2 Formula Grant EASIE Part II

U.S. DEPARTMENT OF EDUCATION
OFFICE OF ELEMENTARY AND SECONDARY EDUCATION
WASHINGTON, DC 20202-6335

INDIAN EDUCATION PROGRAMS
Application for Formula Grants to
Local Educational Agencies
CFDA Number: 84.060

Formula Grant EASIE
(Electronic Application System for Indian Education)

Part II

Disclaimer:
This is not a paper application but a hardcopy representation of the EASIE online
system. Applicants must apply on EASIE
unless they qualify for and receive a
paper application.
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 Formula Grant EASIE (Electronic Application
System for Indian Education) is 1810-0021. The time required to complete the information collection is estimated to average 7.0
hours per response, inclusive of both Part I and Part II, 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 or suggestions for improving this form, please write to: U.S. Department of Education, Washington, D.C. 202024700. If you have comments or concerns regarding the status of your individual submission of this form, write directly to: Office of
Indian Education, U.S. Department of Education, Lyndon B. Johnson Building, 400 Maryland Avenue, S.W., Room 3E205,
Washington, DC 20202-6335.

U.S. DEPARTMENT OF EDUCATION
Office of Indian Education
This package contains instructions and forms for Part II of the grant applications for the Formula Grants to Local
Educational Agencies Program (CFDA 84.060). The purpose of the Indian Education Formula Grant program,
authorized in Part A, Subpart 1, of Title VII of the Elementary and Secondary Education Act (the Act), is to assist
eligible applicants to provide Indian students with the opportunity to meet the same challenging state standards as
all other students and meet the unique educational and culturally related academic needs of American Indian and
Alaska Native students. The Act and the instructions in this application package are to be used in developing Part
II of your application. Your application provides funds for your school year (SY) 2014-15project.

General Instructions
Applying for Funds
Applicants for grants from the U.S. Department of Education (ED) must compete for limited funds. Deadlines
assure that all applicants are treated fairly, equally, and without last minute haste.
The rules, including the deadline, for applying for each grant are published, individually, in the Federal Register.
A one-year subscription to the Federal Register may be ordered from the U.S. Government Printing Office,
Washington, D.C. 20402-9371. Order from http://bookstore.gpo.gov. The Federal Register is also available free
on the Web at http://www.federalregister.gov.
The instructions in the Federal Register must be followed exactly. Do not accept any other advice you may
receive. No ED employee is authorized to extend any deadline published in the Federal Register.
Questions regarding submission of applications may be addressed to:
U.S. Department of Education
Office of Indian Education
400 Maryland Ave., SW
Washington, D.C. 20202-6335

Formula Grant EASIE
The method for applying for funds for this program is Web-based, using the Formula Grant Electronic Application
System for Indian Education (Formula Grant EASIE). Please see http://www.EASIE.org/ to register for access to
Formula Grant EASIE. If you need assistance, please contact our Partner Support Center:
U.S. Department of Education Partner Support Center
Telephone: 877-457-3336 (877-HLP-EDEN)
Fax: 888-329-3336 (888-FAX-EDEN)
TTY/TDD: 888-403-3336 (888-403-EDEN)
[email protected]

Paper Submission
Paper submission is permitted with pre-arrangements for districts that are unable to use Web-based submission
because they have no Internet connection or inadequate Web access. For paper submission, contact the U.S.
Department of Education EDEN Partner Support Center as shown above.
If you are a district that made pre-arrangements and are submitting a paper form, please follow the directions in
the Federal Register notice for submitting your paper application. Use the forms that you received in response to
your request for paper submission, not the sample forms attached to these instructions.

Application Deadlines
Applications submitted must address all required information in order to be funded.


Part I of the application consists of the Indian Student Count. The deadline for Part I is February 28, 2014.



If Part I is submitted by the closing date, you will complete an application for Part II. The deadline for Part II
is May 30, 2014.

Part II of the application contains five sections:
o Section 1. General Applicant Information: requests identifying information about the
entity or entities applying for funds.
o Section 2. Coordination of Services for American Indian/Alaska Native Students:
requests information about your LEA’s comprehensive program, which may be funded
through a combination of local, State, and/or federal funds.
o Section 3. Project Description: requests information about the objectives, activities, and
evaluation of your proposed Indian Education formula grant project.
o Section 4. Budget Information: requests information about how you plan to spend the Indian
Education formula grant funds.
o Section 5. Other Project Information Required of all Applicants: contains Program
Assurances and certification document
o Section 6. Items Required for Some Applicants: contains Waiver Request and Waiver Use
Report Forms, information for Applications Under 7116, Integration of Services, Parent
Committee Approval form, , and comment box for any additional information.

Late Applications
Late applications will not be accepted. All applicants must meet the pre-established deadlines for both Part I and
Part II to be eligible for funding.

Transmittal Instructions for Formula Grant EASIE
Using Formula Grant EASIE. If you use the online Formula Grant EASIE, application information is transmitted
electronically to the Department. Be sure that you complete the certification screen by clicking the [I
CERTIFY] button. If you don’t click the [I CERTIFY] button, your application is not complete and is not
transmitted. After you certify, click [Continue] and download the PDF file of your application to your computer or
to a disk. You must do this before the due date of the application period. This is your permanent record.

Specific Instructions for Part II
Contact Information, Allocation, and Student Count. This information will be pre-entered for you based on the
information you provided with your Part I application.
Required Items. This application package includes 26 numbered items in 6 sections; each numbered item
consists of one or more questions or one or more tables. Which items you must complete and submit is
determined by several factors.
Type of application (your response to item 1)
 If you are applying as a regular formula grant program, then you must complete and submit items 1 –
20b. Item 20b requires the original signature of an authorized official from your LEA.
 If you are applying as a formula grant project consolidated with a Title I school-wide program, then you
must complete and submit items 1-5, 18-20b.. Item 20b requires the original signature of an authorized
official from your entity.
 If you are applying for integration of services under ESEA section 7116, then you must complete and
submit items 1-5, 18-20a, 23 and 24. Item 20b requires the original signature of an authorized official
from your LEA.
Single entity applicant or multi-entity applicant
 If you are a single-entity applicant (a single LEA, or a single BIE school, or a tribe applying in lieu of a
single LEA), then you must complete each of the required items once for your project, using data for that
entity.
 If you are a multi-entity applicant (a consortium of LEAs, a consortium of BIE schools, or a tribe applying
in lieu of multiple LEAs) then use the following guidelines for submitting required items.
o Complete the following items once for each participating LEA in your project: items 1-5.
o Complete the remaining required items once for your project; the information covers all
participating LEAs.
Administrative Costs
 If your planned budget includes administrative costs of more than 5%, then you must complete and
submit item 21.
 If your most recent prior-year grant award included a waiver of the administrative cap, then you must
complete and submit item 22.
Parent Committee Requirements
 If you are not a Bureau of Indian Education entity or a tribe applying in lieu of an LEA(s), then you must
complete and submit item 25. This item must be signed by representatives of the Parent Committee and
submitted with your application.
 If you are a Bureau of Indian Education entity or a tribe applying in lieu of an LEA(s), then you do not
need to complete and submit item 25.
 The Parent Committee form must be received on or before the EASIE Part II deadline to be considered
eligible for funding.
Comments to the Office of Indian Education
 Item 26 is available to any applicant that wishes to provide brief explanatory information about their
application.
Please be certain to complete all required items and to include all required forms in your submission
package. Also be sure to provide a copy to your state education agency, as specified in the general
instructions on p. 3 and to keep a file copy for yourself.
Item-by-Item Instructions. Instructions for each item are contained in the form. Consult the FAQ document for
additional explanatory information. To access the FAQ document, go to the main page of EASIE and click on
Getting Started. The first page of Getting Started provides a button to download the FAQ document. If you don’t
have access to the Internet, you can obtain the FAQ document by calling the Partner Support Center; see contact
information provided on p. 2 of this application package.
This application contains a very limited amount of free narrative response. Where you are asked to select items
from a list to enter into a table, please use only those items. Other responses will not be accepted.

Application for SY 2014-15 Funds Under the
Indian Education Formula Grants to Local Educational Agencies
Part II

SECTION 1: GENERAL APPLICATION INFORMATION
1. PROJECT IDENTIFYING INFORMATION
Please fill in the following information:
Applicant Name:
DUNS #
PR #
Address:
Contact Name:
Telephone:
E-mail:

Allocation:
Allocation was based on student count of:

2. Application Type. Identify the type of application you are submitting for SY 2014-15 (check exactly
one):
___ Regular formula grant program (complete items 1 – 20b; complete items 21 and/or 22 if they apply for a
waiver; and complete item 25 unless you are a school funded by the Bureau of Indian Education or a
tribe applying in lieu of an LEA; complete item 26 if needed.)
___ Formula grant project consolidated with a Title I school-wide program (complete items 1-5, and 1820b; complete item 25 unless you are a school funded by the Bureau of Indian Education or tribe
applying in lieu of an LEA; complete item 26 if needed.)
___ Integration of services under ESEA section 7116 (complete items 1-5, 18-20b 23, and 24; complete
item 25 unless you are a school funded by the Bureau of Indian Education or a tribe applying in lieu
of an LEA; complete item 26 if needed.)
Award start date. The date for your SY 2014 – 15 grant award to begin is July 1, 2014. The end date of
the award period will automatically be June 30, 2015.

3. Grades Offered in SY 2013 – 14. Indicate the grade levels offered by this LEA. Check all that apply.
Grades offered refers to the grades at which instruction is offered to students by the LEA or BIE school.
This is unrelated to whether any Indian students are in that grade or whether your Title VII project will
provide activities for that grade.
___PK ___K ___1 ___2 ___3 ___4 ___5 ___6 ___7 ___8 ___9 ___10 ___11 ___12

Section 2: Coordination of Services for American Indian/Alaska Native Students
4. Coordination of Services with Formula Grant Programs.
Please indicate which of the following LEA programs: [a] were available in your district during the last
school year (2013-2014); and [b] if that program is currently coordinated with Title VII services.

Programs

[a] Is this
program
available?
YES

Department of Education Formula Grant Programs (please specify):
Title I
Homeless Children and Youth
Title III: English Language Acquisition
School Improvement Grants
Rural and Low-Income School Program
Impact Aid
Migrant Education
Other:
Other:
Other Federal, tribal, State, or local Programs (please specify):
BIE: Johnson O'Malley
Other:
Other:

NO

[b] Is this
program
coordinated
with Title VII
services?
YES
NO

5. Description of Coordinated Services for American Indian/Alaska Native Students.
Each application must include a description of the applicant’s comprehensive program for meeting the
culturally related academic needs of Indian children, including their language and cultural needs.
Describe how the Coordination of Services for AI/AN Students (using a variety of funding sources)
will meet the needs of AI/AN students, including their language and cultural needs with an
explanation of specific programs and activities. In your explanation, also include programs from the
chart above in item 4 (Coordination of Services with Formula Grant Programs) that currently
coordinate with your Title VII project, or which will coordinate with Title VII during the grant year.
Enter narrative response here (Please limit to 1,000 characters):

Section 3: Indian Education Project Description
Applicants submitting as a Title VII project consolidated with a Title I school-wide program should skip
to Section 4
Applicants submitting under section 7116 (Integrated Services) should skip items 9 and 10 and go to
item 23.

6. Indian Education Formula Grant Objectives.
Identify your specific project objectives towards the goal of providing culturally-responsive
education for AI/AN students to meet their academic needs and help them meet State
achievement standards. The objectives listed in the table align to the allowable activities and
services as specified in Section 7115(b) of the ESEA.
Permissible Values for Item 6
Objective: The goal of providing culturallyresponsive education for AI/AN students to meet
their academic needs and help them meet State
achievement standards.

 Increase school readiness
 Increase integration of Indian specific
content into curriculum
 Increase academic achievement
 Increase knowledge of cultural identity
and awareness
 Enhance problem solving and
cognitive skills development
 Increase school attendance rate
 Decrease school dropout rate
 Increase graduation rate
 Increase career readiness skills (e.g.,
technology skills, leadership skills)
 Increase college enrollment
 Increase substance abuse prevention
 Increase parent participation

Column a
Type(s) of supplemental activity or service

















Culturally-responsive early childhood
programs and activities
Culturally-responsive professional
development
Curriculum development integrating
local knowledge, language and
culture
Indian education (e.g., language,
history)
Cultural enrichment (e.g., events,
field trips, clubs)
Culturally-responsive academic
support (e.g., study skills, homework
support)
o overall
o in reading or ELA
o in mathematics
o in science
o in other subjects (e.g., social
studies)
Culturally-responsive academic
enrichment (e.g., after school
programs, projects)
College preparation (e.g., ACT or
SAT preparation, exploration,
advanced placement classes or
testing)
Career preparation (e.g., technology
skills, internships)
Gifted and talented programs
Student advocacy or leadership
Culturally-responsive mentoring
Substance abuse prevention

Column b
Grade levels served by
activity or service

 Pre-K
 Elementary
school grades
 Middle school
grades
 High school
grades

Objective: The goal of providing culturallyresponsive education for AI/AN students to meet
their academic needs and help them meet State
achievement standards.

Column a
Type(s) of supplemental activity or service





Column b
Grade levels served by
activity or service

Culturally-responsive counseling
Family literacy with culturally-based
materials
Parent involvement

Instructions for completing the table:
(1) Complete a separate table for each objective. You must have at least one objective;
however, you may have several.
(2) Select a permissible value for each objective.
(3) In column a, identify each activity or service that will be used to address the objective.
Use a separate row for each activity or service.
(4) In column b, identify the grade levels to be served by each activity or service.
Item 6 Proposed Project Objectives for SY 2014 – 15
Objective #1:

Column a
Type(s) of activity or service

Column b
Grade levels served by activity or
service

Item 6 Proposed Project Objectives for SY 2014 – 15
Objective #2:

Column a
Type(s) of activity or service

Column b
Grade levels served by activity or
service

7. Program Objectives Data Sources. Use this section to describe how you will measure
progress on each of the objectives.
Permissible Values for Item 7














Column a.
Objective
Increase school readiness
Increase integration of Indian specific
content into curriculum
Increase academic achievement
Increase knowledge of cultural identity and
awareness
Enhance problem solving and cognitive
skills development
Increase school attendance rate
Decrease school dropout rate
Increase graduation rate
Increase career readiness skills (e.g.,
technology skills, leadership skills)
Increase college enrollment
Increase substance abuse prevention
Increase parent participation



















Column b.
Data source
School readiness screening
Documents (e.g., lesson plans, curriculum)
State standardized test
District benchmark assessment
Other standardized achievement test
Non-standardized achievement test
Student portfolios
Teacher surveys, interviews, or focus groups
Classroom observations
Parent surveys, interviews, or focus groups
Student surveys, interviews, or focus groups
Administrator surveys, interviews, or focus groups
Attendance data
Dropout data
Graduation data
College application and acceptance data
Other data source – If you select “Other data source” enter
“Other data source” in column b of a row and also specify the
data source

Instructions for completing the table:
(1) In column a, identify the objectives chosen in item 8a. Use a separate row for each
objective.
(2) In column b, identify the data source(s) for each objective in column a. Identify at least
one data source for each objective. If you identify more than one data source for an
objective, use a new row for each objective and data source combination.
(3)

I
Item 7 Data Sources
Column a
Objective

Column b
Data source

8. Coordination of Services Professional Development.
Describe the professional development opportunities that will be provided by your coordination of
services to ensure that teachers and other school professionals who are new to the Indian
community are prepared to work with Indian children, and all teachers who will be involved in
programs assisted by this grant, have been properly trained to carry out such programs. The
professional development opportunity or opportunities can be funded using other local, State, and/or
federal funds. (The specific use of Indian Education formula grant funds will be detailed in Section4.)
Note: The professional development opportunity or opportunities identified in item 8 do not have to be
new opportunities or opportunities for which funding is requested. Applicants should include existing
professional development opportunities that will continue to be implemented in the school year for
which funding is requested, as long as those opportunities are components of the coordinated
services program.
Permissible Values for Item 8
Pick one of the following to enter
Pick one of the following to enter in
in column a
column b
(Types of staff)
(Type of professional development
activity)
 All teachers and other school
professionals
 Teachers and other school
professionals that are new to the
Indian community

 Workshops/Sessions
 Conferences, including national,
regional, state, or LEA-sponsored
 Pre-service training or orientation

 Subset of teachers

 School-based coaching or mentoring

 LEA staff (example, Title VII
coordinators)

 Other (example: online courses,
webinars, Tribal Agency training)--if
you select “Other” as a professional
development activity, enter “Other” in
column b of a row and also specify the
activity there.

 Other non-teaching staff
(examples: counselors, Parent
Committee)

Pick one of the following to enter in
column c
(Content)
 Integrating Indian- specific content into
the general curriculum
 Indian Education-specific
(example: instruction specific to
language or specific Indian
curricula)
 Cultural Awareness Education and
Sensitivity (example: working with Indian
students)
 Use of Data/ Data-driven decision
making (example: examining
patterns in Indian Student test data;
using data to focus instruction for AI
students; identification of exceptional
students)
 Impact of district policies on AI students
(example: grading policies, attendance
policies, discipline, suspensions, etc.)
 Other--if you select “Other” as
content, enter “Other” in column
c of a row and also specify the
content there.

Instructions for completing the table:
(1) Using permissible values, enter the types of staff that will be served by professional development
activities to support the coordination of services program in column a. Use a new row for each
type of staff.
(2) Using permissible values, in column b enter the type of professional development activity that
each type of staff identified in column a will receive.
(3) Using permissible values, in column c enter the content of each professional development activity
entered in column b.
Item 8
Coordination of Services Program Professional Development Activities for SY 2014 – 15
Column b
Column c
Column a
Content
Type of professional development
Types of staff
activity

You may duplicate this table, as needed.

SECTION 4: BUDGET INFORMATION
Complete the budget section for your project (not separately for each participating LEA). The budget
must match the objectives you selected for items in section 3. The information you enter covers the
entire project including all participating LEAs.
Total costs in your budget cannot exceed your allocation. If your administrative costs exceed 5% of your
allocation, you must reduce those costs to less than 5%, or complete the waiver request form (item 21
and 22).
Note: Applicants submitting as a Title VII project consolidated with a Title I school-wide program should skip Section 4. Applicants
submitting under section 7116 (Integrated Services) must complete item 23 in lieu of items 11 – 18.

9. Supplemental Information.
□ By checking this box, I will ensure that the Indian Education formula grant funds will supplement and not
supplant other funding for the education of Indian children, with the goal of providing culturallyresponsive education to meet the academic needs of AI/AN students and to assist those students in
meeting State achievement standards. See FAQs for guidance and examples.
10. Personnel Budget. Complete the table for personnel to be funded by the project.
Permissible values. Complete rows a-g (Project Director and Project Coordinator) as they are applicable.
Complete additional rows for each type of personnel at each certification status and each percentage of
time. [Example, if you have some academic advisors who work 20% time on the project and other
academic advisors who work 30% time on the project, you would need to complete two rows for
academic advisors.]
Choose values for columns a from the following table of permissible values.
Permissible Values for Table 11.
For each row, pick one of the following values for
For each row, pick one of the following values for
column a.
column b. Use the abbreviation.
Academic Advisors
Administrative Assistants
College instructors
Consultants
Counselors, Guidance
Counselors, Mental Health
Cultural Resource Specialists
Curriculum Specialists
Data Specialists
Home/School Coordinators
Instructional Assistants
Language Instructors
Liaisons, Home/School or Community
Nutrition Specialists
Reading Coaches or Specialists
Social workers
Support, Clerical or Secretarial
Teachers
Tribal Elders
Youth Development Specialists
Other
(If you select “Other”, enter “Other” in column a of a row
and also specify the personnel type it represents.

For each row, enter in column b the number of personnel in this group; enter in column c the percent of
time that group of personnel will be assigned to and funded by the project; enter dollar values in columns

d,e and f; enter in column g the sum of the values for columns d, e, and f for that row. Use as many rows
as necessary.
On the last row of your table, enter the column totals for columns d, e, f, and g.

a
Type of Personnel

Your Project’s Personnel Budget for SY 2014-15
b
c
d
e
f
g
#
% of
Admin Program Fringe
Total
time
Cost ($) Cost ($) Cost ($) Cost ($)

Project Director
Project Coordinator

Category Subtotals

11. Travel Budget. Complete the table for travel to be funded by the project.
Enter the dollar value for each type of travel. Enter row and column totals.

Type of Travel
In-district (non-PD)
Out of district (non-PD)
Professional development
(only)
Category Subtotals

Your Project’s Travel Budget for SY 2014-15
Admin Cost ($)
Program Cost ($)

Total Cost ($)

12. Equipment Budget. Complete the table for equipment to be funded by the program (defined as a
single item with value exceeding $5,000).
In column a, identify the item in your own words. In column b, enter the code to identify the purpose as
one of the following:
Instr = Instructional Service Delivery
Prog Mgmt = Program Management
In columns c and d, enter dollar values. Use as many rows as necessary. Enter row and column totals.

a
Item

Your Project’s Equipment Budget for SY 2014-15
b
c
d
e
Purpose
Admin Cost ($) Program Cost ($) Total Cost ($)

Category Subtotals

13. Supplies Budget. Complete the table for supplies to be funded by the project.
Enter the dollar value for supplies of each listed type. Note that Direct Instructional Materials and Student
Consumables have no administrative cost. Enter row and column totals.
Your Project’s Supplies Budget for SY 2014-15
a
b
c
Item
Admin Cost ($)
Program Cost ($)
Direct Instructional Delivery
Student Consumables
Program Management
Category Subtotals

d
Total Cost ($)

14. Contractual Budget. Complete the table for contractual services to be funded by the project.
Enter the dollar value for contractual services for each listed purpose. Note that Direct Instructional
Materials and Student Consumables have no administrative cost. If you use the row for “Other”, describe
the expense in the column a. Enter row and column totals.
Your Project’s Contractual Budget for SY 2014-15
a
b
c
Purpose
Admin Cost ($)
Program Cost ($)
Direct Instructional Delivery
Student Evaluations
Other. Specify:

d
Total Cost ($)

Category subtotals

15. Other Budget. Complete the table for other expenses to be funded by the project.
Enter the dollar value for other expenses for each listed purpose. Note that Direct Instructional Materials,
Student Activities Related to Services, and Student Consumables have no administrative cost. If you use
the row for “Other”, describe the expense in the column a. Enter row and column totals.

a
Purpose
Direct Instructional Delivery
Student Activities Related to
Services
Professional Development
(non-travel related)
Other. Specify:

Your Project’s Other Budget for SY 2014-15
b
c
Admin Cost ($)
Program Cost ($)

Category subtotals

d
Total Cost ($)

16. Indirect costs. Enter your entity’s restricted indirect cost rate. The rate should be entered as a
percent and may have up to two decimal places (e.g. 4.08%). If you choose to budget project funds for
indirect costs, enter the total amount of indirect costs associated with the project. You are entitled to
budget indirect costs from your Title VII allocation up to a maximum of your indirect cost rate times your
allocation. You can budget a lesser amount of your indirect costs from your Title VII allocation. You do
not have to budget for indirect costs. In that case, you may leave the table blank.
Your Project’s Indirect Costs for SY 2014-15
Rate (%)
Total ($)

17a. Budget Summary. Transcribe the “category total” from each budget category to column b of this
summary table. The “category total” is the value in the bottom right-hand cell of each category table. Be
sure that the values in the summary table match the values in the category tables. Enter the percent for
each row and enter column totals.
Your Project’s Budget Summary for SY 2014-15
a
b
c
Budget Category
Category Subtotal
Percent of Overall Allocation
Personnel
Travel
Equipment
Supplies
Contractual
Other
Total Direct Charges
Indirect Costs
Total Costs

17b. Administrative Costs Summary. Administrative costs cannot exceed 5% of your grant award.
Transcribe the category subtotals for administrative costs to column b in the following table. The category
subtotals for administrative costs are found as the last row of the administrative cost column of each of
the budget category tables except indirect cost. Be sure the values in the administrative cost summary
table match the values in the category tables. In the last row, enter the total Administrative Cost in
column b. In column c, enter the percent calculated as the last row of column b divided by the LEA’s total
allocation for the Indian Education formula grant for SY 2014-15.
Your Project’s Administrative Cost Summary for SY 2014-15
a
b
c
Budget Category
Administrative Cost
Percent of Overall Allocation
Category Total
Personnel
Travel
Equipment
Supplies
Contractual
Other
Totals
If the value in the last row of column c is more than 5%, then you are required complete and submit the
waiver request (item 21).

SECTION 5: OTHER PROJECT INFORMATION REQUIRED OF ALL APPLICANTS
18. Dissemination of Assessment Data. Provide information on how the state assessment data of all
Indian students (not just those served) are used. Indicate how you plan to disseminate information to the
Indian community and Parent Committee. Check all that apply. All applicants must respond to these
items.
Method of dissemination to Indian community and Parent Committee:
___ Public hearing for application
___ Parent Committee meeting
___ Other open meeting
___ Within a written report
___ Posted on website
___ Sent home with student(s)
___ Radio broadcast
___ Newsletter
19. Additional Assessment Data Use. Indicate how assessment data from the previous school year
were used (check all that apply)
___ No changes in services/programs
___ Modification to services/programs at LEA level Describe: ___________________________
___ Modification to services/programs within project Describe: ___________________________

20a. Program Assurances. The following are the program assurances that are referenced in item 20b
and to which the applicant LEA must agree. The signature of the authorizing official in item 20b will
indicate agreement to these provisions.
Additional Program Assurances for 84.060 - Indian Education Formula Grants
1.

If the applicant is an LEA, it assures that funds received under this program will be used only to supplement
the level of funds that, in the absence of the Federal funds made available under this program, the LEA
would make available for the education of Indian children, and not to supplant such funds. (Section
7114(c)(1) of Part A, Title VII)

2.

It assures that it will submit a performance report, or, for the last year of a project, a final report, that
evaluates at least annually: (a) the grantee's progress in achieving the objectives in its approved
application; (b) the effectiveness of the project in meeting the purposes of the program; and (c) the effect of
the project on participants being served by the project. (34 CFR 75.590)

3.

It assures that it will cooperate in any evaluation of the program by the Secretary. (34 CFR 75.591)

4.

It assures that the program for which funds are sought is based on a comprehensive local assessment and
prioritization of the unique educational and culturally related academic needs of the American Indian and
Alaska Native students for whom the LEA is providing an education. (Section 7114(c)(3) of Part A, Title VII)

5.

It assures that it will use the best available talents and resources, including persons from the Indian
community. (Section 7114(c)(3) of Part A, Title VII)

6.

It assures that it has developed the project for which application is made (a) in open consultation with
parents of Indian children and teachers and, if appropriate, Indian students from secondary schools,
including through public hearings held to provide a full opportunity to understand the program and to offer
recommendations regarding the program; and (b) with the participation of a parent committee selected in
accordance with section 7114(c) of the statute; and (c) with the written approval of that parent committee.
(Section 7114(c)(3)(4) of Part A, Title VII)

7.

It assures, if it is a local educational agency, that the parent committee will adopt and abide by reasonable
by-laws for the conduct of the activities of the committee. (Section 7114(c)(4) of Part A, Title VII)

8. It assures that the LEA has established policies and procedures, including policies and procedures
relating to the hiring of personnel, will ensure that the program will be operated and evaluated in
consultation with, and with the involvement of, parents of the children, and representatives of the
area, to be served. (Section 7114(c)(4)).
9.

It assures that an application for inclusion of these program funds in a Title I school-wide project, has been
approved, in writing, by the parent committee and that the parent committee was allowed to review the
application in a timely fashion, has determined that the program will not diminish the availability of culturally
related activities for American Indians and Alaska Native students, and has determined that the Title I schoolwide project meets the purpose of the Indian education formula grant program. (Sections 7114(c)(4)(D) and
7115(c) of Part A, Title VII)It assures that it will directly administer or supervise the administration of the project.
(34 CFR 75.701)It assures that it will keep records related to grant funds, program compliance and program
performance and will afford the Secretary access to these records as the Secretary may find necessary to assure
the correctness and verification of reports made by the applicant. (34 CFR sections 75.730-.732)

10. It assures that it has fiscal control and fund accounting procedures that insure proper disbursement of and
accounting for Federal funds. (34 CFR 75.702)
11. Pursuant to Section 9306(a) of the Elementary and Secondary Education Act, it assures that:


The program will be administered in accordance with all applicable statutes, regulations, program plans,
and application;



The control of funds provided under the program and title to property acquired with program funds will
be in a public agency or in a nonprofit private agency, institution, organization, or Indian tribe, if the law
authorizing the program provides for assistance to those entities and who will administer these funds
and property to the extent required by the authorizing statute;



The applicant will adopt and use proper methods of administering the program, including -- the
enforcement of any obligations imposed by law on agencies, institutions, organizations, and other
recipients responsible for carrying out the program; and the correction of deficiencies in program
operations that are identified through audits, monitoring, or evaluation;



The applicant will cooperate in carrying out any evaluation of the program conducted by or for the State
educational agency (SEA, if the applicant is an LEA), the Secretary or other Federal officials;



The applicant will make reports, maintain records, provide information, and afford access to the State
educational agency and the Secretary as may be necessary to enable the SEA, for LEA applicants,
and the Secretary to carry out and perform their duties under this program; and



Before the application is submitted, the applicant affords a reasonable opportunity for public comment
on the application and has considered those comments.

20b. Certification. An authorized official must certify as follows.
The applicant certifies that by accepting the award for the Indian Education Formula Grant
Program, this grantee will comply with all program assurances, agrees to carry out the program
and meet all applicable requirements described herein. A copy of the Parent Committee
Approval form (if applicable) is uploaded with this certification no later than the EASIE Part II
deadline.
Signature:________________________________
_________________________________________
Printed Name
Title

________________
Date

SECTION 6: ITEMS REQUIRED FOR SOME APPLICANTS
21. Waiver Request. If your project’s administrative costs for SY 2014-15 are budgeted at more than
5% of your allocation, you must complete the following form.
Waiver Request for SY 2014-15
Indian Education Formula Grant Program
The administrative costs associated with this application total ______%.
Under the authority of Section 9401, a waiver is requested of the following statutory requirement:
 Administrative cap of 5% on grant funds under the Indian Education Formula Grant
Program to Local Education Agencies (section 7115(d)).
This waiver is requested by:
LEA Name: __________________________________________________________
Mailing Address:_______________________________________________________
City/State/Zip_________________________________________________________

The waiving of this requirement will increase the quality of instruction for students by:

The waiving of this requirement will improve the academic achievement of students as follows:

The methods for measuring and evaluating the educational goals of the program are described within the accompanying
application for the Indian Education Formula Grant Program. Approval of this waiver will not affect the population to be
served by this application. The students to be served are those students certified as Indian according to the Indian
Student Eligibility Form (ED 506 form) and for whom the services of this project are targeted according to the project’s
objectives.
The duration of this waiver will be for a maximum period of one year.

Authorized signature: __________________________________

___________________________________________________
Printed Name:
Title:

________________________
Date

22. Waiver Use Report. If you received a waiver of the administrative cap for your prior year’s grant,
you must complete the following form.
Waiver Use Report
Indian Education Formula Grant Program

For the previous grant year, the following LEA received a waiver of the requirement restricting
the use of program funds for administrative purposes to 5%.
LEA Name: __________________________________________________________
Mailing Address:_______________________________________________________
City/State/Zip_________________________________________________________

Complete the following statements:
Under the waiver, the grantee
 Utilized ____% of the total funds for administrative purposes.
 Used these funds for administrative purposes to increase the quality of instruction to
students as follows:

 Is improving the academic achievement of students as follows:

23. Program Summary for Applications Under Section 7116, Integrated Services. This table is must
be completed by projects that submit a plan for the integration of education and related services provided
to Indian students under Section 7116 of the Elementary and Secondary Education Act, as amended.
Funds from any Federal program exclusively serving Indian children, or the funds reserved under any
Federal program to exclusively serve Indian children, received through a statutory or administrative
formula for the purposes of providing education and related services to serve Indian students, may be
consolidated in a demonstration project that integrates the program services involved into a single,
coordinated, comprehensive program and reduces administrative costs by consolidating administrative
functions.
Applicants submitting under this provision must complete the following table in lieu of table 9. List the
services to be provided, the entity providing the service, and the timeframe for service delivery.
Your Project Summary for a SY 2014-15 Application Under Section 7116
a
b
c
Service(s) to be Provided
Entity Providing Service
Timeframe for Service Delivery

24. Budget Summary for Applications Under Section 7116, Integrated Services. This budget table
must be completed by projects that submit a plan for the integration of education and related services
provided to Indian students under Section 7116 of the Elementary and Secondary Education Act, as
amended. Funds from any Federal program exclusively serving Indian children, or the funds reserved
under any Federal program to exclusively serve Indian children, received through a statutory or
administrative formula for the purposes of providing education and related services to serve Indian
students, may be consolidated in a demonstration project that integrates the program services involved
into a single, coordinated, comprehensive program and reduces administrative costs by consolidating
administrative functions.
Applicants submitting under this provision must complete the following table in lieu of tables 11-18. List
the programs to be consolidated and the estimated amount of each.
Your Project’s Funding Summary for a SY 2014-15 Application Under Section 7116
a
b
c
Program
Funding Agency
Estimated Amount

25. Parent Committee Approval. This item must be completed and submitted with LEA applications
and LEA consortium applications on or before the certification deadline by upload within the EASIE
system, unless you are approved to submit the form outside the EASIE system. The form must contain
original signatures of the required members of the Parent Committee (PC) for that applicant. The
applicant and Parent Committee (PC) are to locally determine the number of PC members that are
required for PC approval of the application. Please see the FAQs for more detail about this
requirement.
Note: This form is not required of schools funded by the Bureau of Indian Education or a tribe that is applying in lieu of an LEA(s).

PARENT COMMITTEE APPROVAL OF A TITLE VII FORMULA GRANT PROGRAM
Elementary and Secondary Education Act, Title VII, Part A, Subpart 1

Name: ____________________________________
PR Award #: _______________________________
Address __________________________________

Check the type of application submitted.
Check only one box:
 Regular formula grant program
 Title I school-wide program
 Integration of Services (Section 7116)

City/State/Zip ______________________________
Additional Assurances (Check all that apply):


This certifies that the Parent Committee for the above entity has participated in the development of the application
for Title VII funds and approves the proposed project.



The application is for a regular formula grant project.



o

The Parent Committee has established bylaws.

o

The Parent Committee is composed of parents/guardians of Indian children in the local educational
agency's schools; teachers in the schools; and if appropriate, Indian students attending secondary
schools of the agency.

The application submitted will include project funds in a Title I school-wide program.
o

The Parent Committee determined that the program will not diminish the availability of culturally related
activities for American Indian and Alaska Native students.

o

The Parent Committee also certifies that it had an opportunity to review the program in a timely fashion
and it is consistent with the purpose of the formula grant program for American Indian and Alaska Native
students.

The written approval of the parent committee must be obtained before Part II closes and must be uploaded within the
EASIE system. The Parent Committee locally determines the number of PC members that are required for PC approval of
the application. Parent committee members’ signatures, titles and date are required.

_________________________________

_________________________________

Name

Name

Date

Date

Title: (Choose one)

Parent/Guardian

Teacher

High School Student

Other _______________________

Title: (Choose one)

Parent/Guardian

Teacher

High School Student

Other _______________________

___________________________________
Name
Date

___________________________________
Name
Date

Title: (Choose one)

Parent/Guardian

Teacher

High School Student

Other _______________________

Title: (Choose one)

Parent/Guardian

Teacher

High School Student

Other _______________________

26. Comment.
Use the space below (limited to 1,000 characters) to provide additional information that will assist the
Department in analyzing your application.
If not needed for the above reasons this comment item can be left blank.

Applicant Comment: