For SED use only The State Education Department | Albany, NY 12234 Applicant: Reviewer Checklist: SED Use Only Perkins Title I Adult Program in Secondary Agency Formula Application Application Last Updated (Right-click on this date and Update Field to refresh): 5/17/2018 Application Review YES/NO NA Comments or Missing Information Transmittal letter is enclosed Cover page is signed. Verify contact info Note any new info for Kathy. (If no signature have Kathy contact agency) Applic. Items 1-3 are addressed pertaining to Local Advisory Comm./Council Current Codes Used: Form A 8-12) are completed and signed Recommendations are appropriate Changes to Local Plan are noted (If no signature have Kathy contact agency) Forms L,M are complete Form G is signed Certifications and Assurances are signed. FS-10 submitted with original signature. (If no signature have Kathy contact agency) Effort(s) Year of M.E. Objective Total of Funds being Used to support this M.E. # of Students being Impacted by this M.E. Comments/Notes 1. 0 0 2. 0 0 3. 0 0 4. 0 0 Applicant: For SED use only Budget Related Y/N or subtotal amount Follow Up or Comments Budget cover page info complete with correct dates Code 15 (Salaries of professional staff- employees of fiscal agent only) 0 Code 16 (Salaries of Support Staff- employees of fiscal agent only) 0 Code 40 (Purchase Services- generally outside vendors, contracts) 0
Code 49 (BOCES Services- From other BOCES with some exceptions) 0 Code 45 (Supplies and Materials- unit cost of < $5000) 0 Code 46 (Travel Expenses) 0 Code 80 (Employee Benefits- fiscal agent employees only) 0 Code 90 (Indirect Cost- negotiated for each LEA or BOCES, verify from list) 0 Code 20 (Equipment- unit value > $5000) 0 Sum of all as approved 0 Budget Detail Pages Reviewed/ Summary Page Signed by CEO and SED (If Yes, Original Signature) Person Completing Review and Signing for SED Date (If no CEO signature have Kathy contact agency) Statement of Assurances Signed (If no signature have Kathy contact agency) Certs for Lobbying Debarment Signed (If no signature have contact agency)
Displaced Homemaker $ English Language Learners $ Applicant: Major Effort 2 Perkins Mandated Activities Perkins Mandated Activities Estimated expenditure for the upcoming program year 1. Strengthen the academic and career skills of students participating in career education through integration. $ 2. Link secondary career education and postsecondary career education. $ 3. Provide students with strong experience in and understanding of all aspects of the industry. $ 4. Develop, improve, or expand the use of technology in career education. $ 5. Provide professional development programs to teachers, counselors and administrators. $ 6. Develop and implement evaluations of the career education programs carried out with funds under Title I of Perkins, including an assessment of how the needs of special populations are being met. $ 7. Initiate, improve, expand and modernize quality career education programs. $ 8. Provide services and activities that are of sufficient, size, scope and quality to be effective. $ 9. Provide programs to prepare special populations for high skill, high wage, and high demand occupations. $ Total [auto calculated] $0
B. Approved Restricted Indirect Cost Rate % (B) C. (A) x (B) = Total Indirect Cost (for this Major Effort) [auto calculated] $ 0 (C) [use mouse click, not tab to return to Major Effort 2 budget]