Education Jobs Fund Application

Application of a Governor for Funding

under the

Education Jobs Fund Program

U.S. Department of Education

Washington, D.C. 20202

OMB Number: XXXX

Expiration Date: XXXX

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 XXXX. The time required to complete this information collection is estimated to average 2 hours per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Education, Washington, D.C. 20202-4537. If you have comments or concerns regarding the status of your individual submission of this form, write directly to: Education Jobs Fund Program, Office of Elementary and Secondary Education, U.S. Department of Education, 400 Maryland Ave., S.W., Room 3E108, Washington, D.C. 20202-3118

EDUCATION JOBS FUND APPLICATION

(Public Law No. 111-226, Section 101)

Legal Name of Applicant:

DUNS No:

Employer Identification Number:

Governor’s Mailing Address:

State Contact for the Education Jobs Fund Program:

Contact’s Position and Office:

Contact’s Mailing Address:

Contact’s Telephone No.:

Contact’s Fax No.:

Contact’s E-mail Address:

Completion of this application constitutes a request by the Governor

for funding under the Education Jobs Fund program.

The Governor hereby assures that:

1. The State will comply with all applicable statutes, regulations, and its approved Education Jobs Fund (Ed Jobs) application and will use funds under the program in accordance with those statutes and regulations and its approved application;

2. The State will comply with the maintenance-of-effort (MOE) requirements in section 101 (10)(A) of Public Law No. 111-226 (Act) and, within 60 days of the date of the State’s grant award, submit to the U.S. Department of Education (Department) the most current applicable MOE data available;

3. The State will use fiscal control and fund accounting procedures that ensure proper disbursement of and accounting for funds under the Ed Jobs program, including procedures to ensure compliance with Federal cash management requirements;

4. The State will reserve not more than 2 percent of its allocation for the administrative costs of carrying out its responsibilities with respect to Ed Jobs funds and will use all remaining funds to make awards to local educational agencies (LEAs) for the support of elementary and secondary education in accordance with section 101(5) of the Act;

5. The State will make awards to LEAs on a timely basis so that funds are available for their use during the 2010-2011 school year;

6. The State will not require an LEA that has previously submitted the required local application under the State Fiscal Stabilization Fund (SFSF) program to submit an application to receive funding under the Ed Jobs program;

7. The State will not use funds under the Ed Jobs program, directly or indirectly, to

(a) establish, restore, or supplement a rainy-day fund; (b) supplant State funds in a manner that has the effect of establishing, restoring, or supplementing a rainy-day fund; (c) reduce or retire debt obligations incurred by the State; or (d) supplant State funds in a manner that has the effect of reducing or retiring debt obligations incurred by the State;

8. The State will develop and implement a monitoring plan that will enable the State to ensure that its LEAs comply with all applicable programmatic and fiscal requirements;

9. The State will comply with the reporting requirements (including subrecipient reporting requirements) of section 1512 of the American Recovery and Reinvestment Act of 2009 and such other reporting requirements as the Secretary may establish;

10. The State will comply with all applicable assurances in OMB Standard Form 424B (Assurances for Non-Construction Programs); and

11. With respect to the certification regarding lobbying in Department Form 80-0013, 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; the State will complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," when required (34 C.F.R. Part 82, Appendix B); and the State will require the full certification, as set forth in 34 C.F.R. Part 82, Appendix A, in the award documents for all subawards at all tiers.

The State further assures that it will distribute funds to LEAs on the basis of either – (check one of the boxes below)

• The State’s primary elementary and secondary education funding formula(e) as identified in its application for funding under the SFSF program; or

• The LEAs’ relative shares of funds under Part A of Title I of the Elementary and Secondary Education Act of 1965 for the most recent fiscal year for which data are available.

_____________________________________________

Governor or Authorized Representative (Printed Name)

_____________________________________________ ______________

Signature of Governor or Authorized Representative Date

Appendices to the

Application for Funding under the

Education Jobs Fund Program

APPENDIX A

STATE ALLOCATION DATA

NOTE: The amounts provided in the chart below represent the amount of each State’s estimated Education Jobs Fund allocation (Public Law 111-226, Section 101)

State	Estimated
	Allocations
Alabama	$149,539,554
Alaska	23,540,399
Arizona	211,824,489
Arkansas	91,311,898
California	1,201,534,585
Colorado	159,521,991
Connecticut	110,486,654
Delaware	27,425,111
District of Columbia	18,072,658
Florida	554,821,008
Georgia	322,313,830
Hawaii	39,311,983
Idaho	51,641,026
Illinois	415,397,841
Indiana	207,058,122
Iowa	96,490,048
Kansas	92,457,070
Kentucky	134,945,560
Louisiana	147,031,839
Maine	39,068,602
Maryland	178,929,680
Massachusetts	204,016,907
Michigan	318,132,952
Minnesota	166,717,087
Mississippi	97,823,122
Missouri	189,727,725
Montana	30,737,469
Nebraska	58,890,974
Nevada	83,113,178
New Hampshire	40,988,015
New Jersey	268,104,738
New Mexico	64,869,642
New York	607,591,394
North Carolina	298,458,355
North Dakota	21,517,716
Ohio	361,179,690
Oklahoma	119,380,027
Oregon	117,949,095
Pennsylvania	387,815,661
Puerto Rico	129,371,097
Rhode Island	32,929,312
South Carolina	143,700,517
South Dakota	26,292,261
State	Estimated
	Allocations
Tennessee	195,881,328
Texas	830,820,460
Utah	101,303,951
Vermont	19,304,177
Virginia	249,482,375
Washington	208,335,375
West Virginia	54,657,667
Wisconsin	179,650,099
Wyoming	17,533,686
American Samoa	8,324,352
Guam	20,146,108
Northern Mariana Islands	8,289,850
Virgin Islands	13,239,690
BIE Set-aside	50,000,000
Administrative Set-aside	1,000,000
	10,000,000,000

APPENDIX B

APPLICATION SUBMISSION INFORMATION

SUBMISSION INFORMATION

Please submit your application to the Department as follows:

1. E-mail an electronic version of your application in .PDF (Portable Document) format to [email protected] and

2. Mail the original and two copies of your application by express mail service through the U.S. Postal Service or through a commercial carrier to the following address:

Dr. Joseph C. Conaty

Director, Academic Improvement and Teacher Quality Programs

Office of Elementary and Secondary Education

U.S. Department of Education

400 Maryland Avenue, S.W., Room 3E314

Washington, D.C. 20202