School Improvement Grants 

Application for FY 2013 New Awards Competition

Section 1003(g) of the

Elementary 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 information 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 reducing 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.
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SCHOOL IMPROVEMENT GRANTS

Purpose of the Program

School Improvement 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 competitive 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 order 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 improvement funds are to be focused on each State’s “Tier I” and “Tier II” schools. Tier I schools are the lowestachieving five percent of a State’s Title I schools in improvement, corrective action, or restructuring, Title I secondary schools in 

improvement, corrective action, or restructuring with graduation rates below 60 percent over a number of years, and, if a State so 

chooses, certain Title I eligible (and participating) elementary schools that are as low achieving as the State’s other Tier I schools 

(“newly 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 number of years, and, if a State so chooses, certain additional Title I eligible (participating 

and non-participating) secondary schools that are as low achieving as the State’s other Tier II schools or that have had a graduation

rate below 60 percent over a number of years (“newly eligible” Tier II schools). An LEA also may use school improvement funds in 

Tier III schools, which are Title I schools in improvement, corrective action, or restructuring that are not identified as Tier I or Tier II 

schools and, if a State so chooses, certain additional Title I eligible (participating and non-participating) schools (“newly eligible” Tier 

III schools). In the Tier I and Tier II schools an LEA chooses to serve, the LEA must implement one of four school intervention 

models: turnaround model, restart model, school closure, or transformation model. 

ESEA Flexibility

An SEA that has received ESEA flexibility no longer identifies Title I schools for improvement, corrective action, or restructuring; 

instead, it identifies priority schools, which are generally a State’s lowest-achieving 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 Tier 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 for 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. The 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 $506 million 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 eligible to 

apply to receive a SIG grant. The 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 must allocate 

at least 95 percent of its SIG funds directly to LEAs in accordance with the final requirements (http://www.gpo.gov/fdsys/pkg/FR2010-10-28/pdf/2010-27313.pdf). The SEA may retain an amount not to exceed five percent of its allocation for State administration, 

evaluation, and technical assistance.

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 policies contained therein. The 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.
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FY 2013 NEW AWARDS APPLICATION INSTRUCTIONS

This application is for use only by SEAs that will make new awards. New awards are 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 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 

SIG application. However, those SEAs using FY 2013 funds solely for continuation purposes are only required 

to complete the Continuation Awards Only Application for FY 2013 School Improvement Grants Program

located at the end of this application. 

SUBMISSION INFORMATION

Electronic Submission: 

The Department strongly prefers to receive an SEA’s FY 2013 SIG application electronically. 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 electronically, it may submit the original and two copies of its 

SIG application to the following address:

Carlas McCauley, Group Leader

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

Applications 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.
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APPLICATION COVER SHEET

SCHOOL IMPROVEMENT GRANTS

Legal Name of Applicant: Applicant’s Mailing Address: 

State Contact for the School Improvement Grant 

Name: 

Position and Office:

Contact’s Mailing Address: 

Telephone: 

Fax: 

Email address: 

Chief State School Officer (Printed Name): Telephone: 

Signature of the Chief State School Officer: 

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.
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PART I: SEA REQUIREMENTS

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

Part 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. If the SEA’s 

definition of persistently lowest-achieving schools that it makes publicly available on its website is identical to 

the definition that it used to develop its list of Tier I, Tier II, and Tier III schools, it may provide a link to the 

page on its website where that definition is posted rather than providing the complete definition. If an SEA is 

requesting 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 State 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 

years.) In providing its list of schools, the SEA must indicate whether a school has been identified as a Tier I or 

Tier II school solely because it has had a graduation rate below 60 percent over a number of years. 

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 

ELIGIBLE1

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 two 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 lowestachieving 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 2014-2015 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 NAME SCHOOL NAME DESCRIPTION OF HOW REMAINING FUNDS 

WERE OR WILL BE USED

AMOUNT OF 

REMAINING FUNDS

TOTAL AMOUNT OF REMAINING FUNDS:

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.

Part 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. Accordingly, 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 school, as applicable,

identified in the LEA’s application in order to implement fully 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 school, 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 schools list waiver, throughout the period of availability of those funds (taking 

into account any waiver extending that period received by 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 receiving a School Improvement 

Grant. Accordingly, 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 applicable, to ensure their quality;

 Align other resources with the interventions;

 Modify its practices or policies, if necessary, to enable it to implement the interventions fully and 

effectively; and,

 Sustain the reforms after the funding period ends.
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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 preimplementation 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-implementation” enables an LEA to prepare for full implementation of a school intervention model 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 SIG competition here]

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 schools, 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 LEA’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 effectively 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 LEAs if the SEA does not have 

sufficient school improvement funds to serve all eligible schools for which each LEA applies.

(5) Describe 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 schools, 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 directly to any schools 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 have 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 schools 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 with 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 each priority school, as applicable, that 

the SEA approves the LEA to serve.

Monitor and evaluate the actions an LEA has taken, as outlined in its approved SIG application, to recruit, 

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 SIG application, to sustain 

the reforms after the funding period ends and provide technical assistance to LEAs on how they can sustain 

progress in the absence of SIG 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 holds 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 each year of implementation; name and 

NCES identification number of each school to be served; and type 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 describe the activities related to administration, evaluation, and technical assistance that 

the SEA plans to conduct with any State-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. An SEA must 

check the corresponding box(es) to indicate which waiver(s) it is requesting.
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[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 SIG program effectively 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 “persistently lowest-achieving schools” in Section I.A.3 

of the SIG final requirements and incorporation of that definition in identifying Tier 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 

determines 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 yearly progress (AYP) for at least two 

consecutive years 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 I that either (1) have not made AYP for at least two consecutive years; 

or (2) 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. Within that pool, the State assures that it will identify as 

Tier II schools the persistently lowest-achieving schools in accordance with its approved definition. 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 comply with the SIG final requirements for 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 definition of “persistently lowest-achieving schools” in Section I.A.3 of the SIG 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 five 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 lowest-achieving schools.” In addition, the State will include in its list of Tier III schools any 

schools excluded from the pool of schools from which it identified the persistently lowest-achieving schools in 

accordance with this waiver. 
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Waiver 3: Priority schools list waiver 

In order 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 Flexibility 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 identifying priority schools, 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 requirements and definition of persistently

lowest-achieving schools in the SIG final requirements.

Waiver 4: Period of availability of FY 2013 funds waiver

Note: This waiver 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 of its LEAs to September 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 Improvement 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 

effectively 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 receive 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 requirement in section 1116(b) of the ESEA to 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 school 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 restart model beginning in the 2014–2015 school 

year to “start over” in the school improvement timeline. 
10

Assurances

The State assures that it will permit an LEA to implement this waiver only 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 beginning in the 2014–2015 school year in a school that the SEA has approved it to serve. 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.

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 receive 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 request.

Waive the 40 percent poverty eligibility threshold in section 1114(a)(1) of the ESEA to permit LEAs to 

implement 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 only 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 copy 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 request(s) to the public in the manner in which the State customarily provides such notice and 

information to the public (e.g., by publishing a notice in the newspaper; by posting information on its website) 

and has attached a copy of, or link to, that notice.
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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 each Tier I, Tier II, and Tier III school, or each priority school, 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 not 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 analyzed the needs of each school, such as instructional programs, school 

leadership and school infrastructure, and selected interventions 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 local 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 

effectively, the required activities of the school intervention model it has selected;

 Design and implement interventions consistent with the final requirements of the turnaround model, 

restart model, school closure, or transformation model; 
12

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

 Modify its practices or policies, if necessary, to enable its schools to implement the interventions fully

and effectively; 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 intervention 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 

receives school improvement funds including by-

 Establishing 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 by 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 I and 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 

year 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 I and 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 should 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 period must be included in the first year of 

the LEA’s three-year 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-implementation

Year 1 - Full 

Implementation

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 effectively 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. If 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 I participating 

 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 2013 School Improvement Grants 

(SIG) Program

In the table below, list the schools that will receive continuation awards using FY 2013 SIG funds:

LEA

NAME

SCHOOL NAME COHORT # PROJECTED AMOUNT OF 

FY 13 ALLOCATION

TOTAL AMOUNT OF CONTINUATION FUNDS PROJECTED FOR ALLOCATION IN FY 13:

In the table below, list 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 as noting the 

explicit reason and process for reallocating those funds (e.g., reallocate to rural schools with SIG grants in cohort 2 who demonstrate a need 

for technology aimed at increasing student literacy interaction).

LEA NAME SCHOOL NAME DESCRIPTION OF HOW REMAINING FUNDS WERE OR WILL BE USED AMOUNT OF REMAINING 

FUNDS

TOTAL AMOUNT OF REMAINING FUNDS:
2

School Improvement Grants (SIG) Program FY 2013 Assurances

By submitting this application, the SEA assures that it will do the following (check each box):

Use FY 2013 SIG funds solely to make continuation awards and will not make any new awards2to its LEAs. 

Use the renewal process identified in [State]’s most recently 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 provide 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 how 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, for meeting the final 

requirements.

Report the specific school-level data required in section III of the final SIG requirements.

By submitting the assurances and information above, [State] agrees to carry out its most recently approved SIG application and does not 

need to submit a new FY 2013 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 2013 funds or any remaining SIG funds not 

already committed to grants made in earlier competitions.