Assurance of Compliance-Civil Rights Certificate

OMB Approval No. 1870-0503

United States Department of Education, Office for Civil Rights

ASSURANCE OF COMPLIANCE – CIVIL RIGHTS CERTIFICATE
TITLE VI OF THE CIVIL RIGHTS ACT OF 1964, TITLE IX OF THE EDUCATION AMENDMENTS OF 1972,
SECTION 504 OF THE REHABILITATION ACT OF 1973, THE AGE DISCRIMINATION ACT OF 1975, AND
THE BOY SCOUTS OF AMERICA EQUAL ACCESS ACT OF 2001
The applicant or recipient (hereinafter applicant) provides this assurance in consideration of and for the purpose of obtaining
Federal grants, loans and contracts (except contracts of insurance or guaranty), property, discounts, other Federal financial
assistance from the United States Department of Education (Department), or funds made available through the Department.
This assurance applies to all Federal financial assistance from or funds made available through the Department, including any
that an applicant may seek in the future.
The applicant assures that it will comply with:
1.
2.
3.
4.
5.

6.

Title VI of the Civil Rights Act of 1964, as amended, 42 U.S.C. 2000d et seq., which prohibits discrimination
on the basis of race, color, or national origin in any program or activity receiving Federal financial assistance.
Title IX of the Education Amendments of 1972, as amended, 20 U.S.C. 1681 et seq., which prohibits
discrimination on the basis of sex in any education program or activity receiving Federal financial assistance.
Section 504 of the Rehabilitation Act of 1973, as amended, 29 U.S.C. 794, which prohibits discrimination on
the basis of handicap in any program or activity receiving Federal financial assistance.
The Age Discrimination Act of 1975, as amended, 42 U.S.C. 6101 et seq., which prohibits discrimination on
the basis of age in any program or activity receiving Federal financial assistance.
If applicable, the Boy Scouts of America Equal Access Act of 2001, 20 U.S.C. 7905, which requires equal
access for the Boy Scouts of America and other designated youth groups to meet at public schools. This law
applies to any public elementary school, public secondary school, local educational agency, or State
educational agency that has a designated open forum or limited public forum and that receives funds made
available through the Department.
All regulations, guidelines, and standards lawfully adopted under the above statutes by the Department.

The applicant agrees that compliance with this Assurance constitutes a condition of continued receipt of Federal financial
assistance from or funds made available through the Department, and that it is binding upon the applicant, its successors,
transferees, and assignees for the period during which this assistance or these funds are provided. The applicant further
assures that all contractors, subcontractors, subgrantees, or others with whom it arranges to provide services or benefits are
not discriminating in violation of the above statutes, regulations, guidelines, and standards. In the event of failure to comply,
the applicant understands that this assistance or these funds can be terminated and the applicant denied the right to receive
further assistance or funds. The applicant also understands that the Department may, at its discretion, seek a court order
requiring compliance with the terms of the Assurance or seek other appropriate judicial relief.
The person or persons whose signature(s) appear(s) below is/are authorized to commit the applicant to the above provisions.

Authorized Official(s)

Title of Authorized Official(s)

Print Name

Name of Institution or Agency

Date

Street

PLEASE RETURN TO:
U.S. Department of Education
Office for Civil Rights
400 Maryland Avenue, SW
Washington, DC 20202-1100

City, State, Zip Code
Office Email Address

Paperwork Burden Statement
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such
collection displays a valid OMB control number. The valid OMB control number for this information collection is 1870-0503. The time
required to complete this information collection is estimated to average 20 minutes per response, including the time to review instructions
and complete 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. 20202-4651. If you have comments or
concerns regarding the status of your individual submission of this form, write directly to: U.S. Department of Education, Office
for Civil Rights, 400 Maryland Avenue, SW, Washington, DC 20202-1100.