate, results in employment in an integrated
> setting;

**(B)(i)** a description of the specific vocational rehabilitation
services that are‑‑

> **(I)** needed to achieve the employment outcome, including, as
> appropriate, the provision of assistive technology devices and
> assistive technology services, and personal assistance services,
> including training in the management of such services; and
>
> **(II)** provided in the most integrated setting that is appropriate
> for the service involved and is consistent with the informed choice of
> the eligible individual; and

**(ii)** timelines for the achievement of the employment outcome and for
the initiation of the services;

**(C)** a description of the entity chosen by the eligible individual
or, as appropriate, the individual\'s representative, that will provide
the vocational rehabilitation services, and the methods used to procure
such services;

**(D)** a description of criteria to evaluate progress toward
achievement of the employment outcome;

**(E)** the terms and conditions of the individualized plan for
employment, including, as appropriate, information describing‑‑

> **(i)** the responsibilities of the designated State unit;
>
> **(ii)** the responsibilities of the eligible individual, including‑‑
>
> **(I)** the responsibilities the eligible individual will assume in
> relation to the employment outcome of the individual;
>
> **(II)** if applicable, the participation of the eligible individual
> in paying for the costs of the plan; and
>
> **(III)** the responsibility of the eligible individual with regard to
> applying for and securing comparable benefits as described in section
> 101(a)(8); and
>
> **(iii)** the responsibilities of other entities as the result of
> arrangements made pursuant to comparable services or benefits
> requirements as described in section 101(a)(8);

**(F)** for an eligible individual with the most significant
disabilities for whom an employment outcome in a supported employment
setting has been determined to be appropriate, information identifying‑‑

> **(i)** the extended services needed by the eligible individual; and
>
> **(ii)** the source of extended services or, to the extent that the
> source of the extended services cannot be identified at the time of
> the development of the individualized plan for employment, a
> description of the basis for concluding that there is a reasonable
> expectation that such source will become available; and

**(G)** as determined to be necessary, a statement of projected need for
post‑employment services.

**Sec. 103. Vocational Rehabilitation Services**

**(a)** **Vocational Rehabilitation Services for Individuals**

> Vocational rehabilitation services provided under this title are any
> services described in an individualized plan for employment necessary
> to assist an individual with a disability in preparing for, securing,
> retaining, or regaining an employment outcome that is consistent with
> the strengths, resources, priorities, concerns, abilities,
> capabilities, interests, and informed choice of the individual,
> including‑‑

**(1)** an assessment for determining eligibility and vocational
rehabilitation needs by qualified personnel, including, if appropriate,
an assessment by personnel skilled in rehabilitation technology;

**(2)** counseling and guidance, including information and support
services to assist an individual in exercising informed choice
consistent with the provisions of section 102(d);

**(3)** referral and other services to secure needed services from other
agencies through agreements developed under section 101(a)(11), if such
services are not available under this title;

**(4)** job‑related services, including job search and placement
assistance, job retention services, followup services, and follow‑along
services;

**(5)** vocational and other training services, including the provision
of personal and vocational adjustment services, books, tools, and other
training materials, except that no training services provided at an
institution of higher education shall be paid for with funds under this
title unless maximum efforts have been made by the designated State unit
and the individual to secure grant assistance, in whole or in part, from
other sources to pay for such training;

**(6)** to the extent that financial support is not readily available
from a source (such as through health insurance of the individual or
through comparable services and benefits consistent with section
101(a)(8)(A)), other than the designated State unit, diagnosis and
treatment of physical and mental impairments, including‑‑

> **(A)** corrective surgery orthorapeutic treatment necessary to
> correct or substantially modify a physical or mental condition that
> constitutes a substantial impediment to employment, but is of such a
> nature that such correction or modification may reasonably be expected
> to eliminate or reduce such impediment to employment within a
> reasonable length of time;
>
> **(B)** necessary hospitalization in connection with surgery or
> treatment;
>
> **(C)** prosthetic and orthotic devices;
>
> **(D)** eyeglasses and visual services as prescribed by qualified
> personnel who meet State licensure laws and who are selected by the
> individual;
>
> **(E)** special services (including transplantation and dialysis),
> artificial kidneys, and supplies necessary for the treatment of
> individuals with end‑stage renal disease; and
>
> **(F)** diagnosis and treatment for mental and emotional disorders by
> qualified personnel who meet State licensure laws;

**(7)** maintenance for additional costs incurred while participating in
an assessment for determining eligibility and vocational rehabilitation
needs or while receiving services under an individualized plan for
employment;

**(8)** transportation, including adequate training in the use of public
transportation vehicles and systems, that is provided in connection with
the provision of any other service described in this section and needed
by the individual to achieve an employment outcome;

**(9)** on‑the‑job or other related personal assistance services
provided while an individual is receiving other services described in
this section;

**(10)** interpreter services provided by qualified personnel for
individuals who are deaf or hard of hearing, and reader services for
individuals who are determined to be blind, after an examination by
qualified personnel who meet State licensure laws;

**(11)** rehabilitation teaching services, and orientation and mobility
services, for individuals who are blind;

**(12)** occupational licenses, tools, equipment, and initial stocks and
supplies;

**(13)** technical assistance and other consultation services to conduct
market analyses, develop business plans, and otherwise provide
resources, to the extent such resources are authorized to be provided
through the statewide workforce investment system, to eligible
individuals who are pursuing self‑employment or telecommuting or
establishing a small business operation as an employment outcome;

**(14)** rehabilitation technology, including telecommunications,
sensory, and other technological aids and devices;

**(15)** transition services for students with disabilities, that
facilitate the achievement of the employment outcome identified in the
individualized plan for employment;

**(16)** supported employment services;

**(17)** services to the family of an individual with a disability
necessary to assist the individual to achieve an employment outcome; and

**(18)** specific post‑employment services necessary to assist an
individual with a disability to, retain, regain, or advance in
employment.

**(b)** **Vocational Rehabilitation Services for Groups of Individuals**

> Vocational rehabilitation services provided for the benefit of groups
> of individuals with disabilities may also include the following:

**(1)** In the case of any type of small business operated by
individuals with significant disabilities the operation of which can be
improved by management services and supervision provided by the
designated State agency, the provision of such services and supervision,
along or together with the acquisition by the designated State agency of
vending facilities or other equipment and initial stocks and supplies.

**(2)(A)** The establishment, development, or improvement of community
rehabilitation programs, including, under special circumstances, the
construction of a facility. Such programs shall be used to provide
services that promote integration and competitive employment.

> **(B)** The provision of other services, that promise to contribute
> substantially to the rehabilitation of a group of individuals but that
> are not related directly to the individualized plan for employment of
> any one individual with a disability.

**(3)** The use of telecommunications systems (including telephone,
television, satellite, radio, and other similar systems) that have the
potential for substantially improving delivery methods of activities
described in this section and developing appropriate programming to meet
the particular needs of individuals with disabilities.

**(4)(A)** Special services to provide nonvisual access to information
for individuals who are blind, including the use of telecommunications,
Braille, sound recordings, or other appropriate media.

> **(B)** Captioned television, films, or video cassettes for
> individuals who are deaf or hard of hearing.
>
> **(C)** Tactile materials for individuals who are deaf‑blind.
>
> **(D)** Other special services that provide information through
> tactile, vibratory, auditory, and visual media.

**(5)** Technical assistance and support services to businesses that are
not subject to title I of the Americans with Disabilities Act of 1990
(42 U.S.C. 12111 et seq.) and that are seeking to employ individuals
with disabilities.

**(6)** Consultative and technical assistance services to assist
educational agencies in planning for the transition of students with
disabilities from school to post‑school activities, including
employment. \[Code of Federal Regulations\]\[Title 34, Volume 2, Parts
300 to 399\]\[Revised as of July **1**, 1998\]From the U.S. Government
Printing Office via GPO Access\[**CITE**: **34CFR369**.**1**\] \[Page
394-395\]

# PLEASE NOTE:

# American Indian Vocational Rehabilitation Services Program

The American Indian Vocational Rehabilitation Services (AIVRS) program
(part 371) is authorized by sections 110(c) and 121 of the Act. Under
this program, grants are awarded to governing bodies of Indian tribes
located on Federal and State reservations to provide vocational
rehabilitation services for American Indians with disabilities residing
on or near those reservations.

The 1998 Amendments changed the AIVRS Program in three significant
ways: 1) the geographic area that can be served by these programs was
expanded to include American Indians with disabilities who live near the
reservation, in addition to providing services to those who live on the
reservation; 2) the project period for which these programs can be
approved was extended from three to five years; 3) section 101(a)(11)(F)
of the Act requires State vocational rehabilitation services agencies to
enter into formal cooperative agreements with AIVRS program grantees
within the State that describe strategies for collaboration and
coordination in providing vocational rehabilitation services to American
Indians with disabilities.

In addition, please note the longstanding statutory provision in section
121(b)(4) of the Act that directs the Secretary to give priority
consideration to applications for the continuation of programs that have
been funded previously under this program.

TITLE 34\--EDUCATION

CHAPTER III\--OFFICE OF SPECIAL EDUCATION AND

REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION

PART 371\--VOCATIONAL REHABILITATION SERVICE PROJECTS FOR AMERICAN
INDIANS WITH DISABILITIES

Subpart A\--General

Sec.

371.1 What is the Vocational Rehabilitation Services Program for

American Indians with Disabilities?

371.2 Who is eligible for assistance under this program?

371.3 What regulations apply to this program?

371.4 What definitions apply to this program?

371.5 What is the length of the project period under this program?

Subpart B\--What Kinds of Activities Does the Department of Education

Assist Under This Program?

371.10 What types of projects are authorized under this program?

Subpart C\--How Does One Apply for a Grant?

371.20 What are the application procedures under this program?

371.21 What are the special application requirements related to the

State plan Program?

Subpart D\--How Does the Secretary Make a Grant?

371.31 How are grants awarded?

Subpart E\--What Conditions Apply to a Grantee Under This Program?

371.40 What are the matching requirements?

371.41 What are allowable costs?

371.42 How are services to be administered under this program?

371.43 What other special conditions apply to this program?

Authority: 29 U.S.C. 711(c) and 750, unless otherwise noted.

Source: 46 FR 5423, Jan. 19, 1981, unless otherwise noted.

Subpart A\--General

Sec. 371.1 What is the Vocational Rehabilitation Services Program for
American Indians with Disabilities?

This program is designed to provide vocational rehabilitation services
to American Indians with disabilities who reside on Federal or State
reservations, consistent with their individual strengths, resources,
priorities, concerns, abilities, capabilities, and informed choice so
that they may prepare for and engage in gainful employment.

(Authority: Secs. 100(a)(2) and 130(a) of the Act; 29 U.S.C. 720(a)(2)
and 750(a))

\[60 FR 58137, Nov. 24, 1995\]

Sec. 371.2 Who is eligible for assistance under this program?

Applications may be made only by the governing bodies of Indian tribes
and consortia of those governing bodies located on Federal and State
reservations.

(Authority: Sec. 130(a) of the Act; 29 U.S.C. 750(a))

\[46 FR 5423, Jan. 19, 1981, as amended at 52 FR 30555, Aug. 14, 1987\]

Sec. 371.3 What regulations apply to this program?

The following regulations apply to this program\--

\(a\) 34 CFR part 369;

\(b\) The regulations in this part 371.

(Authority: Sec. 130 of the Act; 29 U.S.C. 750)

Sec. 371.4 What definitions apply to this program?

\(a\) The definitions in 34 CFR part 369 apply to this program;

\(b\) The following definitions also apply specifically to this

program\--

American Indian means a person who is a member of an Indian tribe.

(Authority: Secs. 12(c) and 130 of the Act; 29 U.S.C. 711(c) and 750)

Consortium means two or more eligible governing bodies of Indian tribes
that make application as a single applicant under an agreement whereby
each governing body is legally responsible for carrying out all of the
activities in the application.

(Authority: Secs. 12(c) and 130 of the Act; 29 U.S.C. 711(c) and 750)

Governing bodies of Indian tribes means those duly elected or appointed
representatives of an Indian tribe or of an Alaskan native village.
These representatives must have the authority to enter into contracts,
agreements, and grants on behalf of their constituency.

(Authority: Secs. 12(c) and 130 of the Act; 29 U.S.C. 711(c) and 750)

Indian tribe means any Federal or State Indian band, rancheria, pueblo,
colony, and community, including any Alaskan native village or regional
village corporation (as defined in or established pursuant to the Alaska
Native Claims Settlement Act).

(Authority: Secs. 12(c) and 130 of the Act; 29 U.S.C. 711(c) and 750)

Reservation means a Federal or State Indian reservation, public domain
Indian allotment, former Indian reservation in Oklahoma, and land held
by incorporated Native groups, regional corporations and village

corporations under the provisions of the Alaska Native Claims Settlement
Act.

(Authority: Secs. 12(c) and 130(c) of the Act; 29 U.S.C. 711(c) and
750(c))

\[46 FR 5423, Jan. 19, 1981, as amended at 52 FR 30555, Aug. 14, 1987;
59 FR 8338, Feb. 18, 1994\]

Sec. 371.5 What is the length of the project period under this program?

\(a\) The Secretary approves a project period of up to three years.

\(b\) The Secretary may extend a grant for up to two additional years if
the grantee includes in its extension request\--

\(1\) An assurance that the project is in compliance with all applicable
program requirements; and

\(2\) Satisfactory evidence that\--

\(i\) The project has made substantial and measurable progress in
meeting the needs of American Indians with disabilities on the
reservation or reservations it serves;

\(ii\) American Indians with disabilities who have received project
services have achieved employment outcomes consistent with their
strengths, resources, priorities, concerns, abilities, capabilities, and
informed choice; and

\(iii\) There is a continuing need for the project.

(Approved by the Office of Management and Budget under control number
1820-0018)

(Authority: Section 130(b)(3) of the Act; 29 U.S.C. 750(b)(3))

\[60 FR 58137, Nov. 24, 1995\]

Subpart B\--What Kinds of Activities Does the Department of Education
Assist Under This Program?

Sec. 371.10 What types of projects are authorized under this program?

The Vocational Rehabilitation Service Program for American Indians with
Disabilities provides financial assistance for the establishment and
operation of tribal vocational rehabilitation service programs for

American Indians with disabilities who reside on Federal or State
reservations.

(Authority: Sec. 130(a) of the Act; 29 U.S.C. 750(a))

\[59 FR 8338, Feb. 18, 1994\]

Subpart C\--How Does One Apply for a Grant?

Sec. 371.20 What are the application procedures for this program?

In the development of an application, a governing body or consortium is
required to consult with the designated State unit or the designated
State units of the State or States in which vocational rehabilitation
services are to be provided.

(Authority: Sec. 130(b) of the Act; 29 U.S.C. 750(b))

\[46 FR 5423, Jan. 19, 1981, as amended at 52 FR 30555, Aug. 14, 1987\]

Sec. 371.21 What are the special application requirements related to the
State plan program?

Each applicant under this program must provide evidence that\--

\(a\) Effort will be made to provide a broad scope of vocational
rehabilitation services in a manner and at a level of quality at least
comparable to those services provided by the designated State unit under
34 CFR part 361.

(Authority: Sec. 12(c) of the Act; 29 U.S.C. 711(c))

\(b\) All decisions affecting eligibility for and the nature and scope
of vocational rehabilitation services to be provided, and the provision
of these services, will be made by the tribal vocational rehabilitation
program through its vocational rehabilitation unit and will not be
delegated to another agency or individual.

(Authority: Secs. 12(c) and 101(a) of the Act; 29 U.S.C. 711(c) and
721(a))

\(c\) Priority in the delivery of vocational rehabilitation service will
be given to those American Indians with disabilities who are the most
severely disabled.

(Authority: Secs. 12(c) and 101(a)(5) of the Act; 29 U.S.C. 711(c) and
721(a)(5))

\(d\) An order of selection of individuals with disabilities to be
served under the program will be specified if services cannot be
provided to all eligible American Indians with disabilities who apply.

(Authority: Secs. 12(c) and 101(a)(5) of the Act; 29 U.S.C. 711(c) and
721(a)(5))

\(e\) All vocational rehabilitation services will be provided according
to an individualized written rehabilitation program which has been
developed jointly by the representative of the service providing
organization and each American Indian with disabilities being served.

(Authority: Secs. 12(c) and 101(a)(9) of the Act; 29 U.S.C. 711(c) and
721(a)(9))

\(f\) American Indians with disabilities living on Federal or State
reservations where service programs are being carried out under this
part will have an opportunity to participate in matters of general
policy development and implementation affecting vocational
rehabilitation service delivery on the reservation.

(Authority: Secs. 12(c) and 101(a)(18) of the Act; 29 U.S.C. 711(c) and
721(a)(18))

\(g\) Cooperative working arrangements will be developed with the
designated State unit, or designated State units, as appropriate, which
are providing vocational rehabilitation services to other individuals
with disabilities who reside in the State or States being served.

(Authority: Secs. 12(c) and 101(a)(11) of the Act; 29 U.S.C. 711(c) and
721(a)(11))

\(h\) Any similar benefits available to American Indians with
disabilities under any other program which might meet in whole or in
part the cost of any vocational rehabilitation service will be fully
considered in the provision of vocational rehabilitation services in
accordance with 34 CFR part 361.

(Authority: Secs. 12(c) and 101(a)(8) of the Act; 29 U.S.C. 711(c) and
721(a)(8))

\(i\) Any American Indian with disabilities who is an applicant or
recipient of services, and who is dissatisfied with a determination made
by a counselor or coordinator under this program and files a request for
a review, will be afforded a review under procedures developed by the
grantee comparable to those under the provisions of section 102(d)
(1)-(3) of the Act.

(Authority: Secs. 12(c) and 102(d) of the Act; 29 U.S.C. 711(c) and
722(d))

\(j\) Minimum standards will be established for community rehabilitation
programs and providers of service which will be comparable to the
standards set by the designated State unit or designated State units in
the State or States in which the program is to be provided; and

(Authority: Secs. 12(c) and 101(a) (6) and (7) of the Act; 29 U.S.C.
711(c) and 721(a) (6) and (7))

\(k\) Maximum use will be made of public or other vocational or
technical training facilities or other appropriate community resources.

(Authority: Secs. 12(c) and 101(a)(12) of the Act; 29 U.S.C. 711(c) and
721(a)(12))

\[46 FR 5423, Jan. 19, 1981, as amended at 52 FR 30555, Aug. 14, 1987;
59 FR 8337, 8338, Feb. 18, 1994\]

Subpart D\--How Does the Secretary Make a Grant?

Sec. 371.31 How are grants awarded?

To the extent that funds have been appropriated under this program, the
Secretary approves all applications which meet acceptable standards of
program quality. If any application is not approved because of
deficiencies in proposed program standards, the Secretary provides
technical assistance to the applicant Indian tribe with respect to any

areas of the proposal which were judged to be deficient.

(Authority: Secs. 12(c) and 130 of the Act; 29 U.S.C. 711(c) and 750)

Subpart E\--What Conditions Apply to a Grantee Under This Program?

Sec. 371.40 What are the matching requirements?

\(a\) Federal share. Except as provided in paragraph (c) of this
section, the Federal share may not be more than 90 percent of the total
cost of the project.

\(b\) Non-Federal share. The non-Federal share of the cost of the
project may be in cash or in kind, fairly valued.

\(c\) Waiver of non-Federal share. In order to carry out the purposes of
the program, the Secretary may waive the non-Federal share requirement,
in part or in whole, only if the applicant demonstrates that it does not
have sufficient resources to contribute the non-Federal share of the
cost of the project.

(Authority: Secs. 12(c) and 130(a) of the Act; 29 U.S.C. 711(c) and
750(a))

\[52 FR 30556, Aug. 14, 1987\]

Sec. 371.41 What are allowable costs?

\(a\) In addition to those allowable costs established in EDGAR Secs.
75.530-75.534, the following items are allowable costs under this
program\--

\(1\) Expenditures for the provision of vocational rehabilitation
services and for the administration, including staff development, of a
program of vocational rehabilitation services.

\(2\) Expenditures for services reflecting the cultural background of
the American Indians being served, including treatment provided by
native healing practitioners who are recognized as such by the tribal
vocational rehabilitation program when the services are necessary to
assist an individual with disabilities to achieve his or her vocational

rehabilitation objective.

\(b\) Expenditures may not be made under this program to cover the costs
of providing vocational rehabilitation services to individuals with
disabilities not residing on Federal or State reservations.

(Authority: Secs. 12(c) and 130(a) of the Act; 29 U.S.C. 711(c) and
750(a))

\[46 FR 5423, Jan. 19, 1981, as amended at 52 FR 30555, Aug. 14, 1987;
59 FR 8337, Feb. 18, 1994\]

Sec. 371.42 How are services to be administered under this program?

\(a\) Directly or by contract. A grantee under this part may provide the
vocational rehabilitation services directly or it may contract or
otherwise enter into an agreement with a designated State unit, a
community rehabilitation program, or another agency to assist in the
implementation of the vocational rehabilitation service program for

American Indians with disabilities.

\(b\) Inter-tribal agreement. A grantee under this part may enter into
an inter-tribal arrangement with governing bodies of other Indian tribes
for carrying out a project that serves more than one Indian tribe.

\(c\) Comparable service program. To the maximum extent feasible,
services provided by a grantee under this part must be comparable to
rehabilitation service provided under this title to other individuals
with disabilities residing in the State.

(Authority: Secs. 12(c) and 130 of the Act; 29 U.S.C. 711(c) and 750)

\[52 FR 30556, Aug. 14, 1987, as amended at 59 FR 8337, 8338, Feb. 18,
1994\]

Sec. 371.43 What other special conditions apply to this program?

\(a\) Any American Indian with disabilities who is eligible for service
under this program but who wishes to be provided service by the
designated State unit must be referred to the State unit for such
services.

\(b\) Preference in employment in connection with the provision of
vocational rehabilitation services under this section must be given to
American Indians, with a special priority being given to American
Indians with disabilities.

\(c\) The provisions of sections 5, 6, 7, and 102(a) of the Indian
Self-Determination and Education Assistance Act also apply under this
program. These provisions relate to grant reporting and audit
requirements, maintenance of records, access to records, availability of
required reports and information to Indian people served or represented,

repayment of unexpended Federal funds, criminal activities involving
grants, penalties, wage and labor standards, preference requirements
forAmerican Indians in the conduct and administration of the grant,and
requirements affecting requests of tribal organizations to enter into
contracts. For purposes of applying these requirements to this program,
the Secretary carries out those responsibilities assigned to the
Secretary of Interior.

(Authority: Secs. 12(c) and 130(b)(2) of the Act; 29 U.S.C. 711(c) and
750(b)(2))

\[46 FR 5423, Jan. 19, 1981, as amended at 52 FR 30555, Aug. 14, 1987;
59 FR 8337, Feb. 18, 1994\]

**[SECTION G]{.underline}**

**APPLICATION FORMS**

**U.S. Department of Education**

**Office of Special Education and Rehabilitative Services**

#### REHABILITATION SERVICES ADMINISTRATION

**INSTRUCTIONS FOR AN APPLICATION FOR FEDERAL ASSISTANCE**

(Nonconstruction Programs)

The enclosed forms shall be used by all applicants for Federal
Assistance under all Rehabilitation Services Administration programs. A
separate application must be submitted for each grant sought. No grant
may be awarded unless the completed application forms have been
received. If an item does not appear to be relevant to the assistance
requested, write \"NA\" for not applicable.

This application consists of four parts. These parts are organized in
the same manner that the submitted application should be organized.
These parts are as follows:

**Part I** - Federal Assistance Application Face Page

**Part II** - Budget Information

**Part III** - Program Narrative

**Part IV** - Assurances, Certifications and Disclosures

Each submitted application must include an index or table of contents
and a one-page project abstract. Pages should be consecutively numbered.

According to the Paperwork Reduction Act of 1995, no persons are
required to respond to a collection of information unless it displays a
valid OMB control number. The valid OMB control number for this
information collection is 1820-0018. The time required to complete this
information collection is estimated to average 40 hours per response,
including the time to review instructions, search existing data
resources, gathering and maintaining the data needed, and completing and
reviewing the collection of information.

Under terms of the Paperwork Reduction Act of 1980, as amended, and the
regulations implementing that Act, the Department of Education invites
comment on the public reporting burden in this collection of
information. You may send comments regarding this burden estimate or any
other aspect of this collection of information, including suggestions
for reducing this burden, to the U.S. Department of Education,
Information Management and Compliance Division, Washington, D.C.
20202-4651; and to the Office of Management and Budget, Paperwork
Reduction Project 1820-0018, Washington, D.C. 20503.

![](media/image2.wmf)Application for Federal **U.S. Department of
Education**

# Education Assistance (ED 424)

**Applicant Information** Organizational Unit

**1.** Name and Address

Legal
Name:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Address:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_ - \_\_\_\_\_\_\_\_

City State County ZIP Code + 4

**2.** Applicant's D-U-N-S Number
\|\_\_\_\|\_\_\_\|\_\_\_\|\_\_\_\|\_\_\_\|\_\_\_\|\_\_\_\|\_\_\_\|\_\_\_\|
**6.** Novice Applicant \_\_\_Yes \_\_\_No

**3.** Applicant's T-I-N \|\_\_\_\|\_\_\_\| -
\|\_\_\_\|\_\_\_\|\_\_\_\|\_\_\_\|\_\_\_\|\_\_\_\|\_\_\_\| **7.** Is the
applicant delinquent on any Federal debt? ­\_\_\_Yes \_\_\_No

*(If "Yes," attach an explanation.)*

**4.** Catalog of Federal Domestic Assistance #:
**84.\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|**

Title:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
**8.** Type of Applicant *(Enter appropriate letter in the box.)
\|\_\_\_\_\|*

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

**5.** Project
Director:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Address:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

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

City State Zip code + 4

Tel. #: ( ) \_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_ Fax #: (
)\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_

**9.** State Application Identifier
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

E-Mail Address:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**Application Information**

**10.** Type of Submission: **13.** Are any research activities
involving human subjects planned at

*-PreApplication -Application* any time during the proposed project
period?

\_\_\_ Construction \_\_\_ Construction ­­\_\_\_ Yes (Go to 13a.) \_\_\_
No (Go to item 14.)

\_\_\_ Non-Construction \_\_\_ Non-Construction

**13a.** Are **all** the research activities proposed designated to be

**11.** Is application subject to review by Executive Order 12372
process? exempt from the regulations?

\_\_\_ Yes (*Date made available to the Executive Order 12372* \_\_\_
Yes (Provide Exemption(s) #):
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

*process for review):* \_\_\_\_/\_\_\_\_/\_\_\_\_\_\_\_\_\_

**\_\_\_** No (Provide Assurance #):
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_ No *(If "No," check appropriate box below.)*

\_\_\_ Program is not covered by E.O. 12372. **14.** Descriptive Title
of Applicant's Project:

\_\_\_ Program has not been selected by State for review.

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

**12.** Proposed Project Dates: \_\_\_\_/\_\_\_\_/\_\_\_\_\_\_\_\_
\_\_\_\_/\_\_\_\_/\_\_\_\_\_\_\_\_\_

**Start Date: End Date:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Estimated Funding** **Authorized Representative Information**

**16.** To the best of my knowledge and belief, all data in this
preapplication/application are true

**15a.** Federal **\$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. 00** and
correct. The document has been duly authorized by the governing body of
the applicant

**b.** Applicant **\$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. 00** and the
applicant will comply with the attached assurances if the assistance is
awarded.

**c.** State **\$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. 00 a.** Authorized
Representative (*Please type or print name clearly*.)

**d.** Local **\$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. 00
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**e.** Other **\$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. 00 b.** Title:
**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**f.** Program Income **\$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. 00 c.**
Tel. #: ( ) \_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_ Fax #: ( )
\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_

**d.** E-Mail Address:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**g. TOTAL \$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. 00 e. Signature of
Authorized Representative**

> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
> Date:\_\_\_/\_\_\_\_/\_\_\_\_\_\_

**Instructions for Form ED 424**

**1.** **Legal Name and Address.** Enter the legal name of applicant and
the name of the primary organizational unit which will undertake the
assistance activity.

**2.** **D-U-N-S Number.** Enter the applicant's D-U-N-S Number. If your
organization does not have a D-U-N-S Number, you can obtain the number
by calling 1-800-333-0505 or by completing a D-U-N-S Number Request
Form. The form can be obtained via the Internet at the following URL:
**http://www.dnb.com.**

**3. Tax Identification Number.** Enter the taxpayer's identification
number as assigned by the Internal Revenue Service.

**4.** **Catalog of Federal Domestic Assistance** **(CFDA) Number.**
Enter the CFDA number and title of the program under which assistance is
requested. The CFDA number can be found in the federal register notice
and the application package.

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

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

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

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

**8. Type of Applicant.** Enter the appropriate letter in the box
provided.

**9. State Application Identifier**. State use only (if applicable).

**10. Type of Submission**. See "Definitions for Form ED 424" attached.

**11. Executive Order 12372**. See "Definitions for Form ED 424"
attached. Check "**Yes**" if the application is subject to review by
E.O. 12372. Also, please enter the month, day, and four (4) digit year
(mm/dd/yyyy). Otherwise, check "**No**."

**12. Proposed Project Dates**. Please enter the month, day, and four
(4) digit year (mm/dd/yyyy).

**13. Human Subjects Research**. (See I.A. "Definitions" in attached
page entitled "Definitions for Form ED 424.")

**If Not Human Subjects Research**. Check "**No**" if research
activities involving human subjects are not planned at any time during
the proposed project period. The remaining parts of Item 12 are then not
applicable.

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

**13a. If Human Subjects Research is Exempt from the Human Subjects
Regulations**. Check "**Yes**" if all the research activities proposed
are designated to be exempt from the regulations. Insert the exemption
number(s) corresponding to one or more of the six exemption categories
listed in I.B. "Exemptions." In addition, follow the instructions in
II.A. "Exempt Research Narrative" in the attached page entitled
"Definitions for Form ED 424." Insert this narrative immediately
following the ED 424 face page.

**13a. If Human Subjects Research is Not Exempt from Human Subjects
Regulations**. Check "**No**" if some or all of the planned research
activities are covered (not exempt). In addition, follow the
instructions in II.B. "Nonexempt Research Narrative" in the page
entitled "Definitions for Form ED 424." Insert this narrative
immediately following the ED 424 face page.

**13a. Human Subjects Assurance Number**. If the applicant has an
approved Federal Wide (FWA) or Multiple Project Assurance (MPA) with the
Office for Human Research Protections (OHRP), U.S. Department of Health
and Human Services, that covers the specific activity, insert the number
in the space provided. If the applicant does not have an approved
assurance on file with OHRP, enter "None." In this case, the applicant,
by signature on the face page, is declaring that it will comply with 34
CFR 97 and proceed to obtain the human subjects assurance upon request
by the designated ED official. If the application is
recommended/selected for funding, the designated ED official will
request that the applicant obtain the assurance within 30 days after the
specific formal request.

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

**14. Project Title**. Enter a brief descriptive title of the project.
If more than one program is involved, you should append an explanation
on a separate sheet. If appropriate (e.g., construction or real property
projects), attach a map showing project location. For preapplications,
use a separate sheet to provide a summary description of this project.

**15. Estimated Funding**. Amount requested or to be contributed during
the first funding/budget period by each contributor. Value of in-kind
contributions should be included on appropriate lines as applicable. If
the action will result in a dollar change to an existing award, indicate
**only** the amount of the change. For decreases, enclose the amounts in
parentheses. If both basic and supplemental amounts are included, show
breakdown on an attached sheet. For multiple program funding, use totals
and show breakdown using same categories as item 15.

**16. Certification**. To be signed by the authorized representative of
the applicant. A copy of the governing body's authorization for you to
sign this application as official representative must be on file in the
applicant's office. Be sure to enter the telephone and fax number and
e-mail address of the authorized representative. Also, in item 15e,
please enter the month, day, and four (4) digit year (mm/dd/yyyy) in the
date signed field.

**Paperwork Burden Statement**. According to the Paperwork Reduction Act
of 1995, no persons are required to respond to a collection of
information unless such collection displays a valid OMB control number.
The valid OMB control number for this information collection is
1875-0106. The time required to complete this information collection is
estimated to average between 15 and 45 minutes per response, including
the time to review instructions, search existing data resources, gather
the data needed, and complete and review the information collection.
**If you have any comments concerning the accuracy of the estimate(s) or
suggestions for improving this form, please write to**: U.S. Department
of Education, Washington, D.C. 20202-4700. **If you have comments or
concerns regarding the status of your individual submission of this form
write directly to**: Joyce I. Mays, Application Control Center, U.S.
Department of Education, Potomac Center Plaza, 550 12th Street SW, Room
7076, Washington, DC 20202-4260.

##  {#section-4 .unnumbered}

**Definitions for Form ED 424**

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

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

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

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

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

**Type of Submission.** "Construction" includes construction of new
buildings and acquisition, expansion, remodeling, and alteration of
existing buildings, and initial equipment of any such buildings, or any
combination of such activities (including architects' fees and the cost
of acquisition of land). "Construction" also includes remodeling to meet
standards, remodeling designed to conserve energy, renovation or
remodeling to accommodate new technologies, and the purchase of existing
historic buildings for conversion to public libraries. For the purposes
of this paragraph, the term "equipment" includes machinery, utilities,
and built-in equipment and any necessary enclosures or structures to
house them; and such term includes all other items necessary for the
functioning of a particular facility as a facility for the provision of
library services.

**Executive Order 12372.** The purpose of Executive Order 12372 is to
foster an intergovernmental partnership and strengthen federalism by
relying on State and local processes for the coordination and review of
proposed Federal financial assistance and direct Federal development.
The application notice, as published in the Federal Register, informs
the applicant as to whether the program is subject to the requirements
of E.O. 12372. In addition, the application package contains information
on the State Single Point of Contact. An applicant is still eligible to
apply for a grant or grants even if its respective State, Territory,
Commonwealth, etc. does not have a State Single Point of Contact. For
additional information on E.O. 12372 go to
http://12.46.245.173/pls/portal30/catalog.REQ_FOR_12372.show

**PROTECTION OF HUMAN SUBJECTS IN RESEARCH**

**I. Definitions and Exemptions**

**A. Definitions.**

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

---**Research**

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

**---Human Subject**

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

**B. Exemptions.**

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

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

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

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

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

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

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

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

If the applicant marked "Yes" for Item 13 on the ED 424, the applicant
must provide a human subjects "exempt research" or "nonexempt research"
narrative and insert it immediately following the ED 424 face page.

**A. Exempt Research Narrative.**

If you marked "Yes" for item 13 a. and designated exemption

If you marked "Yes" for item 13 a. and designated exemption numbers(s),
provide the "exempt research" narrative. The narrative must contain
sufficient information about the involvement of human subjects in the
proposed research to allow a determination by ED that the designated
exemption(s) are appropriate. The narrative must be succinct.

**B. Nonexempt Research Narrative.**

If you marked "No" for item 13 a. you must provide the "nonexempt
research" narrative. The narrative must address the following seven
points. Although no specific page limitation applies to this section of
the application, be succinct.

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

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

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

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

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

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

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

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

[***http://www.ed.gov/about/offices/list/ocfo/humansub.html***](http://www.ed.gov/about/offices/list/ocfo/humansub.html)

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+--------+---+-------+-------+-------+-------+---+-----+-------------+
| 5\.    |   |       |       |       |       |   |     |             |
| Su     |   |       |       |       |       |   |     |             |
| pplies |   |       |       |       |       |   |     |             |
+--------+---+-------+-------+-------+-------+---+-----+-------------+
| 6\.    |   |       |       |       |       |   |     |             |
| Contr  |   |       |       |       |       |   |     |             |
| actual |   |       |       |       |       |   |     |             |
+--------+---+-------+-------+-------+-------+---+-----+-------------+
| 7\.    |   |       |       |       |       |   |     |             |
| Constr |   |       |       |       |       |   |     |             |
| uction |   |       |       |       |       |   |     |             |
+--------+---+-------+-------+-------+-------+---+-----+-------------+
| 8\.    |   |       |       |       |       |   |     |             |
| Other  |   |       |       |       |       |   |     |             |
+--------+---+-------+-------+-------+-------+---+-----+-------------+
| 9\.    |   |       |       |       |       |   |     |             |
| Total  |   |       |       |       |       |   |     |             |
| Direct |   |       |       |       |       |   |     |             |
| Costs  |   |       |       |       |       |   |     |             |
| (lines |   |       |       |       |       |   |     |             |
| 1-8)   |   |       |       |       |       |   |     |             |
+--------+---+-------+-------+-------+-------+---+-----+-------------+
| 10\.   |   |       |       |       |       |   |     |             |
| In     |   |       |       |       |       |   |     |             |
| direct |   |       |       |       |       |   |     |             |
| C      |   |       |       |       |       |   |     |             |
| osts\* |   |       |       |       |       |   |     |             |
+--------+---+-------+-------+-------+-------+---+-----+-------------+
| 11\.   |   |       |       |       |       |   |     |             |
| Tr     |   |       |       |       |       |   |     |             |
| aining |   |       |       |       |       |   |     |             |
| St     |   |       |       |       |       |   |     |             |
| ipends |   |       |       |       |       |   |     |             |
+--------+---+-------+-------+-------+-------+---+-----+-------------+
| 12\.   |   |       |       |       |       |   |     |             |
| Total  |   |       |       |       |       |   |     |             |
| Costs  |   |       |       |       |       |   |     |             |
| (lines |   |       |       |       |       |   |     |             |
| 9-11)  |   |       |       |       |       |   |     |             |
+--------+---+-------+-------+-------+-------+---+-----+-------------+
| >      |   |       |       |       |       |   |     |             |
| **\*In |   |       |       |       |       |   |     |             |
| direct |   |       |       |       |       |   |     |             |
| > Cost |   |       |       |       |       |   |     |             |
| >      |   |       |       |       |       |   |     |             |
|  Infor |   |       |       |       |       |   |     |             |
| mation |   |       |       |       |       |   |     |             |
| > *(To |   |       |       |       |       |   |     |             |
| > Be   |   |       |       |       |       |   |     |             |
| > Com  |   |       |       |       |       |   |     |             |
| pleted |   |       |       |       |       |   |     |             |
| > by   |   |       |       |       |       |   |     |             |
| > Your |   |       |       |       |       |   |     |             |
| > Bu   |   |       |       |       |       |   |     |             |
| siness |   |       |       |       |       |   |     |             |
| >      |   |       |       |       |       |   |     |             |
|  Offic |   |       |       |       |       |   |     |             |
| e*):** |   |       |       |       |       |   |     |             |
| >      |   |       |       |       |       |   |     |             |
| > If   |   |       |       |       |       |   |     |             |
| > you  |   |       |       |       |       |   |     |             |
| > are  |   |       |       |       |       |   |     |             |
| > requ |   |       |       |       |       |   |     |             |
| esting |   |       |       |       |       |   |     |             |
| > r    |   |       |       |       |       |   |     |             |
| eimbur |   |       |       |       |       |   |     |             |
| sement |   |       |       |       |       |   |     |             |
| > for  |   |       |       |       |       |   |     |             |
| > in   |   |       |       |       |       |   |     |             |
| direct |   |       |       |       |       |   |     |             |
| >      |   |       |       |       |       |   |     |             |
|  costs |   |       |       |       |       |   |     |             |
| > on   |   |       |       |       |       |   |     |             |
| > line |   |       |       |       |       |   |     |             |
| > 10,  |   |       |       |       |       |   |     |             |
| >      |   |       |       |       |       |   |     |             |
| please |   |       |       |       |       |   |     |             |
| >      |   |       |       |       |       |   |     |             |
| answer |   |       |       |       |       |   |     |             |
| > the  |   |       |       |       |       |   |     |             |
| > fol  |   |       |       |       |       |   |     |             |
| lowing |   |       |       |       |       |   |     |             |
| > ques |   |       |       |       |       |   |     |             |
| tions: |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
| (1) Do |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
|    you |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
|   have |   |       |       |       |       |   |     |             |
|     an |   |       |       |       |       |   |     |             |
|     In |   |       |       |       |       |   |     |             |
| direct |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
|   Cost |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
|   Rate |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
|    Agr |   |       |       |       |       |   |     |             |
| eement |   |       |       |       |       |   |     |             |
|     ap |   |       |       |       |       |   |     |             |
| proved |   |       |       |       |       |   |     |             |
|     by |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
|    the |   |       |       |       |       |   |     |             |
|     F  |   |       |       |       |       |   |     |             |
| ederal |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
|  gover |   |       |       |       |       |   |     |             |
| nment? |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
|  \_\_\ |   |       |       |       |       |   |     |             |
| _\_Yes |   |       |       |       |       |   |     |             |
|     \_ |   |       |       |       |       |   |     |             |
| \_\_\_ |   |       |       |       |       |   |     |             |
|     No |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
| (2) If |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
|   yes, |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
| please |   |       |       |       |       |   |     |             |
|     p  |   |       |       |       |       |   |     |             |
| rovide |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
|    the |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
|    fol |   |       |       |       |       |   |     |             |
| lowing |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
| inform |   |       |       |       |       |   |     |             |
| ation: |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
| >      |   |       |       |       |       |   |     |             |
| Period |   |       |       |       |       |   |     |             |
| > C    |   |       |       |       |       |   |     |             |
| overed |   |       |       |       |       |   |     |             |
| > by   |   |       |       |       |       |   |     |             |
| > the  |   |       |       |       |       |   |     |             |
| > In   |   |       |       |       |       |   |     |             |
| direct |   |       |       |       |       |   |     |             |
| > Cost |   |       |       |       |       |   |     |             |
| > Rate |   |       |       |       |       |   |     |             |
| > Agre |   |       |       |       |       |   |     |             |
| ement: |   |       |       |       |       |   |     |             |
| >      |   |       |       |       |       |   |     |             |
|  From: |   |       |       |       |       |   |     |             |
| > \_   |   |       |       |       |       |   |     |             |
| \_\_/\ |   |       |       |       |       |   |     |             |
| _\_\_/ |   |       |       |       |       |   |     |             |
| \_\_\_ |   |       |       |       |       |   |     |             |
| \_\_\_ |   |       |       |       |       |   |     |             |
| > To:  |   |       |       |       |       |   |     |             |
| > \_   |   |       |       |       |       |   |     |             |
| \_\_/\ |   |       |       |       |       |   |     |             |
| _\_\_/ |   |       |       |       |       |   |     |             |
| \_\_\_ |   |       |       |       |       |   |     |             |
| \_\_\_ |   |       |       |       |       |   |     |             |
| >      |   |       |       |       |       |   |     |             |
| (mm/dd |   |       |       |       |       |   |     |             |
| /yyyy) |   |       |       |       |       |   |     |             |
| >      |   |       |       |       |       |   |     |             |
| > App  |   |       |       |       |       |   |     |             |
| roving |   |       |       |       |       |   |     |             |
| > F    |   |       |       |       |       |   |     |             |
| ederal |   |       |       |       |       |   |     |             |
| > a    |   |       |       |       |       |   |     |             |
| gency: |   |       |       |       |       |   |     |             |
| > \_   |   |       |       |       |       |   |     |             |
| \_\_\_ |   |       |       |       |       |   |     |             |
| > ED   |   |       |       |       |       |   |     |             |
| > \_   |   |       |       |       |       |   |     |             |
| \_\_\_ |   |       |       |       |       |   |     |             |
| >      |   |       |       |       |       |   |     |             |
|  Other |   |       |       |       |       |   |     |             |
| > (    |   |       |       |       |       |   |     |             |
| please |   |       |       |       |       |   |     |             |
| > spe  |   |       |       |       |       |   |     |             |
| cify): |   |       |       |       |       |   |     |             |
| > \_\_ |   |       |       |       |       |   |     |             |
| \_\_\_ |   |       |       |       |       |   |     |             |
| \_\_\_ |   |       |       |       |       |   |     |             |
| \_\_\_ |   |       |       |       |       |   |     |             |
| \_\_\_ |   |       |       |       |       |   |     |             |
| \_\_\_ |   |       |       |       |       |   |     |             |
| \_\_\_ |   |       |       |       |       |   |     |             |
| \_\_\_ |   |       |       |       |       |   |     |             |
| \_\_\_ |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
| (      |   |       |       |       |       |   |     |             |
| 3) For |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
|   Rest |   |       |       |       |       |   |     |             |
| ricted |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
|   Rate |   |       |       |       |       |   |     |             |
|     Pr |   |       |       |       |       |   |     |             |
| ograms |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
| (check |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
|   one) |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
|    \-- |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
|    Are |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
|    you |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
|  using |   |       |       |       |       |   |     |             |
|     a  |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
|   rest |   |       |       |       |       |   |     |             |
| ricted |   |       |       |       |       |   |     |             |
|     in |   |       |       |       |       |   |     |             |
| direct |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
|   cost |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
|   rate |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
|  that: |   |       |       |       |       |   |     |             |
|        |   |       |       |       |       |   |     |             |
| >      |   |       |       |       |       |   |     |             |
| \_\_\_ |   |       |       |       |       |   |     |             |
| > Is   |   |       |       |       |       |   |     |             |
| > in   |   |       |       |       |       |   |     |             |
| cluded |   |       |       |       |       |   |     |             |
| > in   |   |       |       |       |       |   |     |             |
| > your |   |       |       |       |       |   |     |             |
| > ap   |   |       |       |       |       |   |     |             |
| proved |   |       |       |       |       |   |     |             |
| > In   |   |       |       |       |       |   |     |             |
| direct |   |       |       |       |       |   |     |             |
| > Cost |   |       |       |       |       |   |     |             |
| > Rate |   |       |       |       |       |   |     |             |
| > Agre |   |       |       |       |       |   |     |             |
| ement? |   |       |       |       |       |   |     |             |
| > or   |   |       |       |       |       |   |     |             |
| >      |   |       |       |       |       |   |     |             |
| \_\_\_ |   |       |       |       |       |   |     |             |
| > Co   |   |       |       |       |       |   |     |             |
| mplies |   |       |       |       |       |   |     |             |
| > with |   |       |       |       |       |   |     |             |
| > 34   |   |       |       |       |       |   |     |             |
| > CFR  |   |       |       |       |       |   |     |             |
| > 7    |   |       |       |       |       |   |     |             |
| 6.564( |   |       |       |       |       |   |     |             |
| c)(2)? |   |       |       |       |       |   |     |             |
+--------+---+-------+-------+-------+-------+---+-----+-------------+

+---------+--------+--------+--------+--------+--------+------------+
| > Name  |        |        | Appl   |        |        |            |
| > of    |        |        | icants |        |        |            |
| > Ins   |        |        | requ   |        |        |            |
| titutio |        |        | esting |        |        |            |
| n/Organ |        |        | f      |        |        |            |
| ization |        |        | unding |        |        |            |
|         |        |        | for    |        |        |            |
|         |        |        | only   |        |        |            |
|         |        |        | one    |        |        |            |
|         |        |        | year   |        |        |            |
|         |        |        | should |        |        |            |
|         |        |        | co     |        |        |            |
|         |        |        | mplete |        |        |            |
|         |        |        | the    |        |        |            |
|         |        |        | column |        |        |            |
|         |        |        | under\ |        |        |            |
|         |        |        | \"P    |        |        |            |
|         |        |        | roject |        |        |            |
|         |        |        | Year   |        |        |            |
|         |        |        | 1.\"   |        |        |            |
|         |        |        | Appl   |        |        |            |
|         |        |        | icants |        |        |            |
|         |        |        | requ   |        |        |            |
|         |        |        | esting |        |        |            |
|         |        |        | f      |        |        |            |
|         |        |        | unding |        |        |            |
|         |        |        | for    |        |        |            |
|         |        |        | mult   |        |        |            |
|         |        |        | i-year |        |        |            |
|         |        |        | grants |        |        |            |
|         |        |        | should |        |        |            |
|         |        |        | co     |        |        |            |
|         |        |        | mplete |        |        |            |
|         |        |        | all    |        |        |            |
|         |        |        | appl   |        |        |            |
|         |        |        | icable |        |        |            |
|         |        |        | co     |        |        |            |
|         |        |        | lumns. |        |        |            |
|         |        |        | Please |        |        |            |
|         |        |        | read   |        |        |            |
|         |        |        | all    |        |        |            |
|         |        |        | instru |        |        |            |
|         |        |        | ctions |        |        |            |
|         |        |        | before |        |        |            |
|         |        |        | comp   |        |        |            |
|         |        |        | leting |        |        |            |
|         |        |        | form.  |        |        |            |
+---------+--------+--------+--------+--------+--------+------------+
| **      |        |        |        |        |        |            |
| SECTION |        |        |        |        |        |            |
| B -     |        |        |        |        |        |            |
| BUDGET  |        |        |        |        |        |            |
| SU      |        |        |        |        |        |            |
| MMARY** |        |        |        |        |        |            |
|         |        |        |        |        |        |            |
| **NON-  |        |        |        |        |        |            |
| FEDERAL |        |        |        |        |        |            |
| FUNDS** |        |        |        |        |        |            |
+---------+--------+--------+--------+--------+--------+------------+
| Budget  | P      | P      | P      | P      | P      | Total      |
| Cat     | roject | roject | roject | roject | roject |            |
| egories | Year 1 | Year 2 | Year 3 | Year 4 | Year 5 | \(f\)      |
|         |        |        |        |        |        |            |
|         | \(a\)  | \(b\)  | \(c\)  | \(d\)  | \(e\)  |            |
+---------+--------+--------+--------+--------+--------+------------+
|         |        |        |        |        |        |            |
+---------+--------+--------+--------+--------+--------+------------+
| 1\.     |        |        |        |        |        |            |
| Pe      |        |        |        |        |        |            |
| rsonnel |        |        |        |        |        |            |
+---------+--------+--------+--------+--------+--------+------------+
| 2\.     |        |        |        |        |        |            |
| Fringe  |        |        |        |        |        |            |
| B       |        |        |        |        |        |            |
| enefits |        |        |        |        |        |            |
+---------+--------+--------+--------+--------+--------+------------+
| 3\.     |        |        |        |        |        |            |
| Travel  |        |        |        |        |        |            |
+---------+--------+--------+--------+--------+--------+------------+
| 4\.     |        |        |        |        |        |            |
| Eq      |        |        |        |        |        |            |
| uipment |        |        |        |        |        |            |
+---------+--------+--------+--------+--------+--------+------------+
| 5\.     |        |        |        |        |        |            |
| S       |        |        |        |        |        |            |
| upplies |        |        |        |        |        |            |
+---------+--------+--------+--------+--------+--------+------------+
| 6\.     |        |        |        |        |        |            |
| Cont    |        |        |        |        |        |            |
| ractual |        |        |        |        |        |            |
+---------+--------+--------+--------+--------+--------+------------+
| 7\.     |        |        |        |        |        |            |
| Const   |        |        |        |        |        |            |
| ruction |        |        |        |        |        |            |
+---------+--------+--------+--------+--------+--------+------------+
| 8\.     |        |        |        |        |        |            |
| Other   |        |        |        |        |        |            |
+---------+--------+--------+--------+--------+--------+------------+
| 9\.     |        |        |        |        |        |            |
| Total   |        |        |        |        |        |            |
| Direct  |        |        |        |        |        |            |
| Costs   |        |        |        |        |        |            |
|         |        |        |        |        |        |            |
| (Lines  |        |        |        |        |        |            |
| 1-8)    |        |        |        |        |        |            |
+---------+--------+--------+--------+--------+--------+------------+
| 10\.    |        |        |        |        |        |            |
| I       |        |        |        |        |        |            |
| ndirect |        |        |        |        |        |            |
| Costs   |        |        |        |        |        |            |
+---------+--------+--------+--------+--------+--------+------------+
| 11\.    |        |        |        |        |        |            |
| T       |        |        |        |        |        |            |
| raining |        |        |        |        |        |            |
| S       |        |        |        |        |        |            |
| tipends |        |        |        |        |        |            |
+---------+--------+--------+--------+--------+--------+------------+
| 12\.    |        |        |        |        |        |            |
| Total   |        |        |        |        |        |            |
| Costs   |        |        |        |        |        |            |
|         |        |        |        |        |        |            |
| (Lines  |        |        |        |        |        |            |
| 9-11)   |        |        |        |        |        |            |
+---------+--------+--------+--------+--------+--------+------------+
| *       |        |        |        |        |        |            |
| *ECTION |        |        |        |        |        |            |
| C --    |        |        |        |        |        |            |
| BUDGET  |        |        |        |        |        |            |
| NARR    |        |        |        |        |        |            |
| ATIVE** |        |        |        |        |        |            |
| (see    |        |        |        |        |        |            |
| instru  |        |        |        |        |        |            |
| ctions) |        |        |        |        |        |            |
+---------+--------+--------+--------+--------+--------+------------+

**Instructions for ED 524**

[General Instructions]{.underline}

This form is used to apply to individual U.S. Department of Education
(ED) discretionary grant programs. Unless directed otherwise, provide
the same budget information for each year of the multi-year funding
request. Pay attention to applicable program specific instructions, if
attached. Please consult with your Business Office prior to submitting
this form.

[Section A - Budget Summary]{.underline}

[U.S. Department of Education Funds]{.underline}

All applicants must complete Section A and provide a breakdown by the
applicable budget categories shown in lines 1-11.

Lines 1-11, columns (a)-(e): For each project year for which funding is
requested, show the total amount requested for each applicable budget
category.

Lines 1-11, column (f): Show the multi-year total for each budget
category. If funding is requested for only one project year, leave this
column blank.

Line 12, columns (a)-(e): Show the total budget request for each project
year for which funding is requested.

Line 12, column (f): Show the total amount requested for all project
years. If funding is requested for only one year, leave this space
blank.

Indirect Cost Information:\
If you are requesting reimbursement for indirect costs on line 10, this
information is to be completed by your Business Office. (1): Indicate
whether or not your organization has an Indirect Cost Rate Agreement
that was approved by the Federal government. (2): If you checked "yes"
in (1), indicate in (2) the beginning and ending dates covered by the
Indirect Cost Rate Agreement. In addition, indicate whether ED or
another Federal agency (Other) issued the approved agreement. If you
check "Other," specify the name of the Federal agency that issued the
approved agreement. (3): If you are applying for a grant under a
Restricted Rate Program (34 CFR 75.563 or 76.563), indicate whether you
are using a restricted indirect cost rate that is included on your
approved Indirect Cost Rate Agreement or whether you are using a
restricted indirect cost rate that complies with 34 CFR 76.564(c)(2).
Note: State or Local government agencies may not use the provision for a
restricted indirect cost rate specified in 34 CFR 76.564(c)(2). Check
only one response. Leave blank, if this item is not applicable.

[Section B - Budget Summary]{.underline}

[Non-Federal Funds]{.underline}

If you are required to provide or volunteer to provide matching funds or
other non-Federal resources to the project, these should be shown for
each applicable budget category on lines 1‑11 of Section B.

Lines 1-11, columns (a)-(e): For each project year, for which matching
funds or other contributions are provided, show the total contribution
for each applicable budget category.

Lines 1-11, column (f): Show the multi-year total for each budget
category. If non-Federal contributions are provided for only one year,
leave this column blank.

Line 12, columns (a)-(e): Show the total matching or other contribution
for each project year.

Line 12, column (f): Show the total amount to be contributed for all
years of the multi-year project. If non-Federal contributions are
provided for only one year, leave this space blank.

[Section C - Budget Narrative \[Attach separate sheet(s)\]]{.underline}

[Pay attention to applicable program specific instructions,\
if attached.]{.underline}

1.  Provide an itemized budget breakdown, and justification by project
    year, for each budget category listed in Sections A and B. For grant
    projects that will be divided into two or more separately budgeted
    major activities or sub-projects, show for each budget category of a
    project year the breakdown of the specific expenses attributable to
    each sub-project or activity.

2.  If applicable to this program, provide the rate and base on which
    fringe benefits are calculated.

3.  If you are requesting reimbursement for indirect costs on line 10,
    this information is to be completed by your Business Office. Specify
    the estimated amount of the base to which the indirect cost rate is
    applied and the total indirect expense. Depending on the grant
    program to which you are applying and/or your approved Indirect Cost
    Rate Agreement, some direct cost budget categories in your grant
    application budget may not be included in the base and multiplied by
    your indirect cost rate. For example, you must multiply the indirect
    cost rates of "Training grants\" (34 CFR 75.562) and grants under
    programs with "Supplement not Supplant" requirements (\"Restricted
    Rate\" programs) by a "modified total direct cost" (MTDC) base (34
    CFR 75.563 or 76.563). Please indicate which costs are included and
    which costs are excluded from the base to which the indirect cost
    rate is applied.

> When calculating indirect costs (line 10) for \"Training grants\" or
> grants under \"Restricted Rate\" programs, you must refer to the
> information and examples on ED's website at:
> [http://www.ed.gov/fund/grant/apply/appforms/appforms.html]{.underline}.
>
> You may also contact (202) 377-3838 for additional information
> regarding calculating indirect cost rates or general indirect cost
> rate information.

4.  Provide other explanations or comments you deem necessary.

Paperwork Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are
required to respond to a collection of information unless such
collection displays a valid OMB control number. The valid OMB control
number for this information collection is 1890-0004. The time required
to complete this information collection is estimated to vary from 13 to
22 hours per response, with an average of 17.5 hours per response,
including the time to review instructions, search existing data sources,
gather the data needed, and complete and review the information
collection. If you have any comments concerning the accuracy of the time
estimate(s) or suggestions for improving this form, please write to:
U.S. Department of Education, Washington, D.C. 20202-4651. If you have
comments or concerns regarding the status of your individual submission
of this form, write directly to (insert program office), U.S. Department
of Education, 400 Maryland Avenue, S.W., Washington, D.C. 20202.

![](media/image4.png){width="0.9722222222222222in"
height="0.75in"}**Certification of eligibility for federal assistance in
certain programs**

I understand that 34 CFR 75.60, 75.61, and 75.62 require that I make
specific certifications of eligibility to the U.S. Department of
Education (ED) as a condition of applying for Federal funds in certain
programs and that these requirements are in addition to any other
eligibility requirements that ED imposes under program regulations.
Under 34 CFR 75.60 -- 75.62:

I.  I certify that:

```{=html}
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```
A.  I do not owe a debt, or I am current in repaying a debt, or I am not
    in default (as that term is used at 34 CFR Part 668) on a debt:

```{=html}
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```
1.  To the Federal Government under a nonprocurement transaction (e.g.,
    a previous loan, scholarship, grant, or cooperative agreement); or

2.  For a fellowship, scholarship, stipend, discretionary grant, or loan
    in any program of ED that is subject to 34 CFR 75.60, 75.61, and
    75.62, including:

-   Federal Pell Grant Program (20 U.S.C. 1070a, et seq.);

-   Federal Supplemental Educational Opportunity Grant (SEOG) Program
    (20 U.S.C. 1070(b), et seq.):

-   State Student Incentive Grant Program (SSIG) 20 U.S.C. 1070c, et
    seq.);

-   Federal Perkins Loan Program (20 U.S.C. 1087aa, et seq.);

-   Income Contingent Direct Loan Demonstration Project (20 U.S.C.
    1087a, note);

-   Federal Stafford Loan Program, Federal Supplemental Loans for
    Students \[SLS\], Federal PLUS, or Federal Consolidation Loan
    Program (20 U.S.C. 1071, et seq.);

-   William D. Ford Federal Direct Loan Program (20 U.S.C. 1087a, et.
    seq.);

-   Cuban Student Loan Program (20 U.S.C. 2601, et seq.);

-   Robert C. Byrd Honors Scholarship Program (20 U.S.C. 1070d-31, et
    seq.);

-   Jacob K. Javits Fellows Program (20 U.S.C. 1134h-1134l);

-   Patricia Roberts Harris Fellowship Program (20 U.S.C. 1134d-1134g);

-   Christa McAuliffe Fellowship Program (20 U.S.C. 1105-1105i);

-   Bilingual Education Fellowship Program (20 U.S.C. 3221-3262);

-   Rehabilitation Long-Term Training Program (29 U.S.C. 774(b));

-   Paul Douglas Teacher Scholarship Program (20 U.S.C. 1104, et seq.);

-   Law Enforcement Education Program (42 U.S.C. 3775);

-   Indian Fellowship Program (29 U.S.C. 774(b));

-   Teacher Quality Enhancement Grants Program (20 U.S.C. 1021, et
    seq.);

**OR**

B.  I have made arrangements satisfactory to ED to repay a debt as
    described in A.1. or A.2. (above) on which I had not been current in
    repaying or on which I was in default (as that term is used in 34
    CFR Part 668).

```{=html}
<!-- -->
```
II. I certify also that I have not been declared by a judge, as a
    condition of sentencing under section 5301 of the Anti-Drug Abuse
    Act of 1988 (21 U.S.C. 862), ineligible to receive Federal
    assistance for the period of this requested funding.

I understand that providing a false certification to any of the
statements above makes me liable for repayment to ED for funds received
on the basis of this certification, for civil penalties, and for
criminal prosecution under 18 U.S.C. 1001.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
(signature) (Date)

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

(typed or printed name)

Name or number of ED program under which this certification is being
made: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

ED 80-0016 (Revised 2/01) **OMB Approval No. 0348-0040**

**ASSURANCES - NON-CONSTRUCTION PROGRAMS**

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

# CERTIFICATION REGARDING LOBBYING

Applicants must review the requirements for certification regarding
lobbying included in the regulations cited below before completing this
form. Applicants must sign this form to comply with the certification
requirements under 34 CFR Part 82, \"New Restrictions on Lobbying.\"
This certification is a material representation of fact upon which the
Department of Education relies when it makes a grant or enters into a
cooperative agreement.

As required by Section 1352, Title 31 of the U.S. Code, and implemented
at 34 CFR Part 82, for persons entering into a Federal contract, grant
or cooperative agreement over \$100,000, as defined at 34 CFR Part 82,
Sections 82.105 and 82.110, the applicant certifies that:

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

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

\(c\) The undersigned shall require that the language of this
certification be included in the award documents for all subawards at
all tiers (including subgrants and contracts under grants and
cooperative agreements) and that all subrecipients shall certify and
disclose accordingly.

As the duly authorized representative of the applicant, I hereby certify
that the applicant will comply with the above certification.

  -----------------------------------------------------------------------
  NAME OF APPLICANT PR/AWARD NUMBER AND / OR PROJECT NAME

  PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE

  SIGNATURE DATE
  -----------------------------------------------------------------------

ED 80-0013 06/04

**Certification Regarding Debarment, Suspension, Ineligibility and**

**Voluntary Exclusion \-- Lower Tier Covered Transactions**

This certification is required by the Department of Education
regulations implementing Executive Order 12549, Debarment and
Suspension, 34 CFR Part 85, for all lower tier transactions meeting the
threshold and tier requirements stated at Section 85.110.

**Instructions for Certification**

1\. By signing and submitting this proposal, the prospective lower tier
participant is providing the certification set out below.

2\. The certification in this clause is a material representation of
fact upon which reliance was placed when this transaction was entered
into. If it is later determined that the prospective lower tier
participant knowingly rendered an erroneous certification, in addition
to other remedies available to the Federal Government, the department or
agency with which this transaction originated may pursue available
remedies, including suspension and/or debarment.

3\. The prospective lower tier participant shall provide immediate
written notice to the person to which this proposal is submitted if at
any time the prospective lower tier participant learns that its
certification was erroneous when submitted or has become erroneous by
reason of changed circumstances.

4\. The terms \"covered transaction,\" \"debarred,\" \"suspended,\"
\"ineligible,\" \"lower tier covered transaction,\" \"participant,\" \"
person,\" \"primary covered transaction,\" \" principal,\" \"proposal,\"
and \"voluntarily excluded,\" as used in this clause, have the meanings
set out in the Definitions and Coverage sections of rules implementing
Executive Order 12549. You may contact the person to which this proposal
is submitted for assistance in obtaining a copy of those regulations.

5\. The prospective lower tier participant agrees by submitting this
proposal that, should the proposed covered transaction be entered into,
it shall not knowingly enter into any lower tier covered transaction
with a person who is debarred, suspended, declared ineligible, or
voluntarily excluded from participation in this covered transaction,
unless authorized by the department or agency with which this
transaction originated.

6\. The prospective lower tier participant further agrees by submitting
this proposal that it will include the clause titled Certification
Regarding Debarment, Suspension, Ineligibility, and Voluntary
Exclusion-Lower Tier Covered Transactions,without modification, in all
lower tier covered transactions and in all solicitations for lower tier
covered transactions.

7\. A participant in a covered transaction may rely upon a certification
of a prospective participant in a lower tier covered transaction that it
is not debarred, suspended, ineligible, or voluntarily excluded from the
covered transaction, unless it knows that the certification is
erroneous. A participant may decide the method and frequency by which it
determines the eligibility of its principals. Each participant may but
is not required to, check the Nonprocurement List.

8\. Nothing contained in the foregoing shall be construed to require
establishment of a system of records in order to render in good faith
the certification required by this clause. The knowledge and information
of a participant is not required to exceed that which is normally
possessed by a prudent person in the ordinary course of business
dealings.

9\. Except for transactions authorized under paragraph 5 of these
instructions, if a participant in a covered transaction knowingly enters
into a lower tier covered transaction with a person who is suspended,
debarred, ineligible, or voluntarily excluded from participation in this
transaction, in addition to other remedies available to the Federal
Government, the department or agency with which this transaction
originated may pursue available remedies, including suspension and/or
debarment.

**Certification**

\(1\) The prospective lower tier participant certifies, by submission of
this proposal, that neither it nor its principals are presently
debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any
Federal department or agency.

\(2\) Where the prospective lower tier participant is unable to certify
to any of the statements in this certification, such prospective
participant shall attach an explanation to this proposal.

  -----------------------------------------------------------------------
  NAME OF APPLICANT PR/AWARD NUMBER AND/OR PROJECT NAME

  PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE

  SIGNATURE DATE
  -----------------------------------------------------------------------

ED 80-0014, 9/90 (Replaces GCS-009 (REV.12/88), which is obsolete)

Approved by OMB

0348-0046

**Disclosure of Lobbying Activities**

Complete this form to disclose lobbying activities pursuant to 31 U.S.C.
1352

(See reverse for public burden disclosure)

+----------------------+----------+---------+-------------------------+
| 1.  **Type of        | 2.       |         | 3.  **Report Type:**    |
|     Federal          | **Status |         |                         |
|     Action:**        |     of   |         | a\. initial filing      |
|                      |          |         |                         |
| a\. contract         |  Federal |         | \_\_\_\_\_ b. material  |
|                      |     A    |         | change                  |
| \_\_\_\_ b. grant    | ction:** |         |                         |
|                      |          |         | **For material change   |
| c\. cooperative      | a\.      |         | only:**                 |
| agreement            | bid/o    |         |                         |
|                      | ffer/app |         | Year \_\_\_\_\_\_\_     |
| d\. loan             | lication |         | quarter \_\_\_\_\_\_\_  |
|                      |          |         |                         |
| e\. loan guarantee   | \_       |         | Date of last            |
|                      | \_\_\_\_ |         | repor                   |
| f\. loan insurance   | b.       |         | t\_\_\_\_\_\_\_\_\_\_\_ |
|                      | initial  |         |                         |
|                      | award    |         |                         |
|                      |          |         |                         |
|                      | c\.      |         |                         |
|                      | po       |         |                         |
|                      | st-award |         |                         |
+----------------------+----------+---------+-------------------------+
| 4.  **Name and       |          | 5       |                         |
|     Address of       |          | .  **If |                         |
|     Reporting        |          |     Re  |                         |
|     Entity:**        |          | porting |                         |
|                      |          |         |                         |
| \_\_\_\_ Prime       |          |  Entity |                         |
| \_\_\_\_\_           |          |     in  |                         |
| Subawardee           |          |     No. |                         |
|                      |          |     4   |                         |
| > Tier\_\_\_\_\_\_,  |          |     is  |                         |
| > if Known:          |          |         |                         |
|                      |          |  Subawa |                         |
| **Congressional      |          | rdee,** |                         |
| District, if         |          |         |                         |
| known:**             |          |   Enter |                         |
|                      |          |         |                         |
|                      |          |    Name |                         |
|                      |          |     and |                         |
|                      |          |         |                         |
|                      |          | Address |                         |
|                      |          |     of  |                         |
|                      |          |         |                         |
|                      |          |  Prime: |                         |
|                      |          |         |                         |
|                      |          | *       |                         |
|                      |          | *Congre |                         |
|                      |          | ssional |                         |
|                      |          | Di      |                         |
|                      |          | strict, |                         |
|                      |          | if      |                         |
|                      |          | k       |                         |
|                      |          | nown:** |                         |
+----------------------+----------+---------+-------------------------+
| 6.  **Federal        |          | **7.    |                         |
|                      |          | Federal |                         |
| Department/Agency:** |          | Program |                         |
|                      |          | Name/   |                         |
|                      |          | Descrip |                         |
|                      |          | tion:** |                         |
|                      |          |         |                         |
|                      |          | CFDA    |                         |
|                      |          | Number, |                         |
|                      |          | *if     |                         |
|                      |          | appli   |                         |
|                      |          | cable*: |                         |
|                      |          | \       |                         |
|                      |          | _\_\_\_ |                         |
|                      |          | \_\_\_\ |                         |
|                      |          | _\_\_\_ |                         |
|                      |          | \_\_\_\ |                         |
|                      |          | _\_\_\_ |                         |
+----------------------+----------+---------+-------------------------+
| 7.  **Federal Action |          | **9.    |                         |
|     Number,** *if    |          | Award   |                         |
|     known:*          |          | Am      |                         |
|                      |          | ount**, |                         |
|                      |          | *if     |                         |
|                      |          | known:* |                         |
|                      |          |         |                         |
|                      |          | **\$**  |                         |
+----------------------+----------+---------+-------------------------+
| **10. a. Name and    |          | **b.    |                         |
| Address of Lobbying  |          | Indi    |                         |
| Registrant**         |          | viduals |                         |
|                      |          | Per     |                         |
| *(if individual,     |          | forming |                         |
| last name, first     |          | Ser     |                         |
| name, MI):*          |          | vices** |                         |
|                      |          | *(in    |                         |
|                      |          | cluding |                         |
|                      |          | address |                         |
|                      |          | if      |                         |
|                      |          | di      |                         |
|                      |          | fferent |                         |
|                      |          | from    |                         |
|                      |          | No.     |                         |
|                      |          | 10a)*   |                         |
|                      |          |         |                         |
|                      |          | *(last  |                         |
|                      |          | name,   |                         |
|                      |          | first   |                         |
|                      |          | name,   |                         |
|                      |          | MI):*   |                         |
+----------------------+----------+---------+-------------------------+
| **11. Information    |          | **Sig   |                         |
| requested through    |          | nature: |                         |
| this form is         |          | \_\_\_\ |                         |
| authorized by title  |          | _\_\_\_ |                         |
| 31 U.S.C. section    |          | \_\_\_\ |                         |
| 1352. This           |          | _\_\_\_ |                         |
| disclosure of        |          | \_\_\_\ |                         |
| lobbying activities  |          | _\_\_\_ |                         |
| is a material        |          | \_\_\_\ |                         |
| representation of    |          | _\_\_\_ |                         |
| fact upon which      |          | \_\_\_\ |                         |
| reliance was placed  |          | _\_\_** |                         |
| by the tier above    |          |         |                         |
| when this            |          | **Print |                         |
| transaction was made |          | Name:   |                         |
| or entered into.     |          | \_\_\   |                         |
| This disclosure is   |          | _\_\_** |                         |
| required pursuant to |          |         |                         |
| 31 U.S.C. 1352. This |          | *       |                         |
| information will be  |          | *Title: |                         |
| reported to the      |          | \_\_\   |                         |
| Congress             |          | _\_\_** |                         |
| semi-annually and    |          |         |                         |
| will be available    |          | **Te    |                         |
| for public           |          | lephone |                         |
| inspection. Any      |          | No.:    |                         |
| person who fails to  |          | \_\     |                         |
| file the required    |          | _\_\_\_ |                         |
| disclosure shall be  |          | \_\_\_\ |                         |
| subject to a civil   |          | _\_\_\_ |                         |
| penalty of not less  |          | Date:   |                         |
| than \$10,000 and    |          | \_      |                         |
| not more than        |          | \_\_\_\ |                         |
| \$100,000 for each   |          | _\_\_** |                         |
| such failure.**      |          |         |                         |
+----------------------+----------+---------+-------------------------+
| **Federal Use Only** |          | **Aut   |                         |
|                      |          | horized |                         |
|                      |          | for     |                         |
|                      |          | Local   |                         |
|                      |          | Reprodu |                         |
|                      |          | ction** |                         |
|                      |          |         |                         |
|                      |          | **S     |                         |
|                      |          | tandard |                         |
|                      |          | Form -  |                         |
|                      |          | LLL     |                         |
|                      |          | (Rev.   |                         |
|                      |          | 7-97)** |                         |
+----------------------+----------+---------+-------------------------+

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

IMPORTANT NOTICES

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

**NOTICE TO ALL APPLICANTS**

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

**To Whom Does This Provision Apply?**

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

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

**What Does This Provision Require?**

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

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

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

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

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

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

**Estimated Burden Statement for GEPA Requirements**

According to the Paperwork Reduction Act of 1995, no persons are
required to respond to a collection of information unless such
collection displays a valid OMB control number. The valid OMB control
number for this information collection is **1890-0007.** The time
required to complete this information collection is estimated to average
1.5 hours per response, including the time to review instructions,
search existing data resources, gather the data needed, and complete and
review the information collection. **If you have any comments concerning
the accuracy of the time estimate(s) or suggestions for improving this
form, please write to:** Director, Grants Policy and Oversight Staff,
U.S. Department of Education, 400 Maryland Avenue SW, Washington, DC
20202-4250.

**Estimated Burden Statement for GEPA Requirements**

According to the Paperwork Reduction Act of 1995, no persons are
required to respond to a collection of information unless such
collection displays a valid OMB control number. The valid OMB control
number for this information collection is **1890-0007.** The time
required to complete this information collection is estimated to average
1.5 hours per response, including the time to review instructions,
search existing data resources, gather the data needed, and complete and
review the information collection. **If you have any comments concerning
the accuracy of the time estimate(s) or suggestions for improving this
form, please write to:** Director, Grants Policy and Oversight Staff,
U.S. Department of Education, 400 Maryland Avenue, SW (Room 3652, GSA
Regional Office Building No. 3). Washington, DC 20202-4248.

+-----------------------------------------------------------------------+
| **NOTICE TO ALL APPLICANTS:**                                         |
|                                                                       |
| **The Government Performance and Results Act (GPRA)**                 |
+-----------------------------------------------------------------------+

# **What is GPRA**

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

How has the United States Department of Education Responded to the GPRA
Requirements?

As required by GPRA, the United States Department of Education (the
Department) has prepared a strategic plan for 1998-2002. This plan
reflects the Department's priorities and integrates them with its
mission and program authorities and describes how the Department will
work to improve education for all children and adults in the United
States. The Department's goals, as listed in the plan, are:

***Goal 1*:** Help all students reach challenging academic standards so
that they are prepared for responsible citizenship, further learning,
and productive employment.

***Goal 2:*** Build a solid foundation for learning for all children.

***Goal 3:*** Ensure access to postsecondary education and lifelong
learning.

***Goal 4:*** Make the United States Department of Education a high
performance organization by focusing on results, service quality, and
customer satisfaction.

![](media/image5.jpeg){width="0.7534722222222222in"
height="0.7597222222222222in"}

> 1\. Does the applicant have 501(c)(3) status?

Yes No

2\. How many full-time equivalent employees does the applicant have?
*(Check only one box).*

> 3 or Fewer 15-50
>
> 4-5 51-100
>
> 6-14 over 100

3\. What is the size of the applicant's annual budget? *(Check only one
box.)*

Less Than \$150,000

\$150,000 - \$299,999

\$300,000 - \$499,999

\$500,000 - \$999,999

\$1,000,000 - \$4,999,999

\$5,000,000 or more

4\. Is the applicant a faith-based/religious organization?

Yes No

5\. Is the applicant a non-religious community-based organization?

Yes No

6\. Is the applicant an intermediary that will manage the grant on
behalf of other organizations?

> Yes No

7.  Has the applicant ever received a government grant or contract
    (Federal, State, or local )?

Yes No

8\. Is the applicant a local affiliate of a national organization?

Yes No

# Survey Instructions on Ensuring Equal Opportunity for Applicants

# 

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

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

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

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

4\. Self-identify.

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

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

7.  Self-explanatory.

8.  Self-explanatory.

**\
Paperwork Burden Statement**

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

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

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

**APPLICATION CHECKLIST AND COMMON QUESTIONS AND ANSWERS**

**Application Checklist**

Does your application include each of the following?

\[ \] Cover page (ED 424)

\[ \] Budget form (ED Form 524)

\[ \] Program specific budget form \[if applicable\]

\[ \] Budget narrative \[if applicable\]

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

\[ \] Assurances and Certifications \[list\]

Did You \--

\[ \] Provide one (1) original plus two 2 copies of the application (One
original and six copies are requested)?

\[ \] Include all required forms with original signatures and dates?

\[ \] Submit a copy of the application to the State Single Point of
Contact, if applicable?

\[ \] Mail\* Application To: **OR** Hand-deliver\* Application To:

  ----------------------------------- -----------------------------------
  **American Indian Vocational        **American Indian Vocational
  Rehabilitation Services**           Rehabilitation Services**

  ATTN: 84.250B                       ATTN: 84.250B

  U.S. Department of Education        U.S. Department of Education

  Application Control Center          Application Control Center

  400 Maryland Avenue, SW             550 12^th^ Street, SW, Room 7041

  Washington, DC 20202-4260           Washington, DC 20202-4260
  ----------------------------------- -----------------------------------

+---------------------------------------------+---+--------------------+
| DUNS Number Instructions                    |   |                    |
|                                             |   |                    |
| **D-U-N-S No.:**                            |   |                    |
|                                             |   |                    |
| Please provide the Applicant's D-U\--N-S    |   |                    |
| Number. You can obtain your D-U-N-S Number  |   |                    |
| at not charge by calling **1-800-333-0505** |   |                    |
| or by completing a D-U-N-S Number Request   |   |                    |
| Form. The form can be obtained via the      |   |                    |
| Internet at the following URL:              |   |                    |
|                                             |   |                    |
| <http://www.dnb.com/>                       |   |                    |
|                                             |   |                    |
| The D-U-N-S Number is a unique nine-digit   |   |                    |
| number that does not convey any information |   |                    |
| about the recipient. A built in check digit |   |                    |
| helps assure the accuracy of the D-U-N-S    |   |                    |
| Number. The ninth digit of each number is   |   |                    |
| the check digit, which is mathematically    |   |                    |
| related to the other digits. It lets        |   |                    |
| computer systems determine if a D-U-N-S     |   |                    |
| Number has been entered correctly.          |   |                    |
|                                             |   |                    |
| DUN & Bradstreet, a global information      |   |                    |
| services provider, has assigned D-U-N-S     |   |                    |
| number to over 43 million companies         |   |                    |
| worldwide.                                  |   |                    |
|                                             |   |                    |
| **\                                         |   |                    |
| **                                          |   |                    |
|                                             |   |                    |
| **GRANT APPLICATION RECEIPT                 |   |                    |
| ACKNOWLEDGEMENT\_\_\_\_\_\_\_\_\_\_**       |   |                    |
|                                             |   |                    |
| **If you fail to receive the notification   |   |                    |
| of application within fifteen (15) days     |   |                    |
| from the closing date, call:**              |   |                    |
|                                             |   |                    |
| **U.S. Department of Education**            |   |                    |
|                                             |   |                    |
| **Application Control Center**              |   |                    |
|                                             |   |                    |
| **(202) 245-6288**                          |   |                    |
|                                             |   |                    |
| **GRANT AND CONTRACT FUNDING INFORMATION**  |   |                    |
|                                             |   |                    |
| **The Department of Education provides      |   |                    |
| information about grant and contract        |   |                    |
| opportunities electronically in several     |   |                    |
| ways:**                                     |   |                    |
|                                             |   |                    |
| **ED Internet Home Page                     |   |                    |
| <http://www.ed.gov/> (WWW address)**        |   |                    |
+---------------------------------------------+---+--------------------+