## U.S. DEPARTMENT OF EDUCATION **OFFICE OF POSTSECONDARY EDUCATION WASHINGTON, DC 20006**  **- 85**  **15**

**Fiscal Year 201**  **3 APPLICATION FOR GRANTS**  

## PREDOMINANTLY BLACK INSTITUTIONS **FORMULA**

**GRANT PROGRAM**  **CFDA No . 84.**  **031P CLOSING DATE**  **S :**  **PHASE I: April 5**  **, 2013 PHASE II:**  **May 3, 2013**

**OMB No. 1840 -**  **0812 Expires on: 06/30/2013** 

## TA **BLE OF CONTENTS**

Dear Applicant Letter............................................................................... 1 Competition Highlights.............................................................................. 3 Overview of Program ............................................................................ ... 4 Requir ements and Funding Rules............................................................
..... 7 Statute.........
....................................................................................... 8 Closing Date Notice...........................................................................
..... 14 Instructions for Completing the Application Part I : Formula Elements......................................................................... 3 6 Part I I : Project P lan...............................................................................
. 3 9 Goals and Objectives Form.....................................................................42 Part III: Standard Forms, Certifications and Surveys Application for Federal Assist ance (SF 424)................................................ 44 Instructions for the SF 424......
......... ............ .......................................... 4 7 S upplemental Information Required for Dep artment of Education....................... 4 9 Instructions for Supplement to SF 424................................................... .....50 Definitions for Supplement to SF 424......................................................... 51 ED 524 Budget Information....................................
......... ....................... 5 4 Instructions for E D 524
............................................................ .... ......... 5 6 GEPA......
....................................................................................... 5 8 Disclosure of Lobb yi ng Activi ties SF
- L LL.............................................
.. ... 5 9 Instructions for Completio n of SF
- LLL...................................................... 60 GPRA..............................................................................
......... ......61 Survey on Ensuring Equ al Opportuni ty for Appli cants..................................... 6 2 Application Transmittal In structions.......................................................... 64

### UNITED STATES DEPARTMENT OF EDUCATION OFFI CE OF POSTSECONDARY EDUCATION

1 Dear Applicant: Thank you for your interest in appl yi ng for a fiscal year (FY) 201 3 grant under the Predominantly

Black Institutions (PBI) Formu la grant program. This program was established by

the Higher Education Opportunity Act o f 2008 and is authorized under Title III, P art A, S ection 318 of the Higher Education Act of 1965, as amended (HEA). The purpose of the PBI program is to assist eligible institutions in e xpanding educational opportunities for their students through a program of Federal assistance. A copy of the statute for this program and all instructions and forms required to appl y for a grant are included in this application bookle t. To be eligible to apply

for a grant under the PBI program, institutions of higher education must first apply

for and be designate d as eligible institutions for Title III and T itle V funding. Information about applying for designation as an eligible i nstitution may be found at: http://www.ed.gov/about/offices/list/ope/idues/eligibility .html. Institutions must also meet the statutory definition of a PBI, and must not be receiving assi stance under other programs in Parts A and B of Title III; P art A of Title V; or be authorized to receive an annual appropriation under the Act of March 2, 1867 (14 Stat. 438; 20 U.S.C. 123). All eligible institutions who qualify as PBIs and submit the required application materials in accordance with the instructions wil l receive a portion of the total appropriation for the PBI Formula grant program. Funds to eligible PBIs will be awarded based on the funding formula included in the program statute. Please read carefull y the Closing Date Notice for this program that w as published in the Federal Register and is included in this application. The Closing Date Notice includes information on the deadline for transmittal of applications and other program requirements. Do not follow any guidance that is in conflict with the contents of the Closing Date Notice. Please note that there are two deadlines for transmittal of application materials, each pertaining to different phases of the application process. Phase I of the application involves the submission of data necessary to determine statutory eligibility and appl y the funding formula that determines the amount each eligible institution will receive. Phase II of the application involves the submission of the narrative project plan, abstract, and all standard forms, including the SF 524 Budget form and narrative. The deadlines for submission of Phase Iand Phase II of the application are listed in the Closing Date Notice.

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Page 2

– Dear Applicant

If you have an y questions or require additional information, please contact Bernadette D. Miles via email at bernadette.miles @ed.gov or b y phone at (202) 502
- 76 16
. I appreciate your interest in the PBI program and look forward to receiving your application.

Sincerel y,

Debra Saunders
- White, Ph.D. Deputy Assistant Secretary f or Higher Education Programs Office of Postsecondary

Education

### 3 **Competition Highlights**

 The Predominantly

Black Institutions (PBI) Program was established by the Higher Education Opportunity Act of 2008 and is authorized unde r Title III, Part A of the Higher Education Act of 1965, as amended (HEA). The PBI program makes grant awards for up to five ye ars to eligible institutions to plan, develop, undertake and implement programs to enhance the institution’s capacity to expand higher education opportunities for low
- income and Black American students. A copy of the statute for this program and all instructions and forms necessary to apply for grants are included in this application booklet.

 To be eligible to apply for a grant under the PBI program, institutions of higher education must first apply for and be designated eligible institutions for Title III and Title V funding. Information about applying for designation as an eligible institution may

be found at http://www.ed.gov/about/offices/list/ope/idues/eligibility .html
. Institutions must also meet the program
- specific eligibility requirements described in the statute.

 The amount allotted to each PBI under this program may not be less than $250,000. If the amount appropriated for this program for a fiscal ye ar is not sufficient to pay

the minimum allotment to eligible institutions , then the amount of the minimum allotment must be ratably reduced , in accordance with the statute
.
 Amounts will be awarded based on a formula. All institutions who meet the statutory definition of a PBI and submit the required materials will receive a portion of the total appropriation . The amount that an eligible inst itution receives depends on a formula based on the number of Federal Pell Grant recipients, the number of graduates, and the number of graduates seeking a higher degree at that institution.

 The application process will have two phases
.
 In Phase 1 , appl icant institutions will submit the data requested in Part I of the application, demonstrating that they meet the program
- specific eligibility requirements, and enabling program staff to calculate how much funding the institution qualifies for based on the formula contained in the statute.

 In Phase 2 , Part s II and III of the application will be submitted after the institution is informed by the Department how much funding it will receive based on the data submitted by the institution in Part I. Part II in cludes the budget, budget narrative, and a project narrative of no more than 50 pages describing the project activities, the goals and objectives of the project, and an evaluation plan including performance measures. Part III of the application includes th e standard forms , certifications and survey s .
 Deadline for Submitting P hase 1 Data: April 5, 2013

 Deadline for Submitting P hase 2 Data: May 3, 2013

### 4

**PREDOMINANTLY BLACK INSTITUTIONS FORMULA GRANT**  **PROGRAM**
**AUTHORIZING LEGISLATION** Higher Education Act of 1965 as amended (HEA), Title III , Part A , Section 318
. **APPLICABLE REGULATIONS** Education Department Administrative Regulations (EDGAR), Parts 74, 75, 77, 79, 81, 82, 84, 85, 86, 97, 98 and 99. **I. OVERVIEW OF PROGRAM**  **Purpose :**  The Pre dominantly

Black Inst itutions ( PBI) Program makes five
- ye ar grant awards to eligible institutions to plan, develop, undertake and implement programs to enhance the institution’s capacity

to serve more low
- and middle
- income Black American students; to expand higher education o pportunities for eligible students by encouraging college preparation and student persistence in secondary school and postsecondary education; and to strengthen the financial ability of the institution to serve the academic needs of these students. **Eligib ility**  **:** To be eligible to apply

for a grant under the PBI program, institutions of higher education must first apply

for and be designated eligible institutions for Title III and Title V funding. Information about applying for designation as an eligible i nstitution may be found at http://www.ed.gov/about/offices/list/ope/idues/eligibility .html
. To be eligible, an institution of higher education must
--  have an enrollment of needy undergraduate students;  have an average educational and general expenditure that is low, per full
- time equivalent undergraduate student, in comparison with the average educational and general expenditure per full
- time equivalent undergraduate student of institutions that offer similar instruction ;  have an enrollment of undergraduate students that is not less than 40 percent Black American students;  be legall y authorized to provide, and provide, within the State an educational program for which the institution of higher education awards a baccalaureate degree or, in the case of a junior or community college, an associate's degree;  be accredited b y a nationally recognized accrediting agency or association determined b y the Secretary to be a reliable authority as to the quality

of training offered or is, according to such an agency or association, making reasonable progress toward accreditation;

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 not be receiving assistance under other programs in parts A and B of Title III ; part A of title V; or be authorized to receive an annual appropriation under the Act of March 2, 1867 (14 Stat. 438; 20 U.S.C. 123).  have not less than 1,000 undergraduate students;  have not less than 50 percent of undergraduate students enrolled that are low
income individuals or first
- generation college students; and  have not less than 50 percent of the undergradu ate students enrolled in an educational program leading to a bachelor's or associate's degree that the eligible institution is licensed to award b y the State in which the eligible institution is located. **Enrollment of Needy Students**

– For purposes of this part, the term “enrollment of needy students” means enrollment at an eligible institution with respect to which not less than 50 percent of the undergraduate students enrolled in an academic program leading to a degree

—  in the second fiscal ye ar preceding the fiscal year for which the determination is made, were Federal Pell Grant recipients for such year;  come from families that receive benefits under a means
- tested Federal benefit program;  attended a public or nonprofit private secondary school that
-- 1. is in the school district of a local educational agency that was eligible for assistance under part A of title Iof the Elementary and Secondary Education Act of 1965 for an y ye ar during which the student attended such secondary school; and 2. for such ye ar of attendance, was determined b y the Secretary (pursuant to regulations and after consultation with the State educational agency of the State in which the school is located) to be a school in which the enrollment of children meeting a measure of poverty under section 1113(a)(5) of such Act exceeds 30 percent of the total enrollment of such school; or  are first
- generation college students and a majority of such first
- generation college students are low
- income individuals. **Low -**  **Income Individual**
- For the purpose of this part, the term “low
- income individual” means an individual from a family whose taxable income for the preceding year did not exceed 150 percent of an amount equal to the poverty level determined by

using criteria of poverty established b y the Bure au of the Census. **First Generation College Student**

– For the purposes of this part, the term “first generation college student” means
- (A) an individual both of whose parents did not complete a baccalaureate degree; or (B) in the case of an y individual who regu larly resided with and received support from one parent, an individual whose only such parent did not complete a baccalaureate degree. **Means -**  **tested Federal Benefit Program**
- a program of the Federal Government, other than a program under title IV of the H EA , in which eligibility for the program's benefits, or the amount of such benefits, are determined on the basis of income or resources of the individual or family

seeking the benefit.

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**Authorized Activities :**  Grant funds may

be used for the following acti vities:

 Academic instruction in disciplines in which Black Americans are underrepresented.  Establishing or enhancing a program of teacher education designed to qualify students to teach in a public elementary school or secondary

school in the State that must include, as part of such program, preparation for teacher certification or licensure.  Establishing community outreach programs that will encourage elementary school and secondary

school students to develop the academic skills and the interest to pursue postsecondary

education.  Purchase, rental, or lease of scientific or laboratory equipment for educational purposes, including instructional and research purposes.  Construction, maintenance, renovation, and improvement in classrooms, libraries, laboratorie s, and other instructional facilities, including the integration of computer technology

into institutional facilities to create smart buildings.  Support of faculty exchanges, faculty development, and faculty fellowships to assist in attaining advanced degrees in the field of instruction of the faculty.  Development and improvement of academic programs
.  Purchase of library

books, periodicals, and other educational materials, including telecommunications program material.  Tutoring, counseling, and student service programs designed to improve academic success, including innovative, customized, instruction courses designed to help retain students and move the students rapidly into core courses and through program completion, which may include remedial education and English language instruction
.  Education or counseling services designed to improve the financial literacy and economic literacy

of students or the students' families.  Funds management, administrative management, and acquisition of equipment for use in strengthening funds management.  Joint use of facilities, such as laboratories and libraries.  Establishing or improving a development office to strengthen or improve contributions from alumni and the private sector.  Establishing or improving an endowment fund.  Creating or improving facilities for Internet or other distance learning technologies, including purchase or rental of telecommunications technology equipment or services.  Other activities proposed in the application that
-- a. contribute to carrying out the purpose of the PBI Program; and b. are approved b y the Secretary as part of the review and approval of an application.

### 7 **REQUIREMENTS AND FUNDING RULES**
**Endowment Funds:**  A PBI may

use not more than **20 percent** of the grant funds to establish or increase an endowment fund at the institution. In order to be eligible to use grant funds to establish or increase an endowment, a PBI must provide **ma tching funds**  from non
- Federal sources, in an amount equal to or greater than the Federal funds used for the establis hment or increase of the endowment fund. The provisions of part C of Title III apply to the establishment or increase of an endowment fund under the PBI program. **Construction:** Not more than 50 percent of the grant funds provided to a PBI under this program may be used for constructing or maintaining a classroom, library , laboratory , or other instructional facility
. **Minimum Award:** The amount allotted to each PBI may not be less than $250,000. If the amount appropriated for this program for a fiscal ye ar is not sufficient to pay the minimum allotment, then the amount of the minimum allotment must be ratabl y reduced. **Funding Formula:** Grant amounts to PBIs will be awarded according to the following formula: (1) **Federal Pell Grants**
- From the amount appropri ated for this program for any fiscal ye ar, the Secretary must allot to each PBI a sum that bears the same ratio to one
half of that amount as the number of Federal Pell Grant recipients in attendance at such institution at the end of the academic ye ar prec eding the beginning of that fiscal year, bears to the total number of Federal Pell Grant recipients at all such institutions at the end of such academic ye ar. (2) **Graduates**
- From the amount appropriated for this program for any fiscal year, the Secretary will allot to each PBI a sum that bears the same ratio to one
- fourth of that amount as the number of graduates for such academic year at such institution, bears to the total number of graduates for such academi c year at all such institutions. (3) **Graduate s Seeking a Higher Degree** 
- From the amount appropriated for this program for an y fiscal year, the Secretary must allot to each PBI a sum that bears the same ratio to one
- fourth of that amount as the percentage of graduates from such institution who are adm itted to and in attendance at, not later than two years after graduation with an associate's degree or a baccalaureate degree, a baccalaureate degree
- granting institution or a graduate or professional school in a degree program in disciplines in which Blac k American students are underrepresented, bears to the percentage of such graduates for all such institutions.

### 8



## PREDOMINANTLY BLACK INSTITUTIONS PROGRAM **STATUTE**

### 9 **SEC. 318. (NOTE: 20 USC 1059e) PREDOMINA NTLY BLA** **CK INSTITUTIONS** (a) Purpose.
-- It is the purpose of this section to assist Predominantly Black Institutions in expanding educational opportunity through a program of Federal assistance. (b) Definitions.
-- In this section: (1) Eligible institution.
-- The term “eligible institution” me ans an institution of higher education that -- (A) has an enrollment of needy undergraduate students; (B) has an average educational and general expenditure that is low, per full
- time equivalent undergraduate student, in comparison with the average educational and general expenditure per full
- time equivalent undergraduate student of institutions that offer similar instruction, except that the Secretary may apply the waiver requirements described in section 392(b) to this subparagraph in the same mann er as the Secretary applies the waiver requirements to section 312(b)(1)(B); (C) has an enrollment of undergraduate students that is not less than 40 percent Black American students; (D) is legally authorized to provide, and provides, wit hin the State an educational program for which the institution of higher education awards a baccalaureate degree or, in the case of a junior or community college, an associate's degree; (E) is accredited by a nationally recognized accrediting agen cy or association determined by the Secretary to be a reliable authority as to the quality of training offered or is, according to such an agency or association, making reasonable progress toward accreditation; and (F) is not receiving assistance under part B or part A of title V. (2) Enrollment of needy students.
-- The term “enrollment of needy students” means the enrollment at an eligible institution with respect to which not less than 50 percent of the undergraduate students enrolled in an aca demic program leading to a degree -- (A) in the second fiscal year preceding the fiscal year for which the determination is made, were Federal Pell Grant recipients for such year; (B) come from families that receive benefits under a means
- tested Federal benefit program; (C) attended a public or nonprofit private secondary school that
-- (i) is in the school district of a local educational agency that was eligible for assistance under part A of title I of the Elementa ry and Secondary Education Act of 1965 for any year during which the student attended such secondary school; and (ii) for the purpose of this paragraph and for such year of attendance, was determined by the Secretary (pursuant to regulation s and after consultation with the State educational agency of the State in which the school is located) to be a school in which the enrollment of children meeting a measure of poverty under section 1113(a)(5) of such Act exceeds 30 percent of the total enrollment of such school; or (D) are first
- generation college students and a majority of such first
- generation college students are low- income individuals. (3) First
- generation college student. -- The term “first
- generation college student” has th e meaning given the term in section 402A(h).* (4) Low
- income individual. -- The term “low
- income individual” has the meaning given such term in section 402A(h).** (5) Means
- tested federal benefit program.
-- The term `means - tested Federal benefit program ' means a program of the Federal Government, other than a program under title IV, in which eligibility for the program's benefits, or the amount of such benefits,

### 10 are determined on the basis of income or resources of the individual or family seeking the be nef it. (6) Predominantly black institution.
-- The term “Predominantly Black Institution” means an institution of higher education, as defined in section 101(a)
-- (A) that is an eligible institution with not less than 1,000 undergraduate student s; (B) at which not less than 50 percent of the undergraduate students enrolled at the eligible institution are low- income individuals or first
- generation college students; and (C) at which not less than 50 percent of the undergraduate students are enrolled in an educational program leading to a bachelor's or associate's degree that the eligible institution is licensed to award by the State in which the eligible institution is located. (7) State.
-- The term “State” means each of the 50 States and the District of Columbia. (c) Grant Authority.
-- (1) In general.
-- The Secretary is authorized to award grants, from allotments under subsection (e), to Predominantly Black Institutions to enable the Predominantly Black Institutions to carry out the authorized activities described in subsection (d). (2) Priority.
-- In awarding grants under this section the Secretary shall give priority to Predominantly Black Institutions with large numbers or percentages of students described in subsection s (b)(1)(A) or (b)(1)(C). The level of priority given to Predominantly Black Institutions with large numbers or percentages of students described in subsection (b)(1)(A) shall be twice the level of priority given to Predominantly Black Institutions with la rge numbers or percentages of students described in subsection (b)(1)(C). (d) Authorized Activities.

— (1) Required activities.
-- Grant funds provided under this section shall be used
-- (A) to assist the Predominantly Black Institution to plan , develop, undertake, and implement programs to enhance the institution's capacity to serve more low- and middle - income Black American students; (B) to expand higher education opportunities for students eligible to participate in programs under ti tle IV by encouraging college preparation and student persistence in secondary school and postsecondary education; and (C) to strengthen the financial ability of the Predominantly Black Institution to serve the academic needs of the students desc ribed in subparagraphs (A) and (B). (2) Additional activities.
-- Grant funds provided under this section shall be used for one or more of the following activities: (A) The activities described in paragraphs (1) through (12) of section 311(c).* * * (B) Academic instruction in disciplines in which Black Americans are underrepresented. (C) Establishing or enhancing a program of teacher education designed to qualify students to teach in a public elementary school or secondary schoo l in the State that shall include, as part of such program, preparation for teacher certification or licensure. (D) Establishing community outreach programs that will encourage elementary school and secondary school students to develop the academ ic skills and the interest to pursue postsecondary education. (E) Other activities proposed in the application submitted pursuant to subsection (f ) that
-- (i) contribute to carrying out the purpose of this section; and

### 11 (ii) are approved by the Secretary as part of the review and approval of an application submitted under subsection (f). (3) Endowment fund.
-- (A) In general.
-- A Predominantly Black Institution may use not more than 20 percent of the grant fu nds provided under this section to establish or increase an endowment fund at the institution. (B) Matching requirement.
-- In order to be eligible to use grant funds in accordance with subparagraph (A), a Predominantly Black Institution shall prov ide matching funds from non
- Federal sources, in an amount equal to or greater than the Federal funds used in accordance with subparagraph (A), for the establishment or increase of the endowment fund. (C) Comparability.
-- The (NOTE: Applicability) provisions of part C, regarding the establishment or increase of an endowment fund, that the Secretary determines are not inconsistent with this subsection, shall apply to funds used under subparagraph (A). (4) Limitation.
-- Not more than 50 percent of the grant funds provided to a Predominantly Black Institution under this section may be available for the purpose of constructing or maintaining a classroom, library, laboratory, or other instructional facility. (e) Allotments to Predominantly Black Instituti ons. — (1) Federal Pell grant basis.
-- From the amounts appropriated to carry out this section for any fiscal year, the Secretary shall allot to each Predominantly Black Institution having an application approved under subsection (f) a sum that bears the sa me ratio to one - half of that amount as the number of Federal Pell Grant recipients in attendance at such institution at the end of the academic year preceding the beginning of that fiscal year, bears to the total number of Federal Pell Grant recipients at all such institutions at the end of such academic year. (2) Graduates basis.
-- From the amounts appropriated to carry out this section for any fiscal year, the Secretary shall allot to each Predominantly Black Institution having an application approved unde r subsection (f) a sum that bears the same ratio to one - fourth of that amount as the number of graduates for such academic year at such institution, bears to the total number of graduates for such academic year at all such institutions. (3) Graduates s eeking a higher degree basis. -- From the amounts appropriated to carry out this section for any fiscal year, the Secretary shall allot to each Predominantly Black Institution having an application approved under subsection (f ) a sum that bears the same rati o to one - fourth of that amount as the percentage of graduates from such institution who are admitted to and in attendance at, not later than two years after graduation with an associate's degree or a baccalaureate degree, a baccalaureate degree - granting in stitution or a graduate or professional school in a degree program in disciplines in which Black American students are underrepresented, bears to the percentage of such graduates for all such institutions. (4) Minimum allotment.
-- (A) In general.
-- Notwi thstanding paragraphs (1), (2), and (3), the amount allotted to each Predominantly Black Institution under this section may not be less than $250,000. (B) Insufficient amount.
-- If the amounts appropriated to carry out this section for a fiscal year are not sufficient to pay the minimum allotment provided under subparagraph (A) for the fiscal year, then the amount of such minimum allotment shall be ratably reduced. If additional sums become available for such fiscal year, such reduced allotment shall be incr eased on the same basis as the allotment was

### 12 reduced until the amount allotted equals the minimum allotment required under subparagraph (A). (5) Reallotment.
-- The amount of a Predominantly Black Institution's allotment under paragraph (1), (2), (3), or (4) for any fiscal year that the Secretary determines will not be needed for such institution for the period for which such allotment is available, shall be available for reallotment to other Predominantly Black Institutions in proportion to the original a llotments to such other institutions under this section for such fiscal year. The Secretary shall reallot such amounts from time to time, on such date and during such period as the Secretary determines appropriate. (f ) Applications.
-- Each Predominantly Bl ack Institution desiring a grant under this section shall submit an application to the Secretary at such time, in such manner, and containing or accompanied by such information as the Secretary may reasonably require. (g) Application Review Process.
-- Sect ion 393 shall not apply to applications under this section. (h) Duration and Carryover.
-- Any grant funds paid to a Predominantly Black Institution under this section that are not expended or used for the purposes for which the funds were paid within ten y ears following the date on which the grant was awarded, shall be repaid to the Treasury. (i) Special Rule on Eligibility.
-- No Predominantly Black Institution that receives funds under this section shall concurrently receive funds under any other provision of this part, part B, or part A of title V. ***First Generation College Student**

– For the purposes of this part, the term “first generation college student” means - (A) an individual both of whose parents did not complete a baccalaureate degree; or (B) in the cas e of any individual who regularly resided with and received support from one parent, an individual whose only such parent did not complete a baccalaureate degree.  Low**  **- Income Individual**  - For the purpose of this part, the term “low
- income individual” mean s an individual from a family whose taxable income for the preceding year did not exceed 150 percent of an amount equal to the poverty level determined by using criteria of poverty established by the Bureau of the Census.

****** *** PA RT**  **A STRENGTHENING**  **INSTITU TIONS**  (c) AUTHORIZED ACTIVITIES.
-- Grants awarded under this section shall be used for 1 or more of the following activities: (1) Purchase, rental, or lease of scientific or laboratory equipment for educational purposes, including instructional and resear ch purposes. (2) Construction, maintenance, renovation, and improvement in classrooms, libraries, laboratories, and other instructional facilities, including the integration of computer technology into institutional facilities to create smart buildings. (3 ) Support of faculty exchanges, faculty development, and faculty fellowships to assist in attaining advanced degrees in the field of instruction of the faculty. (4) Development and improvement of academic programs

### 13

(5) Purchase of library books, periodical s, and other educational materials, including telecommunications program material. (6) Tutoring, counseling, and student service programs designed to improve academic success, including innovative, customized, instruction courses designed to help retain st udents and move the students rapidly into core courses and through program completion, which may include remedial education and English language instruction (7) Education or counseling services designed to improve the financial literacy and economic litera cy of students or the students' families. (8) Funds management, administrative management, and acquisition of equipment for use in strengthening funds management. (9) Joint use of facilities, such as laboratories and libraries. (10) Establishing or improvi ng a development office to strengthen or improve contributions from alumni and the private sector. (11) Establishing or improving an endowment fund. (12) Creating or improving facilities for Internet or other distance learning technologies, including purch ase or rental of telecommunications technology equipment or services. (13) Other activities proposed in the application submitted pursuant to subsection (b) and section 391 that - (A) contribute to carrying out the purposes of the program assisted under thi s part; and (B) are approved by the Secretary as part of the review and acceptance of such application.

### 14 

## CLOSING DATE NOTICE

### 15

4000
- 01
- U DEPARTMENT OF EDUCATION Applications for New Awards; Predominantly Black Institutions Formula Grant Progr am AGENCY: Office of Postsecondary Education, Department of Education. ACTION: Notice. Overview Information : Predominantly Black Institutions (PBI) Formula Grant Program Notice inviting applications for new awards for fiscal year (FY) 201 3 . Catalog of F ederal Domestic Assistance (CFDA) Number: 84. 031P . Dates : Applications Available: . Deadline for Transmittal of Phase I of Applications: . April 5, 2013 Deadline for Transmittal of Phase II of Applications: . May 3, 2013 Full Text of Announcement I. Fundi ng Opportunity Description Purpose of Program : Th rough th e Predominantly Black Institutions (PBI) Formula Grant Program , the Department makes grant awards to eligible institutions to plan,

### 16

develop, undertake, and implement programs to enhance their capaci ty to serve more low
- and middle
- income Black American students; to expand higher education opportunities for eligible students by encouraging college preparation and student persistence in secondary school and postsecondary education; and to strengthen th e financial ability of the institution s to serve the academic needs of these students. Program Authority : Title III, part A, section 318 of the Higher Education Act of 1965, as amended (HEA) (20 U.S.C. 1059e). Applicable Regulations : The Education Depart ment General Administrative Regulations (EDGAR) in 34 CFR parts 74, 75, 77, 82, 84, 85, 86, 97, 98, and 99. II. Award Information Type of Award : Formula Grant . Estimated Available Funds : $9,262, 461 . Estimated Average Size of Awards : Grants awarded under the PBI Formula Grant Program will be allotted to eligible institutions based on the formula included in section 318(e) of the HEA (20 U.S.C. 105 9e (e)) , with no grant ee allotted less than $250,000. If the amount appropriated for this program for a fiscal year is not sufficient to pay the minimum allotment to eligible institutions, then the amount of the minimum

### 17

allotment must be ratably reduced, in accordance with section 318(e) of the HEA (20 U.S.C. 1059e(e)(4)) . Funding Formula : Grant amounts to PBIs will be awarded according to the following formula: (1) Federal Pell Grant basis
- - From the amount appropriated for this program for any fiscal year, the Secretary allot s to each PBI with an approved application a sum that bears the same ratio to one
- half of that amount as the number of Federal Pell Grant recipients in attendance at such institution at the end of the academic year preceding the beginning of that fiscal year, bears to the total number of Federal Pell Grant recipients at all such institution s at the end of such academic year. (2) Graduates basis
- - From the amount appropriated for this program for any fiscal year, the Secretary allot s to each PBI with an approved application a sum that bears the same ratio to one
- fourth of that amount as the number of graduates for such academic year at such institution, bears to the total number of graduates for such academic year at all such institutions. ( 3) Graduates Seeking a h igher d egree basis
- - From the amount appropriated for this program for any fiscal ye ar, the Secretary allot s to each PBI with an approved application a sum that bears the same ratio to one
- fourth

### 18

of that amount as the percentage of graduates from such institution who are admitted to and in attendance at, not later than two years after gra duation with an associate's degree or a baccalaureate degree, a baccalaureate degree
granting institution or a graduate or professional school in a degree program in disciplines in which Black American students are underrepresented, bears to the percentage of such graduates for all such institutions. Estimated Number of Awards : All applicant institutions that meet the eligibility requirements will receive a portion of the total appropriation s for the PBI Formula Grant Program . Note : The Department is not bound by any estimates in this notice. Project Period : 60 months. III. Eligibility Information 1. Eligible Applicants : To be eligible, an applicant must have previously submitted the “Application for Designation as an Eligible Institution” and receive d FY 201 2 designation as an eligible institution for programs under title III and title V of the HEA. The regulations explaining the standards for designation can be found in 34 CFR 607.2 through 607.5. In addition, an applicant must -- (1) H ave an enrol lment of needy undergraduate students as defined in section 318(b)(2) of the HEA;

### 19 (2) H ave an average educational and general expenditure that is low, per full
- time equivalent undergraduate student, in comparison with the average educational and general e xpenditure per full
- time equivalent undergraduate student of institutions that offer similar instruction, except that the Secretary may apply the waiver requirements described in section 392(b) of the HEA to this subparagraph in the same manner as the Secr etary applies the waiver requirements to section 312(b)(1)(B) of the HEA; (3) H ave an enrollment of undergraduate students that is not less than 40 percent Black American students; (4) B e legally authorized to provide, and provide, within the State an ed ucational program for which the institution of higher education awards a baccalaureate degree or, in the case of a junior or community college, an associate's degree; (5) B e accredited by a nationally recognized accrediting agency or association determine d by the Secretary to be a reliable authority as to the quality of training offered or is, according to such an agency or association, making reasonable progress toward accreditation; and (6) N ot be receiving funds under any other provision of p art A or p art B of title III of the HEA or part A of

### 20

t itle V of the HEA or be authorized to receive an annual appropriation under the Act of March 2, 1867 (20 U.S.C. 123). To be eligible for a grant under the PBI Formula Grant Program, an applicant must also meet th e definition of a Predominantly Black Institution in section 318(b)(6) of the HEA. The term Predominantly Black Institution means an institution of higher education, as defined in section 101(a) of the HEA
-- (A) T hat is an eligible institution with not l ess than 1,000 undergraduate students; (B) A t which not less than 50 percent of the undergraduate students enrolled at the eligible institution are low
- income individuals or first
- generation college students; and (C) A t which not less than 50 percent of the undergraduate students are enrolled in an educational program leading to a bachelor's or associate's degree that the eligible institution is licensed to award by the State (defined as each of the 50 States and the District of Columbia) in which the eli gible institution is located . 2. Cost Sharing or Matching : This program does not require cost sharing or matching unless the grantee uses a portion of its grant for establishing or improving an endowment fund. If a grantee uses a portion of its grant

### 21

fo r endowment fund purposes, it must match those grant funds with non
- Federal funds in an amount equal to or greater than the Federal funds used for the establishment or increase of the endowment fund (20 U.S.C. 1059 e(d)(3) ). IV. Application and Submission Information 1. Address to Request Application Package : You can obtain an application package via the Internet or from the Department. To obtain a copy via the Internet, use the following address for the PBI Formula Grant Program Web site: ww w.ed.gov/programs/pbihea/index.html . To obtain a copy from the Department, write, fax, or call the following: Bernadette D. Miles , U.S. Department of Education, 1990 K Street, NW., r oom 60 25 , Washington, DC 20006
- 85 15 . Telephone: (202) 502
- 76 16 , or by e - mail: bernadette . miles @ed.gov. If you use a telecommunications device for the deaf (TDD), call the Federal Relay Service (FRS), toll free, at 1
- 800
- 877
- 8339. Individuals with disabilities can obtain a copy of the application package in an accessible for mat (e.g., braille, large print, audiotape, or comp act dis c ) by contacting the program contact person listed in this section. 2. Content and Form of Application Submission : The application process for this program has two phases: Phase I involves submit ting 201 1

– 201 2 data used to run the

### 22

funding formula; Phase II includes the narrative project plan and standard forms. The deadline dates for submitting Phases I and II of the application are listed in this notice. Other r equirements concerning the cont ent of an application, together with the forms you must submit, are in the application package for this program. 3. Submission Dates and Times : Applications Available : Deadline for Transmittal of Phase I of Applications: . April 5, 2013 Deadline for Tr ansmittal of Phase II of Applications: . May 3, 2013 Applications for grants under this competition must be submitted electronically as an e
- mail attachment to pbiprogram@ed.gov by 12:00:00 a.m. Washington , DC time , on the deadline date. We do not consider an application that does not comply with the deadline requirements. 4 . Intergovernmental Review : This program is not subject to Executive Order 12372 and the regulations in 34 CFR part 79. 5. Funding Restrictions : We reference regulations outlining f unding restrictions in the Applicable Regulations section in this notice.

### 23 6. Data Universal Numbering System Number, Taxpayer Identification Number, and Central Contractor Registry : To do business with the Department of Education, you must
-- a. Hav e a Data Universal Numbering System (DUNS) number and a Taxpayer Identification Number (TIN); b. Register both your DUNS number and TIN with the Central Contractor Registry (CCR), the Government’s primary registrant database; c. Provide your DU NS number and TIN on your application; and d. Maintain an active CCR registration with current information while your application is under review by the Department and, if you are awarded a grant, during the project period. You can obtain a DUNS num ber from Dun and Bradstreet. A DUNS number can be created within one business day. If you are a corporate entity, agency, institution, or organization, you can obtain a TIN from the Internal Revenue Service. If you are an individual, you can obtain a T IN from the Internal Revenue Service or the Social Security Administration. If you need a new TIN, please allow 2
- 5 weeks for your TIN to become active. The CCR registration process may take five or more business days to complete. If you are currently registered with the CCR, you may not need to make any changes.

### 24

However, please make certain that the TIN associated with your DUNS number is correct. Also note that you will need to update your CCR registration on an annual basis. This may take three or more business days to complete. 7. Other Submission Requirements : Applications for grants under this program must be submitted electronically unless you qualify for an exception to this requirement in accordance with the instructions in this section.
a. Electronic Submission of Applications . Applications for grants under the Predominantly Black Institutions Formula Grant Program -- CFDA Number 84.031P must be submitted electronically via e
- mail to pbiprogram@ed.gov . We will reject your application if you submit it in paper format unless, as described elsewhere in this section, you qualify for one of the exceptions to the electronic submission requirement and submit, no later than two weeks before the application deadl ine date, a written statement to the Department that you qualify for one of these exceptions. Further information regarding calculation of the date that is two weeks before the application deadline date is provided later in this section under Exception to Electronic Submission Requirement . You may access the electronic grant application for the PBI Program at www.ed.gov/programs/pbihea/index.html.

### 25 Please note the following: • You must complete the electronic submissio n of your grant application by 12 : 00:0 0 a. m., Washington, DC time, on the application deadline date. We will not accept an application for this program after 12 : 0 0:00 a .m., Washington, DC time, on the application deadline date. Therefore, we strongly recommend that you do not wait until the application deadline date to begin the application process. • You will not receive additional point value because you submit your application in electronic format, nor will we penalize you if you qualify for an exception to the electronic submission requi rement, as described elsewhere in this section, and submit your application in paper format. • You must submit all documents electronically, including all information you typically provide on the following forms: the Application for Federal Assistance (S F 424), the Department of Education Supplemental Information for SF 424, Budget Information
-- Non Construction Programs (ED 524) , and all necessary assurances and certifications.

• 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

### 26

file type other than the three file types specified in this paragraph 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.

• Prior to submitting your electronic application, you may wish to print a copy of it for your records.

• Within three working days after submitting Phase II of your electronic application, fax a signed copy of the SF 424 to the Application Control Center after following these steps: (1) Print SF 424 from e
- Application. (2) The applicant’s Authorizing Representative must sign this form. (3) Place the PR/Award number in the upper right hand corner of the hard
- copy signature page of the SF 424. (4) Fax the signed SF 424 to the Application Control Center at (202) 245
- 6272. • We may request that you provide us original signatures on other forms at a later date. Exception to Electronic Su bmission Requirement : You qualify for an exception to the electronic submission requirement , and may submit your application in paper format , if you are unable to submit an application via e
mail because

––

### 27 • You do not have access to the Internet; and
• No later than two weeks before the application deadline date (14 calendar days or, if the fourteenth calendar day before the application deadline date falls on a Federal holiday, the next business day following the Federal holiday), you mail or fax a writ ten statement to the Department, explaining which of the two grounds for an exception prevents you from using the Internet to submit your application. If you mail your written statement to the Department, it must be postmarked no later than two weeks bef ore the application deadline date. If you fax your written statement to the Department, we must receive the faxed statement no later than two weeks before the application deadline date. Address and mail or fax your statement to: Bernadette D. Miles , U.S. Department of Education, 1990 K Street, NW.,
r oom 60 25 , Washington, DC 20006
- 85 1 3 . FAX: (202) 502
- 78 61 . Your paper application must be submitted in accordance with the mail or hand delivery instructions described in this notice. b. Submission of Paper Applications by Mail .

### 28 If you qualify for an exception to the electronic submission requirement, you may mail (through the U.S. Postal Service or a commercial carrier) your application to the Department. You must mail the original and two copies of your a pplication, 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 84.031P) LBJ Basement Level 1 400 Maryland Avenue, SW. Washington, DC 2020 2
- 4260 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. (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. ( 2) A mail receipt that is not dated by the U.S. Postal Service.

### 29 If your application is postmarked after the application deadline date, we will not consider your application. Note : The U.S. Postal Service does not unifo rmly 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 . If you qualify for an exception to the electronic submission requirement, you (or a courier service) may deliver your paper application to the Department by hand. You must deliver the 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 Ed ucation Application Control Center Attention: (CFDA Number 84.031P) 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 4:30:00 p.m., Washi ngton, DC time, except Saturdays, Sundays, and Federal holidays. Note for Mail or Hand Delivery of Paper Applications : If you mail or hand deliver your application to the Department -- (1) You must indicate on the envelope and
-- if not provided by the Dep artment -- in Item 11 of the SF 424 the CFDA number, including suffix letter, if any, of the

### 30

competition under which you are submitting your application; and (2) The Application Control Center will mail to you a notification of receipt of your grant applic ation. If you do not receive this notification 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 Grants awarded und er the PBI Formula Grant Program are based on a formula. All applicants who meet the eligibility requirements will receive a portion of the total appropriation s for this program based on the formula contained in section 318(e) of the HEA (20 U.S.C. 1059e( e)) . Department staff will review applications to determine eligibility and to ensure that all activities proposed in the application are allowable under section 318(d) of the HEA (20 U.S.C. 1059e(d)) . 1. Award Notices : 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 notify you informally, also. If your application is not evaluated or not selected for funding, we notify you.

### 31 2. Administrative and National Polic y Requirements : We identify administrative and national policy requirements in the application package and reference these and other requirements in the Applicable Regulations section of this notice. We reference the regulations outlining the terms and
co nditions of an award in the Applicable Regulations 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 : 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 pe rformance and financial expenditure information as directed by the Secretary under 34 CFR 75.118. The Secretary may also require more frequent performance reports under 34 CFR 75.720(c). For specific requirements on reporting, please go to: www.ed.gov/f und/grant/apply/appforms/appforms.html. 4 . Performance Measures : The Secretary has established the following key performance measures for assessing the effectiveness of the PBI Formula Grant Program:

### 32 (a) Enrollment Rate: The percentage change of the number of full
- time degree
- seeking undergraduate students enrolled at PBIs. (b) Persistence Rate
- - four
- year institutions : The percentage of first
- time, full
- time degree
- seeking undergraduate students at four
- year PBIs who were in their first year of post secondary enrollment in the previous year and are enrolled in the current year at the same four
- year PBI. (c) Persistence Rate
- - two - year institutions : The percentage of first
- time, full
- time degree
- seeking undergraduate students at two - year PBIs who were in their first year of postsecondary enrollment in the previous year and are enrolled in the current year at the same two
- year PBI. (d) Completion Rate
-- four
- year institutions : The percentage of first
- time, full
- time degree
- seeking undergraduate student s enrolled at four
- year PBIs who graduate within six years of enrollment. (e) Completion Rate
-- two - year institutions : The percentage of first
- time, full
- time degree
- seeking undergraduate students enrolled at two
- year PBIs who graduate within three years of enrollment. (f) Efficiency Measure: Cost per successful program outcome: Federal cost per undergraduate degree at PBI s .

### 33

VII. Agency Contact For Further Information Contact : Bernadette D. Miles , Institutional Service, U.S. Department of Education, 1990 K Street, NW., r oom 60 25 , Washington, DC 20006
- 85 1 3 . Telephone: (202) 502
- 76 16 , or by e
- mail: bernadette . miles @ed.gov . If you use a TDD, call the FRS, toll free, at 1
- 800
- 877
- 8339. VIII. Other Information Accessible Format : Individuals with dis abilities can obtain this document and a copy of the application package in an accessible format (e.g., braille, large print, audiotape, or comp act dis c ) on request to the program contact person listed under For Further Information Contact in section VII o f this notice. Electronic Access to This Document : The official version of this document is the document published in the Federal Register . Free Internet access to the official edition of the Federal Register and the Code of Federal Regulations is availa ble via the Federal Digital System at: www.gpo.gov/fdsys. At this site you can view this document, as well as all other documents of this Department published in the Federal Register , in text or Adobe Portable Document Format (PDF). To use PDF you must have Adobe Acrobat Reader, which is available free at the site.

### 34 You may also access documents of the Department published in the Federal Register by using the article search feature at: www.federalregister.gov. Specifically, through the advanced search feature at this site, you can limit your search to documents published by the Department. Dated:

_______________________________ David Bergeron, Assistant Secretary for Postsecondary Education .

### 35



## INSTRUCTIONS FOR COMPLETING THE APPLICATI **ON**

### 36



## P **art I. Formula Data** Part Iof the application is the submission of information required for the Department to determine whether or not an institution qualifies as a PBI, and to calculate how much funding a PBI will receive, based on the formula estab lished in the program legislation. The information will be submitted on this form, pages 36
- 38 , which the applicant will submit to the program office at pbiprogram@ed.gov as an email attachment by April 5 , 201 3 . In order to calculate how much all grantee institutions will receive, it is essential that Part Iof the application, the Formula Data, be submitted on time. No calculations can be made until all PBIs have submitted the required information in full. Once determinations have been made, institutions will be informed whether or not it qualifies as a PBI, and if so, the institution will also be notified of the amount it will receive. **Applicants are strongly encouraged not to wait for this notification before**  **beginning Part II of the application.**  **After completing**  **and signing**  **this form,**  **please scan**  **and email**  **it (**  **all three**  **pages) to**  **pbiprogram@ed.gov .**  **I f**  **you do**  **not have**  **scanning capability,**  **you may**  **fax the**  **signed copy**  **to :**  **Predominantly Black**  **Institutions Program,**  **Fax No.**  **(202) 502**  **- 78**  **61 .**  

## THIS INFORMATION MUST BE SUBMITTED BY **April 5 , 201**  **3 .**  Legal Name of Institution: Address: City : State: Zip: **Eligibility** The following information is required to dete rmine whether or not your institution qualifies as a Predominantly Black Institution according to the program statute and is eligible for funding under this program
. 1. What is your institution’s enrollment of needy students*?

___________________________ 2. What was your institution’s average educational and general expenditure per full
- time equivalent undergraduate student for the 2011
- 2012 academic ye ar ?

_______________________________ _________________________ _ 3. What wa s your institution’s undergraduate enrollm ent for the 2011
- 2012 academic year ? ______________ For the 2011
- 2012 academic year, h ow man y students in this undergraduate enrollment we re : 3 a. Lo w - income individuals*?

_______________ 3b
. First generation college students*?

___________

### 37 3 c. Black Americans?

______________ _ 3d. E nrolled in an educational program at your institution leading to a bachelor’s or associate’ s degree?

_________________________ 4. Is your institution receiving funding from another program under Title III, Part s A or B; or Title V ; or authorized to receive an annual appropriation under the Act of March 2, 1867 (14 Stat. 438; 20 U.S.C. 123 ?

___________________ If so, which program(s)?

______________________________________________________________ 5. Is your institution currently acc redited by

a nationally

recognized accrediting agency or association?

______________________________________________ *see page 12 for definition **Funding Formula Data** The formula has three elements. Applicants must submit accurate information on all three elements so that the awards may be calculated correctly. **1. Federal Pell Grant Basis**  From the amounts appropriated to carry out this section for an y fiscal ye ar, the Secretary of Education must allot to each Predominantly Black Institution having an app lication approved by

the Department of Education a sum that bears the same ratio to one - half of that amount as the number of Federal Pell Grant recipients in attendance at such institution at the end of the academic year preceding the beginning of that fis cal ye ar, bears to the total number of Federal Pell Grant recipients at all such institutions at the end of such academic ye ar. **Please submit the number of Pell Grant recipients in attendance at your institution at the end of**  **academic year ( AY** **) 20**  **1 1**  **- 201**  **2 :** 

**_______________________________ 2.**  **Graduates Basis** From the amounts appropriated to carry out this section for an y fiscal ye ar, the Secretary of Education must allot to each Predominantly Black Institution having an application approved by

the Department of Education a sum that bears the same ratio to one - fourth of that amount as the number of graduates for such academic year at such institution, bears to the total number of graduates for such academic year at all such institutions.

### 38

**3. Graduates Seeking a**  **Higher Degree Basis** From the amounts appropriated to carry out this section for an y fiscal ye ar, the Secretary of Education must allot to each Predominantly Black Institution having an application approved by

the Department of Education a sum that bears the same ratio to one - fourth of that amount as the percentage of graduates from such institution who are admitted to and in attendance at, not later than two years after graduation with an associate's degree or a baccalaureate degree, a baccalaureate degree
- granting institution or a graduate or professional school in a degree program in disciplines in which Black American students are underrepresented, bears to the percentage of such graduates for all such institutions.

**Signature I attest to the accuracy of the data presented on this form.**  **Name of Institutional Represe ntative (printed or typed):**  **Signature of Institutional Representative:**
**Date: 20**  **1 1**  **2 01**  **2 Totals (20**  **1 1**  **+201 2**  **) Total N**  **umber of Graduates from**  **Undergraduate Class :**  _________________ _________________ _________________ **Number of Graduates of Your Institution**  **Admitted to and in Attendance at a**  **Baccalaureate degree**   ** granting institution or a** **Graduate or Professional Schoo**  **l in a Degree Program in Disciplines in**  **which Black American Students are**  **Underrepresented :** 

___________________ _________________ __________________

### 39



## Part II. Project Plan Part II of the application is the Project Plan. The deadline for transmittal of Part II of the application is May

3 , 201 3
. Part II of th e application must be submitted with Part III of the application as an e
- mail attachment to pbiprogram@ed.gov
. **A. Abstract:**  Applicants must provide a one
- page overview of the project and planned activities, demonstrating how the project will enhance the institution’s capacity to serve more low
- and middle
- income Black American students. **B. Project Narrative:**  Applicants must provide a project narrative of no more than 50 pages that describes how the institution will str engthen its ability to enhance higher education opportunities for low
- income and Black American students. The narrative should address the following key topics: 1. **Need for the Project:** Please give a comprehensive anal ys is of your institution’s strengths an d weaknesses, and describe how specific weaknesses in services, infrastructure, or opportunities will be addressed b y the proposed project. Please describe how the proposed project directly relates to the purpose of the PBI program, and will improve the in stitution’s capacity to serve its target student populations. 2. **Project Design:** Please describe the goals and objectives of the proposed project, the activities that will address these goals and objectives, and an implementation plan for each activity . Plea se describe how the activities will result in clearl y defined and measurable project outcomes. Where applicable, please include an explanation of how each activity in the proposed project reflects up
- to - date knowledge from research and effective practice. 3. **Project Services:** Please describe how the services provided by the proposed project are appropriate to the needs of the intended recipients, the likely impact of the project services on the intended recipients, and how the services are of sufficient quali ty , intensity and duration to lead to improvements in practice of the recipients. 4. **Project Personnel:** Please describe the qualification s , including relevant training and experience, of the project director and other key personnel. 5. **Resources:** Please describ e the level of commitment by the institution’s management and key

stakeholders to supporting the activities of the proposed project and achieving the goals and objectives of the project and the program. 6. **Management Plan:** Please describe the management plan for the proposed project, and how it will ensure that the goals and objectives are achieved on time and within the budget, including clearl y defined responsibilities, timelines and milestones for accomplishing project tasks. Please also describe the proce dures for ensuring feedback and continuous improvement in the operation of the proposed project, and the mechanisms for ensuring high
- qualit y products and services. 7. **Evaluation Plan:** Please describe the way s in which the methods of evaluation: are thorough, feasible and appropriate to the goals, objectives and outcomes of the proposed project; include the use of objective performance measures that are clearl y related to the intended outcomes and will produce quantitative and qualitative data; provide for examining the effectiveness of

### 40 project implementation strategies; and will provide feedback and permit periodic assessment of progress toward achieving intended outcomes. **NOTE: The 50 page limit applies to the Project Narrative only. It does**  **not apply**  **to th e Goals and Objectives Form or the Budget**  **Summary or Narrative forms.**  **C. Goals and Objectives Form:**  For purposes of project evaluation, please complete the Goals and Objectives Form on page 42
. Id entify all of the allowable activities listed in the statute and on page 6 of this booklet for which the institution will use grant funds, the goals or objectives to be addressed b y each activity , related baseline data, and a measurable outcome, including quantitative target data, developed to evaluate success. Use the example provided on the form for guidance.  **Allowable Activities**

**–** these are on page 6 of this application, as well as in the program legislation, Title III, Part A, Sec. 318(d).  **Goals and Objectives**

**–** institutional goals and objectives to be achieved using PBI funding should correspond to an allowable activity . If there is more than one objective for a given activity , enter only one project objective per row and please number the goals and objectives within each activity . Example: the first project g oal or objective associated with an allowable activity

should be numbered “1,” the second should be numbered “2,” etc.  **Performance Indicators/Measures Addressed -**  For each project objective, enter each associated performance measure. These might be program performance measures, as listed on page 64 or they may be institutional or project
- specific performance indicators developed b y the institution. I f there are multiple performance measures associated with a project objective, enter only one performance me asure per row and please label each measure using a numerical and an alpha indicator. Example: the first performance measure associated with project objective “1” should be labeled “1 a.,” the second performance measure for project objective “1” should be labeled “1.b.,” etc.  **Baseline Data -**  Provide the baseline data for each performanc e measure. If baseline data is not available for a performance measure, please use an estimate.  **Proposed Outcomes/Target Data -**  Provide the target data that the institutio n has established for meeting each performance measure. Every applicant is expected to set targets for each budget period of the grant.* Note: If the collection of quantitative data is not appropriate for a particular performance measure, please provid e any relevant qualitative data for the performance measure. If necessary , attach a narrative page to the form.  **Budget Period -**  For each objective, please provide the budget period in which this objective will be accomplished. If the objective will be ac hieved over more than one budget period, please indicate this. *I f necessary , ED may

approve revised target data for a performance measure at a future date.

### 41

**D. Budget Form and Narrative:**  Please complete Budget Form 524 and the accompan yi ng Budget Narrati ve (see pages 56

– 57 ) in Part III of the application
. Please address all budget periods within the project period. Please include in the Budget Narrative all activities for which you are requesting funding, placing them in the appropriate Budget Categories, and provide a detailed breakdown of the costs associated with each activity
.

### 42 

## Goals and Objectives Form Please provide a detailed description of the activities to be supported using program funding: please reference the allowable activity as state d in the program legislation, measurable goals and objectives within the scope of these activities; associated performance indicators/measures ; baseline data; proposed outcomes, including quantitative target data, to be used to evaluate the success of the funded activities; and the budget period(s) in which the objectives will be achieved. Please make sure that the information on this form reflects the goals, activities and outcomes described in your Project Narr ative, especially your Evaluation Plan.

**Al lowable A** **ctivities Goals and Objectives**  **Performance Indicators/Measures**  **Ad dressed**  **Baseline Data Proposed**  **Outcomes/Target Data Budget**  **Period*** Example: #3 Purchase of library books, periodicals, technical and other scientific journals, microfilm, microfiche, and other educational materials, including telecommunications and program materials. 1. Increase and expand the university library's collection of books and periodicals related to economics

. N/A University library currently maintains an econom ics c ollection of 150 books and two periodicals. Increase university library econom ics collection to 350 books and 5 periodicals. 3 2. Etc. 2.a. 2.b.

* Budget Periods: 1 = Academic Year 2010 - 2011, 2 = Academic Year 2011 - 2012, 3 = Academic Year 2012 - 2013, 4 = Academic Year 2013 - 2014, 5 = Academic Year 2014 - 2015

### 43



## Part III. Standard Forms, Certifications and Surveys **Part III of the a pplication, the standard forms**  **, certifications and**  **surveys, must be submitted with Part II of the application, the Project Plan,**  **by May 3**  **, 201 3**  **. Part III of the application must be submitted as**  **an e -**  **mail attachment to pbiprogram@ed.gov**  **. The signed copies of the standard forms may be scanned and submitted via email, or faxed to:**  **P redominantly Black Institutions Program, fax number (202) 502**  **- 78**  **61.**

### 44 OMB Number: 4040
- 0004 Expiration Date: 04 / 30 /2014 **Ap plication for**  **Federal Assistance SF -**  **424** *1. Type of Submission: Preapplication Application Changed/Corrected Application *2. Type of Application: New Continuation Revision * If Revision, select appropriate letter(s): *Other (Specify):

* 3. Date Received: 4. Applicant Identifier: 5a. Federal Entity Identifier: *5b. Federal Award Identifier: **State Use Only :**  6. Date Received by State: 7. State Application Identifier: **8. APPLICANT INFORMATION:** *a. Legal Name: *b. Employer/Taxpayer Identification Number (EIN/TIN): *c. Organizational DUNS:
**d. Address:** *Street 1: Street 2: *City: County/Parish: *State: Province: *Country: *Zip / Postal Code: **e. Organizational Unit:** Department Name: Division Name: **f. Name and contact information of person to be contacted on matters involving this applicatio n:**  Prefix: *First Name: Middle Name: *Last Name: Suffix: Title: Organizational Affiliation: *Telephone Number: Fax Number: Com pleted by Grants.gov upon s ubmission

### 45

*Email:
**Ap plication for Federal Assistance SF**  **- 424**  **9. Ty pe of Applicant 1: Select Applicant Ty**  **pe:** Type o f Applicant 2: Select Applicant Type: Type of Applicant 3: Select Applicant Type: *Other (Specify) ***10 Name of Federal Agency: 11. Catalog of Federal Domestic Assistance Nu**  **mber** :
CFDA Title:
***12 Funding Opportunity Number**  :

*Title:

**13. Competition Identification Number** :
Title:

**14. Ar eas Affected by**  **Project (Cities, Counties, States, etc.):**

***15. Descriptive Title of Applicant’s Project** :

Attach supporting documents as specified in agency instructions.

### 46 **Ap plication for Federal Assistance SF**  **- 424**  **16. Congressional Districts Of:** *a. Applica nt: *b. Program/Project: Attach an additional list of Program/Project Congressional Districts if needed. **17. Proposed Project** : *a. Start Date: *b. End Date: **18. Estimated Funding ($):** *a. Federal *b. Applicant *c. State *d. Local *e. Other *f. Program Income *g. TOTAL ***19. Is Application Subject to Review By State Under Executive Order 12372 Process?**  a. This application was made available to the State under the Executive Order 12372 Process for review on b. Program is subject to E.O. 12372 but has not been selected by the State for review. c. Program is not covered by E.O. 12372. ***20. Is the Applicant Delinquent On An y**  **Federal Debt? (If “Yes,” provide explanation in attachm ent.)**  Yes No If “Yes”, provide explanation and attach. **21. *By** **signing this application, I certify (1) to the statements contained in the list of certifications**  and (2) that the** **statements herein are true, comple te and accurate to the best of my**  **knowledge. I also provide the required assurances  ** and agree to comply**

**with any resulting terms if I accept an award. I am aware that an y**  **false, fictitious, or fraudulent statements or claims may**  **subject me to criminal, civil, or administrative penalties. (U. S. Code, Title 218, Section 1001)**  ** I AGREE ** The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announc ement or agency specific instructions. **Authorized Representative:** Prefix: *First Name: Middle Name: *Last Name: Suffix: *Title: *Telephone Number: Fax Number: * Email: *Signature of Authorized Representative: *Date Signed: Completed by Grants.gov upon submission Completed by Grants.gov upon submission

### 47 **INSTRUCTIONS FOR THE SF -**  **424** This is a standard form required for us e as a cover sheet for submission of pre
- applications and applications and related information under discretionary programs. Some of the items are required and some are optional at the discretion of the applicant or the federal agency (agency). Required fi elds on the form are identified with an asterisk (*) and are also specified as “Required” in the instructions below. In addition to these instructions, applicants must consult agency instructions to determine other specific requiremen ts. Item Entry: Item : Entry: 1. **Type of Submission:** (Required) Select one type of submission in accordance with agency instructions. • Pre - application • Application • Changed/Corrected Application

– Check if this submission is to change or correct a previously submitted appl ication. Unless requested by the agency, applicants may not use this form to submit changes after the closing date. 10. **Name Of Federal Agency** : (Required) Enter the name of the federal agency from which assistance is being requested with this application. 11. **Catalog Of Federal Domestic Assistance Number/Title:** Enter the Catalog of Federal Domestic Assistance number and title of the program under which assistance is requested, as found in the program announcement, if applicable. 2. **Type of Application** : (Required) Select one type of application in accordance with agency instructions. • New
– An application that is being submitted to an agency for the first time. • Continuation
- An extension for an additional funding/budget period for a project with a projected completion date. This can include renewals. • Revision - Any change in the federal government’s financial obligation or contingent liability from an existing obligation. If a revision, enter the appropriate letter(s). More than one may be selected. If "Other" is selected, please specify in text box provided. A. Increase Award D. Decrease Duration B. Decrease Award E. Other (specify) C. Increase Duration 12. **Funding Opportunity Number/Title:** (Required) Enter the Funding Opportunity Number (FON) and title of the opportunity under which assistance is requested, as found in the program announcement. 13. **Competition Identification Number/Title:** Enter the competition identification number and title of the comp etition under which assistance is requested, if applicable. 14. **Areas Affected By Project:** This data element is intended for use only by programs for which the area(s) affected are likely to be different than the place(s) of performance reported on the SF
- 424 Project/Performance Site Location(s) Form. Add attachment to enter additional areas, if needed. 3. **Date Received:** Leave this field blank. This date will be assigned by the Federal agency. 15. **Descriptive Title of Applicant’s Project:** (Required) En ter a brief descriptive title of the project. If appropriate, attach a map showing project location (e.g., construction or real property projects). For pre
- applications, attach a summary description of the project. 4. **Applicant Identifier:** Enter the enti ty identifier assigned buy the Federal agency, if any, or the applicant’s control number if applicable. 5a. **Federal Entity Identifier** : Enter the number assigned to your organization by the federal agency, if any. 16. **Congressional Districts Of**: 16a. (Re quired) Enter the applicant’s congressional district. 16b. Enter all district(s) affected by the program or project. Enter in the format: 2 characters state abbreviation
– 3 characters district number, e.g., CA
- 005 for California 5th district, CA
- 012 for California 12 district, NC
- 103 for North Carolina’s 103 district. If all congressional districts in a state are affected, enter “all” for the district number, e.g., MD
- all for all congressional districts in Maryland. If nationwide, i.e. all districts wit hin all states are affected, enter US
- all. If the program/project is outside the US, enter 00
- 000. This optional data element is intended for use only by programs for which the area(s) affected are likely to be different than place(s) of performance repo rted on the SF
- 424 Project/Performance Site Location(s) Form. Attach an additional list of program/project congressional districts, if needed. 5b. **Federal Award Identifier** : For new applications, enter NA. For a continuation or revision to an existing aw ard, enter the previously assigned federal award identifier number. If a changed/corrected application, enter the federal identifier in accordance with agency instructions. 6. **Date Received by State:** Leave this field blank. This date will be assigned by the state, if applicable. 7. **State Application Identifier:** Leave this field blank. This identifier will be assigned by the state, if applicable. 8. **Applicant Information** : Enter the following in accordance with agency instructions:

**a. Legal Nam e**  : (Required) Enter the legal name of applicant that will undertake the assistance activity. This is the organization that has registered with the Central Contractor Registry (CCR). Information on registering with CCR may be obtained by visiting www.Grants .gov. 17. **Proposed Project Start and End Dates** : (Required) Enter the proposed start date and end date of the project.

### 48

**b. Employer/Taxpayer Number (EIN/TIN):** (Required) Enter the employer or taxpayer identification number (EIN or TIN) as assigned by the Internal Revenue Service. If your organization is not in the US, enter 44
- 4444444. 18. **Estimated Funding:** (Required) Enter the amount requested, or to be contributed during the first funding/budget period by each contributor. Value of in
- kind contributions should be included on appropriate lines, as applicable. If the action will result in a dollar change to an existing award, indicate only the amount of the change. For decreases, enclose the amounts in parentheses. **c. Organizational DUNS** : (Required) Ente r the organization’s DUNS or DUNS+4 number received from Dun and Bradstreet. Information on obtaining a DUNS number may be obtained by visiting www.Grants.gov. 19. **Is Application Subject to Review by State Under Executive Order 12372 Process?**  (Required**)** A pplicants should contact the State Single Point of Contact (SPOC) for Federal Executive Order 12372 to determine whether the application is subject to the State intergovernmental review process. Select the appropriate box. If “a.” is selected, enter the da te the application was submitted to the State. **d. Address** : Enter address: Street 1 (Required); city (Required); County/Parish , State (Required if country is US), Province, Country (Required), 9
- digit zip/postal code (Required if country US). 20. **Is the Applicant Delinquent on any Federal Debt?**  (Required) Select the appropriate box. This question applies to the applicant organization, not the person who signs as the authorized representative. Categories of federal debt include; but, may not be limited to : delinquent audit disallowances, loans and taxes. If yes, include an explanation in an attachment. **e. Organizational Unit:** Enter the name of the primary organizational unit, department or division that will undertake the assistance activity. 21. **Auth orized Representative**  : To be signed and dated by the authorized representative of the applicant organization. Enter the first and last name (Required); prefix, middle name, suffix. Enter title, telephone number, email (Required); and fax number. A copy o f the governing body’s authorization for you to sign this application as the official representative must be on file in the applicant’s office. (Certain federal agencies may require that this authorization be submitted as part of the application.) **f. Nam e and contact information of person to be contacted**  **on matters involving this application:** Enter the first and last name (Required); prefix, middle name, suffix, title. Enter organizational affiliation if affiliated with an organization other than that in 7.a. Telephone number and email (Required); fax number. 9. Type of Applicant: (Required) Select up to three applicant type(s) in accordance with agency instructions. A. State Government B. County Government C. City or Township Gover nment D. Special District Government E. Regional Organization F. U.S. Territory or Possession G. Independent School District H. Public/State Controlled Institution of Higher Education I. Indian/Native American Tribal Government (Fed erally Recognized) J. Indian/Native American Tribal Government (Other than Federally Recognized) K. Indian/Native American Tribally Designated Organization L. Public/Indian Housing Authority M. Nonprofit N. Private Institution of Higher Education O. Individual P. For- Profit Organization (Other than Small Business) Q. Small Business R. Hispanic - serving Institution S. Historically Black Colleges and Universities (HBCUs) T. Tribally Controlled Colleges and Universities (TCCUs) U. Alaska Native and Native Hawaiian Serving Institutions V. Non - US Entity W. Other (specify)

[ **U.S Department of Education note**  : As of spring, 2010, the FON discussed in Block 12 of the instructions can be found via the following URL : http://www.grants.gov/applicants/find_grant_opportunities.jsp

. ]

### 49 **SUPPLEMENTAL INFORMATION**

**REQUIRED FOR DEPARTMENT OF EDUCATION**  **1. Project Director:**  Prefix: *First Name: Middle Name: *Last Name: Suffix:

Address: * Street1: Street2: * City: County: * State * Zip Code: * Country: * Phone Number (give area code) Fax Number (give area code)
Email Address:
**2. Applicant Experience:**  Novice Applicant Yes No Not applicable to this program **3. Human Subjects Research:**  Are any research activities involving human subjects planned at any time during the proposed project Period? Yes No Are ALL the research activities proposed designated to be exempt from the regulations? Yes Provide Exemption(s) #: No Provide Assurance #, if available: **Please attach an explanation Narrative:**

OMB Control No. 1894
- 0007 Expiration Date: 0 7 /31/201 4 Add Attachment Delete Attachment View Attachment

### 50 **1. Project Director.**  Name, address, telephone and fax numbers, and e
- mail address of the person to be contacted on matters i nvolving this application. **2. Novice Applicant.** Check **“Yes”** or “ **No** ” only if assistance is being requested under a program that gives special consider ation 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 i n cluded on the attached page entitled “Definitions for Department of Education Supplemental Information for SF 424.” By checking “Yes” the applicant certifies that it meets these novice applicant requirements. Check “ **No** ” if you do not meet the r e quirements for novice applicants **. 3. Hum**  **an Subjects Research.** (See I. A. “Definitions” in attached page ent i tled “Definitions for Department of Education Supplemental Information For SF 424.”) **If Not Hum an Subjects Research.**  Check “ **No** ” i f research activities inv ol v ing human subjects are not planned at any time during the proposed project period. The r e maining parts of Item 3 are then not applicable. **If Hum an Subjects Research.**  Check “ **Yes** ” if research activities involving human subjects are planned at any time dur ing 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 regul ations for the protection of human subjects. (See I. B. “Exemp tions” in attached page entitled “Definitions for Department of Education Supplemental Information For SF 424.”) **3a. If Hum an Subjects Research is Exempt from the Human Subjects Regulations.**  Check “ **Yes** ” if all the research activ i ties proposed are designated to be exempt from the regulations. I n sert 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 Narr ative” in the attached page entitled “Definitions for Department of Education Supplemental Information For SF 424.” **3a. If Hum an Subjects Research is Not Exempt from H**  **u man Subjects Regulations.**  Check “ **No** ” if some or all of the planned research activities are covered (not exe mp t). In addition, follow the instructions in II. B. “Nonexempt Research Narr ative” in the page entitled “Definitions for Department of Education Supplemental Information For SF 424 **3a. Hum an Subjects Assurance Number.**  If the applicant has an approved Federal Wide (FWA) on file with the Office for Human Research Protections (OHRP), U.S. Department of Health and Human Serv ices, that covers the specific activity, insert the number in the space provided. If the applicant does not have an approved assuranc e on file with OHRP, enter “None.” In this case, the ap plicant, by signature on the SF
- 424, is declaring that it will comply with 34 CFR 97 and proceed to obtain the human su b jects assurance upon request by the designated ED official. If the application is recommended/selected for funding, the de s ignated 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 In stitutional Review Board approval with the application. However, if an application that involves non
- exem pt human subjects research is recommended/selected for funding, the designated ED official will request that the applicant obtain and send the certifi cation to ED within 30 days after the formal r e quest. **Paperwork Burden Statement .**  According to the Paperwork Reduction Act of 1995, no persons are required to respond to a co llection of information unless such collection displays a valid OMB control numb er. The valid OMB control number for this information collection is 1894

- 0007. The time required to complete this inform a tion collection is estimated to average between 15 and 45 minutes per response, including the time to review instructions, search exi sting data resources, gather the data needed, and co m plete 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, 4 00 Maryland Avenue, S.W., Was h ington, D.C. 20202

- 4537. If you have comments or concerns regarding the status of your individ ual submission of this form write directly to: Application Control Center, U.S. Department of Education, Potomac Center Plaza, 550 12 th Street, S.W. Room 7076, Was h ington, D.C. 20202

- 4260
. **INSTRUCTION S FOR**  **DEPARTMENT OF EDUCATION SUPPLEMENTAL INFORMATION FOR SF 424**

### 51 **Definitions: Novice Applicant (See 34 CFR 75.2**  **25** ). For discretionary grant programs under which the Secretary gives special consideration to novice applications, a novice appl i cant means any applicant for a grant from ED that

—

 Has never received a grant or subgrant under the pr o gram from which it se eks funding;

 Has never been a member of a group application, submi tted in accordance with 34 CFR 75.127
- 75.129, that r e ceived a grant under the program from which it seeks fun d ing; and

 Has not had an active discretionary grant from the Fe d eral government in the five years before the deadline date for applications under the program. For the purposes of this requirement, a grant is a c tive until the end of the grant’s project or funding period, including any exte n sions of those periods that extend the grant ee’s authority to obl i gate 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 requir e me nts listed above. **PROTECTION OF HUMAN SUBJECTS IN R E**  **SEARCH I. Definitions and E**  **xe mptions**  **A. Definitions.** A research activity involves human subjects if the activity is research, as defined in the Department’s regulations, and the r e search activity will involve use of human subjects, as defined in the regul ations.

—**Research** The E D Regulations for the Protection of Human Su b jects, 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 generali z able knowledge.” If an activity follows a deliberate plan whose pu r pose 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 su

p ported under a program that is considered research for other purposes. For example, some demonstration and service pr o grams may include research activities. **— Human Subject**  The regulations define human subject as “a living individual about whom an investigator (whether pr ofessional 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 per son or that person’s env ironment, as might occur when a new instructional technique is tested, or by comm u nicating or interacting with the individual, as occurs with surveys and interviews, the definition of human su b ject is met. (2) If an activity involv es obtaining private inform a tion 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 dete r mined 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 re a sonably expect that no observation or recording is taking place, and information which has been provided for sp e cific purposes by an individual and which the individual can re a sonably expect will not be made public (for example, a school health re c ord).] **B. Exemptions.** Research activities in which the **only** involvement of human su b jects will be in one or more of the fol lowing six categories of **e x** **emptions** are not covered by the regulations: (1) Research conducted in established or commonly accepted edu cational settings, involving normal educational practices, such as (a) research on regular and special education instruct ional strategies, or (b) research on the effectiveness of or the comparison among instructional techniques, curricula, or classroom management meth ods. (2) Research involving the use of educational tests (cognitive, d i agnostic, 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 su b jects; and (b) any disclosure of the human subjects’ responses outside the r e search could reasonably place the subjects at risk of criminal or civil liability or be damaging to the su b jects’ financial standing, em ployability, or reputation. **If the subjects are chi l**  **dren, exemption 2 applie** **s only to research involving educ a**  **tional tests and observations of public behavior when the**  **investig a**  **tor(s) do not participate in the activities being observed.**  **DEFINITIONS FOR DEPARTMENT OF EDUCATION SUPPLEMENTAL INFORMATION FOR SF 424** 

**(Attachm ent to Instructions for Supplemental Inform**  **ation for SF 424)**

### 52 **Exemption 2 does not apply if children are su r** **veyed or interviewed or if the research involv** **es observation of public behavior and the investigator(s) participate in the activities**  **being observed.** [Children are d e fined as persons who have not attained the legal age for consent to treatments or procedures involved in the r e search, under the applic able law or jurisdiction in which the research will be co n ducted.] (3) Research involving the use of educational tests (cognitive, d i agnostic, aptitude, achievement), survey procedures, interview proc e dures or observation of public behavior that is not ex em pt 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 ma intained throughout the r e search 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 recorde d by the investigator in a manner that su b jects 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 whic h are designed to study, evaluate, or otherwise examine: (a) public benefit or service programs; (b) procedures for obtai n ing benefits or services under those programs; (c) possible changes in or altern atives to those programs or procedures; or (d) possib le changes in methods or levels of payment for ben e fits 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 contai ns a food ingredient at or b e low

the level and for a use found to be safe, or agricultural chem i cal or environmental contaminant at or below the level found to be safe, by the Food and Drug Administration or ap proved by the Environmental Protection Agency or the Food Safety and Inspe c tion Service of the U.S. Department of Agricul ture. **II. Instructions for Exe mpt and Nonexempt Human**  **Subjects R e**  **search Narratives** If the applicant marked “Yes” for Item 3 of Department of Education Supplemental Information fo r SF 424, the ap plicant must provide a human subjects “exempt research” or “nonexempt research” narrative. Insert the narrative(s) in the space provided. If you have multiple projects and need to provide more than one narrative, be sure to label each set of responses as to the project they address. **A. Exempt Research Narrative.** If you marked “Yes” for item 3 a. and designated exemption numbers(s), provide the “exempt research” narrative. The narr ative must contain sufficient information about the invol vement of human subjects in the proposed research to allow a determi nation by ED that the designated exemption(s) are appropriate. The narrative must be succinct. **B. Nonexempt Research Narrative.** If you marked “No” for item 3 a. you must provide the “n one x em

pt research” narrative. The narrative must address the follo w ing seven points. Although no specific page limitation ap plies to this section of the application, be succinct. (1) **Hum an Subjects Involvement and Characteristics**  : Pr o vide a detailed des cription of the proposed involvement of human su b jects. Describe the characteristics of the subject population, including their anticipated num ber, age range, and health status. Identify the criteria for inclusion or exclusion of any subpopulation. Expl ain the ratio n ale for the involvement of special classes of subjects, such as children, children with di s abilities, adults with disabilities, persons with mental disabilities, pregnant women, prisoners, institutionalized individuals, or others who are like ly to be vulne r able (2) **Sources of Materials** : Identify the sources of research mat e rial obtained from individually identifiable living human su b jects in the form of specimens, records, or data. Indicate whether the material or data will be obtained speci fically for research purposes or whether use will be made of existing specimens, re c ords, or data. (3) **Recruitm ent and Informed Consent**  : Describe plans for the recruitment of subjects and the consent procedures to be followed. I n clude the circumstances under which consent will be sought and obtained, who will seek it, the nature of the information to be pr o vided to prospective subjects, and the method of documenting consent. State if the Institutional Revie w Board (IRB) has autho r ized a modification or wa iver of the elements of consent or the requirement for document ation of consent. (4) **Potential Risks** : Describe potential risks (physical, psych o logical, social, legal, or other) and assess their likelihood and seriou s ness. Where appropriate, describe a lternative treatments and procedures that might be advant a geous to the subjects. (5) **Protection Against Risk** : Describe the procedures for protec t ing against or minimizing potential risks, including risks to conf

i dentiality, and assess their likely effecti veness. Where appropr i ate, discuss provisions for ensuring necessary medical or profe s sional intervention in the event of adverse effects to the subjects. Also, where appropriate, d e scribe the provisions for monitoring the data collected to ensure the sa fety of the su

b jects. (6) **Im portance of the Knowledge to be Gained**  : Discuss the i m portance of the knowledge gained or to be gained as a result of the proposed research. Discuss why the risks to subjects are re a sonable in relation to the anticipated benef its to subjects and in relation to the importance of the knowledge that may re a sonably be expected to result.

### 53 (7) **Collaborating Site(s)** : If research involving human subjects will take place at collaborating site(s) or other perfo rmance site(s), name the s ites and briefly describe their involv e ment 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 r** **e search are**  **available from the U.S. Department of Education, Protection of Human Subjects Coordinator,**  **Office of the Chief Financial Officer, LBJ Building, 400 Maryland Avenue, SW, Washington, D.C. 20202** **- 4250,**  **telephone: (202) 260 -**  **3353, and on the U.S. Department of Education’s Protection of Human Su**  **b jects in Research Web**  **Site: http://www.ed.gov/about/offices/list/ocfo/humansub.html**  NOTE: The **State Applicant Identifier** on the SF 424 is for State Use only. Please complete it on the OMB Standard 424 in the upper right corner of the form (if applicable).

### 54 **U.S. DEPA RTMENT OF EDUCA**  **TION BUDGET INFORMA** 

**TION NON**  **- CONSTRUCTION PROGRA**  **MS** OMB Control Number: 1894
- 0008 Expiration Date: 0 4 / 30 /201 4
Name of Institution/Organization Applicants requesting funding for only one year should complete the column under "Project Year 1." Applicants requesting funding for multi
- year grants should complete all applicable columns. Please read all instructions before completing form. **SECTION A -**  **BUDGET SUMMARY**  **U.S. DEPARTMENT OF EDUCATION FUNDS** Budget Categories Project Year 1 (a) Project Year 2

(b) Project Year 3

(c) Project Year 4

(d) Project Year 5

(e) Total

(f) 1. Personnel 2. Fringe Benefits 3. Travel 4. Equipment 5. Su pplies 6. Contractual 7. Construction 8. Other 9. Total Direct Costs (lines 1
- 8) 10. Indirect Costs* 11. Training Stipends 12. Total Costs (lines 9
- 11) ***Indirect Cost Information (To Be Completed by Y**  **our Business Office ):**  If you are requesting reimbursement for indirect costs on line 10, please answer the following questions: (1) Do you have an Indirect Cost Rate Agreement approved by the Federal government? ____Yes ____ No (2) If yes, please provide the f ollowing information: Period Covered by the Indirect Cost Rate Agreement: From: ___/___/______ To: ___/___/______ (mm/dd/yyyy) Approving Federal agency: ____ ED ____ Other (please specify): __________________________ The Indire ct Cost Rate is _________% (3) For Restricted Rate Programs (check one)
-- Are you using a restricted indirect cost rate that: ___ Is included in your approved Indirect Cost Rate Agreement? or ___ Complies with 34 CFR 76.564(c)(2)? The Restricted Indirect Cost Rate is _________%

### 55 ED 524 Name of Institution/Organization Applicants requesting funding for only one year should complete the column under "Project Year 1." Applicants requesting funding for multi
- year grants should complete all applicable columns. Please read all instructions before completing form. **SECTION B -**  **BUDGET SUMMARY NON**  **- FEDERAL FUNDS**  Budget Categories Project Year 1 (a) Project Year 2

(b) Project Year 3

(c) Project Year 4

(d) Project Year 5

(e) Total (f) 1. Personnel 2. Fringe Benefits 3. Travel 4. Equipment 5. Supplies 6. Contractual 7. Construction 8. Other 9. Total Direct Costs (Lines 1
- 8) 10. Indirect Costs 11. Training Stipends 12. Total Costs (Lines 9
- 11) **SECTION C**

**– BUDGET NARRATIVE**  (see instructions)

### 56 **G eneral Instructions**  This form is used to apply to individual U.S. Department of Education (ED) discretionary grant programs. Unless directed otherwise, provide the s ame budget information for each year of the multi
- year funding request. Pay attention to applicable program specific instructions, if attached. You may access the Education Department General Administrative Regulations, 34 CFR 74

– 86 and 97
- 99, on ED’s website at: http://www.ed.gov/policy/fund/reg/edgarReg/edgar.html **You must consult with your Business Office prior to submitting this form .**  Section A
- Budget Summary U.S. Department of

Education Funds All applicants must complete Section A and provide a break
- down 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 requeste d 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, leav e this space blank.
Indirect Cost Information : If you are requesting reimburse ment 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. If you checked “no,” ED gener ally will authorize grantees to use a temporary rate of 10 percent of budgeted salaries and wages subject to the following limitations: (a) The grantee must submit an indirect cost proposal to its cognizant agency within 90 days after ED issues a grant award notification; and (b) If after the 90
- day

period, the grantee has not submitted an indirect cost proposal to its cognizant agency, the grantee may not charge its grant for indirect costs until it has negotiated an indirect cost rate agreement with its cognizant agency. (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, another Federal agency (Other) or State agency issued the approved agreement. If you check “Other,” specify the name of the Federal or other 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 w hether you are using a restricted indi rect 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 restric ted 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 Non
- Federal Funds If you are required to provide or volunteer to provide cost
- sharing or matching f unds 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, sh ow 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.

### 57

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)] Pay attention to applicable program specific instructions,

if attached. 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. For n on - Federal funds or resources listed in Section B that are used to meet a cost
- sharing or matching requirement or provided as a voluntary cost
- sharing or matching commitment, you must include: a. The specific costs or contributions by budget category; b. The source of the costs or contributions; and c. In the case of third
- party in
- kind contributions, a description of how the value was determined for the donated or contributed goods or services. [Please review

ED’s general cost sharing and matching regulations, which include specific limitations, in 34 CFR 74.23, applicable to non
- governmental entities, and 80.24, applicable to governments, and the applicable Office of Management and Budget (OMB) cost principles for your entity type regarding donati ons, capital assets, depreciation and use allowances. OMB cost principle circulars are available on OMB’s website at: http://www. whitehouse.gov/omb/circulars/index.html ] 3. If applicable to this program, provide the rate and base on which fringe benefits are calculated. 4. 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 expens e. 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 mus t refer to the information and examples on ED’s website at: http://www.ed.gov/fund/grant/apply/appforms/appforms.html
. You may also contact (202) 377
- 3838 for additional information regarding calculating indirect cost rates or general indirect cost rate information.
5. 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 **1894 -**  **0008** . 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 respon se, 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
- 4537. I f 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 Educatio n, 400 Maryland Avenue, S.W., Washington, D.C. 20202.

### 58 OMB Control No. 1894
- 0005 (Exp. 03/31/2014) 

### NOTICE TO ALL APPLICANTS The purpose of this enclosure is to inform you about a new provision in the Department of E ducation's General Education Pr ovisions Act (GEPA) that applies to applicants for new grant awards under Department programs. T his 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 ne w 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 pr ogram 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. I n 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. T he State would be responsible for ensuring that the school district or other local entity has submitted a sufficient section 427 statement as d escribed 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 o f the steps the applicant proposes to take to ensure equitable access to, and participation in, its Federally
- assisted program f or students, teachers, and other program beneficiaries with special needs. This provision allow s applicants discretion in devel oping the required description. T he statute highlights six ty pes of b arriers that can im

pede equitable access or participation: gender, race, national origin, color, disability, or age. B ased on local circumstances, yo u should determine whether these or other barriers may prevent yo ur 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; yo u may provide a cl ear and succinct description of how y ou plan to address those barriers that are applicable to your circumstances. I n 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 st andards. C onsistent 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 Require ment 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 applicatio n 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 mo del science program for secondary students and is concerned that girls may be less likely than boys to enroll in the course, might indicate how i t intends to conduct "outreach" efforts to girls, to encourage their enrollment. We recognize that many applicants may already be im plementing effective steps to ensure equity of a ccess 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 su**  **ch collecti**  **on displays a valid OMB control number. Public reporting burden for this collection of information is estimated to average 1**  **.5 hours**  **per response,**  **including tim**  **e for**  **review ing**  **instructions, searching**  **existing data**  **sources, gathering**  **and maintaining**  **the da**  **ta needed,**  **and com** **pleting and**  **reviewing the**  **collection of**  **information. T**  **he obligation**  **to respond**  **to this**  **collection is**  **required to**  **obtain or**  **retain benefit**  **(Public Law**  **103 -**  **382 )**  **. Send**  **comments regarding**  **the burden**  **esti mate**  **or any**  **other aspect**  **of this**  **colle ction**  **of information,**  **including suggestions**  **for reducing**  **this burden,**  **to the**  **U.S. Department**  **of Education,**  **400 Maryland**  **Ave., SW,**  **Washington, DC 20210 -**  **4537 or em**  **ail ICDocketMgr@ed.gov**  **and reference the OMB Control Num**  **ber 1894 -**  **0005.**

### 59 Approved by OMB 0348
- 0046 **Disclosure of Lobbying Activities** Com plete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352

(See reverse for public burden

**INSTRUCTIONS FOR COMPLETION OF SF -**  **LLL, DISCLOSURE OF LOBBYING ACT IVITIES**  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.

**1. Type of Federal Action:**  a. contract ____ b. grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance **2. Status of**  **Federal Action:** a. bid/offer/application _____ b. initial award c. post - aw ard **3. Report Type:**  a. initial filing _____ b. material change **For m aterial change only:**  Year _______ quarter _______ Date o f last report___________ **4. Nam**  **e and Address of Reporting Entity:** ____ Prime _____ Subawardee

Tier______, if Known:

**Congressional District**

**,** if known **: 5.**  **If Reporting En tity in No. 4 is Subawardee,**  Enter Name and Address of Prime:

**Congressional District**

**,** if known **: 6.**  **Federal Departm ent/Agency:**  **7. Federal Program**  **Name/Description:** CFDA Number, if applicable : ____________ **8. Federal Action Number,**  if known: **9. Award Am**  **ount** , if known: **$ 10. a. Nam**  **e and Address of Lobbying Registrant** (if individual, last name, first name, MI): **b. Individuals Performing Services** (including address if different from No. 10a) (last name, first name, MI):

**11. Inform ation requested through this form** **is authorized by title 31 U.S.C. section 1352. This**  **disclosure of lobbying activities is a m aterial**  **representation of fact upon which reliance was placed by the tier above when this transaction was m**  **ade or**  **entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to the**  **Congress semi -**  **annually and will be available for public inspection. Any person who fails to file the required**  **disclosure shall be subject to a civil penalty of not less**  **than $10,000 and not m ore than $100,000 for each such**  **failure. Signature: __________________________________**  **Print Nam e: _____**  **Title: _____ Telephone No.: ____________ Date: _______** 

**Federal Use Only Authorized for Local Re**  **production Standard Form**  **- LLL (Rev. 7**  **- 97)** 

### 60 sectio n 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 em ployee of Congress, or an em ployee 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 ad ditional 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 appro priate 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 th e 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 (ite m 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 i tem 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 collectio n 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 Manag ement and Budget, Paperwork Reduction Project (0348
- 0046), Washington, DC 20503

### 61 **What is GPRA ?**  The Government Performance and Results Act of 1993 (GPRA) is a straightforward statute that requires all federal agencies to manage their activities with attention to the consequences of those activities. Eac h agenc y is to clearly state what it intends to accomplish, identify the resources required, and periodically report their progress to the Congress. In so doing, it is expected that the GPRA will contribute to improvements in accountability for the expend itures of public funds, improve Congressional decision
- ma king through more objective information on the effectiveness of federal programs, and promote a new government focus on results, service delivery, and customer satisfaction. **How has the Department o f Education Responded to the GPRA**  **Requirements?** As required by GPRA, the Department of Education has prepared a strategic plan for 2007
- 2012. This plan reflects the Department’s priorities and integrates them with its mission and program authorities and describes how the Department will work to improve education for all children and adults in the U.S. The Department’s goals, as listed in the plan, are: Goal 1: Improve student achievement, with a focus on bringing all students to grade level in reading a nd mathematics by 2014 Goal 2: Increase the academic achievement of all high school students Goal 3: Ensure the accessibility, affordability, and accountability of higher education, and better prepare students and adults for employment and future learning. **What are the performance indicators for the Predominantly Black Institutions Program?** The performance indicators for the Predominantly Black Institutions Program are part of the Department’s plan for meeting Goal 3. The specific goal for the Predomina ntly Black Institutions Program is The performance indicators for the Predominantly Black Institutions Program are: **Enrollment Rate** The percentage change of the number of full
- tim e degree - granting undergraduate students enrolled at PBI institutions. **P ersistence Rate**  **- four**  **- year schools**  The percentage of first
- tim e full
- tim e degree - seeking undergraduate students who were in their first ye ar of postsecondary enrollment in the previous year and are enrolled in the current year at the sam e four
- ye ar PBI inst itution. **Persistence Rate -** **two -** **year schools** The percentage of first
- tim e full
- tim e degree - seeking undergraduate students who were in their first ye ar of postsecondary enrollment in the previous year and are enrolled in the current year at the sam e two - ye ar PBI institution. **Four year Completion Rate** The percentage of first
- tim e, full
- tim e degree - seeking undergraduate students enrolled at four
- ye ar PBI institutions who graduate within six years of enrollment. **Two Year Completion Rate** The percentage of first
- tim e, full
- tim e degree - seeking undergraduate students enrolled at two - ye ar PBI institutions who graduate within three years of enrollment. **Efficiency Measure** Cost per successful program outcome: federal cost per undergraduate at PBI institutions. 

## GOVERNMENT PER **FORM AN**  **CE AND RESULTS A**  **CT (GPRA )** 

### 62 **Application Transmittal Instructions** All parts of the Application for Grants under the Predominantly Black Institutions Program (CFDA No. 84.031P) must be submitted as email attachment s to pbiprogram@ed.gov
. **Phase 1** Part I of the applicati on, the Formula Elements pages, must be transmitted by April 5 , 201 3 . The Formula Elements pages must be signed. The signed copy can be scanned and sent via email, or faxed to: Predominantly Black Institutions Program, fax number (202) 502
- 7 8 61
. **Phase 2** Parts II and III of the application, the Proj ect Plan and the standard forms, certifications and surveys, must be transmitted by May 3 , 201 3 . Parts II and III must also be submitted as an email attachment to pbiprogram@ed.gov . The signed copies of the standard forms may be scanned and sent via email, or faxed to: Predominantly Black Institutions Program, fax number (202) 502
- 7 8 61
.

### 63 **Paperwork Burden Statement** 

### According to the Pape rwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection display s a valid OMB control number. Public reporting burden for this collection of information is estimated to average 20 hours per resp onse, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The obligation to respond to this collection is required to obtain or retain benefit Section 318 of Title III, Part A of the HEA as amended. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Education, Predominantly Black Institutions Program 1840
- 0812, 1990 K Street, N.W., 6 th 

### Floor, Washington, D.C. 20202
- 8513.