U.S. DEPARTMENT OF EDUCATION

Washington, DC 20202

Fiscal Year 2014

Application Package to Request 

Designation as an Eligible Institution 

Under the Following Title III and Title V Programs: 

 Strengthening Institutions Program (SIP)

 Alaska Native and Native Hawaiian-Serving Institutions (ANNH) 

Program

 Developing Hispanic-Serving Institutions (HSI) Program

 Hispanic Serving-Institutions (STEM and Articulation) Program

 Promoting Post-baccalaureate Opportunities for Hispanic Americans 

(PPOHA)

 Asian American and Native American Pacific Islander-Serving 

(AANAPISI) Program

 Predominantly Black Institutions (PBI) Program

 Waiver of the Non-Federal Cost-Share Requirement

CLOSING DATES:

[Insert Date] for Eligibility Designation 

and

Non-Federal Cost-Share Waiver 

CFDA Number: 84.031H

OMB Number: 1840-xxxx, ED FORM 1049

EXPIRES: [insert date]
TABLE OF CONTENTS

Dear Applicant Letter 1 

Eligibility Highlights 4

Before You Get Started 5

Instructions for Completing the Application

Part I Identity of Applicant Institution 8

Part II Institutional Enrollment 10

Part III Institutional Statistics 11

Part IV Specific Institutional Eligibility 14

 Requirements

Part V Certification 23

APPENDICES

Application For Designation As An Eligible Institution 25

(ED Form 1049)

Federal Register Closing Date Notice Inviting 28

Applications
1

Dear Applicant:

We are pleased to provide the application package for fiscal year (FY) 2014 Designation 

as an Eligible Institution under the following Title III and Title V programs of the Higher 

Education Act of 1965, as amended.

 STRENGTHENING INSTITUTIONS PROGRAM (SIP)

 ALASKA NATIVE AND NATIVE HAWAIIAN-SERVING INSTITUTIONS 

(ANNH) PROGRAM

 DEVELOPING HISPANIC-SERVING INSTITUTIONS (HSI) PROGRAM

 HISPANIC-SERVING INSTITUTIONS STEM and ARTICULATION 

PROGRAM

 PROMOTING POSTBACCALAUREATE OPPORTUNITIES FOR HISPANIC 

AMERICANS (PPOHA)

 ASIAN AMERICAN AND NATIVE AMERICAN PACIFIC ISLANDERSERVING INSTITUTIONS (AANAPISI) PROGRAM

 PREDOMINANTLY BLACK INSTITUTIONS (PBI) PROGRAM

This application package includes the information and instructions that you need to apply 

for eligibility designation. Eligibility designation qualifies an institution of higher 

education (IHE) to apply for grants under the above Title III and Title V programs, 

provided the institution meets certain additional program specific eligibility requirements.

The purpose of these programs is to provide funds to eligible institutions of higher 

education to increase their self-sufficiency by improving their academic programs, 

institutional management, and fiscal stability.

In addition, this application package may be used by IHEs to apply for a waiver of certain 

non-Federal cost-share requirements under the following programs:

 FEDERAL WORK-STUDY (FWS) PROGRAM

 FEDERAL SUPPLEMENTAL EDUCATIONAL OPPORTUNITY GRANTS 

(FSEOG) PROGRAM

 TRIO STUDENT SUPPORT SERVICES (SSS) PROGRAM 

 UNDERGRADUATE INTERNATIONAL STUDIES AND FOREIGN 

LANGUAGE (UISFL) PROGRAM
2

Read this package in its entirety before you begin to complete the application. It is 

essential that you provide sufficient responses to ALL applicable questions and that you 

enter the correct data throughout the application. .

 All institutions interested in applying for a new FY 2014 Title III or Title V grant 

and/or the non-Federal Cost-Share Waiver MUST apply for eligibility

designation by [insert date]. 

 You must reapply for eligibility each year that you wish to apply for a new grant 

award. Even if Title III or Title V grants in subsequent fiscal years are made by

funding down the slate from an FY 2014 competition, an institution would still 

need to be deemed eligible in that fiscal year in order to receive that award.

 IHEs currently receiving Title III or Title V funds do not need to apply for 

eligibility designation unless they intend to apply for a new grant. IHEs 

designated as Historically Black Colleges and Universities or Tribally Controlled 

Colleges and Universities are statutorily exempt from the non-Federal cost-share 

match requirement and do not need to apply for eligibility designation. 

 FY 2014 applicants will report their required student head count figures based 

solely on their 2011 fall semester enrollment. 

 To further assist you in determining the low-income levels of your students, we 

have included (in the Federal Register notice) the 2011 low-income figures, as 

determined by the U.S. Census Bureau. The term “low income individual” means 

an individual from a family whose taxable income for the preceding year did not 

exceed 150 percent of an amount equal to the poverty level established by the 

U.S. Census Bureau.

 To assist you with calculating your institution’s average educational and 

general (E&G) expenditures per Full Time Equivalent (FTE) student, the ED 

Form 1049 has been improved to calculate your institution’s E&G expenditures 

for you. See page 13 for specific instructions. 

 If you are designated as an eligible institution, your waiver of the non-Federal 

cost-share requirement is effective for five consecutive years. You will need to 

request another waiver in [insert date]. 

 If you are a current Title III or Title V grant recipient, you are already entitled to 

the cost-share waiver.

For FY 2014, all applications must be submitted electronically as described in this 

application package. The deadline is [insert date]. 
3

Once you have submitted your eligibility application online, please print a copy of your 

submissions for your records.

If you need further assistance, please contact us at the telephone numbers or e-mail 

addresses cited in this application package. 

Sincerely, 

Leonard L. Haynes, III, Ph.D. 

Senior Director

Institutional Service 

 
4

ELIGIBILITY HIGHLIGHTS

 Please notify the eligibility staff if your institution’s legal name has changed. 

This MUST be done in writing prior to applying for eligibility designation. The 

eligibility staff’s contact information can be found on page 5.

 You must apply for eligibility in your institution’s legal name. Also, if you are 

planning to submit an application for new funds, both applications (i.e., the 

eligibility application and the application for funding) MUST be in the same 

name or your application for funding will be rejected.

 To apply for a waiver of the non-federal cost share requirement, you MUST apply

for eligibility. 

 The term “low income individual” means an individual from a family whose 

taxable income for the preceding year did not exceed 150 percent of an amount 

equal to the poverty level established by the U.S. Census Bureau.

 You have the option to select which program(s) you are applying to for 

Designation as an Eligible Institution.

 Once you submit your eligibility application, the system will determine your 

status. If deemed ineligible, the system will then provide you with the following 

prompt: “Do you want to apply for a waiver?” Click “YES” and then upload 

your waiver narrative.

It is the applicant’s responsibility to upload ALL supporting documentation at the time of 

submission.

 You are responsible for verifying and certifying the accuracy and completeness of 

the data you submit. We are unable to notify institutions of errors or missing

data.

 You must click SUBMIT to officially upload your application. For your 

convenience, a SAVE button has been added to the submission page. 

 Applicants can print their eligibility letters from the eligibility website at: 

http://opeweb.ed.gov/title3and5/. The eligibility homepage list the dates that

letters can be printed. 

 The Department will not mail letters to eligible applicants. Ineligible applicants 

may print their letters from the eligibility Web site.

 Applications must be submitted by 11:59 p.m. Washington, DC time on the 

closing dates with all supporting documentation.
5

BEFORE YOU GET STARTED

Read this entire application package, and collect the required data before you attempt to 

complete the application online. This application package may be obtained using the 

“eligibility” link, at the following Web site:

http://opeweb.ed.gov/title3and5/

For any questions regarding the Eligibility application, you may contact the individuals 

listed below:

Carnisia.Proctor@ed.gov or 202-502-7606

Robyn.Wood@ed.gov or 202-502-7434

Jeffrey.Hartman@ed.gov or 202-502-7607

You will need your institution's unique 8-digit identifier, referred to as the Office of 

Postsecondary Education Identification (OPE ID) number, in order to electronically

retrieve and complete a valid eligibility application form. If your institution’s OPE ID 

number is not readily available, your business office or student financial aid office should 

have your OPE ID number. 

Throughout this application package we refer to certain sections of program regulations. 

In the event that you wish to reference the regulations governing the Title III and Title V 

programs, you may do so at the following Web site:

http://www.ed.gov/legislation/FedRegister/finrule/2001-4/121599a.html

Only individual accredited institutions, including eligible branch campuses, may apply

for designation as an eligible institution. The regulations at 34 CFR Part 606.2(a)(6) and 

607.2(a)(4) outline the accreditation requirements. A higher education system, 

foundation or district may not apply on behalf of individual institutions. 

Only submit data pertinent to your individual institution. Do not include data that is 

reported as part of a single filing by a higher education system or district no matter 

whether your institution normally maintains and submits data to the U. S. Department of 

Education as part of a single filing by a higher education system for all institutions within 

that system or by a district for all institutions within that district. 

Designation As An Eligible Branch Campus

To be designated as an eligible branch campus, the branch campus must meet the needy 

student enrollment requirement, the educational and general (E&G) expenditures 

requirement, and the definition of a branch campus. The regulations at 34 CFR Part 

606.7(b) and 34 CFR Part 607.7(e) define “branch campus” as a unit of a college or 

university that is geographically apart from the main campus and independent of that 

main campus. We consider a unit of a college or university to be independent of the main 
6

campus if the unit is permanent in nature; offers courses for credit and programs leading 

to an associate or bachelor’s degree; is autonomous to the extent that it has its own 

faculty and administrative or supervisory organization; and its own budgetary and hiring 

authority. If your institution is applying for eligibility as a branch campus, provide the 

eligibility data pertinent to the branch campus.

The Government Paperwork Elimination Act (GPEA) of 1998 (P. L. 105-277) and the 

Federal Financial Assistance Management Improvement Act of 1999 (P. L. 106-107) 

encourage us to undertake initiatives to improve our grant processes. Enhancing the 

ability of individuals and entities to conduct business with us electronically is a major 

part of our response to these Acts. Therefore, we are taking steps to adopt the internet as 

our chief means of conducting transactions in order to improve services to our customers 

and to simplify and expedite our business processes.

Note: Some of the procedures for transmitting applications in these instructions differ 

from those in the Education Department General Administrative Regulations (EDGAR) 

(34 CFR 75.102). Under the Administrative Procedure Act (5 U.S.C. 553), the 

Department generally offers interested parties the opportunity to comment on proposed 

regulations. However, these amendments make procedural changes only and do not 

establish new substantive policy. Therefore, under 5 U.S.C. 553(b)(A), the Secretary has 

determined that proposed rulemaking is not required.

All applications and waiver narratives, must be submitted electronically by

[insert date] . 

We are requiring that all FY 2014 applications for eligibility designation be submitted 

electronically at:

http://opeweb.ed.gov/title3and5/

You may submit your application in paper format if you are unable to submit an 

application electronically because:

 You do not have access to the internet; or

 You do not have the capacity to upload the data online.

You must mail or fax a written statement to the Department, explaining which of the two 

grounds for an exception prevent you from using the internet to submit your application, 

no later than two weeks before the application deadline (14 calendar days or, if the 

fourteenth calendar day before the application deadline date falls on a Federal holiday, 

the next business day following the Federal holiday), If you mail your written statement 

to the Department, it must be postmarked no later than two weeks before the application 

deadline date. If you fax your written statement to the Department, we must receive the 

faxed statement no later than two weeks before the application deadline.

Address and mail or fax your statement to: Dr. Nancy Regan, U.S. Department of 

Education, 1990 K Street, N.W., Room 6032, Washington, DC 20006-8513. Fax: (202) 
7

502-7861. Your paper application must be submitted in accordance with the mail or hand 

delivery instructions provided in the official notice published in the Federal Register.

IMPORTANT NOTE: Before submitting your application electronically, double check 

for accuracy and print a copy for yourself. When you press the submit button, the system 

will display a message confirming that you have successfully submitted your application. 

Save and print this confirmation as proof that you have submitted your application 

electronically. If you do not receive this confirmation, you should assume that we did not 

receive your application. Please contact Carnisia Proctor, Robyn Wood or Jeffrey

Hartman (see page 5 for contact information).

You are responsible for verifying and certifying the accuracy and completeness of the 

data you submit. We are unable to notify institutions of errors or missing data. 

Do not wait until the due date to submit your application:

 [Insert date] for Eligibility Designation and the non-Federal Cost-Share Waiver
8

INSTRUCTIONS FOR COMPLETING THE 

APPLICATION (ED Form 1049)

(ELECTRONIC SUBMISSION REQUIRED)

PART I – IDENTITY OF APPLICANT INSTITUTION

ITEM 1. INSTITUTION/CAMPUS OPE ID NUMBER

You will need your institution's unique 8-digit identifier, referred to as the Office of 

Postsecondary Education Identification (OPE ID) number, in order to electronically

retrieve and complete a valid eligibility application form.

ITEM 2. NAME OF INSTITUTION/CAMPUS

Use your institution's complete name. If your institution is a branch campus, use the 

parent institution's name but follow it with the name of the branch campus (see definition 

of branch campus on page 5 of the application package). For example, if you are 

referring to Brockport Campus, you would cite, “State University of New York, 

Brockport Campus”.

Enter the name of the institution in the spaces provided. 

If your institution's name has changed within the last two years, include the former name 

on the appropriate line provided in Part V of the eligibility application form.

ITEMS 3 THROUGH 6.

Self-explanatory. 

ITEM 7. DATA UNIVERSAL NUMBERING SYSTEM (DUNS) NUMBER

Enter your institution’s DUNS number in the spaces provided. 

DUNS Number: Dun and Bradstreet assign your institution's 9-digit DUNS number. 

Your business office will likely know your institution’s DUNS number. If not, you can 

obtain it at no charge by calling 1-800-333-0505 or by completing a DUNS Number 

Request Form. You may obtain the form at:

 

http://www.dnb.com
9

ITEM 8. TYPE OF INSTITUTION

Enter your institution's type: Identify the institution as either a 2-year or 4-year IHE.

If your institution recently changed its status from 2-year to 4-year, identify the 

institution as 4-year.

If the institution offers both undergraduate and graduate education, identify it as a 4-year 

institution.

ITEM 9. CONTROL OF INSTITUTION 

Identify the institution as either a private nonprofit institution or a public institution.
10

PART II - INSTITUTIONAL ENROLLMENT

ITEM 1. TOTAL INSTITUTIONAL ENROLLMENT (Fall 2011 Head Count)

Determine the institution's 2011 fall semester head count of enrolled undergraduate and 

graduate students.

Do not include foreign students who are not eligible to participate in Title IV need-based 

financial assistance programs.

Enter this number in the space provided.

ITEM 2. TOTAL MINORITY ENROLLMENT (Fall 2011 Head Count)

Determine the institution's 2011 fall semester head count of enrolled minority

undergraduate and graduate students.

Do not include foreign students who are not eligible to participate in Title IV need-based 

financial assistance programs. 

The regulations at 34 CFR Part 606.7(b) and Part 607.7(e) define minority student as a 

student who is Hispanic/Latino of any race, Alaska Native or American Indian, Asian

American, Black or African American, Native Hawaiian or Other Pacific Islander. 

Enter this number in the space provided.
11

PART III - INSTITUTIONAL STATISTICS

ITEM 1. NEEDY STUDENT REQUIREMENT

Fill out Part III, Items 1A through 1D, using the following instructions.

ITEM 1.A. FALL 2011 HEAD COUNT ENROLLMENT OF UNDERGRADUATE 

AND GRADUATEDEGREE STUDENTS

Determine the institution's total 2011 fall semester head count of undergraduate and 

graduate students who were enrolled in a degree program. The regulations at 34 CFR 

Part 606.7(b) and at 34 CFR Part 607.7(e) define “degree student” as a student who 

enrolls at an institution for the purpose of obtaining a degree, certificate or other 

recognized educational credential offered by that institution. We consider the transcript 

that a student receives for the successful completion of a two-year transfer program to be 

an “other recognized educational credential.”

Do not include foreign students who are not eligible to participate in Title IV need-based 

assistance programs.

Determine the undergraduate student head count by including all undergraduate students 

who were enrolled in a program that resulted in the award of a bachelor’s degree. 

Include those enrolled in a two-year transfer program and those enrolled in a two-year 

educational program that resulted in the award of an associate degree. Include those 

enrolled in a vocational or technical program of at least two years in length that resulted

in the award of a certificate that testifies that the student qualifies to work as a technician 

or at the semiprofessional level in technological fields. 

Enter the total in the space provided under Part III, Item 1.A.

ITEM 1.B. FALL 2011 RECIPIENTS OF TITLE IV NEED-BASED FINANCIAL 

ASSISTANCE

Determine the institution's total 2011 fall semester unduplicated student head count of 

degree students who received any of the following Title IV need-based assistance: 

Federal Pell Grant, Federal College Work Study, Federal Perkins Loan or Federal 

Supplemental Educational Opportunity Grant. To compute the unduplicated student 

head count, count each student who received Title IV need-based assistance, regardless of 

the number of need-based programs in which the student participated. If a student 

participates in multiple need-based programs, that student is to be counted only 

once. 

Enter the total in the space provided under item Part III, Item 1.B.
12

ITEM 1.C. FALL 2011 ENROLLMENT OF HALF TIME, UP TO AND 

INCLUDING FULL-TIME, UNDERGRADUATE STUDENTS

Determine the institution's total 2011 fall semester undergraduate head count of students 

who were enrolled at least half time in degree programs at your institution. 

Do not include foreign students who are not eligible for Title IV need-based financial 

assistance. 

Enter the total in the space provided under Part III, Item 1.C.

ITEM 1.D. FALL 2011 PELL GRANT RECIPIENTS ONLY

Determine your institution's total 2011 fall semester undergraduate head count of 

students who received Pell Grants for the 2011-2012 academic term. Include Pell Grant 

recipients who were enrolled in a program on at least a half-time basis. 

Enter the total undergraduate head count of Pell Grant recipients in the space provided 

under Part III, Item 1.D.

ITEM 2. EDUCATIONAL AND GENERAL (E&G) EXPENDITURES 

REQUIREMENT

Use the following instructions to complete items 2.A through 2.D. 

ITEM 2.A. UNDERGRADUATE FULL-TIME EQUIVALENT, FALL 2011

ENROLLMENT

Determine your institution's full-time equivalent (FTE) 2011 fall semester enrollment of 

undergraduate students. The regulations at 34 CFR Part 606.7(b) and 34 CFR Part 

607.7(e) describe how to calculate your FTE enrollment and the instructions below 

paraphrase those regulations.

Based on the full-time load at your institution, count a full-time undergraduate student as 

one FTE.

Determine the FTE for part-time undergraduate students by entering the total number of 

credit hours of all part-time undergraduate students. The total will automatically be 

divided by 12. The result is the FTE for part-time undergraduate students.

The system will then add the total (full-time AND part-time) undergraduate students. 

The result is the total number of undergraduate FTE equivalent FY 2011 enrollment.

NOTE: This number should not exceed the total institutional enrollment entered 

under Part II, Item 1.

ITEM 2.B. GRADUATE FULL-TIME EQUIVALENT 2011 FALL 

ENROLLMENT
13

Determine the institution's FTE 2011 fall semester enrollment of graduate students, if 

any, including both full-time and part-time students, as explained here.

Based on the full-time load at your institution, count a full-time graduate student as one 

FTE.

Determine the FTE for part-time graduate students by entering the total number of credit 

hours of all part-time graduate students. That number will automatically be divided by

12. The result is the FTE for part-time graduate students.

Calculate the total graduate FTE by adding the FTE of full-time graduate students to the 

FTE of part-time graduate students, then multiply this total by a factor of 2.5. This final 

figure is the graduate FTE. The use of the 2.5 factor is required by the Department’s 

regulations at 34 CFR 606.4(a) (2) and 607.4(a) (2) to account for higher educational and 

general expenditures for graduate versus undergraduate students.

The system will then add the total (full-time plus part-time) graduate students. The result 

is the total number of graduate FTE equivalent FY 2011 enrollment.

ITEM 2.C. TOTAL EDUCATIONAL AND GENERAL EXPENDITURES

Determine the institution's E&G expenditures for 2011-2012. The regulations at 34 CFR 

Part 606.7(b) and 34 CFR Part 607.7(e) define E&G expenditures as the total amount 

expended by an IHE for: instruction, research, public service, academic support 

(including library expenditures), student services, institutional support, scholarships and 

fellowships, operation and maintenance expenditures for physical plant, and any

mandatory transfers which the institution is required to pay by law. In determining the 

institution's E&G expenditures, total these costs. Do not include Federal student 

financial aid.

Enter the total 2011-2012 E&G expenditures in the space provided under Part III, Item 

2.C.

ITEM 2.D. AVERAGE EDUCATIONAL AND GENERAL EXPENDITURES PER 

FTE STUDENT 

The system will calculate the institution's average E&G expenditures per FTE for 2011-

2012. 
14

PART IV. SPECIFIC INSTITUTIONAL ELIGIBILITY 

REQUIREMENTS

ITEM 1. NEEDY STUDENT REQUIREMENTS 

Use the following calculations to determine whether your institution meets the needy 

student requirement in at least one of two possible ways. 

YOUR INSTITUTION MEETS THE NEEDY STUDENT REQUIREMENT IF:

A. At least 50% of its 2011 fall semester, unduplicated student head count 

of undergraduate degree students received financial assistance under one 

or more of the following programs: Federal Pell Grant, Federal College 

Work-Study, Federal Perkins Loan or Federal Supplemental Educational 

Opportunity Grant Programs (Part III, 1B).

Or

B. The percentage of its 2011 fall semester, undergraduate degree students 

who were enrolled on at least a half-time basis and received Federal Pell 

Grants exceeded the median percentage of undergraduate degree students 

who were enrolled on at least a half-time basis and received Federal Pell 

Grants at comparable institutions that offered similar instruction (Part III, 

1D).

ITEM 1. A. AT LEAST 50% OR MORE OF FALL 2011 DEGREE STUDENTS 

WERE RECIPIENTS OF NEED-BASED FINANCIAL SUPPORT 

If your institution meets the needy student requirement because 50 percent or more of 

its 2011 fall semester enrolled degree students received the above-mentioned Title IV 

need-based financial assistance, select Part IV, Item 1.A. If the percentage turns out to 

be less than 50%, DO NOT select Part IV, Item 1.A. 
15

EXAMPLE: Needy Student Calculation 

To determine whether your institution meets the statutory needy student requirement for 2011-2012, 

divide the number of 2011 fall semester, Title IV recipients (Part III, Item 1.B) by the 2011 fall 

semester enrollment of degree students (Part III, Item 1.A). The result (Part III, 1.B., divided by Part 

III, 1.A) is the percentage of needy students enrolled in the institution for the base year. If the result 

is 50 percent or more, your institution meets the statutory needy student requirement threshold. The 

regulations at 34 CFR Part 606.3(a)(1) and at 34 CFR Part 607.3(a)(1) describe the needy student 

requirement. 

Example

2011 fall semester enrollment (Part III, 1.A) = 800 degree students

2011fall semester Title IV recipients (Part III, 1.B) = 600 students

Percentage of recipients of need-based financial support 

 = 75% (600 divided by 800)

The example institution meets the needy student requirement because 50 percent or more of its 2011

fall semester degree students received need-based financial support.

ITEM 1.B. THE PERCENTAGE OF FEDERAL PELL GRANT RECIPIENTS AT 

THE APPLICANT INSTITUTION EXCEEDED THE MEDIAN PERCENTAGE 

AT SIMILAR INSTITUTIONS. 

If your institution meets the statutory needy student requirement because the percentage 

of its 2011 fall semester enrolled students that received Pell Grants exceeded the median

Federal Pell Grant percentage for its category of institutions (see below), check Part IV, 

Item 1.B. If your percentage does not exceed the median Federal Pell Grant percentage 

for your category of institutions, do not check Part IV, Item 1.B.

If the institution meets both Part IV, Items 1.A and 1.B, check the box next to Part 

IV, Item 1.A only. 
16

EXAMPLE: Needy Student Calculation 

To determine if your institution meets the statutory needy student requirement for 2011, divide the 

number of 2011 fall semester Pell Grant recipients (Part III Item 1.D) by the 2011 fall semester 

enrollment of half-time up to and including full-time degree seeking students (Part III Item 1.C). The 

result (Part III, 1.D, divided by Part III, 1.C) is the percentage of Pell Grant recipients enrolled in the 

institution for the base year. If this result exceeds the "Median Federal Pell Grant Percentage" for your 

category of institutions, your institution meets the statutory needy student requirement threshold. 

Example

 2011 fall semester enrollment of half-time to full-time degree students 

(Part III, 1.C) = 600 

 2011fall semester Pell Grant recipients (Part III, 1.D) = 250) 

 2011 Pell Grant percentage = 41.6% (250 divided by 600)

 

Here are the median Federal Pell Grant percentages or thresholds for base year 2011-2012:

For 2-year public institutions, the median = 37.6%

For 2-year non-profit private institutions, the median =44.1%

For 4-year public institutions, the median = 35.4%

For 4-year non-profit private institutions, the median = 35.5%

Since in our example, the institution’s Pell Grant percentage is greater than the median Pell Grant 

percentage for any category of institution, the example institution meets the needy student requirement. 

ITEM 1.C. REQUESTING A WAIVER OF THE NEEDY STUDENT 

REQUIREMENT 

If the institution does not meet the statutory needy student requirement, under either the 

Title IV need-based financial assistance 50% threshold or the appropriate Pell Grant 

threshold, you may request a waiver of this requirement. Before doing so, review the 

seven possible waiver options below. These options correspond to the seven options 

listed in the regulations at 34 CFR Part 606.3(b) and 34 CFR Part 607.3(b).

Check Part IV, Item 1.C, denoting that you are requesting a waiver. 

After you review the seven possible waiver options for the needy student requirement, 

select the option(s) that applies to your institution’s particular situation. You may apply

for more than one option. 
17

Prepare a separate narrative that provides the required evidence for the chosen 

waiver option(s) and demonstrates that the waiver(s) applies to your particular 

institution. Following the instructions detailed below, the narrative must contain 

compelling evidence. Mere statements of fact may not be enough to support your 

request. Provide supporting documentation (relevant studies, recent reports and/or 

data, etc.) to justify your request for a waiver. It is acceptable to upload 

photocopies of supporting documentation when addressing the waivers.

Needy Student Waiver Option #1, 34 CFR 606.3(b)(1) and 607.3(b)(1)

Provide evidence that the state provided more than 30 percent of your institution’s 

budget for the 2011-2012 base year.

AND

Provide evidence that your institution charged not more than $99.00 per student for 

tuition and fees for the 2011-2012 base year.

Please identify the resources provided by the state, citing specific dollar amounts. Also, 

show actual tuition and fees charged per student, and provide supporting 

documentation such as posted tuition and fees. 

Needy Student Waiver Option #2, 34 CFR 606.3(b)(2) and 607.3(b)(2) 

Provide evidence that at least 30 percent of the students served by your institution in the 

2011-2012 base year were students from low-income families. 

The regulations at 34 CFR Part 606.7(c) and 34 CFR 607.7(e) define a low income 

individual to be one from a family whose taxable income for the base year did not exceed 

150% of an amount equal to the poverty level as determined by the U.S. Census Bureau. 

In the Federal Register Closing Date Notice, we stated the low-income figures for 2011. 

Support your request by providing documentation (statistical and whole numbers 

baseline data) that verifies your claim that at least 30 percent of your enrolled students 

were from low-income families.

Needy Student Waiver Option #3, 34 CFR 606.3(b)(3) and 607.3(b)(3)

Provide evidence that your institution, in the base year, substantially increased the 

higher education opportunities for low-income students who were also educationally 

disadvantaged, or from groups underrepresented in postsecondary education, or 

were minority students. The program regulations at 34 CFR 606.7(b) and 607.7(e) 

define "educationally disadvantaged ", "minority student” and "underrepresented ". 

Include ALL the following information:
18

l. A description of the student body characteristics, including the racial/ethnic 

composition and the number of low-income students, for the 2011-2012 base year.

2. The number of low-income students for the 2011-2012 base year that were 

also educationally disadvantaged, from groups underrepresented in postsecondary

education, or minority students.

3. A description of the programs and services in place during the 2011-2012 base 

year that were specifically designed to increase the educational opportunities for the low 

income students who were also educationally disadvantaged, from groups 

underrepresented in higher education, or minority students.

4. A longitudinal progression detailing the number of these students served by the 

institution’s programs and services during the past five academic periods: 2007-2008, 

2008-2009, 2009-2010, 2010-2011 and 2011-2012.

Needy Student Waiver Option #4, 34 CFR 606.3(b)(4) and 607.3(b)(4) 

Provide evidence that your institution substantially increased the higher education 

opportunities in the 2011-2012 base year for individuals who resided in an area that is 

not included in a "metropolitan statistical area" (MSA) as defined by the Office of 

Management and Budget and who were unserved by other postsecondary institutions.

Include ALL the following information:

1. The geographical areas of residence for enrolled students in the 2011-2012

base year including:

-- The percentage of enrolled students from MSAs; and

-- The percentage of enrolled students from locations outside an MSA.

2. A map or scale drawing showing the geographically isolated or rural nature of 

your institution’s location. Include its geographic relationship to the nearest other 

institution(s) of higher education and nearest MSA; and the mileage between the 

institution and other institutions and the nearest MSA.

3. A description of the geographic barriers and climatic and other conditions that 

limit the options of individuals to attend other institutions.

4. A brief longitudinal progression detailing the number of enrolled students 

served by the applicant institution during the past five academic periods: 2007-2008, 

2008-2009, 2009-2010, 2010-2011 and 2011-2012 who resided in areas outside the 

boundaries of an MSA.
19

Needy Student Waiver Option #5, 34 CFR 607.3(b)(5)

Provide evidence that your institution is located on or within 50 miles of an American 

Indian reservation or of a substantial population of American Indians, and that the 

institution will substantially increase higher education opportunities for American 

Indians. In addressing "higher education opportunities for American Indians;” include 

both student enrollment and retention. 

Include ALL the following information:

1. A map or scale drawing showing your institution's location in relation to the 

American Indian reservation or population center. Include the mileage between the 

institution and the reservation or population center.

2. A description of the student body characteristics for the 2011-2012 base year 

and the two academic years following the base year (2012-2013 and 2013-2014). Include 

the racial/ethnic composition and specifically identify the number and percentage of 

American Indian students by full-time and part-time status.

3. Describe the programs and services in place during the 2011-2012 base year 

and the two academic years following the base year (2012-2013 and 2013-2014) that 

were specifically designed to increase the higher educational opportunities for American 

Indians.

4. Describe your institution's plans to develop and implement programs and 

services specifically designed to increase the higher educational opportunities for 

American Indians.

5. Describe the institution's enrollment goals for American Indian students for the 

next three academic years (2011-2012, 2012-2013 and 2013-2014). Detail the 

institution's plans to meet these goals. 

Needy Student Waiver Option #7, 34 CFR 607.3(b)(7):

Provide evidence that your institution will substantially increase higher education 

opportunities for Hispanic/Latino of any race, Alaska Native or American Indian, 

Asian American, Black or African American, Native Hawaiian or Other Pacific 

Islander, White, Two or More. When addressing "higher education opportunities" 

include both student enrollment and retention. 

Include ALL of the following information:

1. A description of the student body characteristics for the 2011-2012 base year 

and the two academic years following the base year (2012-2013 and 2013-2014). Include 

the racial/ethnic composition and specifically identify the number and the percentage for 

each racial/ethnic group listed above by full-time and part-time status. 
20

 2. Describe the programs and services in place during the 2011-2012 base year 

and the two academic years following the base year (2012-2013 and 2013-2014) that 

were specifically designed to increase the higher educational opportunities for one or 

more of the racial/ethnic groups listed above. 

 3. Describe the programs and services your institution is currently developing

that are specifically designed to increase the higher educational opportunities for one or 

more of the racial/ethnic groups listed above. Include the projected date(s) for the 

implementation of these programs and services.

4. Describe your institution's enrollment goals for one or more of the racial/ethnic 

groups listed above for the next three academic years (2011-2012, 2012-2013 and 2013-

2014). Explain in detail the institution's plans to meet these goals.

PART IV, ITEM 2. EDUCATIONAL & GENERAL EXPENDITURES

REQUIREMENT

Your institution meets the E&G expenditures requirement if its average E&G 

expenditures per FTE student cited in Part III, Item 2.D, is less than the average E&G per 

FTE for the same category of institution. The average 2011-2012 E&G expenditures 

per FTE student for each category of institution is the following:

2- year public institution = $ per FTE student

2- year non-profit private = $ per FTE student

4- year public institution = $ per FTE student

4- year non-profit private = $ per FTE student

PART IV, ITEM 2.A 

Check Item 2.A only if your institution’s 2011-2012 average E&G expenditures per FTE 

are less than the average E&G expenditures per FTE student for its category of 

institution.

PART IV, ITEM 2.B 

Check Item 2.B if your institution exceeded the E&G expenditures threshold and you are 

requesting a waiver. 

Write a justification for each waiver option you are requesting.

Instructions for Selecting Waiver Option(s) for the E&G Expenditures 

Requirement

Review all six waiver options below and select the option(s) that applies to your 

institution’s situation. You may request multiple options. You must submit a written 

justification with the eligibility application form for each option requested. The waiver 
21

option justification narrative must contain compelling evidence that the specific waiver 

condition exists. Mere statements of fact may not be enough to support your request. 

Provide supporting documentation (relevant studies, recent reports and/or data, 

etc.) to justify your request for a waiver. It is acceptable to upload photocopies of 

supporting documentation when addressing the waivers.

E&G Waiver Option #1, 34 CFR 606.4(d)(1) and 607.4(d)(1) 

Low student enrollment in the Fall 2011 distorted your institution’s E&G expenditures 

per FTE undergraduate student and the institution’s eligible designation is otherwise 

consistent with the purposes of the Title III or Title V program. Please show your 

institutions enrollment was low relative to the enrollment before the base year and/or low 

relative to the enrollment after the base year.

Provide detailed evidence to support your claim that low student enrollment in 2011

distorted your E&G expenditures. Show that enrollments in the years prior to and 

after 2011 were greater, citing specific numbers. Please include comparisons with 

similar IHEs.

E&G Waiver Option #2, 34 CFR 606.4(d)(2) and 607.4(d)(2) 

Location of the institution in an unusually high cost-of-living area distorted your 

institution’s E&G expenditures per FTE undergraduate student and the institution’s 

eligible designation is otherwise consistent with the purposes of the Title III or Title V 

program. Provide documentation from a governmental source to substantiate the high 

cost of living in the area.

Cite recent statistics from local, state and/or national levels. Please include 

comparisons with similar IHEs.

E&G Waiver Option #3, 34 CFR 606.4(d)(3) and 607.4(d)(3)

High energy costs distorted your institution’s E&G expenditures per FTE undergraduate 

student and the institution’s eligible designation is otherwise consistent with the purposes 

of the Title III or Title V program. 

Provide documentation to substantiate the high energy costs. Please show 

comparisons with similar IHEs and include supporting documentation.

E&G Waiver Option #4, 34 CFR 606.4(d)(4) and 607.4(d)(4)

An increase in State funding, that was part of a desegregation plan for higher 

education, distorted your institution’s E&G expenditures per FTE undergraduate student 

and the institution’s eligible designation is otherwise consistent with the purposes of the 

Title III or Title V program.
22

Provide documentation to substantiate your request.

E&G Waiver Option #5, 34 CFR 606.4(d)(5) and 607.4(d)(5)

Operation of high cost professional schools such as medical and dental schools or 

technology and health science programs, distorted your institution’s E&G expenditures 

per FTE undergraduate student, and the institution’s eligible designation is otherwise 

consistent with the purposes of the Title III or Title V program.

Provide documentation to substantiate your request. Please include enrollment and 

cost comparisons with similar IHEs.
23

PART V. CERTIFICATION

A duly authorized representative of the institution must check the box in Part V to certify

that to the best of his or her knowledge that all data in the application are true and correct 

and that the applicant institution will comply with the required assurances. By checking 

this box and submitting this application, the applicant institution also certifies that they 

meet the accrediting requirements and, if applicable, meet the definition of a branch 

campus.
24

APPENDICES

Application for Designation As An Eligible Institution

(ED Form 1049)

Federal Register Closing Date Notice Inviting Applications
25

UNITED STATES DEPARTMENT OF EDUCATION

WASHINGTON, D.C. 20006

APPLICATION FOR DESIGNATION AS AN ELIGIBLE INSTITUTION

FISCAL YEAR 2014

CFDA Number: 031H

To apply for grants under

Title III Programs (SIP), (ANNH), (AANAPISI), 

Title V Programs (HSI-STEM and ARTICULATION), (PPOHA) 

and the Predominately Black Institutions (PBI) Programs

Authority: 34 CFR Part 606 and 607 Programs

Important: You are required to provide the information requested

in order to obtain or retain a benefit.

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information 

unless such collection displays a valid OMB control number. The valid OMB control number for this information collection 

is 1840-0103. The time required to complete this information collection is estimated to average 7.00 hours (or minutes) 

per response, including the time to review instructions, search existing data resources, gather the data needed, and 

complete and review the information collection. If you have any comments concerning the accuracy of the time 

estimate(s) or suggestions for improving this form, please write to: U.S. Department of Education, Washington, D.C. 

20202-4561. If you have comments or concerns regarding the status of your individual submission for this form, write 

directly to: Institutional Services, U.S. Department of Education, 1990 K Street, N.W., 6th Floor; Washington, DC 20006-

8513

* This form must be completed electronically.

Part I. Identity of Applicant Institution

1. Institution/Campus OPE ID Number:

2. Name of Institution/Campus Requesting:

3. Address (Street # or P.O. Box and Street Name, City, State, Zip):

4. Contact Person’s Name: (Last Name, First Name, Middle Initial):

5. Contact Person’s Title, Phone Number, Extension:

6. E-mail Address:

7. Data Universal Numbering System (DUNS Number):

8. Type (mark one): ( ) 2-Year Institution ( ) 4-Year Institution

9. Control (mark one): ( ) Private Non-Profit Institution ( ) Public Institution

Part II. Institutional Enrollment

1. Total Institutional Enrollment (Fall 2011 Head Count):

2. Total Minority Enrollment (Fall 2011 Head Count):

Part III. Institutional Statistics

1. Needy Student Requirement

A. Fall 2011 Head Count Enrollment of Undergraduate and Graduate Degree Students:
26

B. Fall 2011 Recipients of Title IV Need-Based Financial Assistance:

(Include Only Pell Grant, Supplemental Educational Opportunity Grant, College Work Study, and Perkins Loan)

C. Fall 2011 Enrollment of Half-Time up to and including Full-Time Undergraduate 

Students:

D. Fall 2011 Pell Grant Recipients:

2. Educational & General Expenditures Requirement (E&G)

A. Undergraduate Full-Time Equivalent Fall 2011 Enrollment

a. Total Full-Time Undergraduate Students: 

b. Total Number of Credit Hours for all Part-Time Undergraduate Students: 

B. Graduate Full-Time Equivalent Fall 2011 Enrollment:

a. Total Full-Time Graduate Students: 

b. Total Number of Credit Hours for all Part-Time Graduate Students: 

C. Total 2011-2012 Educational & General Expenditures (E&G):

D. Average 2011-2012 E&G per FTE = C/(A+B):

Part IV. Specific Institutional Eligibility Requirements

1. Needy Student Requirement (mark A, B. or C)

( ) A. According to the result, after dividing item 1B by item 1A in Part III of this form, at 

least 50% of Degree Students are recipients of Need-Based Financial Support; or

( ) B. According to the result, after dividing item 1D by item 1C in Part III of this form, our 

enrollment exceeds the pertinent threshold for Substantial Percentage of Students 

Receiving Pell Grants for the 2011-2012 year.

( ) C. Requesting Waiver (Section 607.3(b) and Section 606.3(b) option(s):

Check an option, and attach the narrative justification to this form.

AND

2. Educational & General Expenditures Requirement (mark A or B)

( ) A. The E&G expenditures per FTE Student are less than the pertinent threshold for 

base year 2011-2012.

( ) B. Requesting Waiver (Section 607.4(c) and (d) and Section 606.4(c) and (d) 

option(s):

Check an option, and attach the narrative justification to this form.
27

Part V. Certification

(Although this Certification requirement is waived for applicants applying online,

the Department reserves the right to require a signed form on request.)

To the best of my knowledge and belief, all data in this application are true and correct. The 

governing body of the applicant has duly authorized this document and the applicant will comply 

with the required assurances. We meet the accrediting requirements and, if applicable, we meet 

the definition of a branch campus as defined in 34 CFR Part 606.7(b) and 34 CFR 607.7(e).

Authorized Representative's Typed Name and Title:

Date:

Authorized Representative's Signature:

Phone Number:

Fax Number:

Former Name of Applicant:

Institution/Campus (if applicable)”

Form Approved - OMB No. 1840-0103 Expiration Date 03/31/2014

ED Form 1049 (Revised 11/99), Replaces ED Form 1049, Revised 8/95 which is obsolete.

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