Form 1 LSA Community-based Application

Learn and Serve America Higher Education

Grant Application Instructions

Table of Contents

Important Notice page 2

Application Overview page 3

Submission Procedures Date and Time page 4

Eligibility Information page 5

Contents of the Grant Application page 6

Application Narratives page 7

Performance Measures page 9

Required Documents page 10

Appendix A SF 424 Facesheet (Application for Federal Assistance) page 11

Appendix B Certifications and Assurances page 12

Appendix C Budget Instructions page 17

IMPORTANT NOTICES

These application instructions conform to the Corporation for National and Community Service’s (the Corporation) online grant application system, eGrants. The eGrants system is designed to serve the Corporation’s applicants and grantees. All Corporation funding announcements are posted on our web site www.cns.gov and at www.grants.gov.

Public Burden Statement: The Paperwork Reduction Act of 1995 requires the Corporation to inform all potential persons who are to respond to this collection of information that such persons are not required to respond unless it displays a currently valid OMB control number. (See 5 CFR 1320.5(b)(2)(i)).

Time Burden: The time required to complete this collection of information is estimated to average 8 hours per applicant, including the time to review instructions; search existing data resources; gather the data needed; and complete and review the information collection before submitting.

Use of Information: The information collected constitutes an application to the Corporation for grant funding. The Corporation evaluates the application and makes funding decisions through the Corporation’s grant review and selection process.

Effects of Non-Disclosure: Providing this information is voluntary; however, failure to provide the information would not allow the Corporation to assess the applicant’s request for funding. Therefore it would not be possible to consider granting funds to the applicant.

Privacy Act: Information provided for this collection may be shared with federal, state, and local agencies for law enforcement purposes.

Application Overview

Before you begin developing your application, please review the following documents:

• Notice of Funding Availability (NOFA)

Guidance on specific Learn and Serve America grant competitions, including funding availability, how to apply, deadlines for applying, and selection criteria.

• Application Instructions (below)

Application questions and instructions on how to complete the Standard Form 424 application for federal assistance for Learn and Serve America.

• Budget Instructions (below)

Program-specific instructions for Learn and Serve America Higher Education grants.

Each section of this Learn and Serve America application guidance contains the information needed to complete a high-quality application. You must follow the guidance and address the items specific to this competition.

The above documents are available electronically at: http://www.learnandserve.gov/for_organizations/funding/index.asp

• Learn and Serve America School and Community-Based Grant Provisions:

http://www.learnandserve.org/pdf/grantmaking_prov_06.pdf

Applicants are required to:

• Submit applications by the posted deadline.

• Adhere to the character limits listed in the narrative sections below¹.

• If requested, make available financial statements, audits, and recent evaluations of your program available during the application review process. Do not submit any other supplementary materials such as annual reports, videos, brochures, letters of support, or any supplementary material not requested in the application.

Submission Procedures Date and Time

If you have questions about Learn and Serve America application procedures, please contact xxx- or[email protected].

Applying Online using the eGrants System

The Corporation requires that applicants make every effort to submit their applications electronically using eGrants, the Corporation’s integrated, secure, web-based system for grants application and management. Go to http://www.learnandserve.gov/egrants/ and create an eGrants account (if you do not already have one) to begin the process of submitting your application online. Instructions on how to create an account are available at this website.

The Corporation strongly encourages you to create an eGrants account and begin completing your application at least three weeks prior to the final submission deadline. This will allow you time to address technical issues prior to the deadline.

Submission Deadline

The deadline for eGrants application submissions is 5:00 p.m. Eastern Time on xx.

If you are unable to submit your application using eGrants, you may submit a paper application along with a diskette or CD Rom with an exact duplicate of your application to the Corporation for National and Community Service, Learn and Serve America, 1201 New York Avenue, NW, Washington, DC 20525 by 5:00 p.m. Eastern Time on the working day after the due date. Applicants should use an overnight mailing service to ensure applications arrive on time. Applicants should not send proposals via the United States Postal Service due to security screening-related delays.

Eligibility Information

Eligible Applicants

Applicants eligible for Learn and Serve America School-Based funds are State Education Agencies, SEAs, GMEs (grantmaking entities), and Indian Tribes and U.S. Territories.

Applicants eligible for Learn and Serve America Community-Based funds under are State Service Commissions and GMEs. GMEs are defined as public or private non-profit organizations in existence at least one year at the time of application, experienced with service-learning, and proposing to make subgrants in two or more states.

GMEs are defined as public or private nonprofit organizations in existence at least one year before the time of application that are experienced in service-learning and proposing to make subgrants in two or more states. Local partners may include private and public schools, for-profit businesses, faith-based and other nonprofits, and institutions of higher education. The local partnerships are responsible for implementation, replication, and expansion of service-learning activities in local communities. Indian Tribes and U.S. Territories are not required to make subgrants.

Match Requirements

The grantee share of the total cost (grantee + Corporation share) of carrying out a program must be at least:

1. • 10 percent for the first year

2. • 20 percent for the second year

3. • 30 percent for the third year

4. • 50 percent for the fourth and any subsequent year

For example, if an applicant new to Learn and Serve America applies for $450,000 in each of three years, the minimum match required would be: $50,000 in Year One (10 percent of $500,000), $112,500 in Year Two, and $192,858 in Year Three. Previous grantees requesting a $450,000 grant must match at least $450,000, or 50 percent of the total budget amount for each year. Applicants who have been only a sub-recipient of Learn and Serve America funds in the past will be considered a new grantee in this competition.

The grantee’s share of the program cost can be in cash or in kind, which may include facilities, equipment, or services. The grantee’s share may come from private, state, or federal sources. In the case of federal sources, the funds of another agency may only be used as match if the other agency permits such use.

Project Period

 

The project period for Learn and Serve America grants is generally three years. Unless otherwise instructed, proposals should include a detailed three year project overview. Please carefully note the competition-specific instructions for submitting the proposed project budget. In some cases, funding is awarded for the first year of operation with subsequent years of funding provided through Continuation Requests as noted below. In other cases, Learn and Serve may award funding for the full project period through the initial grant award.

 

Continuation Funding

 

If not provided in full through the initial award agreement, funding for subsequent years of an approved program is contingent upon: 1) Satisfactory progress toward meeting approved performance objectives; 2) the availability of funds via Congressional appropriation; 3) the timely submission of continuation requests; 4) consistent, timely compliance with all reporting requirements; and, 5) any other criteria established in your award agreement.

Multiple Submissions

Legal Applicants can submit only one application under each grant competition.

Contents of the Grant Application

Your completed application consists of the following components. Please make sure to complete each one.

1. Standard Form 424 Facesheet

2. Applicant Info

3. Application Info

4. Narrative

5. Performance Measures

6. Documents

7. Budget

8. Funding/Demographics

9. Review and Submit

10. Survey on Ensuring Equal Opportunity for Applicants (Optional)

I. Standard Form 424 Facesheet

The Standard Form-424 facesheet is required for applications submitted for federal assistance. The SF-424 contents are duplicated in eGrants, although the format is different. (See Appendix A.)

Note: When completing the application in eGrants, a number of the below boxes will already be completed through the process of setting up an account for the applicant organization and individual program contact.

II. Applicant Info

After you create your eGrants account, begin by selecting “New” from your Home Page. Select “Learn and Serve America” as the Program Area and click “Go.” You will then be asked to select a NOFA. Choose: Learn and Serve America xxx. Once you create an application, you will be allowed to edit as needed until you are ready to submit.

When you want to return to a previously started application, it will now appear under View My Grants/Applicants in the status For Grantee Edit or Action. Clicking on this option will allow you to re-enter your application. Do not use the New button again.

Please note that the Authorized Representative name is blank. You cannot select a name for this field. Instead, the Authorized Representative will need to have his/her own account to click on the Assurances and Certifications at the end of the application. (Part VIII below)

Under Project Information select, “enter new” and choose a title for your project. You can enter another address for the project, which may or not be the same as that of the Legal Applicant.

To select an individual as the Project Director, choose a name from the pull-down menu or add a new contact.

III. Application Info

Areas affected by the project: List only the largest political or municipal entities affected (e.g., counties and cities).

Enter the dates for the proposed project start and end dates. Your project period is up to three years and may begin xxx.

Intergovernmental Review of Federal Programs: This program is NOT subject to Executive Order 12372.

Delinquent on any federal debt: Check the appropriate box. This question applies to the applicant organization, not the person who signs as the authorized representative. Categories of debt include delinquent audit allowances, loans, and taxes. If Yes, type your explanation in the text box provided.

State Application Identifier: Enter N/A.

Note: Falsification or concealment of a material fact or submission of false, fictitious or fraudulent statements or representations to any department or agency of the United States Government may result in a fine of not more than $10,000 or imprisonment for not more than five (5) years, or both. (18 U.S. Code Section 1001)

IV. Narrative Sections

Sections 1-8 are text boxes in eGrants. Click on the heading of each one to enter text, or cut and paste your text into the box.

1. Executive Summary—Briefly summarize your proposed program. Include the projected number of participants, subgrantees (if applicable), service project goals, and main activities.

2. Summary of Accomplishments—Briefly summarize the accomplishments from prior Learn and Serve and/or other Corporation program funds you have received.

3. Three Year Plan –All applicants must submit a program plan that outlines major goals, key tasks, and corresponding dates for the development and management of your proposed program. Please refer to the grant purpose and selection criteria listed in the Notice of Funds Available when completing your project plan.

4. Needs and Service Activities

Needs: Describe the specific community needs your program will address and how these needs were identified.

Strategy: Describe your strategy for meeting those needs and your rationale for that strategy.

Description of Activities: Describe your proposed Service-Learning activities and how they support your strategy.

5. Strengthening Communities

Community Partnerships: Describe the community partnerships you intend to develop, including well-defined roles for private schools, and/or faith- and/or community-based organizations where appropriate.

Sustainability: Describe how your program will work to institutionalize Service-Learning at the grantee and, if appropriate, subgrantee levels.

Adult Volunteers: Describe how you will generate additional adult volunteers to support or help coordinate your efforts. Estimate the number of volunteers you expect to recruit.

6. Developing Participants

School and Community-Based Participants are defined as youth aged 5-17 engaged in service through the program.

Support: Describe your plans for involving participants in the program planning as well as training, supervising, developing, and recognizing participant efforts.

Citizenship: Describe your plan to ensure participants in your program develop civic responsibility; attaining new levels of citizenship knowledge, skills and attitudes, and developing life-long habits of service.

Disadvantaged Youth: Describe strategies for engaging and/or serving disadvantaged youth in your program model.

Diversity: Describe how your program will provide opportunities for participants and volunteers to serve together with people of different backgrounds (such as ethnicity, race, religion, socioeconomic status, age and physical ability).

7. Organizational Capacity

This section refers to the capacity of the applicant to manage a federal grant, effectively lead a group of subgrantees (where applicable), and complete the project plan.

Applicants should include the following subheadings in this section of their applications: 1) Program/Fiscal Oversight, 2) Federal Grant Experience/Track Record, 3) Staff Roles and Experience, 4) Evaluation Plan, and 5) Training and Technical Assistance (T/TA).

1. Program/Fiscal Oversight. Applicants must be capable of providing sound fiscal management and oversight. Fiscal and program oversight plans should include the type and frequency of monitoring of subgrantees and partner sites as appropriate.

2. Federal Grant Experience/Track Record. Applicants must provide evidence that they have had the experience and/or the capacity to manage federal grants. If applicable, applicants should also be capable of assessing the capacity of subgrantees, and the proposal should describe the plan for this.

3. Staff Roles and Experience. Applicants should list the key personnel who will oversee and implement their program, describe their roles and responsibilities, and their experience administering federal grants. Applicants must ensure that qualified personnel who have appropriate experience in service-learning and program and fiscal management are responsible for program operations.

4. Evaluation Plan. The evaluation plan should contain the strategies grantees will use to track progress toward meeting the performance measures. Applicants are strongly encouraged to allocate ample resources for program evaluation. Grantees and subgrantees may consider an independent evaluation and/or seeking support from higher education or other experts to help design data collection and evaluation system.

5. Training and Technical Assistance. It is the grantee’s responsibility to ensure that subgrantees have the training and support they need to develop strong partnerships, build the capacity of community partners to meet community needs through service-learning, and sustain support for institutionalization.

8. Budget/Cost Effectiveness

1. Explain how your program builds community support for your program at the local, state and national levels.

2. Describe the other sources of support used by your program and your plans and ability to expand this support.

3. Describe plans for supporting Learn and Serve national identity and publicizing your program.

IV. Performance Measures

Before you complete this section please see Performance Measurement Guidance for Learn and Serve America at http://www.servicelearning.org/nslc/perf_measurement/index.php.

Your performance measures should be clearly linked to the program narrative and focus on the particular issue(s) or need(s) that will be addressed. Performance measures can cover a period of up to three years, with targets set for each year, whenever feasible, based on the type of data collected.

When entering your performance measures in the Performance Measures section, please note:

• You will need to select the Issue Area and Service Categories that represent the core activities of your program;

• All Performance Measures must have an output, intermediate outcome and end outcome measure; (A total of three measures, with 3 parts for each measure, must be submitted.)

• Measures will have associated pull-downs (population measured, indicator, target and instrument) that must be completed. If you select “Other,” you must indicate what that means in the narrative box. If you do not select “Other,” anything typed in the narrative box will not be saved.

VI. Documents

The default setting in eGrants is “Not Sent.” If you do not change this status, eGrants will not verify your application for submission. “Sent” documents must arrive at CNCS within 5 working days after the application deadline. Please note your eGrants Application ID # on the documents you send. They should be mailed to: Corporation for National and Community Service, Learn and Serve America, 1201 New York Avenue, NW, Washington, D.C. 20525.

1. A133 Audit Report or Financial Statement

The Corporation may request applicants’ financial information after approval of a grant application and prior to award. Nonprofit organizations and US Tribes must be prepared to submit either the most recent A133 Audit report (for organizations who expend $500,000 or more of federal funds annually), or your organization’s most recent financial statement upon request.

Learn and Serve America applicants are NOT required to submit an A133 or other audit at the time of application and should select “Not Applicable” on the eGrants documents screen.

2. Previous Evaluations of Program Activities

If you have conducted a recent (within the past 2 years) evaluation of previous program activities, you may be asked to provide a copy of this evaluation during the grant application review process.

Learn and Serve America applicants are NOT required to submit an evaluation at the time of application and should select “Not Applicable” on the eGrants documents screen.

3. No Additional Appendices

We cannot accept any additional appendices with this application. Any additional documents you send will not be reviewed.

VII. Budget

Please see Budget Instructions in Appendix C.

VIII. Funding/Demographics

Please enter the approximate number of participants you expect to engage in community service and service-learning activities over the full project period

IX. Review, Authorize and Submit

eGrants requires that you review and verify your entire application before submitting. Read the Authorization, Assurances, and Certifications carefully. Complete each section of the Assurances and Certifications by clicking on “I Agree.”

Certifications and Assurances (Appendix B)

The Authorized Representative must carefully read the assurances and certifications. He/she must complete the form that certifies that your organization will comply with the required Federal assurances and certifications. In eGrants, the Authorized Representative must log on to the system using his/her own account and verify that he/she has read them.

X. Survey on Ensuring Equal Opportunity for Applicants (Optional)

APPENDIX A – FACESHEET (Form SF424)

APPLICATION FOR FEDERAL ASSISTANCE						1. TYPE OF SUBMISSION: Application Non-Construction
2. DATE SUBMITTED TO CORPORATION FOR NATIONAL AND COMMUNITY SERVICE (CNCS):		3. a. DATE RECEIVED BY STATE:      				3.b. STATE APPLICATION IDENTIFIER:      
     		4. a. DATE RECEIVED BY CNCS:      				4.b. CNCS GRANT NUMBER:      
5. APPLICANT INFORMATION
5a. LEGAL NAME:       5b. ORGANIZATIONAL UNIT:      				5d. NAME AND CONTACT INFORMATION FOR PROJECT DIRECTOR OR OTHER PERSON TO BE CONTACTED ON MATTERS INVOLVING THIS APPLICATION (give area codes):
5c. ADDRESS (give street address, city, county, state and zip code):                  				NAME:       TELEPHONE NUMBER: (     )       -       FAX NUMBER: (     )       -       INTERNET E-MAIL ADDRESS:       WEBSITE:      
6. EMPLOYER IDENTIFICATION NUMBER (EIN):                  				7.a. TYPE OF APPLICANT: (enter appropriate letter in box) A. State H. Independent School District B. County I. State Controlled Institution of Higher Learning C. Municipal J. Private University D. Township K. Indian Tribe E. Interstate L. Individual F. Intermunicipal M. Profit Organization G. Special District N. Private Non-Profit Organization O. Other (specify) 7.b. CNCS APPLICANT CHARACTERISTICS Enter appropriate code in each blank: ______, ______, ______, ______, ______
8. TYPE OF APPLICATION (Check appropriate box): NEW NEW/PREVIOUS GRANTEE CONTINUATION AMENDMENT If Revision, enter appropriate letter(s) in box(es):     A. AUGMENTATION: B. BUDGET REVISION: C. NO COST EXTENSION: to       (enter date) E. OTHER (specify below):      
				9. NAME OF FEDERAL AGENCY: Corporation for National and Community Service
10. CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER:           Name of Program ___________________________________________­__________________________________________				11. a. TITLE OF APPLICANT’S PROJECT:                  
12. AREAS AFFECTED BY PROJECT (List Cities, Counties, States, etc.):                  				11.b. CNCS PROGRAM INITIATIVE (IF ANY):
13. PROPOSED PROJECT: START DATE:       END DATE:            
14. ESTIMATED FUNDING: Check applicable box: Yr 1: Yr.2: or Yr 3:					15. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE ORDER 12372 PROCESS? a. YES. THIS PREAPPLICATION/APPLICATION WAS MADE AVAILABLE TO THE STATE EXECUTIVE ORDER 12372 PROCESSS FOR REVIEW ON: DATE ___________________________________ b. NO. PROGRAM IS NOT COVERED BY E.O. 12372 OR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR REVIEW 16. IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT? YES If “Yes,” attach an explanation. NO
a. FEDERAL	$      
b. APPLICANT	$      
c. STATE	$      
d. LOCAL	$ N/A
e. OTHER	$ N/A
f. PROGRAM INCOME	$ N/A
g. TOTAL	$      
17. TO THE BEST OF MY KNOWLEDGE AND BELIEF, ALL DATA IN THIS APPLICATION/PREAPPLICATION ARE TRUE AND CORRECT, THE DOCUMENT HAS BEEN DULY AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED.
a. TYPED NAME OF AUTHORIZED REPRESENTATIVE:      			b. TITLE:      				c. TELEPHONE NUMBER:      
d. SIGNATURE OF AUTHORIZED REPRESENTATIVE:							e. DATE SIGNED:

Modified Standards Form 424-(Rev. 4/03 to conform to the CNCS eGrants system)

APPENDIX B Assurances and Certifications

Instructions

By signing and submitting this application, as the duly authorized representative of the applicant, you certify that the applicant will comply with the Assurances and Certifications described below.

a) Inability to certify

Your inability to provide the assurances and certifications listed below will not necessarily result in denial of a grant. You must submit an explanation of why you cannot do so. We will consider your explanation in determining whether to enter into this transaction. However, your failure to furnish an explanation will disqualify your application.

b) Erroneous certification or assurance

The assurances and certifications are material representations of fact upon which we rely in determining whether to enter into this transaction. If we later determine that you knowingly submitted an erroneous certification or assurance, in addition to other remedies available to the federal government, we may terminate this transaction for cause or default.

c) Notice of error in certification or assurance

You must provide immediate written notice to us if at any time you learn that a certification or assurance was erroneous when submitted or has become erroneous because of changed circumstances.

d) Definitions

The terms “covered transaction”, “debarred”, “suspended”, “ineligible”, “lower tier covered transaction”, “participant”, “person”, “primary covered transaction”, “principal”, “proposal”, and “voluntarily excluded” as used in this clause, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. An applicant shall be considered a “prospective primary participant in a covered transaction” as defined in the rules implementing Executive Order 12549. You may contact us for assistance in obtaining a copy of those regulations.

e) Certification requirement for subgrant agreements

You agree by submitting this proposal that if we approve your application you shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by us.

f) Certification inclusion in subgrant agreements

You agree by submitting this proposal that you will include the clause titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion-Lower Tier Covered Transactions,” provided by us, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions.

g) Certification of subgrant principals

You may rely upon a certification of a prospective participant in a lower-tier covered transaction that is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless you know that the certification is erroneous. You may decide the method and frequency by which you determine the eligibility of your principals. You may, but are not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Programs.

h) Non-certification in subgrant agreements

If you knowingly enter into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, we may terminate this transaction for cause or default.

i) Prudent person standard

Nothing contained in the foregoing may be construed to require establishment of a system of records in order to render in good faith the assurances and certifications required. Your knowledge and information is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.

ASSURANCES

As the duly authorized representative of the applicant, I certify, (to the best of my knowledge) and belief, that the applicant:

OMB STANDARD ASSURANCES:

• Has the legal authority to apply for federal assistance, and the institutional, managerial, and financial capability (including funds sufficient to pay the non-federal share of program costs) to ensure proper planning, management, and completion of the program described in this application.

• Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the state, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives.

• Will establish safeguards to prohibit employees from using their position for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain.

• Will comply with all rules regarding screening, including background checks of program staff and participants.

• Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.

• Will comply with all rules regarding prohibited activities, including those stated in applicable application guidelines, grant provisions, and program regulations, and will ensure that no assistance made available by the Corporation will be used to support any such prohibited activities.

• Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. 4728-4763) relating to prescribed standards for merit systems for programs funded under one of the statutes or regulations specified in Appendix A of OPM’s Standards for a Merit System of Personnel Administration (5 CFR 900, Subpart F).

• Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color, or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. 1681-1683, and 1685-1686) which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 794), which prohibits discrimination on the basis of handicaps (d) The Age Discrimination Act of 1975, as amended (42 U.S.C. 6101-6107), which prohibits discrimination on the basis of age; (e) The Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) sections 523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee-3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the National and Community Service Act of 1990, as amended; and (j) the requirements of any other nondiscrimination statute(s) which may apply to the application.

• Will comply, or has already complied, with the requirements of Titles II and III of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of federal or federally assisted programs. These requirements apply to all interests in real property acquired for program purposes regardless of federal participation in purchases.

• Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. 1501-1508 and 7324-7328) which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds.

• Will comply, as applicable, with the provisions of the Davis-Bacon Act (40 U.S.C 276a and 276a-7), the Copeland Act (40 U.S.C 276c and 18 U.S.C. 874), and the Contract Work Hours and Safety Standards Act (40 U.S.C. 327-333), regarding labor standards for Federally assisted construction sub-agreements.

• Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires the recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000 or more.

• Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of program consistency with the approved state management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C 1451 et seq.); (f) conformity of federal actions to State (Clean Air) Implementation Plans under Section 176(c) of the Clean Air Act of 1955, as amended (42 U.S.C. 7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended (P.L. 93-523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended (P.L. 93-205).

• Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C 1271 et seq.) related to protecting components or potential components of the national wild and scenic rivers system.

• Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. 470), EO 11593 (identification, and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16U.S.C. 469a-l et seq.).

• Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance.

• Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. 2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance.

• Will comply with the Lead-Based Paint Poisoning Prevention Act (42 U.S.C. 4801 et seq.) which prohibits the use of lead based paint in construction or rehabilitation of residence structures.

• Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act of 1984, as amended, and OMB Circular A-133, Audits of States, Local Governments, and Non-Profit Organizations.

• Will comply with all applicable requirements of all other Federal laws, executive orders, regulations, application guidelines, and policies governing this program.

CERTIFICATIONS

1. Lobbying (Activities)

This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 34 CFR Part 85, Section 85.510, Participants’ responsibilities.

1. No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer of Congress in connection with the making of any federal grant, the entering into of any cooperative agreement, and the extension, renewal, amendment or modification of any federal grant, or cooperative agreement;

2. If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal grant or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions;

3. The undersigned shall require that the language of this certification be included in the award documents for all tiers (including subawards, subgrants, contracts under grants and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.

2. Debarment, Suspension, and Other Responsibility Matters

As required by Executive Order 12549, Debarment and Suspension, and implemented at 34 CFR Part 85, Sections 85.105 and 85.510,

A. As the duly authorized representative of the applicant, I certify, to the best of my knowledge and belief, that neither the applicant nor any of the principals:

(a) Are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency.

(b) Has, within a three-year period preceding this application, been convicted of, or had a civil judgment entered against them for commission of fraud or other criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction or records, making false statements, or receiving stolen property.

(c) Is presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (2) (b) of this certification, and

(d) Has not, within a three-year period preceding this application, had one or more public transactions (Federal, State or local) terminated for cause or default and

B. Where the applicant is unable to certify to any of the statements in this certification, he or she shall attach an explanation to this application.

3. Drug-Free Workplace (Grantees other than Individuals)

As required by the Drug-Free Workplace Act of 1988, and implemented at 34 CFR Part 85, Subpart F. The regulations require certification by grantees, prior to award, that they will maintain a drug-free workplace. The certification set out below is a material representation of fact upon which reliance will be placed when the agency determines to award the grant. False certification or violation of the certification may be grounds for suspension of payments, suspension or termination of grants, or government-wide suspension or debarment (see 34 CFR Part 85, Section 85.615 and 85.620).

The applicant certifies that it has or will continue to:

(a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the grantee’s workplace and specifying the actions that will be taken against employees for violation of such prohibition;

(b) Establish an ongoing drug-free awareness program to inform employees about—

(1) the dangers of drug abuse in the workplace,

(2) the grantee’s policy of maintaining a drug-free workplace.

(3) any available drug counseling, rehabilitation, and employee assistance programs, and

(4) the penalties that may be imposed upon employees for drug abuse violations occurring in the workplace;

(c) Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement required by paragraph (a);

(d) Notifying the employee in the statement required by paragraph (A) that, as a condition of employment under the grant, the employee will:

(1) abide by the terms of the statement, and

(2) notify the employer, in writing of his or her conviction for a violation conviction for a violation of any criminal drug statute occurring in the workplace no later than five days after such conviction.

(e) Notifying the agency in writing within ten days after receiving notice under subparagraph (d) (2)) from an employee or otherwise receiving actual notice of such conviction;

(f) Taking one of the following actions, within 30 days of receiving notice under subparagraph (d) (2), with respect to any employee who is so convicted—

(1) Taking appropriate personnel action against such an employee, up to and including termination…; or

(2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency;

G. Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (a), (b), (c), (d), (e) and (f)

APPENDIX C – Budget Instructions

Learn and Serve America

School-and community-Based Budget Instructions

The budget narrative must provide a full explanation of associated costs including their purpose, justification, and the basis of your calculations. Where possible, your calculations should be presented in an equation format, identifying the number of persons or items involved, the per person or unit cost, and/or the annual salary cost.

Summary of statutory budget requirements for School-Based applicants:

All Corporation for National and Community Service (CNCS) School-Based Learn and Serve America (Learn and Serve) budgets must conform to the following statutory requirements:

• You must match, with cash or in-kind contributions, at least 10% of the project’s total costs for year one of the grant, 20% for the second year continuation, and at least 30% for the third year continuation. Grantees who have received Learn and Serve America funding for more than three years must provide at least 50% of the total program costs (a minimum of a dollar for dollar match) for each year. The source(s) may be federal (non-CNCS), state, or local (public or private).

• You must allocate at least 10%, and not more than 15%, of the CNCS share to planning and capacity building costs (Section I of your budget). State Education Agencies and Indian tribes can request a waiver to allocate up to 20% for this category.

• Equipment costs can not exceed 10% of the total CNCS share.

• Administrative Indirect costs can not exceed 5% of the total CNCS funds requested.

Consistency of treatment: To be allowable under this award, costs must be consistent with policies and procedures that apply uniformly to both federally financed and other activities of the applicant. Furthermore, the costs must be accorded consistent treatment in both federally financed and other activities as well as between activities supported by different sources of federal funds.

Summary of statutory budget requirements for Community-Based applicants:

All Corporation for National and Community Service (CNCS) Community-Based Learn and Serve America (LSA) budgets must conform to the following statutory requirements:

• You must match, with cash or in-kind contributions, at least 10% of the project’s total costs for year one of the grant, 20% for the second year continuation, and at least 30% for the third year continuation. Grantees who have received Learn and Serve America funding for more than three years must provide at least 50% of the total program costs (a minimum of a dollar for dollar match) for each year. The source(s) may be federal (non-CNCS), state, or local (public or private).

• You must allocate at least 10% of the Corporation share to planning and capacity building costs.

• Equipment costs must not exceed 10% of the total federal share.

• Administrative costs must not exceed 5% of the total Corporation funds requested.

Consistency of treatment: To be allowable under this award, costs must be consistent with policies and procedures that apply uniformly to both federally financed and other activities of the applicant. Furthermore, the costs must be accorded consistent treatment in both federally financed and other activities as well as between activities supported by different sources of federal funds.

Section I. Planning and Capacity Building Costs

Source of Funds/Match. Describe the major source(s) of match contributions for Section I by clearly indicating the source(s), the type of contribution (cash or in-kind), and the approximate amount (or estimate) of the match.

Please note:  The grantee’s share of match may come from private, state, local, or federal sources. In the case of federal sources, the funds of another agency may only be used as match if the other agency permits such use.

A. Personnel Expenses

Include the portion of staff time attributed directly to the operation of the Learn and Serve America project. List each staff position as a separate line item.

B. Personnel Fringe Benefits

Include costs of benefit(s) for your project staff. You can identify and calculate each benefit or show cost as a percentage of all salaries. Fringe benefit rates totaling greater than 30 percent of the relevant salary will require additional explanation/justification.

C. Monitoring and Other Travel

Describe the purposes for travel. Allowable costs include transportation, lodging, subsistence, and other related expenses for local and outside the project area travel. Please specify different types of travel expenses as separate line items (e.g., monitoring visits, conference attendance, etc.) and show detailed breakdown of all costs (e.g. 2 people x 3 days @ $50 per day for lodging = $300).

D. Equipment

Equipment is defined as tangible, non-expendable personal property having a useful life of more than one year AND an acquisition cost of $5,000 (five thousand) or more per unit (including accessories, attachments, and modifications). Include items that do not meet this definition in section E below. Purchase of equipment is limited to 10% of the total CNCS share. Show the unit cost and number of units you request.

E. Supplies

Include the purchase of consumable supplies and materials, including equipment that does not fit the equipment definition of D. above. You must individually list any single item costing $1,000 (one thousand) or more.

F1. Curriculum Development

Include costs for consultants related to curriculum development (contracts/mini-grants/release time). Payments to individuals for services under this grant may not exceed $540 per day (exclusive of any indirect expenses, travel, and supplies). Indicate daily rate for consultants where applicable.

F2. Contractual and Consultant Services

Include costs for any contractual services not covered in other categories. Payments to individuals for consultant services under this grant may not exceed $540 per day (exclusive of any indirect expenses, travel, and supplies). Indicate daily rate for consultants where applicable.

G. Training and Technical Assistance

Include the costs associated with training and professional development of teachers or program staff, such as costs for consultants, trainers, speakers, conference attendance and training materials. Indicate daily rates of consultants, where applicable. Please note that training of Service-Learning Coordinators may be paid for under Implementation (Section II of your budget).

H. Evaluation

Include costs for project evaluation activities and data collection against performance measures; including additional staff time or subcontracts you did not budget under Section IA (Personnel Expenses). Include use of evaluation consultants, purchase of instrumentation and other costs specific to this activity. Indicate daily rates of consultants, where applicable.

I. Other Operating Costs

Allowable costs in this category may include travel to CNCS-sponsored meetings and dissemination. In addition, these costs may include Internet expenses that are specifically used for Learn and Serve America and are not part of the organizations indirect cost/admin cost. If shared with other projects or activities, you must prorate the costs equitably. List each item and provide a justification in the budget narrative.

Please include:

Travel to CNCS-Sponsored Meetings – Include up to $2,500 in this line item to cover the cost of CNCS-sponsored technical assistance meetings.

Dissemination (optional)– Include costs to publish or disseminate training manuals, evaluation assessment tools, promising practice guides and other successful products of your program.

Section II. Implementation, Expansion, Operation and Replication of Service-Learning Programs

Source of Funds. Describe the major source(s) of match contributions for Section II by clearly indicating the source(s), the type of contribution (cash or in-kind), and the approximate amount (or estimate) of the match. See Source of Funds/Match in section I for additional information.

1. Subgrants to Local Partnerships

Include costs for subgrants to local partnerships (Local Education Agencies must be the legal subgrantee applicants for School-Based grants) to implement service-learning programs. Indicate any match that you will require of your subgrantees under the “grantee share” column in this category. Subgrant funds may cover only costs allowable under CNCS grant guidelines. Provide a breakdown of the types of subgrants you are proposing by Category (e.g. planning, technical assistance, operating, sustaining, etc.). Use a separate line item for each type of subgrant you propose to make. Be sure to give a description of each type of subgrant in the budget narrative section.

2. Personnel Expenses

Include the portion of staff costs that are attributed to implementation activities of the program (e.g. service-learning coordinators). Identify each staff member in terms of responsibilities and title, and express the cost of that person either as a percentage of the individual’s base salary (the total salary and percentage of time allocated to the proposed project cited) or as an hour pro-ration (the hourly rate and the number of projected hours cited). Note that staff time may be prorated between the Capacity Building, Implementation and Administrative sections as appropriate.

3. Personnel Benefits

Include costs of benefit(s) for your project staff. You can identify and calculate each benefit or show cost as a percentage of all salaries.

4. Adult Volunteer Programs

Include costs for subgrants to local partnerships to implement school-based service-learning programs involving adult volunteers.

E. Other Costs

List individually and clearly explain items related to implementation that do not fit in other categories.

Section III. Administrative/Indirect Costs (choose either A or B)

The CNCS/federal share of administrative costs is limited by statute to 5% of total federal funds actually expended under this grant. To calculate the federal maximum share of 5%, add the CNCS share subtotals of Sections I and II and multiply the sum by 5.26% ( .0526). This total is the maximum amount you may request from CNCS for this budget category.

Applicants can choose to use one of two methods to calculate administrative costs – a CNCS Fixed Percentage method (Option A) or a Federally Approved Indirect Cost Rate method (Option B). Select only one of these options.

A. CNCS Fixed Percentage Method—Option A

If you choose Option A, you may charge, for administrative costs, a fixed 5% of the total of the federal funds expended. In order to charge this fixed 5%, the grantee match for administrative costs may not exceed 10% of all direct cost expenditures. These rates may be used without supporting documentation and are in lieu of a formally approved indirect cost rate.

1. To calculate the maximum CNCS share for administrative/indirect costs under Option A, add the subtotals of the CNCS share in Sections I and II and Multiply this sum by .0526. This is the maximum amount you can request as CNCS share of. Enter this amount as the CNCS share for Section III A.

2. To calculate the maximum grantee share of administrative/indirect costs, add the subtotals of Sections I and II (grantee share + CNCS share) and multiply this sum by 10 percent (.10). This is the maximum amount you can claim as grantee share of administrative/indirect costs. Enter this amount as the grantee share for Section III A.

3. Enter the sum of the CNCS and grantee shares under Total Amount in Section III A.

B. Federally Approved Indirect Cost Rate Method—Option B

Applicants who choose to use their federally approved indirect cost (IDC) rate to calculate administrative costs should select Option B. Specify the Cost Type for which your organization has current documentation on file (i.e., Provisional, Predetermined, Fixed, or Final indirect cost rate). Supply your approved IDC rate (percentage). Whether or not your entire IDC rate is used to calculate administrative costs for this grant is at your discretion. Please show your calculations and indicate, if different than the approved IDC, the rate you have chosen to use.

1. Calculate the total allowable administrative costs for the project using the method prescribed by your organization (i.e., based on salaries and benefits, total direct costs, or other), and calculate all totals.

2. Multiply the sum of the CNCS share subtotals in Sections I and II by .0526. This is the maximum amount you can request as CNCS share of administrative/indirect costs. Enter this amount as the CNCS share for Section III B.

3. Subtract the amount calculated in step 2 from the amount calculated in step 1. This is the maximum amount the applicant can claim as grantee share for administrative/indirect costs. Enter this amount as the grantee share for Section III B.

Definitions. Administrative costs means general or centralized expenses of overall administration of an organization that receives CNCS funds and does not include particular project costs. For organizations that have an established indirect cost rate for federal awards, administrative costs means those costs that are included in the organization’s indirect cost rate. Such costs are generally identified with the organization’s overall operation and are further described in Office of Management and Budget (OMB) Circulars A-21, A-87, and A-122. For organizations that do not have an established indirect cost rate for federal awards, administrative costs include:

1. costs for financial, accounting, auditing, contracting or general legal services, except in unusual cases where they are specifically approved in writing by CNCS as project costs;

2. costs for internal evaluation, including overall organizational management improvement costs (except for independent and internal evaluations of the project); and

3. costs for general liability insurance that protects the organization(s) responsible for operating a project, other than insurance costs solely attributable to the project.

Administrative costs may also include that portion of salaries and benefits of the project director and other administrative staff not attributable to the time spent in support of a specific project. The principles that pertain to the allocation and documentation of personnel costs are stated in the OMB circulars that are incorporated in CNCS regulations [45 CFR 2541.220(b)].

Administrative costs do not include the following allowable expenses directly related to a project (including their operations and objectives), such as:

1. costs for independent evaluations and any internal evaluations of the project;

2. costs, excluding those already covered in an organization’s indirect cost rate, attributable to staff that work in a direct project support, operational, or oversight capacity, including, but not limited to: support staff whose functions directly support project activities; staff who coordinate and facilitate single or multi-site project activities; and staff who review, disseminate and implement CNCS guidance and policies directly relating to a project;

3. space, facility and communications costs that primarily support project operations, excluding those costs that are already covered by an organization’s indirect costs rate; and

4. other allowable costs, excluding those costs that are already covered by an organization’s indirect cost rate, specifically approved by CNCS as directly attributable to a project.

Indirect Cost Rates

1. If grantees have an approved indirect cost rate, such rate will constitute documentation of the grantee’s administrative costs, including the 5% maximum payable by CNCS and the grantee match of administrative costs.

2. If a grantee wants to claim more than 10% match in administrative costs, it must have an approved indirect cost rate. Where appropriate, CNCS will establish an indirect cost rate that may be used for this and other federal awards.

SCHOOL and COMMUNITY-BASED BUDGET WORKSHEET

Section I. Planning and Capacity Building

1. Personnel Expenses

Position/Title	Qty	Annual Salary	% Time	Total Amount			CNCS Share	Grantee Share
Totals

B. Personnel Fringe Benefits

Item/Purpose	Calculation	Total Amount			CNCS Share		Grantee Share
Totals

C. Monitoring and Other Travel

Item/Purpose	Calculation	Total Amount		CNCS Share		Grantee Share
Totals

4. Equipment

Item/Purpose	Qty	Unit Cost	Total Amount		CNCS Share		Grantee Share
Totals

E. Supplies

Item/Purpose	Calculation	Total Amount			CNCS Share		Grantee Share
Totals

F1. Curriculum Development

Item/Purpose	Calculation	Total Amount		CNCS Share		Grantee Share
Totals

F2. Contractual and Consultant Services

Item/Purpose	Calculation	Total Amount		CNCS Share		Grantee Share
Totals

G. Training and Technical Assistance

Item/Purpose	Calculation	Total Amount		CNCS Share		Grantee Share
Totals

H. Evaluation

Item/Purpose	Calculation	Total Amount		CNCS Share		Grantee Share
Totals

9. Other Program Operating Costs

Item/Purpose	Calculation	Total Amount	CNCS Share	Grantee Share
Travel to CNCS-Sponsored Meetings
Dissemination
Totals

SUBTOTAL SECTION I

Section II. Planning, Implementation, Expansion, Operation and Replication of Service-Learning Programs

A. Subgrants/Local Partnerships

Item/Purpose	Calculation	Total Amount			CNCS Share		Grantee Share
Totals

2. Salaries

Position/Title	Qty	Annual Salary	% Time	Total Amount			CNCS Share	Grantee Share
Totals

C. Benefits

Item/Purpose	Description	Total Amount			CNCS Share		Grantee Share
Totals

D. Adult Volunteer Programs

Item/Purpose	Description	Total Amount			CNCS Share		Grantee Share
Totals

E. Other Costs

Item/Purpose	Description	Total Amount			CNCS Share		Grantee Share
Totals

SUBTOTAL SECTION II

SUBTOTAL SECTION I & II

Section III. Administrative/Indirect Costs

A. CNCS Fixed Percentage Method

Purpose	Calculation	Total Amount			CNCS Share		Grantee Share
CNCS Fixed Amount
Totals

B Federally Approved Indirect Cost Rate Method

Cost Type	Basis	Calculation	Rate	Rate Claimed		Total Amount		CNCS Share		Grantee Share
Totals

1 The character count includes all letters, punctuation, and spaces in a document. One double-spaced, 12-point font page equals approximately 2,000 characters.

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Learn and Serve America

School & Community-Based Application Instructions

OMB Control #: 3045-0045        

Exp.