### 1 

## Attachment A
**Data Groups for the Electronic Application System f**  **or Indian Education (EASIE)**

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The following appendices delineate the data items that will be collected for the Office of Indian Education’s Formula Grant Electronic Application S ys tem for Indian Education (EASIE). Formula Grant EASIE has eliminated the need for paper forms; the application process has been conducted electronically

for the past 6 cycles. EASIE emplo ys a two

- phase collection

— basic eligibility data are collected through Part I, allowing the Department to calculate the exact allocation for each applicant. Then, in Part II, applicants provide program and budget data for their project, tailored to their exact allocation. This Supporting Statement covers both Parts I and II of EASIE. EASIE is conducted in close collaboration with EDFacts , the Department of Education’s primary

collection of data about elementary and secondary

education. As a result, in this Supporting Statement, the application data items are presente d in the standard EDFacts data group format, rather than by means of a paper - based table layout. Please note that **no applicant has to answer all data groups**  . The software is responsive to user answers so that items that don’t apply to a particular appl icant are never presented. For example, if a user identifies itself as an LEA, then questions for BIE applicants are not presented; if a user identifies itself as a regular application type, then questions for schoolwide types are not presented, etc.
If an applicant has no access to the Internet or limited Web access, then a paper

- based submission will be permitted upon request. However, in the six years of implementation of EASIE, no applicant has requested this and applications have been at an all

- time high.
The following is a word version of the screen shots for the data group format.
**Public Burden Statement:** According to the Paperwork 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 6 hours per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data ne eded, and completing and reviewing the collection of information. The obligation to respond to this collection required to obtain or retain benefit ( section 7114(a) of the ESEA, 20 USC 7424(a) ) . Send comments regarding the burden estimate or any other asp ect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Education, 400 Maryland Ave., SW, W ashington, DC 20210

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

- 0021 . Note: Please do not return the completed EASIE application to this address.

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Supporting Statement Format (Data Table)
**PROFESSIONA L DEVELOPMENT**  (Professional Development includes the activities that the applicant will provide to staff to improve their capacity to effectively educate Indian students) **Ar ea**  **Data Item Categories**  **Format Comment** 

Professional Development (1) Professional

Development

– The professional development opportunities planned using grant funds. Staff Type Professional Development Opp ortunity Menu Options


### ( Category Tables) Category Professional Development Opportunity Definition The types of professional development activities offered using funds from the grant. Code Set Orientation on working with Indian students Multi

- cultu ral education and sensitivity LEA required training Subject

- specific and related training Standards

- based related training Assessments and related training Program Objective

- specific and related training State sponsored sessions or conferences Regional edu cational conferences OIE sponsored workshops/sessions National educational conferences Other conferences related to Indian education Other Category Staff Type Definition Specify which staff type will be included in the professional development opportuni ty.

Code Set Project Staff Teachers and Other School Professionals All LEA Staff 

### Formula Grant EASIE Describe the professional opportunities planned:

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The data tables and category tables include:
**Data Table Header:** The table hea ding specifies that all of the Professional Development data including in this table involves data for the grant application year. **Area:** The Area column indicates the topic within the header, Professional Development. In this example, Professional Develop ment is repeated in the Header and Area sections because there is onl y one element. Other tables have multiple areas. **Data Item:** This column highlights the key information being collected for this area, including a definition. **Category:** The Category column identifies information to be included with the data item. In this example, applicants must identify which professional development opportunities will be offered to different t ypes of staff. These are also shown in the Formula Grant EASIE mockup screen sh ot (Example 1). More information about these categories can be found in the subsequent tables in Example 2 and in the explanation of Category Tables below. **Format:** The format column indicates the required format for applicants to provide this information. Inthis example, applicants will select from pre

- determined drop down menus (shown as downward pointing arrows in Example 1). Other data elements use numeric dollar values, percentages, and string fields. **Comments:** This column is generall y used to offer guidance or to note when Formula Grant EASIE will automatically calculate totals or percentages for applicants. In this example, there are no comments. **Category Tables:** Data tables are followed by category tables, which detail the definition and code sets (when applicable) of categories. Category tables appear in alphabetical order following the data table. In this example, there are two category tables: Professional Development Opportunity and Staff Ty

pes. **Code Sets:** Code sets are the permitted values fo r that category

. As can be seen in both Example 1 and the Staff Ty pe category

table in Example 2, the permitted values from which applicants can select Staff Ty pe are : Project Staff, Teachers and Other School Professionals, and/or All LEA Staff. The Appe ndices below graphicall y show the various sections of the EASIE online application as it is presented to the applicant during the online process. Part I is detailed by Appendix A and B. Part II is covered b y Appendix C through H. Appendix I summarizes the technical changes

. Appendix A: Eligibility Data

................................ ................................ ................................ .... p. 5 Appendix B : Backgroun d Data

................................ ................................ ................................ . p. 7 Appendix C : Program Data

................................ ................................ ................................ ...... p. 8 Appendix D : Budget Data

................................ ................................ ................................ ...... p. 14 Appendix E : Use of Assessment Data

................................ ................................ .................... p. 16 Appendix F : Integration of Services

................................ ................................ ....................... p. 17 Appendix G : Waiver o f Administrative Cost L imit

................................ ............................... p. 18 Appendix H : Parent Committee Form

................................ ................................ .................... p. 19 Appendix I : Proposed Technical Changes since 2010

................................ .......................... p. 21

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**APPENDIX A:** This Appendix describes the Eligibility Data collected in Part I of the Electronic Application Sy stem for Indi an Education under OMB No. 1810

- 0021. These data groups were approved under I.C. 1875

- 0240 in the fall of 2006 and transferred to I.C. 1875

- 0021 in March 2007

. There are no changes to the Eligibility Data section of the EASIE Application for 2012.

**ELIG IBILITY**  **DA TA** 
**Area Data Items**  **Categories Format**  **Comment**

Eligibility Data (1) Applicant T ype
– The type

of entity that is applying. Applicant T ype Menu Options (2) Indian Students

—Total num ber of Indian students with Form 506 * on file with the applica nt entity Indian categor y Wh ole num ber Calculated

total
(3) All students

—Total num ber of all students in district(s) for whom the applicant is applying Wh ole num ber
*Form 506 is a paper form completed by students or their parents. See next page.
Ca tegory Applicant T ype Definition The type of entity that is submitting the application Code Set LEA (Not part of a consortium) LEA (Consortium leader) Bureau of Indian Education (BIE) Operated School Bureau of Indian Education (BIE) Contract or Grant Sch ool (Not part of a consortium) Bureau of Indian Education (BIE) Contract or Grant School (Consortium leader) Tribe Applying in Lieu of a Single LEA Tribe Applying in Lieu of Multiple LEAs Category Indian Category Definition The basis of tribe eligibilit y as specified in ESEA, Title VII Code Set Federally Recognized, Including Alaska Native State Recognized Terminated Tribes Organized Indian Group Meeting the Definition of “Indian”

### 6 U.S. DEPARTMENT OF EDUCATION OFFICE OF INDIAN EDUCATION WASHINGTON, DC 20202 **TITLE VII STUDENT ELIGIBILITY CERTIFICATION Form 506**  Elementary and Secondary Education Act, Title VII, Part A, Subpart 1
**Parents: Please return this com pleted form** **to your child's school.** In order to apply for a formula grant under the Indian Education Program, your child's school must determine the number of Indian children enrolled. Any child who meets the following definition may be counted for this purpose. You are not required to complete or submit this form to the school. However, if you choose not to submit a form, the school cannot count your child for funding under the program **. This form will becom e part of your child's school record and will not need to be com** **pleted every year.** This form will be maintained at the school and information on the form will not be released without your written approval. **Definition: Indian means any individual who is (1) a member (as defined by the Indian tribe or band) of an Indian tribe or band, including those Indian tribe or bands terminated since**  **1940, and those recognized by the State in which the tribe or band reside; or (2) a descendent in the first or second degree (parent or grandparent) as described**  **in (1); or (3) considered by the Secretary of the Interior to be an Indian for any purpose; o r (4) an Eskimo or Aleut**  **or other Alaska Native; or (5) a member of an organized Indian group that received a grant under the Indian Education Act of 1988 as it was in effect October 19, 1994.** 
NAME OF CHILD
**___________________________________________** D ate of Birth

**___________________**

**(As shown on school enrollm ent records)**  School Name ___________________________________________________ Grade _____________ **NAME OF TRIBE, BAND OR GROUP**

___________________________ __________________________ **Tribe, Band or Group is: (check one) Organized Indian Group**  **Federally Recognized, State Meeting #5 o f the**  **_____ Including Alaska Native _____ Recognized _____ Term inated _____ Definition Above** 
**Nam e of individu**  **al with tribal m em**  **bership: _____________________________________________ Individual named is (check one): _____ Child _____ Child's Parent _____ Child's**  **Grandparent**
**Proof of m em**  **bership, as defined by tribe, band, or group is:**
**A. Mem** **bership or enrollment number (if readily available) _________________________ OR** 



###  **Other (explain)**

**_____________________________________________ Nam**  **e and address of organization m aintaining me**  **mbership data for the tribe, band or group:**

**__________________________________________________________** I verify that the information provi ded above is accurate:
**PARENT'S SIGNATURE**
_______________________________________ **DATE**

____________________ **Mailing Address _______________________________________________** Telephone _________________ Notice: Public Reporting Burden Not ice on Reverse Side

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**APPENDIX B**  **:** This Appendix describes the Background data to be collected for the Indian Education Formula Grant Program under OMB No. 1810

- 0021. This and succeeding groups were previousl y approved under I.C. 1810

- 0021 in March 2007. There are no changes to the Background Data section of the EASIE Application for 2012.

**BA CKGROUND DA** **TA**
**Area Data Items**  **Categories Format**  **Comment**

Background Data (1) Application Ty pe
– The

ty pe of application the LEA(s) is submitting. Applica tion Ty p e Menu Options (2) Grades Offered

– The grade levels served by the LEA(s) Grades Offered Menu Options (3) Grant Award Start Date

– The date on which the LEA(s) wishes to have the grant award begin; the date must be between July 1 and September 30 of the current ye ar, inclusive. Grant Award Start Date Date Field Autom atically calculated end date.

Category Application Ty pe Definition The type of application the LEA(s) is submitting. Code Set Regular Formula Grant Integration of Services under Secti on 7116 Form ula Grant Consolidated with a Title I Schoolwide Program Category Grades Offered Definition Grade level(s) offered by the LEA. Code Set PK K 1 2 3 4 5 6 7 8 9 10 11 12 Category Grant Award Start Date Definition The date on which the a pplicant wishes to have the grant award begin; the date must be between July 1 and September 30 of the current year, inclusive.

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**APPENDIX C**  **:** This Appendix describes the Program data to be collected (Performance Data from the Pr e vious Grant Year, Project Objectives, and Professional Development) for the Indian Education Formula Grant Program under OMB No. 1810

- 0021. There are no changes to the Program Data section of the EASIE Application for 2012.

**Areas Data Items**  **Categories Format**  **Comment**

Student Performance on State Assessment (1) Total number of all

students assessed (2) Number of all stu dents proficient or above (3) Total number of Am erican Indian/Alaska Native students assessed (4) Number of American Indian/Alaska Native students proficient or above Content Area of State Assessment Grade Level Number Calculated Percentages

Student Performance on Other Assessment (1) Total number of all

students assessed (2) Number of all students proficient or above (3) Total number of Am erican Indian/Alaska Native students assessed (4) Number of American Indian/Alaska Native students proficient or above Content Area of Other Assessment Data Source Grade Level Number Calculated Percentages

Student Attendance Rate (1) Average Daily

Attendance

– The average number of students in daily attendance computed according to state law or regulation, or if no state definition exists, the aggregate number of days of attendance by students divided by the number of days of enrollment of students during the reporting period. (2) (Optional) Average Daily Attendance of Indian Students

– The average num ber of In dian students in daily attendance com puted according to Number 

### PERFORMA **NCE DA TA**  **FROM THE PREVIOUS GRA NT YEA**  **R** ( Note: A grant application for School Year (SY) 2012

- 1 3 funds , for example,

uses SY 20 10

- 11 performance data.)

### 9 state law or regulation, or if no state definition exists, the aggregate number of days of attendance by students divided by the num ber of days of enrollment of students during the reporting period.

Student Graduation Rate (1) Graduation Rate for All

Students

– The percentage of students who graduated from high schools with a regular diploma. The calculation of the percentage rate is defined in the state’s accountability plan in accordance wi th Title I, Section 200.19. (2) Graduation Rate for Indian Students

– The percentage of Indian students who graduated from high schools with a regular diploma. The calculation of the percentage rate is defined in the state’s accountability plan in accordan ce with Title I, Section 200.19. Percentage to one decimal point



### PROJECT OBJECTIVES (Project Objectives are the areas that the applicant plans to target for student performance im provements during the grant year. )
**Area Data Item**  **Categories Format**  **Comment**

Project Objectives (1) Target for

Achievement

– The grade level(s) and content area(s) targeted for student performance im provement during the grant year through the Indian Education project. Objective Grade Level Service Frequenc y Location Activi ties Menu Options



### PROFESSIONA **L DEVELOPMENT** ( Professional Development includes the activities that the applicant will provide to staff to improve their capacity to effectively educat e Indian students )
**Area Data Item**  **Categories Format**  **Comment**
Professi onal Development (1) The professional

development opportunities planned using grant funds. Staff T yp e Professional Development Opportunity Menu Options

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Category Activities Definition Activities that will be included in this service. Code Set ACT or S AT Preparation and Testing Advanced Placement (AP) Preparation AP Coursework and Testing Career and/or College Guidance Civic Projects Counseling Creative W riting Credit Recovery or Completion Experiential Learning Libraries, Cultural Lending of Materials Multicultural Affairs or Events Stor ytelling Stud y Skills Development Student Clubs with Academic Emphasis Tutoring: Skill Development Individually Tutoring: Skill Development in Small Groups Tutoring: Homework Assistance Individually Tut oring: Homework Assistance in Small Groups Youth Leadership, Groups or Clubs Category Content Area of Other Assessment Definition Content area the data pertains to. Code Set Dropout History Mathematics Other Reading (Language Arts/English) Science S ocial Studies Substance Abuse Technology Wr iting Category Content Area of State Assessment Definition Content area the data pertains to. Code Set Mathematics Reading (Language Arts/English) Science Wr iting

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Category Data Source Definition Ty pe of a ssessment. Code Set Curriculum Designed Tests End of Course Exams High School Exit Exams LEA Selected Standardized Test School Records Student Portfolios Other Formal Assessment First

- Year Objective, will collect baseline data this year Category Frequenc y Definition Frequenc y that the service will occur. Code Set Before School After School Evenings Once a W eek Tw ice a W eek Three times a We ek Four Times a We ek Daily We ek ends Once a Month Tw ice a Month Three Times a Month Bi

- weekly Summer Quarterly Sem ester Tri

- sem ester Grading Periods Year

- Round Special Events

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Category Grade Level Definition Grade level the data pertains to. Code Set PK K 1 2 3 4 5 6 7 8 9 10 11 12 Category Location Definition Location where the service will occur. Code Set Camps Chapter House Community Centers Historical Sites In Class LEA Office/Region Other Organizational Designated Sites Pull

- Outs Residential Hall School Tribal Agencies/Offices Tribal Facilities University Campus Category **Objective** Definition Objective that the data pertains to. Code Set Attendance Dropout Graduation History Mathematics Reading (Language Arts/English) Science Social Studies Substance Abuse Technology Wr iting Other (String Field)

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Category Professional Development Opportunity Definition The types of professional development activities offered using funds from the grant. Code Set Orientation on working with Indian students Multi

- cultural education and sensitivity LEA required training Subject

- s pecific and related training Standards

- based related training Assessments and related training Program Objective

- specific and related training State sponsored sessions or conferences Regional educational conferences OIE sponsored workshops/sessions Nationa l educational conferences Other conferences related to Indian education Other (String Field) Category Service Definition Services the LEA will use to address their objective. Code Set Attendance Dropout prevention Language Arts and/or Wr iting Liter ac y, Fam ily Math, Intervention Math, Accelerated Native American Studies Native Language Instruction Pre

- Advanced Placement (AP) Preparation Reading, Accelerated Reading, Enhancement and Wr iting Reading, Family Literacy Reading, Intervention Rea ding Recover y Program Reading, Success for All School Readiness Science Social Studies State or End of Course Exam Preparation Substance Abuse Prevention Technology, Use and Proficiency Tribal Histor y Category Staff T yp e Definition Specify wh ich staff ty pe will be included in the professional development opportunity. Code Set Project Staff Teachers and Other School Professionals All LEA Staff Other (String Field)

### 14

**APPENDIX D**  **:** This Appendix describes the Budget Data to be collected for the Indian Education Formula Grant Program under OMB No. 1810

- 0021. There are no changes to the Budget Data section of the EASIE Application for 2012.

**BUDGET DA TA** 
**Areas Data Items**  **Categories Format**  **Comment**

Personnel (1) Personnel

– Head count

The numb er of personnel paid for by the grant for each personnel type. Personnel T yp e Certification Status Number Calculated Total
(2) Personnel

– Percentage The percentage of time paid for by the grant for each personnel ty pe. Personnel T yp e Certification Statu s Percentage

(3) Personnel

– Cost The costs for each personnel ty pe. Personnel T yp e Certification Status Adm inistrative Cost Program Cost Fringe Cost Numeric

Dollar Value Calculated

Totals

Travel (1) T yp e of Travel:

- In

- district

- Out

- of

- district

- Profe ssional Development Adm inistrative Cost Program Cost Numeric

Dollar Value Calculated

Total

Equipment (1) Text description and

Purpose of Equipment Item:

- Instructional Service Delivery

- Program Management Adm inistrative Cost Program Cost Numeric

Dollar Va lue Calculated

Total

Supplies (1) Purpose of Supply:

- Direct Instructional Delivery

- Student Consumables

- Program Management Adm inistrative Cost Program Cost Numeric

Dollar Value Calculated

Total

Contractual (1) Contractual Purpose:

- Direct Instructional Delivery

- Student Evaluations

- Program Management

- Other (String Field) Adm inistrative Cost Program Cost Numeric

Dollar Value Calculated

Total

Other (1) Purpose of Other Budget

Items:

- Direct Instructional Delivery

- Student Activities Related to Servi ces

- Student Consumables

- Program Management

- Professional Development

- Other (String Field) Adm inistrative Cost Program Cost Numeric

Dollar Value Calculated

Total

Indirect (1) Indirect Cost Rate

– Rate of

indirect costs. Percentage (2) Indirect Cost Total

– Total indirect costs. Numeric Dollar Value

### 15

Category Adm inistrative Cost Definition The dollar amount that is administrative for Program Management; do not include administrative costs in Direct Instructional Delivery, Student Consumables, St udent Evaluations, or Student Activities Related to Services budget items. Category Certification Status Definition Certification status of personnel. Code Set Certified Non

- certified Category Fringe Cost Definition The dollar amount that is fringe benefits. Category Personnel T yp e Definition Ty pes of personnel who will be involved in the program funded through this grant. Code Set Project Director Project Coordinator Academic advisors Adm inistrative Assistants College instructors Consultant s Counselors, Guidance Counselors, Mental Health Cultural Resource Specialists Curriculum Specialists Data Specialists Home/school Coordinators Instructional Assistants Language Instructors Liaisons : Home/School or Community Nutrition Specialists Reading Coaches or Specialists Social workers Support : Clerical or Secretarial Teachers Tribal Elders Youth Development Specialists Other (String Field) Category Program Cost Definition The dollar amount that is programmatic.

### 16

**APPENDIX E**  **:** This Appendix describes the additional information an LEA will submit with their application for the Indian Education Formula Grant under OMB No. 1810

- 0021. There are no changes to the Additional Information an LEA will submit section of the EASIE Application for 2012.

**USE OF A SSESSMENT DA** **TA** (This details how the state previous school year’s assessment data is used within the LEA

E.g. SY 2010

- 11 grant applications use 200 8

- 09 assessment data.) **Area Data Item**  **Categories Format**  **Comment**
Use of Assessment Data (1) Use of

Assessment Data

– LEA response taken upon last assessment results. Method of Dissemination LEA Response Menu Options

Category LEA Response Definition Wa y( s) that the LEA is responding to the findings of previous assessment(s). Cod e Set No Changes in Services/Programs Modifications to Services/Programs at LEA Level Modification to Services/Programs within Project Category Method of Dissemination Definition Method(s) of dissemination to the Indian Community and Parent Committee Code Set Public Hearing for Application Parent Committee Meeting Other Open Meeting

### 17

**APPENDIX F**  **:** This Appendix includes the information that LEAs must supply in OMB No. 1810

- 0021 if they

appl y for Indian Education grant funds under Section 7116 of Ele mentary and Secondary

Education Act. There are no changes to the Integration of Services section of the EASIE Application for 2012.

**INTEGRA TION OF SERVICES** 
**Areas Data Items**  **Categories Format**  **Comment**

Integration of Services Consolidated (1) Programs to be

Consolidated

– Programs whose funds are to be consolidated into a dem onstration project that integrates the program services involved into a single, coordinated, com prehensive program and reduces administrative costs by consolidating adm inistrative f unctions. (String Field) Funding Agency Estimated Amount String Field & Numeric Dollar Value

Integration of Services Entities (1) Entity Providing Service

– The State, tribal, or local agenc y or agencies to be involved in the delivery of services integra ted under the plan. Service to be Provided Ti me frame for Service Deliver y String Field

Category Estimated Amount Definition List the estimated amount of this program. Category Funding Agency Definition List the funding agencies of the program s being consolidated. Category Service to be Provided Definition List the service(s) to be provided. Category Ti me frame for Service Delivery Definition List the timeframe for service delivery.

### 18

**APPENDIX G**  **:** This Appendix describes the additional in formation an LEA may submit, under specified criteria, with their application for the Indian Education Formula Grant OMB No. 1810

- 0021. There are no changes to the Waiver section of the EASIE Application for 2012.

**WA IVER OF**  **ADMINISTRA TIVE COST LIMIT** 
**A reas**  **Data Items Categories**  **Format Comment** 

Wa iver Request (1) Wa iver Request

– A

request to waive (under Section 9401 waiver authority ) the Section 7115(d) statutory requirement of a 5% adm inistrative cap on grant funds under the Indian Education Formula Grant Program to LEAs. Quality of Instruction Explanation, Proposed Academic Achievement Explanation, Proposed Date of Request String Field & Date Field Only applicant s

applying for the waiver with the current grant application should supply this information.

Wa iver Use Report (1) Wa iver Use Report

– If

granted a waiver for the previous grant year, the LEA mu st provide additional statements about how the additional administrative funds were used to increase the quality of instruction and im prove student achievement Adm inistrative Percentage Quality of Instruction Explanation, Prior Year Academic Achievement Explanation, Prior Year Date of Request Percentage , String Field, & Date Field Only applicants

with an approved waiver reque st from the previous grant ye ar should supply this information.

Category Academic Achievement Explanation, Prior Year Definition Describe how, under the waiver, the grantee improved the academic achievement of students. Category Academic Achievement E xplanation, Proposed Definition Explanation of how waiving the requirement will improve the academic achievement of students. Category Adm inistrative Percentage Definition The percentage of funds under the previous grant year used for adm inistrative pu rposes. Category Date of Request Definition Provide the date the waiver was requested. Category Quality of Instruction Explanation, Prior Year Definition Describe how, under the waiver, the grantee used these funds for adm inistrative purposes to incr ease the quality of instruction to students. Category Quality of Instruction Explanation, Proposed Definition Explanation of how waiving the requirement will increase the quality of instruction for students.

### 19

**APPENDIX H**  **:** This Appendix (next page) incl udes the Parent Committee Form to certify that the Parent Committee has participated in the development of the application and approves the proposed project. As a component of EASIE Part II, this form will be collected locally by applicants and submitted to the Office of Indian Education under OMB No. 1810

- 0021 by mail , email, or fax.

### 20

**(Note: Not applicable to elementary and secondary schools funded by the Bureau of Indian Education or tr** 

**ibes that apply in lieu of an LEA)**

______________________________________________________________________ LEA Name: Address: 

### City /State: Zip : 

### This certifies that the Parent Committee for the above LEA has participated in the developm ent of the application herein submitted and approves the proposed project
**. (Note: The LEA and Parent Committee (PC) are to locally determine the number of PC**  **me mbers that are required for PC approval of the application.)** 

**____________________ _________________ ______________________________________**  **Nam e, Title**  **Date Nam**  **e, Title Date** 

**______________________________________ ______________________________________ Nam**  **e, Title Date**  **Nam e, Title**  **Date**

_____ _________________________________ ______________________________________ **Nam e, Title**  **Date Nam**  **e, Title Date**  

### Check the type of application submitted. Check **only one box:**   The application submitted is for a regular formula grant project.  The application submitted will include project funds in a Title Ischool

- wide program. The Parent Committee also certifies it had an opportunity to review the program in a timely fashion and determines that the school wide program is consistent with the purp ose of the formula grant program and does not diminish the availability of culturall y relevant activities.  The application submitted will consolidate Federal programs funded for the purpose of providing education and related services to Indian students. The Federal funds identified within the budget to be consolidated are those that are allocated under a statutory or administrative formula for the purposes of providing education and related services that would be used to Indian students (see Integration o f Services under Section 7116)

. **PARENT COMMITTEE APPROVAL OF A TITLE VII FORMULA GRANT PROGRAM** 

### 21



## Appendix I: Technical Changes Since 2007
**Data Group Category**  **Change Comment**  Various Multiple

Pages Removed “As Needed” from all

code sets where Frequency wa s a selection

. P. 10 **(in bold)** Al lows grantee to provide a more defined service schedule.


### There are no substantive changes since the 2010 clearance. The changes identified above improve clarit y and reduce confusion for the applicant.