School Improvement Grants 

# Application for FY 2013 **New Awards Competition Section 1003(g) of the**  **Elem entary and Secondary Education Act** 

Fiscal Year 2013 CFDA Number: 84.377A 

## State **Name:**

U.S. Department of Education Washington, D.C. 20202
OMB Number: 1810
- 0682 Expiration Date:

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. Public reporting burden for this collection of inform ation is estimated to average 74 hours 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. The obligation to respond to this collection is required to obtain or retain benefit ( section 1003(g) of Title I of the Elementary and Secondary Education Act of 1965 (Title I or ESEA) . Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reduc ing this burden, to the U.S. Department of Education, 400 Maryland Ave., SW, Washington, DC 20210

- 4537 or email ICDocketMgr@ed.gov and reference the OMB Control Number 1810

- 0682. Note: Please do not return the completed FY 2013 School Improvement Grant application to this address.i **SCHOOL IMPROVEMENT GRANTS Purpose of the Program**  School Im

provement Grants (SIG), authorized under section 1003(g) of Title I of the Elementary and Secondary Education Act of 1965 (Title I or ESEA), are grants to State educational agencies (SEAs) that SEAs use to make com petitive subgrants to local educational agencies (LEAs) that demonstrate the greatest need for the funds and the strongest commitment to use the funds to provide adequate resources in orde r to raise substantially the achievement of students in their lowest -performing schools. Under the final requirements published in the Federal Register on October 28, 2010 (http ://www.gpo.gov/fdsys/pkg/FR

- 2010
- 10
- 28/pdf/2010

- 27313.pdf

), school im

provement funds are to be focused on each State’s “T ier I” and “Tier II” schools . Tier I schools are the lowest

achieving five percent of aS tate’s Title I schools in improvement, corrective action, or restructuring, Title I secondary schools in im provement, corrective action, or restructuring with graduation rates below 6 0 percent over a number of years, and, if a State so choos es, certain Title I eligible (and participating) elementary schools that are as low achieving as the State’s other Tier I schools (“ne wly eligible” Tier I schools). Tier II schools are the lowest

- achieving five percent of a State’s secondary schools that are eligible for, but do not receive, Title I, Part A funds, secondary schools that are eligible for, but do not receive, Title I, Part A funds with graduation rates below 60 percent over a num ber of y ears, and, if a State so chooses, certain additional Title I eligible (participating and non -participating) secondary schools that are as low a chieving as the State’s other Tier II schools or that have had a graduation rate below

6 0 percent over a number of years (“newly e ligible” Tier II schools). An LEA also may use school im provement funds in Tier III schools, which are Title I schools in improvement, corrective action, or restructuring that are not identified as Ti er I or Tier II schools and, if a State so chooses, certain additional Title I eligible (partic ipating and non

- participating) schools (“newl y eligible” Tier III schools). In the Tier I and Tier II schools an LEA chooses to serve, the LEA must im plement one of four school intervention mo dels: turnaround model, restart model, school closure, or tran sformation model. **ESEA Flexibility** An SEA that has received ESEA flexibility no longer identifies Title I schools for im provement, corrective action, or restruc turing; instead, it identifies priority schools, which are generally a State’s lowest

- ac hieving Title I schools. Accordingly, if it chooses, an SEA with an approved ESEA flexibility request may select the “ **priority schools list waiver** ” in Section H of the SEA application for SIG funds. This waiver permits the SEA to replace its lists of Tie r I, Tier II, and Tier III schools with its list of priority schools. Through its approved ESEA flexibility request, an SEA has already received a waiver that permits its LEAs to apply f or SIG funds to serve priority schools that are not otherwise eligible to receive SIG funds because they are not identified as Tier I, Tier II, or Tier III schools. T he waiver offered in this application goes beyond this previously granted waiver to permit the SEA to actually use its priority schools list as its SIG list. **Availability of Funds** The Consolidated and Further Continuing Appropriations Act, 2013 , provided $ 50 6 mi llion for School Improvement Grants in fiscal year (FY) 2013
. FY 2013 SIG funds are available for obligation by SEAs and LEAs through September 30, 2015. **State and LEA Allocations** Each State (including the District of Columbia and Puerto Rico), the Bureau of Indian Education, and the outlying areas are e ligible to apply to receive a SIG grant. Th e Department will allocate FY 2013 SIG funds in proportion to the funds received in FY 2013 by the States, the Bureau of Indian Education, and the outlying areas under Parts A, C, and D of Title I of the ESEA. An SEA mu st al locate at least 95 percent of

i ts SIG funds directly to LEAs in accordance with the final requirements (http://www.gpo.gov/fdsys/pkg/FR

2010
- 10
- 28/pdf/2010

- 27313.pdf ). The SEA may retain an amount not to exceed five percent of its allocation for State administration, evaluation, and technical as sistance. **Consultation with the Committee of Practitioners** Before submitting its application for a SIG grant to the Department, an SEA must consult with its Committee of Practitioners established under section 1903(b) of the ESEA regarding the rules and p olicies contained therein. T he Department recommends that the SEA also consult with other stakeholders, such as potential external providers, teachers’ unions, and business, civil rights, and community leaders that have an interest in its application.ii



# FY **2013 N**  **EW** 

# A**WARDS** 

# A **PPLICATION** 

# I **NSTRUCTIONS** This application is for use o nly by SEAs that will make new awards. New awards are defined as an award of SI G funds to an LEA for a school that the LEA was not previously approved to serve with SIG funds in the school year for which funds are bein g awarded

—in this case, the 2014

–2015 school year. New three

- year awards may

be made with the FY 2013 funds or any unobligated SIG funds from previous competitions not already committed to grants made in earlier competitions
. The Department will require those SEAs that will use FY 2013 funds solely for continuation awards to submit a SI G application
. H owever, those SEAs using FY 2013 funds solely for continuation purposes are only required to complete the Continuation Awards Onl y Application for FY 2013 School Improvement Grants Program located at the end of this application
.



# S **UBMISSION** 

# I **NFORMATION Electronic Submission**  **:** The Department strongly pre fers to receive an SEA’s FY 2013 SI G application electronicall y. The application should be sent as a Microsoft Word document, **not** as a PDF. The SEA should submit its FY 2013 application to OESE.OST@ed.gov
. In addition, the SEA must submit a paper copy of the cover page signed by the SEA’s authorized representative to the address listed below under “Paper Submission.” **Paper Submission :**  If an SEA is not able to submit its application electronicall y, it may s ubmit the original and two copies of its SI G application to the following address: Carlas McCauley , Group L eader Office of School Turnaround U.S. Department of Education 400 Maryland Avenue, SW, Room 3W320 Washington, DC 20202

- 6132 Due to potential delays in government processing of mail sent through the U.S. Postal Service, SEAs are encouraged to use alternate carriers for paper submissions. **Application Deadline** Application s are due on or before October 30 , 2013
. **For Further Information** If you have any questions, please contact Carlas McCauley at (202) 260

- 0824 or by

e - mail at Carlas.Mccauley@ed.gov
.3 APPLICATION COVER SHEET SCHOOLIMPROVEMENT GRANTS
L egal Name o f Appl icant : Applicant’s M ailing A ddress:

S tate Contact for the School Improvement Grant Name : P o s iti on and Office: Contact’s Mailing A ddres s:

T elephone : F ax : Email addre ss:

C hief S tate Schoo l Of

ficer ( Printed Name): Telephone:
Signature of th e C hief S tate Sc hool Offi cer : X Date :

The State, through its authorized representative, agrees to comply with all requirements applicable to the School Improvement Grants program, including the assurances contained herein and the conditions that apply to any waivers that the State receives through this application.4 

### P **ART** 

### I: **SEA R** **EQUIREMENTS** As part of its application for a School Improvement Grant under section 1003(g) of the ESEA, an SEA must provide the following information. **A. ELIGIBLE SCHOOLS Par**  **t 1 (Definition of Persistently Lowest** **- Achieving Schools)**  **:** Along with its list of Tier I , Tier II, and Tier III schools, the SEA must provide the definition that it used to develop this list of schools. I f the SEA’s definition of persistently

lowest

- achieving schools that it m akes publicly available on its web sit e is identical to the definition that it used to develop its list of Tier I , Tier II, and Tier III schools, it may pro vide a link to the page on its web site where that definition is posted rather than providing the complete definition. If an SEA is reques ting the priority schools list waiver , it need not provide this definition, as its methodology for identifying its priority

schools has already

been approved through its ESEA flexibility request. **Part 2 (Eligible Schools List)**  **:** As part of its FY 2013 application an SEA must provide a list, by LEA, of each Tier I, Tier II, and Tier III school in the Stat e or, if it is requesting the priority schools list waiver, of each priority school in the State. (A State’s Tier I and Tier II schools are its persistently lowest
- achieving schools and, if the SEA so chooses, certain additional Title I eligible schools that are as low achieving as the State’s persistently

lowest
- achieving schools or that have had a graduation rate below 60 percent over a number of ye ars.) In providing its list of schools, the SEA must indicate whether a school has been identified as a Tier I or Tier II school solel y because it has had a graduation rate below 60 percent over a number of ye ars. **Directions:** SEAs that generate new lists should create this table in Excel using the format shown below. An example of the table has been provided for guidance. **SCHOOLS ELIGIBLE FOR FY 2013 SIG FUNDS**  **LEA NAME LEA NCES** 

**ID # SCHOOL** 

**NAME SCHOOL** 

**NCES ID# PRIORITY** 

**(if applicable)**  **TIER**

**I TIER**  **II TIER**  **III GRAD**  **RATE NEWLY** 

**ELIGIBLE 1** 

**EXAMPLE: SCHOOLS ELIGIBLE FOR FY 2013**  **SIG FUNDS**
**LEA NAME LEA NCES** 

**ID # SCHOOL NAME**  **SCHOOL NCES ID#**  **PRIORITY TIER**  **I TIER**  **II TIER**  **III GRAD**  **RATE NEWLY** 

**ELIGIBLE**

1 “Newly Eligible” refers to a school that was made eligible to receive SIG funds by the Consolidated Appropriations Act, 2010. A newly eligible school may be identified for Tier I or Tier II because it has not made adequate yearly progress for at least tw o consecutive years; is in the State’s lowest quintile of performance based on proficiency rates on State’s assessments; and is no higher achieving than the highest

- achieving school identified by the SEA as a “persistently lowest

achieving school” or is a high school that has a graduation rate less than 60 percent over a number of years. For complete definitions of and additional information about “newly eligible schools,” please refer to the FY 2010 SIG Guidance, questions A

- 20 to A
- 30.5

LEA 1 ## HARRISON ES ## X LEA 1 ## MADISON ES ## X LEA 2 ## TAYLOR MS ## X X **Part 3 (Terminated Awards)**  **:** All SEAs are required to list any LEAs with one or more schools for which funding under previously awarded SIG grants will not be renewed for the 201 4
- 201 5 school year . For each such school, note the amount of unused remaining funds and explain how the SEA or LEA plans to use those funds. **LEA N** **AME S**  **CHOOL N** **AME D**  **ESCRIPTION OF HOW RE MAINING FUNDS**  **WERE OR WILL BE U**  **SED A** **MOUNT OF R** **EMAINING F**  **UNDS**

**T OTAL**  **A MOUNT OF**  **R EMAINING**  **F UNDS**  **:**
**B. EVALUATION CRITERIA: An SEA must provide the criteria it will use to evaluate the**  **information set forth below in an LEA’s application for a School Improvement Grant.**  **P art 1:**  The three actions listed in Part 1 are ones that an LEA must take prior to submitting its application for a School Improvement Grant. Accordingl y, the SEA must describe, with specificity, the criteria the SEA will use to evaluate an LEA’s application with respect to each of the following actions: (1) The LEA has analyzed the needs of each Tier I and Tier II school , or each priority school, as applicable, identified in the LEA’s application and has selected an intervention for each school. (2) The LEA has demonstrated that it has the capacity to use school improvement funds to provide adequate resources and related support to each Tier I and Tier II school , or each priority s chool, as applicable, identified in the LEA’s application in order to implement ful ly and effectively

the selected intervention in each of those schools. (3) The LEA’s budget includes sufficient funds to implement the selected intervention fully and effectively in each Tier I and Tier II school , or each priority s chool, as applicable, identified in the LEA’s application, as well as to support school improvement activities in Tier III schools in a State that is not requesting the priority

s chools list waiver , throughout the period of availability o f those funds (taking into account any waiver extending that period received b y either the SEA or the LEA). **Part 2:** The actions in Part 2 are ones that an LEA may have taken, in whole or in part, prior to submitting its application for a School Improvement Grant, but most likely will take after rece iving a School Improvement Grant. Accordingl y, an SEA must describe the criteria it will use to assess the LEA’s commitment to do the following:  Design and implement interventions consistent with the final requirements;  Recruit, screen, and select external providers, if appl icable, to ensure their quality ;  Align other resources with the interventions;  Modify

i ts practices or policies, if necessary , to enable it to implement the interventions fully and effectivel y; and,  Sustain the reforms after the funding period ends.6 **B -**  **1. ADDITIONAL EVALUATION CRITERIA:**  **In addition to the evaluation criteria listed in Section B, the SEA must evaluate the following information in an LEA’s budget and application:**  (1) How will the SEA review an LEA’s proposed budget with respect to activities carried out during the pre

implementation period2 to help an LEA prepare for full implementation in the following school year? (2) How will the SEA evaluate the LEA’s proposed activities to be carried out during the pre

- implementation period to determine whether they are allowable?

2 “Pre
- im plementation” enables an LEA to prepare for full implementation of a school interventio n mo del at the start of the 2014

– 2015 school year. For a full description of pre

- implementation, please refer to section J of the SIG Guidance. **C .**  **TIMELINE: An SEA must describe its process and timeline for approving LEA applications.** 

[Insert the SEA’s timeline for the FY 2013 SI G competition h ere] **D . DESCRIPTIVE INFORMATION:**  **An SEA must include the information set forth below.** ( 1 ) Describe the SEA’s process for reviewing an LEA’s annual goals for student achievement for its Tier I and Tier II schools , or for its priority s chools, as applicable, and how the SEA will determine whether to renew an LEA’s School Improvement Grant with respect to one or more Tier I or Tier II schools , or one or more priority schools, in at LEA that is not meeting those goals and making progress on the leading indicators in section III of the final requirements. (2 ) Describe the SEA’s process for reviewing the goals an LEA establishes for its Tier III schools (subject to approval by

the SEA) and how the SEA will determine whether to renew an LE A’s School Improvement Grant with respect to one or more Tier III schools in the LEA that are not meeting those goals. If an SEA is requesting the priority schools list waiver , it need not provide this information, as it will have no Tier III schools. (3 ) Describe how the SEA will monitor each LEA that receives a School Improvement Grant to ensure that it is implementing a school intervention model fully and effectivel y in the Tier I and Tier II schools , or the priority schools, as applicable, the LEA is approved to serve. (4 ) Describe how the SEA will prioritize School Improvement Grants to LE As if the SEA does not have sufficient school improvement funds to serve all eligible schools for which each LEA applies. (5 ) De scribe the criteria, if any , which the SEA intends to use to prioritize among Tier III schools. If an SEA is requesting the priority schools list waiver , it need not provide this information, as it will have no Tier III schools. (6 ) If the SEA intends to take over any Tier I or Tier II schools, or any priority s chools, as applicable, identify those schools and indicate the school intervention model the SEA will implement in each school. (7 ) If the SEA intends to provide services directl y to any school s in the absence of a takeover, identify those schools and, for Tier I or Tier II schools, or for priority schools, as applicable, indicate the school intervention model the SEA will implement in each school and provide evidence of the LEA’s approval to ha ve the SEA provide the services directly
.7

3 If, at the time an SEA submits its application, it has not yet determined whether it will provide services directly to any sc hools in the absence of a takeover, it may omit this information from its application. However, if the SEA later decides that it will provide such services, it must amend its application to provide the required information. **E .**  **ASSURANCES: The SEA must provide the assurances set forth below.**  By submitting this application, the SEA assures that it will do the following (check each box): Comply w ith the final requirements and ensure that each LEA carries out its responsibilities outlined in the final requirements. Award each approved LEA a School Improvement Grant in an amount that is of sufficient size and scope to implement the selected intervention in each Tier I and Tier II school, or e ach priority s chool, as applicable, that the SEA approves the LEA to serve. Monitor and evaluate the actions an LEA has taken, as outlined in its approved SI G application, to recr uit, select and provide oversight to external providers to ensure their quality. Monitor and evaluate the actions the LEA has taken, as outlined in its approved SI G application, to sust ain the reforms after the funding period ends and provide technical assistance to LE As on how they c an sustain progress in the absence of SI G funding. If a Tier I or Tier II school, or priority school, as applicable, implementing the restart model becomes a charter school LEA, hold the charter school operator or charter management organization accountable, or ensure that the charter school authorizer ho lds the respective entity accountable, for meeting the final requirements. Post on its website, within 30 days of awarding School Improvement Grants, all final LEA applications and a summary

of the grants that includes the following information: name and NCES identification number of each LEA awarded a grant; total amount of the three year grant listed by e ach year of implementation; name and NCES identification number of each sch ool to be served; and ty pe of intervention to be implemented in each Tier I and Tier II school or priority school, as applicable. Report the specific school

- level data required in section III of the final SIG requirements. **F .**  **SEA RESERVATION:**  **The SEA**  **may reserve**  **an amount**  **not to**  **exceed five**  **percent of**  **its School**  **Improvement Grant for administration, evaluation, and technical assistance expenses.** The SEA must briefly

d escribe the activities related to administration, evaluation, and technical assistance that the SEA plans to conduct with any S tate - level funds it chooses to reserve from its School Improvement Grant allocation. **G .**  **CONSULTATION WITH STAKEHOLDERS** By checking this box, the SEA assures that it has consulted with its Committee of Practitioners regarding the information set forth in its application. **H .**  **WAIVERS** : **SEAs are**  **invited to**  **request waivers**  **of the**  **requirements set**  **forth below.**  **A n**  **SEA must**  **check the corresponding box(es) to indicate which waiver(s) it is requesting.**8 [Enter State Name Here ] requests a waiver of the State
- level requirements it has indicated below. The State believes that the requested waiver(s) will increase its ability to implement the SI G program effectivel y in eligible schools in the State in order to improve the quality of instruction and raise the academic achievement of students in Tier I , Tier II, and Tier III schools or in its priority schools, as applicable
. **Waiver 1: Tier II waiver** In order to enable the State to generate new lists of Tier I, Tier II, and Tier III schools for its FY 2013 competition, waive paragraph (a)(2) of the definition of “persistentl y lowest

- achieving schools” in Section I.A.3 of the SIG final requirements and incorporation of that definition in identifyingTier II schools under Section I. A.1(b) of those requirements to permit the State to include, in the pool of secondary schools from which it determin es those that are the persistently lowest

- achieving schools in the State, secondary schools participating under Title I, Part A of the ESEA that have not made adequate ye arl y progress (AYP) for at least two consecutive ye ars or are in the State’s lowest quintile of performance based on proficiency rates on the State’s assessments in reading/language arts and mathematics combined. Assurance The State assures that it will include in the pool of schools from which it identifies its Tier II schools all Title I secondary

schools not identified in Tier Ithat either (1) have not made AYP for at least two consecutive years; or (2) are in the State’s lowest quintile of performance based o n proficiency rates on the State’s assessments in reading/language arts and mathematics combined. Within that pool, the State assures that it will identify a s Tier II schools the persistently l owest - achieving schools in accordance with its approved defini tion. The State is attaching the list of schools and their level of achievement (as determined under paragraph (b) of the definition of “persistently lowest

- achieving schools”) that would be identified as Tier II schools without the waiver and those that would be identified with the waiver. The State assures that it will ensure that any LEA that chooses to use SIG funds in a Title I secondary school that becomes an eligible Tier II school based on this waiver will compl y with the SIG final requir ements fo r serving that school. **Waiver 2: n -**  **size waiver** In order to enable the State to generate new lists of Tier I, Tier II, and Tier III schools for its FY 2013 competition, waive the d efinition of “persistentl y lowest

- achieving schools” in Section I .A.3 of the SI G final requirements and the use of that definition in Section I .A.1(a) and (b) of those requirements to permit the State to exclude, from the pool of schools from which it identifies the persistently lowest

- achieving schools for Tier I and Tier II, any school in which the total number of students in the “all students” group in the grades assessed is less than [Please indicate number]. Assurance The State assures that it determined whether it needs to identify f ive percent of schools or five schools in each tier prior to excluding small schools below its “minimum n.” The State is attaching, and will post on its Web site, a list of the schools in each tier that it will exclude under this waiver and the number of students in each school on which that determination is based. The State will include its “minimum n” in its definition of “persistently

l owest - achieving schools.” In addition, the State w ill include in its list of Tier III schools any schools excluded from the pool of schools from which it identified the persistently l owest - achieving schools in accordance with this waiver.9 **Waiver 3 :**  **Priority schools list waiver**  Inorder to enable the State to replace its lists of Tier I, Tier II, and Tier III schools with its list of priority schools that meet the definition of “priority schools” in the document titled ESEA F lexibility and that were identified in accordance with its approved request for ESEA flexibility, waive the school eligibility requirements in Section I.A.1 of the SIG final requirements. Assurance The State assures that its methodology for identifyingpriority school s, approved through its ESEA flexibility request, provides an acceptable alternative methodology for identifying the State’s lowest

- performing schools and thus is an appropriate replacement for the eligibility re quirements and definition of persistently lowest

- achieving schools in the SI G final requirements. **Waiver 4 : Period of availability of FY 2013 funds waiver**  **Note: This wa iver only applies to FY**  **2013 funds for the purpose of making three -** **year awards to eligible LEAs.**  Waive section 421(b) of the General Education Provisions Act (20 U.S.C. § 1225(b)) to extend the period of availability

of FY 2013 school improvement funds for the SEA and all o f its LEAs to Sept ember 30, 2017
. **WAIVERS OF LEA REQUIREMENTS** [ Enter State Name Here ] requests a waiver of the requirements it has indicated below. These waivers would allow any local educational agency ( LEA) in the State that receives a School Improvement Grant to use those funds in accordance with the final requirements for School Impro vement Grants and the LEA’s application for a grant. The State believes that the requested waiver(s) will increase the quality of instruction for students and improve the academic achievement of students in Tier I, Tier II, or Tier III schools by enabling an LEA to use more effectivel y the school improvement funds to implement one of the four school intervention models in its Tier I , Tier II, or Tier III schools. The four school intervention models are specifically designed to raise substantially the achievement of students in the State’s Tier I, Tier II, and Tier III schools. **Waiver 5: School improvement timeline waiver Note: An SEA that requested and received the school improvement**  **timeline waiver for the FY 2012 competition and wishes to also re**  **ceive th e waiver for the FY 2013**  **competition must request the waiver again in this application.**  **An SEA that has been approved for ESEA flexibility need not request this waiver as it has already received a waiver of the requirement in section 1116(b) of the ESEA t**  **o identify schools for improvement through its approved ESEA flexibility request.**  **Schools that started implementation of a turnaround or restart model in the 2011**  **- 2012,**  **2012 -**  **2013 , 2013**  **- 2014**  **school years cannot request this waiver to “start over” their sch ool improvement timeline again.**  Waive section 1116(b)(12) of the ESEA to permit LEAs to allow their Tier I , Tier II, and Tier III Title I participating schools that will fully implement a turnaround or res tart model beginning in the 2014

–2015 school ye ar to “start over” in th e school improvement timeline.10 Assurances The State assures that it will permit an LEA to implement this waiver onl y if the LEA receives a School Improvement Grant and requests the waiver in its application as part of a plan to implement the turnaround or restart model be ginning in the 2014

–2015 school year in a school that the SEA has approved it to serve. As such, the LEA may

onl y implement the waiver in Tier I, Tier II, and Tier III schools, as applicable , included in its application. The State assures that, if it is granted this waiver, it will submit to the U.S. Department of Education a report that sets forth the name and NCES District Identification Number for each LEA implementing a waiver. **Waiver 6: Schoolwide program waiver Note: An SEA that requested and received the schoolwide**  **program waiver for the FY 2012 competition**  **and wishes to also re ceive the waiver for the FY 2013**  **competition must request the waiver again in this application.**  **An SEA that has been approved for ESEA flexibility need not request this waiver as it has already received a waiver of the schoolwide poverty threshold through its approved ESEA flexibility r**  **equest.** Waive the 40 percent poverty eligibility

threshold in section 1114(a)(1) of the ESEA to permit LEAs to impl ement a schoolwide program in a Tier I, Tier II, or Tier III participating school that does not meet the poverty threshold and is fully

implementing one of the four school intervention models. Assurances The State assures that it will permit an LEA to implement this waiver onl y if the LEA receives a School Improvement Grant and requests to implement the waiver in its application. As such, the LEA may only implement the waiver in Tier I, Tier II, and Tier III schools, as applicable, included in its application. The State assures that, if it is granted this waiver, it will submit to the U.S. Department of Education a report that sets forth the name and NCES District Identification Number for each LEA implementing a waiver. **I. ASSURANCE OF NOTICE AND COMMENT PERIOD** 

**– APPLIES TO ALL WAIVER**  **REQUESTS** The State assures that, prior to submitting its School Improvement Grant application, the State provided all LEAs in the State that are eligible to receive a School Improvement Grant with notice and a reasonable opportunity

to comment on its waiver request(s) and has attached a cop y of that notice as well as copies of any comments it received from LEAs. The State also assures that it provided notice and information regarding the above waiver reque st(s) to the public in the manner in which the State customarily provides such notice and information to the public (e.g., b y publishing a notice in the newspaper; b y posting information on its web site) and has attached a cop y of, or link to, that notice.11 **PART II:**  **LEA APPLICATION**  An SEA must develop an LEA application form that it will use to make subgrants of school improvement funds to eligible LEAs. **LEA APPLICATION REQUIREMENTS** The LEA application form that the SEA uses must contain, at a minimum, the information set forth below. An SEA may include other information that it deems necessary in order to award school improvement funds to its LEAs. **A. SCHOOLS TO BE SERVED: An LEA must include the following**  **information with respect to the schools it will serve with a School Improvement Grant.**  An LEA must identify

e ach Tier I, T ier II, and Tier III school, or each priority s chool, as applicable, the LEA commits to serve and identify the model that the LEA will use in each Tier I and Tier II school, or in each priority school, as applicable
. **SCHOOL NAME**  **NCES**

**ID # PRIORITY**  **TIER I**  **TIER II**  **TIER III**  **INTERVENTION (TIER I AND II /PRIORITY**  **ONLY) (if**  **applicable) turnaround**  **restart closure**  **transformation**

Note: An LEA that has nine or more Tier I and Tier II schools may n ot implement the transformation model in more than 50 percent of those schools. **B. DESCRIPTIVE**  **INFORMATION: An**  **LEA must**  **include the**  **following information**  **in its**  **application for a School Improvement Grant.**  **(1)** For each Tier I and Tier II school , or each priority school, that the LEA commits to serve , the LEA must demonstrate that the LEA has anal yz ed the needs of each school, such as instructional programs, school leadership and school infrastructure, and selected intervention s for each school aligned to the needs each school has identified
. **(2)** The LEA must ensure that each Tier I and Tier II school, or each priority school, that it commits to serve receives all of the State and l ocal funds it would receive in the absence of the school improvement funds and that those resources are aligned with the interventions. **(3)** The LEA must describe actions it has taken, or will take, to

—  Determine its capacity to provide adequate resources and related support to each Tier I and Tier II school , or each priority school, identified in the LEA’s application in order to implement, fully and effectivel y, the required activities of the school intervention model it has selected;  Design and implement interventions consis tent with the final requirements of the turnaround model, restart model, school c losure, or transformation model;12

 Recruit, screen, and select external providers, if applicable, to ensure their quality ;  Modify

its practices or poli cies, if necessary , to enable its schools to implement the interventions fully and effectivel y; and ,  Sustain the reforms after the funding period ends. **(4)** The LEA must include a timeline delineating the steps it will take to implement the selected interventi on in each Tier I and Tier II school , or each priority school, identified in the LEA’s application. **(5)** The LEA must describe how it will monitor each Tier I and Tier II school , or each priority school, that rece ives school improvement funds including by

-  Est ablishing annual goals for student achievement on the State’s assessments in both reading/language arts and mathematics; and,  Measuring progress on the leading indicators as defined in the final requirements. **(6)** For each Tier III school the LEA commits to serve, the LEA must identify the services the school will receive or the activities the school will implement. **(7)** The LEA must describe the goals it has established (subject to approval b y the SEA) in order to hold accountable its Tier III schools that receive school improvement funds. **(8)** As appropriate, the LEA must consult with relevant stakeholders regarding the LEA’s application and implementation of school improvement models in its Tier Iand Tier II schools or in its priority schools, as applicable
. **C. BUDGET:**  **An LEA must**  **include a**  **budget that**  **indicates the**  **amount of**  **school improvement funds**  **the LEA**  **will use**  **each year**  **in each**  **Tier I,**  **Tier II,**  **and Tier**  **III school**  **, or**  **each priority**  **school, it**  **commits to**  **serve.** The LEA must provide a budget that indicates the amount of school improvement funds the LEA will use each ye ar to

—  Implement the selected model in each Tier I and Tier II school , or priority school, it commits to serve;  Conduct LEA
- level activities designed to support implementation of the selected school intervention models in the LEA’s Tier Iand Tier II schools or priority schools ; and  Support school improvement activities, at the school or LEA level, for each Tier III school identified in the LEA’s application. Note: An LEA’s budget sh ould cover three years of full implementation and be of sufficient size and scope to implement the selected school intervention model in each Tier I and Tier II school the LEA commits to serve. Any funding for activities during the pre

- implementation peri od must be included in the first year of the LEA’s three

- ye ar budget plan. An LEA’s budget for each year may not exceed the number of Tier I, Tier II, and Tier III schools , or the number of priority schools, it commits to serve multiplied by $2,000,000 (not to exceed $6,000,000 per school over three years ). **Example: LEA XX BUDGET**  **Year 1 Budget Year 2 Budget**  **Year 3 Budget Three**  **- Year Total** 13 **Pre -**  **im plementation**  **Year 1 -**  **Full Imple**  **mentation Tier I ES**  **#1** $257,000 $1,156,000 $1,325,000 $1,200,000 $3,938,000 **Tier I ES #2** $125,500 $890,500 $846,500 $795,000 $2,657,500 **Tier I MS #1** $304,250 $1,295,750 $1,600,000 $1,600,000 $4,800,000 **Tier II HS #1** $530,000 $1,470,000 $1,960,000 $1,775,000 $5,735,000 **LEA -**  **level Activities** $250,000 $250,000 $250,000 $750,000 **Total Budget $6,279,000**  **$5,981,500 $5,620,000**  **$17,880,500 D. ASSURANCES:**  An LEA must include the following assurances in its application for a School Improvement Grant. The LEA must assure that it will

— (1) Use its School Improvement Grant to implement fully and effectivel y an intervention in each Tier I and Tier II school , or each priority school, that the LEA commits to serve consistent with the final requirements; (2) Establish annual goals for student achievement on the State’s assessments in both reading/language arts and mathematics and measure progress on the leading indicators in section III of the final requirements in order to monitor each Tier I and Tier II school , or priority school, that it serves with school improvement funds, and establish goals (approved by the SEA) to hold accountable its Tier III schools that receive school improvement funds; (3) If it implements a restart model in a Tier I or Tier II school , or priority school, include in its contract or agreement terms and provisions to hold the charter operator, charter management organization, or education management organization accountable for complying with the final requirements; (4) Monitor and evaluate the actions a school has taken, as outlined in the approved SIG application, to recruit, select and provide oversight to external providers to ensure their quality; (5) Monitor and evaluate the actions schools have taken, as outlined in the approved SIG application, to sustain the reforms after the funding period ends and that it will provide technical assistance to schools on how they can sustain progress in the absence of SIG funding; and, (6) Report to the SEA the school

- level data required under section III of the final requirements. **E. WAIVERS: If the SEA has requested any waivers of requirements applicable to the LEA’s School**  **Improvement Grant, an LEA must indicate which of those waivers it intends to implement.**  The LEA must check each waiver that the LEA will implement. I f the LEA does not intend to implement the waiver with respect to each applicable school, the LEA must indicate for which schools it will implement the waiver. “Starting over” in the school improvement timeline for Tier I and Tier II Title Iparticipating schools implementing a turnaround or restart model. Implementing a school

- wide program in a Tier I or Tier II Title I participating school that does not meet the 40 percent poverty eligibility threshold.1 

# Continuation Awards Only **Application for**  **FY 201 3**  **School Improvement Grants (SIG) Program** 
**In the table below, list the schools that will receive continuation awards using FY 2013 SIG funds :**  **LEA N** **AME S**  **CHOOL N** **AME C**  **OHORT #**  **P ROJECTED**  **A MOUNT OF**  **FY 13**  **A LLOCATION** 

**T OTAL**  **A MOUNT OF**  **C ONTINUATION**  **F UNDS**  **P ROJECTED FOR**  **A LLOCATION IN**  **FY 13**  **:**
**In the table below, l ist any**  **LEAs with one or more schools for which funding under previously awarded SIG grants will not be renewed. For**  **each such school, note the amount of unused remaining funds and explain how the SEA or LEA plans to use those funds as well a s noting the**  **explicit reason and process for reallocating those funds (e.g., reallocate to rural schools with SIG gran ts in cohort 2 who demonstrate a need**  **for technology aimed at increasing student literacy interaction) .**  **LEA N** **AME S**  **CHOOL N** **AME D**  **ESCRIPTION OF HOW REMAINING**  **FUNDS WERE OR WILL BE**  **U SED**  **A MOUNT OF**  **R EMAINING**  **F UNDS** 

**T OTAL**  **A MOUNT OF**  **R EMAINING**  **F UNDS**  **:**2 **School Improvem ent Grants (SIG) Program FY 2013**  **Assurances** By submitting this application, the SEA assures that it will do the following (check each box): Use FY 201 3 SI G funds solely to make continuation awards and will not make any new awards 2 to its LEAs. Use the renewal process identified in [State]’s most recentl y approved SIG application to determine whether to renew an LEA’s School Improvement Grant. Monitor and evaluate the actions an LEA has taken, as outlined in its approved SIG application, to recruit, select and provid e oversight to external providers to ensure their quality
. Monitor and evaluate the actions the LEA has taken, as outlined in its approved SIG application, to sustain the reforms after the funding period ends and provide technical assistance to LEAs on ho w they can sustain progress in the absence of SIG funding. If a Tier I or Tier II school implementing the restart model becomes a charter school LEA, hold the charter school operator or charter management organization accountable, or ensure that the charter school authorizer holds the respective entity accountable, fo r meeting the final requirements. Report the specific school

- level data required in section III of the final SIG requirements. **By submitting the assurance**  **s and information above, [**  **State ] agrees to carry out its**  **most recently approved SIG application and does not**  **need to submit a new FY 20 1**  **3 SIG application; however**  **, the State must submit the signature page included in the full application package**  **(page 3).**

2 A “new award” is defined as an award of SIG funds to an LEA for a school that the LEA was not previously approved to serve with SIG funds in the school year for which funds are being awarded

—in this case, the 2014

–2015 school year. New awards may be made with the FY 2 013 funds or any remaining SIG funds not already committed to grants made in earlier competitions.