1

Attachment A

Data Groups for the Electronic Application System for Indian Education (EASIE) 
2

The following appendices delineate the data items that will be collected for the Office of Indian 

Education’s Formula Grant Electronic Application System 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 employs 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 presented 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 applicant 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 displays 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 needed, 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 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 1810-0021. Note: Please do not 

return the completed EASIE application to this address.
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Supporting Statement Format

 (Data Table) 

PROFESSIONAL DEVELOPMENT

(Professional Development includes the activities that the applicant will provide to staff to improve their capacity to 

effectively educate Indian students)

Area Data Item Categories Format Comment

Professional 

Development

(1) Professional 

Development – The 

professional development 

opportunities planned 

using grant funds.

Staff Type

Professional Development 

 Opportunity

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-cultural 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 educational 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 

opportunity.

Code Set Project Staff

Teachers and Other School Professionals

All LEA Staff

Formula Grant EASIE 

Describe the professional opportunities planned:
4

The data tables and category tables include:

Data Table Header: The table heading 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 Development is repeated in the Header and Area sections 

because there is only 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 types of staff. These are also shown in the 

Formula Grant EASIE mockup screen shot (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. In this 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 generally 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 Types. 

Code Sets: Code sets are the permitted values for that category. As can be seen in both 

Example 1 and the Staff Type category table in Example 2, the permitted values from 

which applicants can select Staff Type are: Project Staff, Teachers and Other School 

Professionals, and/or All LEA Staff. 

The Appendices below graphically 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 by Appendix C through H. Appendix I summarizes the technical changes. 

Appendix A: Eligibility Data ....................................................................................................p. 5

Appendix B: Background 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 of Administrative Cost Limit ...............................................................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 System for Indian 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.

ELIGIBILITY DATA

Area Data Items Categories Format Comment

Eligibility 

Data

(1) Applicant Type – The type 

of entity that is applying.

Applicant Type Menu 

Options

(2) Indian Students—Total 

number of Indian students 

with Form 506* on file with 

the applicant entity

Indian category Whole 

number

Calculated 

total

(3) All students—Total 

number of all students in 

district(s) for whom the 

applicant is applying

Whole 

number

*Form 506 is a paper form completed by students or their parents. See next page.

Category Applicant Type

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 School (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 eligibility 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”
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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 completed 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 become part of your child's school record and will not need to be completed 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; or (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 ___________________________________________ Date of Birth ___________________

 (As shown on school enrollment 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 of the

_____ Including Alaska Native _____ Recognized _____ Terminated _____ Definition Above

Name of individual with tribal membership: _____________________________________________

 Individual named is (check one): _____ Child _____ Child's Parent _____ Child's

 Grandparent

Proof of membership, as defined by tribe, band, or group is:

A. Membership or enrollment number (if readily available) _________________________ OR

 Other (explain) _____________________________________________

Name and address of organization maintaining membership data for the tribe, band or group:

 __________________________________________________________

 I verify that the information provided above is accurate:

 PARENT'S SIGNATURE _______________________________________ DATE ____________________

 Mailing Address _______________________________________________ Telephone _________________

Notice: Public Reporting Burden Notice 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 previously approved under I.C. 1810-0021 in March 2007. There are no changes to the 

Background Data section of the EASIE Application for 2012.

BACKGROUND DATA

Area Data Items Categories Format Comment

Background 

Data

(1) Application Type – The 

type of application the LEA(s) 

is submitting.

Application Type 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 

year, inclusive.

Grant Award Start Date Date Field Automatically 

calculated 

end date.

Category Application Type

Definition The type of application the LEA(s) is submitting.

Code Set Regular Formula Grant

Integration of Services under Section 7116

Formula 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 applicant 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 Previous 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 students 

proficient or above

(3) Total number of 

American 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 

American 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 

number of Indian students 

in daily attendance 

computed according to 

Number

PERFORMANCE DATA FROM THE PREVIOUS GRANT YEAR

(Note: A grant application for School Year (SY) 2012-13 funds, for example,

uses SY 2010-11 performance data.)
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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.

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 with 

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 accordance 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 

improvements 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 

improvement during the 

grant year through the 

Indian Education project.

Objective

Grade Level

Service

Frequency

Location

Activities

Menu 

Options

PROFESSIONAL DEVELOPMENT

(Professional Development includes the activities that the applicant will provide to staff to improve 

their capacity to effectively educate Indian students)

Area Data Item Categories Format Comment

Professional 

Development

(1) The professional 

development 

opportunities planned 

using grant funds.

Staff Type

Professional Development 

Opportunity

Menu 

Options
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Category Activities

Definition Activities that will be included in this service.

Code Set ACT or SAT Preparation and Testing

Advanced Placement (AP) Preparation

AP Coursework and Testing

Career and/or College Guidance

Civic Projects

Counseling

Creative Writing

Credit Recovery or Completion

Experiential Learning 

Libraries, Cultural Lending of Materials

Multicultural Affairs or Events

Storytelling

Study Skills Development

Student Clubs with Academic Emphasis

Tutoring: Skill Development Individually

Tutoring: Skill Development in Small Groups

Tutoring: Homework Assistance Individually

Tutoring: 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 Social Studies

Substance Abuse

Technology

Writing

Category Content Area of State Assessment

Definition Content area the data pertains to.

Code Set Mathematics

Reading (Language Arts/English)

Science

Writing
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Category Data Source

Definition Type of assessment.

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 Frequency

Definition Frequency that the service will occur.

Code Set Before School

After School

Evenings

Once a Week

Twice a Week

Three times a Week

Four Times a Week

Daily

Weekends

Once a Month

Twice a Month

Three Times a Month

Bi-weekly

Summer

Quarterly

Semester

Tri-semester

Grading Periods

Year-Round

Special Events
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Category Grade Level

Definition Grade level the data pertains to.

Code Set PKK123456789

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

Writing

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-specific 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

National 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 Writing

Literacy, Family

Math, Intervention

Math, Accelerated

Native American Studies

Native Language Instruction

Pre- Advanced Placement (AP) Preparation

Reading, Accelerated

Reading, Enhancement and Writing

Reading, Family Literacy

Reading, Intervention

Reading Recovery 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 History

Category Staff Type

Definition Specify which staff type will be included in the professional 

development opportunity.

Code Set Project Staff

Teachers and Other School Professionals

All LEA Staff

Other (String Field)
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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 DATA

Areas Data Items Categories Format Comment

Personnel

(1) Personnel – Head count

The number of personnel paid 

for by the grant for each 

personnel type.

Personnel Type

Certification Status

Number Calculated 

Total

(2) Personnel – Percentage

The percentage of time paid for 

by the grant for each personnel 

type.

Personnel Type

Certification Status

Percentage

(3) Personnel – Cost

The costs for each personnel 

type.

Personnel Type

Certification Status

Administrative Cost

Program Cost

Fringe Cost

Numeric 

Dollar 

Value

Calculated 

Totals

Travel

(1) Type of Travel:

-In-district

-Out-of-district

-Professional Development

Administrative Cost

Program Cost

Numeric 

Dollar 

Value

Calculated 

Total

Equipment

(1) Text description and 

Purpose of Equipment Item:

-Instructional Service Delivery

-Program Management

Administrative Cost

Program Cost

Numeric 

Dollar 

Value

Calculated 

Total

Supplies

(1) Purpose of Supply:

-Direct Instructional Delivery

-Student Consumables

-Program Management

Administrative Cost

Program Cost

Numeric 

Dollar 

Value

Calculated 

Total

Contractual

(1) Contractual Purpose:

-Direct Instructional Delivery

-Student Evaluations

-Program Management

-Other (String Field)

Administrative Cost

Program Cost

Numeric 

Dollar 

Value

Calculated 

Total

Other

(1) Purpose of Other Budget 

Items:

-Direct Instructional Delivery

-Student Activities Related to 

Services

-Student Consumables

-Program Management

-Professional Development

-Other (String Field)

Administrative 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
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Category Administrative Cost

Definition The dollar amount that is administrative for Program Management; do 

not include administrative costs in Direct Instructional Delivery, 

Student Consumables, Student 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 Type

Definition Types of personnel who will be involved in the program funded 

through this grant.

Code Set Project Director

Project Coordinator

Academic advisors

Administrative Assistants

College instructors

Consultants

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.
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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 ASSESSMENT DATA

(This details how the state previous school year’s assessment data is used within the LEA

E.g. SY 2010-11 grant applications use 2008-09 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 Way(s) that the LEA is responding to the findings of previous 

assessment(s).

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

1810-0021 if they apply for Indian Education grant funds under Section 7116 of Elementary and 

Secondary Education Act. There are no changes to the Integration of Services section of the 

EASIE Application for 2012.

INTEGRATION 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 

demonstration project that 

integrates the program 

services involved into a 

single, coordinated, 

comprehensive program 

and reduces administrative 

costs by consolidating 

administrative functions. 

(String Field)

Funding Agency

Estimated Amount

String Field 

& Numeric 

Dollar 

Value

Integration of 

Services 

Entities

(1) Entity Providing Service 

– The State, tribal, or local 

agency or agencies to be 

involved in the delivery of 

services integrated under 

the plan.

Service to be Provided

Timeframe for Service 

 Delivery

String Field

Category Estimated Amount

Definition List the estimated amount of this program.

Category Funding Agency

Definition List the funding agencies of the programs being consolidated.

Category Service to be Provided

Definition List the service(s) to be provided.

Category Timeframe for Service Delivery

Definition List the timeframe for service delivery.
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APPENDIX G: This Appendix describes the additional information 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.

WAIVER OF ADMINISTRATIVE COST LIMIT

Areas Data Items Categories Format Comment

Waiver 

Request

(1) Waiver Request – A 

request to waive (under 

Section 9401 waiver 

authority) the Section 

7115(d) statutory 

requirement of a 5% 

administrative 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 applicants 

applying for the 

waiver with the 

current grant 

application 

should supply

this 

information. 

Waiver 

Use 

Report

(1) Waiver Use Report – If 

granted a waiver for the 

previous grant year, the LEA 

must provide additional 

statements about how the 

additional administrative 

funds were used to increase 

the quality of instruction and 

improve student 

achievement

Administrative 

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 request 

from the 

previous grant 

year 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 Explanation, Proposed

Definition Explanation of how waiving the requirement will improve the academic 

achievement of students.

Category Administrative Percentage

Definition The percentage of funds under the previous grant year used for 

administrative purposes.

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 

administrative purposes to increase 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) includes 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 tribes 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 development 

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 

members that are required for PC approval of the application.)

 _____________________________________ ______________________________________ 

Name, Title Date Name, Title Date

 ______________________________________ ______________________________________

Name, Title Date Name, Title Date

 ______________________________________ ______________________________________ 

Name, Title Date Name, 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 I school-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 

purpose of the formula grant program and does not diminish the availability of culturallyrelevant 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 of 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 was 

a selection.

 P. 10 (in bold)

Allows grantee to provide 

a more defined service 

schedule.

There are no substantive changes since the 2010 clearance. The changes identified above 

improve clarity and reduce confusion for the applicant.