Revised College Access Challenge Grant Program (CACGP)

U. S. Department of Education

Office of Postsecondary Education

Washington, D.C. 20006-8524

Fiscal Year 2010 Application for the

college access challenge grant program

(CFDA NUMBER 84.378)

CLOSING DATE: TBD

OMB Control Number: 1840-0800

Expiration Date: 05/31/2011

COLLEGE ACCESS CHALLENGE GRANT (CACG) PROGRAM

Table of Contents

Program Overview……………………………………………………………………………….3

Authority

Official Documents Notice

Purpose

Eligibility

Activities and Services

Program Requirements………………………………………………………………………….4

Qualifying Students and Families

Sub-Grants to Non-Profits

Federal Share and Non-Federal Matching

Maintenance of Effort

Annual Performance Report

Program Statute……………………………………………………………………………….…5

Application Instructions………………………………………..………………………………14

Title Page

Sections I – VI

Governor’s Letter

I. PROGRAM OVERVIEW

Legislative Authority:

Title VII, Part E of Higher Education Act of 1965, as amended, 20 U.S.C. Section 1141

Official Documents Notification:

The official document governing this application is available electronically at the following Web site: www.ed.gov/programs/cacg.

Purpose:

The College Access Challenge Grant (CACG) Program is a formula grant program that is designed to foster partnerships among Federal, State and local government entities and philanthropic organizations to significantly increase the number of underrepresented students who enter and remain in postsecondary education. CACG provides grants to States to meet the needs of underrepresented students and families.

Eligibility:

The Governor of the State designates the State agency (i.e., a State agency with jurisdiction over higher education or another State agency) that is eligible to apply for funding under the CACG program. Each State is eligible to receive one grant. In cases where a State fails to meet the matching requirement or fails to comply with other grant requirements, the Secretary shall reduce the amount of grant payment to the State proportionately and may award the proportionate reduction amount of the grant directly to a philanthropic organization.

Authorized Activities/Services:

1. Provide information to students and families on postsecondary education benefits, opportunities, planning and career preparation;

2. Provide information on financing options, including activities that promote financial literacy and debt management among students and families;

3. Conduct outreach activities for students who may be at risk of not enrolling in or completing college;

4. Assist students in completing the Free Application for Federal Student Aid (FAFSA);

5. Offer need based grant aid to students;

6. Implement professional development for guidance counselors at middle and secondary schools, and financial aid administrators and college admissions counselors at institutions of higher education, to improve such individuals’ capacity to assist students and parents with:

   1. Understanding:

      • Entrance requirements for admission to institutions of higher education, and

      • State eligibility requirements for Academic Competitiveness Grants or National SMART Grants;

   2. Applying to institutions of higher education, applying for financial assistance and scholarships;

   3. Activities that increase students’ ability to successfully complete the coursework required for a postsecondary degree (including tutoring and mentoring); and

   4. Activities to improve secondary school students’ preparedness for postsecondary entrance examinations.

7) Repayment of student loans, student loan cancellation, or lowering of interest rates. States are not allowed to use funds to promote any lender’s loans.

II. PROGRAM REQUIREMENTS

Qualifying Students and Families:

States must make activities and services available to all qualifying students and families regardless of a) choice of postsecondary institution; b) type of student loan received; c) server of such loan; and d) student’s academic performance. Students and families cannot be charged a fee to participate in activities and services. In the case of an activity providing grant aid, States cannot require students to meet any condition other than eligibility for Federal financial assistance under Title IV of the Higher Education Act of 1965.

Priority:

Priority must be given to students and families who are living below the poverty line applicable to the individual’s family size.

Sub-Grants to Non-Profit Organizations:

States may award sub-grants to one or more non-profit organizations, or partnerships of organizations, in the State to carry out the services and activities if the non-profit organization or partnership—

1. was in existence on or before September 27, 2007; and

2. is participating in activities and services related to increasing access to higher education.

Federal Share and Non-Federal Matching Requirement:

Federal funds may be used to pay for up to two thirds (2/3) of the cost of the activities and services provided as part of a CACG grant. States are required to provide non-Federal funds equal to one third (1/3) of the costs of authorized activities and services. This non-Federal match may be met through cash or in-kind contributions and cannot be waived. Matching contributions may be provided from State resources, contributions from private organizations, or both.

Documentation of matching contributions must contain adequate source documentation for the claimed cost sharing, provide clear valuation of in-kind matching, and provide support of cost-sharing by grant partners. Grantees are required to value in-kind contributions in accordance with relevant Office of Management and Budget (OMB) circulars and the Education Department General Administrative Regulations (EDGAR). In most cases, grantees must value in-kind contributions of facilities and equipment using depreciation rather than fair market value.

If a State fails to provide the full non-Federal share required, the Secretary will reduce the amount of the grant payment proportionately, and may award the proportionate reduction amount of the grant directly to a philanthropic organization.

Maintenance of Effort:

For any academic year beginning on or after July 1, 2008, States are required to expend amounts that are equal to or greater than: 1) the average amount provided for non-capital and non-direct research and development expenses or cross by the State to the public institutions during the five most recent academic years for which satisfactory data are available; and 2) the average amount provided for student financial aid for paying postsecondary education costs by the State to private institutions during the most recent academic years for which satisfactory data are available.

Annual Performance Report Requirement:

States are required to provide an annual performance report that outlines the activities and services that were implemented during the performance period, the associated cost of each activity or service, the number and percentage of students that participated in such activities and services, and the total non-Federal matching contribution. This information will be used to determine if projects are achieving goals and objectives and if statutory and regulatory requirements are being satisfied. States can be determined to be temporarily ineligible to participate in CACG if an annual performance report is not provided, or if substantial progress is not being made in meeting the goals of the grant.

Performance Indicators for the CACG:

The CACG program will be measured against the following performance measures:

1. For States offering scholarship programs, the percentage increase in the proportion of high school seniors offered CACG grants who enroll in college within a year after graduation.

2. For the portion of State projects offering services directly to secondary schools, the percentage increase in the proportion of high school senior program participants who complete a Free Application for Federal Student Aid (FAFSA).

The CACG program will also be measured against the following efficiency measure:

1. The decrease in the gap between the cost of the scholarship program per high school

senior offered a CACG grant and the cost per high school senior offered a CACG scholarship and enrolling in college within a year after graduation.

TITLE VIII—PARTNERSHIP GRANTS

SEC. 801. COLLEGE ACCESS CHALLENGE GRANT PROGRAM.

Title VII (20 U.S.C. 1133 et seq.) is amended by adding at the end the following new part:

‘‘PART E—COLLEGE ACCESS CHALLENGE GRANT PROGRAM

‘‘SEC. 771. COLLEGE ACCESS CHALLENGE GRANT PROGRAM.

(a) AUTHORIZATION AND APPROPRIATION.—There are authorized to be appropriated, and there are appropriated, to carry out this section $66,000,000 for each of the fiscal years 2008 and 2009. The authority to award grants under this section shall expire at the end of fiscal year 2009.

(b) PROGRAM AUTHORIZED.—

‘(1) GRANTS AUTHORIZED.—From amounts appropriated under subsection (a), the Secretary shall award grants, from allotments under subsection (c), to States (and to philanthropic organization, as appropriate under paragraph (3)) having applications approved under subsection (d), to enable the State (or philanthropic organization) to pay the Federal share of the costs of carrying out the activities and services described in subsection (f).

(2) FEDERAL SHARE; NON-FEDERAL SHARE.—

1. FEDERAL SHARE.—The amount of the Federal share under this section for

a fiscal year shall be equal to 2⁄3 of the costs of the activities and services described in subsection (f) that are carried out under the grant.

(B) NON-FEDERAL SHARE.—The amount of the non-Federal share under this section shall be equal to 1⁄3 of the costs of the activities and services described in subsection (f). The non-Federal share may be in cash or in-kind, and may be provided from State resources, contributions from private organizations, or both.

(3) REDUCTION FOR FAILURE TO PAY NON-FEDERAL SHARE.—

If a State fails to provide the full non-Federal share required under this subsection, the Secretary shall reduce the amount of the grant payment under this section proportionately, and may award the proportionate reduction amount of the grant directly to a philanthropic organization, as defined in subsection (i), to carry out this section.

(4) TEMPORARY INELIGIBILITY FOR SUBSEQUENT PAYMENTS.—

1. IN GENERAL.—The Secretary shall determine a grantee to be temporarily

ineligible to receive a grant payment under this section for a fiscal year if—‘‘(i) the grantee fails to submit an annual report pursuant to subsection (h) for the preceding fiscal year; or

(ii) the Secretary determines, based on information in such annual report,

that the grantee is not effectively meeting the conditions described under subsection (g) and the goals of the application under subsection (d).

2. REINSTATEMENT.—If the Secretary determines that a grantee is ineligible under subparagraph (A), the Secretary may enter into an agreement with the grantee setting forth the terms and conditions under which the grantee may regain eligibility to receive payments under this section.

(c) DETERMINATION OF ALLOTMENT.—

(1) AMOUNT OF ALLOTMENT.—Subject to paragraph (2), in making grant payments to grantees under this section, the allotment to each grantee for a fiscal year shall be equal to the sum of—

1. the amount that bears the same relation to 50 percent of the amount

appropriated under subsection (a) for such fiscal year as the number of residents in the State aged 5 through 17 who are living below the poverty line applicable to the resident’s family size (as determined under section 673(2) of the Community Service Block Grant Act) bears to the total number of such residents in all States; and

2. the amount that bears the same relation to 50 percent of the amount

appropriated under subsection (a) for such fiscal year as the number of residents in the State aged 15 through 44 who are living below the poverty line applicable to the individual’s family size (as determined under section 673(2) of the Community Service Block Grant Act) bears to the total number of such residents in all States.

(2) MINIMUM AMOUNT.—The allotment for each State under this section for a fiscal

year shall not be an amount that is less than 0.5 percent of the total amount appropriated under subsection (a) for such fiscal year.

(d) SUBMISSION AND CONTENTS OF APPLICATION.—

1. IN GENERAL.—For each fiscal year for which a grantee desires a grant payment

under subsection (b), the State agency with jurisdiction over higher education, or another agency designated by the Governor or chief executive of the State to administer the program under this section, or a philanthropic organization, in accordance with subsection (b)(3), shall submit an application to the Secretary at such time, in such manner, and containing the information described in paragraph (2).

2. APPLICATION.—An application submitted under paragraph (1) shall include the

following:

1. A description of the grantee’s capacity to administer the grant under this section and report annually to the Secretary on the activities and services described in subsection (f).

(B) A description of the grantee’s plan for using the grant funds to meet the requirements of subsections (f) and (g), including plans for how the grantee will make special efforts to—

(i) provide such benefits to students in the State that are underrepresented

in postsecondary education; or

(ii) in the case of a philanthropic organization that operates in more than

one State, provide benefits to such students in each such State for which the H. R. 2669—31 philanthropic organization is receiving grant funds

under this section.

3. A description of how the grantee will provide or coordinate the provision of

the non-Federal share from State resources or private contributions.

(D) A description of—

(i) the structure that the grantee has in place to administer the activities and services described in subsection (f); or

(ii) the plan to develop such administrative capacity.

(e) SUBGRANTS TO NONPROFIT ORGANIZATIONS.—A State receiving a payment under this section may elect to make a subgrant to one or more nonprofit organizations in the State, including an eligible not-for-profit holder (as defined in section 435(p) of the Higher Education Act of 1965, as amended by section 303 of this Act), or those who have agreements with the Secretary under section 435(j), or a partnership of such organizations, to carry out activities or services described in subsection (f), if the nonprofit organization or partnership—

1. was in existence on the day before the date of the enactment of this Act; and

2. as of such day, was participating in activities and services related to increasing access to higher education, such as those activities and services described in subsection (f).

(f) ALLOWABLE USES.—

1. IN GENERAL.—Subject to paragraph (3), a grantee may use a grant payment under

this section only for the following activities and services, pursuant to the conditions under subsection (g):

(A) Information for students and families regarding—

(i) the benefits of a postsecondary education;

(ii) postsecondary education opportunities;

(iii) planning for postsecondary education; and

(iv) career preparation.

2. Information on financing options for postsecondary education and activities

that promote financial literacy and debt management among students and families.

(C) Outreach activities for students who may be at risk of not enrolling in or completing postsecondary education.

(D) Assistance in completion of the Free Application for Federal Student Aid or other common financial reporting form under section 483(a) of the Higher Education Act of 1965.

(E) Need-based grant aid for students.

(F) Professional development for guidance counselors at middle schools and secondary schools, and financial aid administrators and college admissions counselors at institutions of higher education, to improve such individuals’ capacity to assist students and parents with—

(i) understanding—

(I) entrance requirements for admission to institutions of higher education; and

(II) State eligibility requirements for Academic Competitiveness Grants or National SMART Grants under section 401A, and other financial H. R. 2669—32 assistance that is dependent upon a student’s coursework;

(ii) applying to institutions of higher education;

(iii) applying for Federal student financial assistance and other State, local, and private student financial assistance and scholarships;

(iv) activities that increase students’ ability to successfully complete the coursework required for a postsecondary degree, including activities such as tutoring or mentoring; and

(v) activities to improve secondary school students’ preparedness for postsecondary entrance examinations.

(G) Student loan cancellation or repayment (as applicable), or interest rate reductions, for borrowers who are employed in a high-need geographical area or a high need profession in the State, as determined by the State.

(2) PROHIBITED USES.—Funds made available under this section shall not be used to promote any lender’s loans.

(3) USE OF FUNDS FOR ADMINISTRATIVE PURPOSES.—A grantee may use not more than 6 percent of the total amount of the sum of the Federal share provided under this section and the non-Federal share required under this section for administrative purposes relating to the grant under this section.

(g) SPECIAL CONDITIONS.—

(1) AVAILABILITY TO STUDENTS AND FAMILIES.—A grantee receiving a grant payment under this section shall—

(A) make the activities and services described in subparagraphs (A) through (F) of subsection (f)(1) that are funded under the payment available to all qualifying students and families in the State;

(B) allow students and families to participate in the activities and services without regard to—

(i) the postsecondary institution in which the student enrolls;

(ii) the type of student loan the student receives;

(iii) the servicer of such loan; or

(iv) the student’s academic performance;

3. not charge any student or parent a fee or additional charge to participate in the activities or services; and

4. in the case of an activity providing grant aid, not require a student to meet any condition other than eligibility for Federal financial assistance under title IV of the Higher Education Act of 1965, except as provided for in the loan cancellation or repayment or interest rate reductions described in subsection (f)(1)(G).

(2) PRIORITY.—A grantee receiving a grant payment under this section shall, in carrying out any activity or service described in subsection (f)(1) with the grant funds, prioritize students and families who are living below the poverty line applicable to the individual’s family size (as determined under section 673(2) of the Community Service Block Grant Act).

(3) DISCLOSURES.—

(A) ORGANIZATIONAL DISCLOSURES.—In the case of a State that has chosen to make a payment to an eligible not-for-profit holder in the State in accordance with subsection (e), the holder shall clearly and prominently indicate

H. R. 2669—33 the name of the holder and the nature of the holder’s work in connection with any of the activities carried out, or any information or services provided, with such funds.

(B) INFORMATIONAL DISCLOSURES.—Any information about financing options for higher education provided through an activity or service funded under this section shall—

(i) include information to students and the students’ parents of the availability of Federal, State, local, institutional, and other grants and loans for postsecondary education; and

(ii) present information on financial assistance for postsecondary education that is not provided under title IV of the Higher Education Act of 1965 in a manner that is clearly distinct from information on

student financial assistance under such title.

(4) COORDINATION.—A grantee receiving a grant payment under this section shall attempt to coordinate the activities carried out with the grant payment with any existing activities that are similar to such activities, and with any other entities that support the existing activities in the State.

(h) REPORT.—A grantee receiving a payment under this section shall prepare and submit an annual report to the Secretary on the activities and services carried out under this section, and on

the implementation of such activities and services. The report shall include—

(1) each activity or service that was provided to students and families over the course of the year;

(2) the cost of providing each activity or service;

(3) the number, and percentage, if feasible and applicable, of students who received each activity or service; and

(4) the total contributions from private organizations included in the grantee’s non-Federal share for the fiscal year.

(i) DEFINITIONS.—In this section:

(1) PHILANTHROPIC ORGANIZATION.—The term ‘philanthropic organization’ means a non-profit organization—

(A) that does not receive funds under title IV of the Higher Education Act of 1965 or under the Elementary and Secondary Education Act of 1965;

(B) that is not a local educational agency or an institution of higher education;

(C) that has a demonstrated record of dispersing grant aid to underserved populations to ensure access to, and participation in, higher education;

(D) that is affiliated with an eligible consortia (as defined in paragraph (2)) to carry out this section; and

(E) the primary purpose of which is to provide financial aid and support services to students from underrepresented populations to increase the number of such students who enter and remain in college.

(2) ELIGIBLE CONSORTIA.—The term ‘eligible consortia’ means a partnership of 2 or more entities that have agreed to work together to carry out this section that—

(A) includes—

(i) a philanthropic organization, which serves as the manager of the consortia; H. R. 2669—34

(ii) a State that demonstrates a commitment to ensuring the creation of a Statewide system to address the issues of early intervention and financial support for eligible students to enter and remain in college; and

(iii) at the discretion of the philanthropic organization described in clause (i), additional partners, including other non-profit organizations, government entities (including local municipalities, school districts,

cities, and counties), institutions of higher education, and other public or private programs that provide mentoring or outreach programs; and

(B) conducts activities to assist students with entering and remaining in college, which may include—

(i) providing need-based grants to students;

(ii) providing early notification to low-income students of their potential eligibility for Federal financial aid (which may include assisting students and families with filling out FAFSA forms), as well as other financial

aid and other support available from the eligible consortia;

(iii) encouraging increased student participation in higher education through mentoring or outreach programs; and

(iv) conducting marketing and outreach efforts that are designed to—

(I) encourage full participation of students in the activities of the consortia that carry out this section; and ‘‘(II) provide the communities impacted by the activities of the consortia with a general knowledge about the efforts of the consortia.

(3) GRANTEE.—The term ‘grantee’ means—

(A) a State awarded a grant under this section; or

(B) with respect to such a State that has failed to meet the non-Federal share requirement of subsection (b), a philanthropic organization awarded the proportionate reduction amount of such a grant under subsection (b)(3).

INSTRUCTIONS FOR COMPLETING & SUBMITTING

THE APPLICATION PACKAGE

I. Electronic Submission of Application

States must submit an application to the United States Department of Education to demonstrate eligibility and receive CACG grant funding. All applications must be submitted electronically by e-mailing a Microsoft Word (.DOC) document to [email protected]. We do not have a secure electronic signature mechanism, so applicants have two days after electronic submission to mail (postmarked) a signed title page and an original letter of designation from the governor. The title page and governor’s letter should be mailed to the following address:

College Access Challenge Grant Program

U.S. Department of Education

Attn: Karmon Simms-Coates

1990 K Street, NW, Suite 6130

Washington, D.C. 20006

You may request permission to submit your application via mail 10 days prior to the application submission deadline by e-mailing [email protected]. In your request you must include the reason why you are unable to submit the application electronically.

Please note applications will not be accepted if the format/forms of the application have been altered or if the application is presented in a format other than Microsoft Word.

II. Required Content of Application

1. Title Page

2. Governor’s Letter

3. Section I : Abstract

4. Section II: Project Narrative

5. Section III: Goals and Objectives

6. Section IV: Budget and Narrative

7. Section V: Assurances and Certifications

1. Title Page. Applicants must provide a signed title page that contains necessary profile

information.

a. Legal Name of Applicant. Enter the legal name of applicant and the name of the

primary organization that will administer the grant.

2. D-U-N-S Number. Enter applicant’s D-U-N-S Number. If your organization does not have a D-U-N- S Number, you can obtain the number by calling 1-800-333-0505 or by completing a D-U-N-S Number Request Form. The form can be obtained via the Internet at the following Web site: http://www.dnb.com.

c. Address. Enter the address of the Applicant Agency presented in box #1.

d. Contact Person. Enter the name, title, telephone and fax numbers, and email address

of the person to be contacted on matters involving the application.

e. Type of Applicant. Please put a check by the type of organization that is applying.

f. Certification of Application Content and Assurances. Print name and telephone

number; provide a signature from the authorizing representative of the organization;

and date.

2. Governor’s Letter. Applicants must mail an original governor’s letter to the address

presented on Page 14, two days after electronic submission of the application. The Governor of the State designates the State agency that is eligible to apply for funding under the CACG program.

2. Section I: Abstract. Applicants must provide a one-page overview of the project that includes its goals, purpose and scope in the abstract section.

3. Section II: Project Narrative. Applicants must address in detail the questions listed in

the project narrative section.

4. Section III: Goals and Objectives. Applicants must submit the goals and objectives

for the project. Activities, services and anticipated outcomes should be clearly aligned with the goals and objectives of the project. The goals provide the overall context for what the project is trying to accomplish in the long-term, and objectives describe what the project is trying to achieve incrementally.

5. Section IV: Budget Summary and Narrative. Applicants must 1) present proposed

expenditures (Federal and non-Federal) for the first year of implementation in the Budget Summary Form, 2) address the questions relative to indirect costs at the bottom of the page, and 3) provide a narrative outlining how funds will be used to accomplish the goals and objectives of the project. Each budget category must be justified in the budget narrative. Applicants should include the basis for estimating the cost of all project expenditures and how costs relate to proposed activities and services. States may use up to 6 percent of funds appropriated for administrative costs and up to 8 percent for indirect costs. Indirect costs are costs incurred for a common or joint purpose benefitting more than one cost objective but not readily assignable to a particular objective. Indirect costs cannot be charged to the grant if the fiscal agent does not have an approved indirect cost rate agreement. Administrative costs are defined by grant recipients consistently across all programs.

6. Section V: Assurances and Certifications. Applicants must provide assurances and

certifications by checking “yes” or “no.”

Application Format

Page Limit: You must limit the application narrative (excluding the title page and program and standard assurances) to no more than 40 pages.

Please use the following formatting standards:

• Use 8.5” x 11” pages, on one side only, with 1” margins at the top, bottom, and both sides.

• Double space (no more than three lines per vertical inch) all text in the application (excluding

the title page and program and standard assurances).

• Use one of the following fonts: Times New Roman or Arial.

• Use a font that is either 12-point or larger or no smaller than10 pitch (characters per inch).

Contact Information

If you have questions regarding any aspect of this application, please contact:

Karmon Simms-Coates, Program Manager

College Access Challenge Grant Program

202-502-7807

[email protected]

OMB Control Number: 1840-001

Expiration Date: 05/31/2011

U.S. DEPARTMENT OF EDUCATION

COLLEGE ACCESS CHALLENGE GRANT PROGRAM

TITLE PAGE

a. Legal Name of Applicant Agency	b. D.U.N.S number: Taxpayer ID Number (TN):
c. Address (include zip):	d. Contact Person Name: Title: Telephone: Fax: E-Mail:
e. Type of Applicant: ____ State Agency ____ Philanthropic Organization (non-profit)
f. To the best of my knowledge and belief, all data provided in this application are true and correct. The governing body of the applicant has duly authorized the application and will comply with statutory and regulatory requirements, assurances and certifications, etc.
Printed Name and Title of Authorized State Representative:	Telephone: Fax: E-Mail:
Signature of Authorized State Representative:	Date:

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is ---. The time required to complete this information collection is estimated to average 30 hours per response, including the time to review instructions, search existing data sources, 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. 20202-4651. If you have comments or concerns regarding the status of your individual submission of the form, write directly to: the CACG, U.S. Department of Education, 1990 K Street, N.W., Washington, D.C. 20006-8524.

SECTION I: PROJECT ABSTRACT

Please provide an abstract that gives an overview of the project – i.e., the need for the project, organizations that will be involved in the project, goals and objectives, and activities and services. The abstract should be no more than 3-4 pages in length.

SECTION II: PROJECT NARRATIVE INFORMATION

Please answer thoroughly the following questions:

1. Please provide a description of the capacity and structure that the State has in place to

administer the authorized services and activities, or the State’s plan to develop such administrative capacity.

2. In the case of a philanthropic organization that operates in more than one State, please

describe plans to use funding to benefit students in each State for which your organization is applying for grant funds.

3. Describe briefly the record keeping system for collecting and reporting student

outcome/achievement data and participation in services and activities. Specifically, what method(s) will your project use to collect and maintain student and family participation in activities and outcome data?

4. If States plan to make sub-grants to non-profit organizations (partnership), describe the

process for awarding and monitoring sub-grants to non-profit organizations (i.e., soliciting applications, application review process, timelines, selection criteria, technical assistance, site visits, progress reports, etc.).

5. Please list below the entities (State and local, philanthropic and other

organizations) that will be actively involved in providing activities and services.

SECTION III: GOALS AND OBJECTIVES FORM

Applicants must outline measurable goals and objectives, activities and services and anticipated outcomes in the chart below. A detailed description of the activities and services must be provided. For instance, if the applicant is implementing a math tutoring program, the applicant will outline who is doing the tutoring (i.e., student volunteers from the University of Maryland), who will receive the service (i.e., high school seniors), when the tutoring will take place (i.e., after school), and where the tutoring will be held (i.e., at the community center).

A. GOALS AND OBJECTIVES	B. ACTIVITIES AND SERVICES	C. ANTICIPATED OUTCOMES
Please provide measurable goals and objectives.	Describe the activities and services that will be conducted to accomplish the goals and objectives.	Present anticipated outcomes based on the implementation of services and activities.
Example: To increase underrepresented students’ and families’ knowledge of postsecondary education financial options.	Example: Conduct informational workshops with parents and students to share sources and availability of financial aid; develop materials/handouts outlining financial aid opportunities.	Example: 2011 survey results (85% participation rate) indicate that 95% of participating students are more knowledgeable about financial aid opportunities.
1.
2.
3.
4.
5.

SECTION IV: BUDGET SUMMARY FORM

Please provide a complete summary of proposed expenditures (Federal and non-Federal) for the first year of implementation.

		PROJECT YEAR 1
Budget Categories		FEDERAL		NON-FEDERAL		TOTAL
1. Salaries and Wages
2. Employee Benefits
3. Travel
4. Materials and Supplies
5. Consultants & Contracts
6. Other
Total Direct Costs: (Sum of lines 1-6)
Total Indirect Costs: (cannot be greater than 8% of Total Direct Costs)
Equipment
D. Scholarships/Tuition Assistance
E. TOTAL REQUESTED A + B+ C+D

A grantee may use not more than 6 percent of the total amount of the sum of Federal funds and non-Federal funds for administrative purposes.

If you are requesting reimbursement for indirect costs on line B, please answer the following questions:

Do you have an Indirect Cost Rate Agreement approved by the Federal government? ____Yes ____ No

If yes, please provide the following information: Period Covered by the Indirect Cost Rate Agreement:

From: ___/___/______ To: ___/___/______ (mm/dd/yyyy)

Approving Federal agency: ____ ED ____ Other (please specify): ____________

For Restricted Rate Programs (check one) -- Are you using a restricted indirect cost rate that:

___Is included in your approved Indirect Cost Rate Agreement? or ___ Complies with 34 CFR 76.564(c)(2)?

BUDGET NARRATIVE

Please provide a detailed justification for each budget category addressing Federal and non-Federal expenditures.

BUDGET CATEGORY	FEDERAL EXPENDITURE	NON-FEDERAL EXPENDITURE
1. Salaries and Wages
2. Employee Benefits
3. Travel
4. Materials and Supplies
5. Consultants & Contracts
6. Other
7. Equipment
8. Indirect Costs
9. Scholarship/Tuition Assistance

SECTION V – PROGRAM ASSURANCES AND CERTIFICATIONS

Please put ‘yes’ or ‘no’ next to the corresponding assurance and certification to indicate the State has the following policies and procedures in place.

Yes	No	Assurances Related to Policies and Procedures
		1. States will give priority to students and families who are living below the poverty line applicable to students’ family size.
		2. States must make activities and services available to all qualifying students and families regardless of a) choice of postsecondary institution; b) type of student loan received; c) server of such loan; and d) student’s academic performance.
		3. States will include in any information about financing options for higher education provided through an activity or service: a. the availability of federal, state, local institutional, and other grants and loans for postsecondary education; and b. information on financial assistance for postsecondary education that is not provided under title IV of the Higher Education Act of 1965 in a manner that is clearly distinct from information on student financial assistance under such title.
		4. States will ensure that sub-grantees have been in existence prior to September 27, 2007 and have experience in implementing activities and services related to increasing access to higher education.
		5. The State will disclose when making a payment to an eligible not-for-profit holder in the State: the name of the holder and the nature of the holder’s work in connection with any of the activities carried out, or any information or services provided with funds.
		6. States will not use funds to promote any lender’s loans.
		7. States will not use more than 6 percent of the total amount of the sum of Federal funds and non-Federal funds for administrative purposes.
		8. As applicable, the assurance in OMB Standard Form 424B (Assurances for Non-Construction Programs), relating to legal authority to apply for assistance; access to records; conflict of interest; merit systems; nondiscrimination; Hatch Act provisions; labor standards; flood insurance; environmental standards; wild and scenic river systems; historic preservation; protection of human subjects; animal welfare; lead-based paint; Single Audit Act; and general agreement to comply with all Federal laws, executive orders and regulations.
Yes	No	Certifications
		1. The State certifies that certifications in the Education Department General Administrative Regulations (EDGAR) at 34 CFR §80.11 relating to State eligibility, authority and approval to submit and carry out the provisions of its State application, and consistency of that application with State law are in place within the State.
		2. The State certifies that ED Form 80-0013, Certification Regarding Lobbying, is on file with the Secretary of Education. With respect to the Certification Regarding Lobbying, the State recertifies that no 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 the making or renewal of Federal grants under this program; that the State shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," when required (34 CFR Part 82, Appendix B); and that the State Agency shall require the full certification, as set forth in 34 CFR Part 82, Appendix A, in the award documents for all sub awards at all tiers.

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