Texas Education Agency
2017-2018 ESC PRIORITY SCHOOL SUPPORTProgram authority:P.L. 107-110, ESEA as amended by NCLB Act of 2001, Title I, Part A FOR TEA USE ONLYWrite NOGA ID here:Grant PeriodStamp-in Date, to August 31, 2018. Pre-award costs are permitted from December 1, 2017, to stamp-in date.Application deadline:5:00 p.m. Central Time, March 23, 2018.Place date stamp here.Submittal information:Three complete copies of the application, printed on one side only. All copies must have an original signature (blue ink preferred) of the person authorized to bind the applicant in a contract. Applications must be received no later than the aforementioned time and date at this address:Document Control Center, Grants Administration DivisionTexas Education Agency, 1701 North Congress AveAustin, TX 78701-1494Contact information:Lizette Ridgeway: lizette.ridgeway@tea.; (512) 463-5226Schedule #1—General Information Part 1: Applicant InformationOrganization nameCounty-District #Amendment # FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Vendor ID #ESC Region #DUNS # FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Mailing addressCityStateZIP Code FORMTEXT ????? FORMTEXT ????? FORMTEXT TX FORMTEXT ?????- FORMTEXT ?????Primary Contact First nameM.I.Last nameTitle FORMTEXT ????? FORMTEXT ?? FORMTEXT ????? FORMTEXT ?????Telephone #Email addressFAX # FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Secondary Contact First nameM.I.Last nameTitle FORMTEXT ????? FORMTEXT ???? FORMTEXT ????? FORMTEXT ?????Telephone #Email addressFAX # FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Part 2: Certification and IncorporationI hereby certify that the information contained in this application is, to the best of my knowledge, correct and that the organization named above has authorized me as its representative to obligate this organization in a legally binding contractual agreement. I further certify that any ensuing program and activity will be conducted in accordance with all applicable federal and state laws and regulations, application guidelines and instructions, the general provisions and assurances, debarment and suspension certification, lobbying certification requirements, special provisions and assurances, and the schedules attached as applicable. It is understood by the applicant that this application constitutes an offer and, if accepted by the Agency or renegotiated to acceptance, will form a binding agreement.Authorized Official:First nameM.I.Last nameTitle FORMTEXT ????? FORMTEXT ???? FORMTEXT ????? FORMTEXT ?????Telephone #Email addressFAX # FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Signature (blue ink preferred)Date signed FORMTEXT ?????Only the legally responsible party may sign this application.Schedule #1—General InformationCounty-district number or vendor ID: FORMTEXT ?????Amendment # (for amendments only): FORMTEXT ????Part 3: Schedules Required for New or Amended ApplicationsAn X in the “New” column indicates a required schedule that must be submitted as part of any new application. The applicant must mark the “New” checkbox for each additional schedule submitted to complete the application. For amended applications, the applicant must mark the “Amended” checkbox for each schedule being submitted as part of the amendment.Schedule #Schedule NameApplication TypeNewAmended1General Information FORMCHECKBOX FORMCHECKBOX 2Required Attachments and Provisions and Assurances FORMCHECKBOX N/A4Request for AmendmentN/A FORMCHECKBOX 5Program Executive Summary FORMCHECKBOX FORMCHECKBOX 6Program Budget Summary FORMCHECKBOX FORMCHECKBOX 7Payroll Costs (6100) FORMCHECKBOX FORMCHECKBOX 8Professional and Contracted Services (6200) FORMCHECKBOX FORMCHECKBOX 9Supplies and Materials (6300) FORMCHECKBOX FORMCHECKBOX 10Other Operating Costs (6400) FORMCHECKBOX FORMCHECKBOX 17Responses to TEA Requirements FORMCHECKBOX FORMCHECKBOX 18Equitable Access and Participation FORMCHECKBOX FORMCHECKBOX Schedule #2—Required Attachments and Provisions and AssurancesCounty-district number or vendor ID: FORMTEXT ?????Amendment # (for amendments only): FORMTEXT ????Part 1: Required AttachmentsThe following table lists the fiscal-related and program-related documents that are required to be submitted with the application (attached to the back of each copy, as an appendix). #Applicant TypeName of Required Fiscal-Related Attachment No fiscal-related attachments are required for this grant. #Name of Required Program-Related AttachmentDescription of Required Program-Related AttachmentNo program-related attachments are required for this grantPart 2: Acceptance and ComplianceBy marking an X in each of the boxes below, the authorized official who signs Schedule #1—General Information certifies his or her acceptance of and compliance with all of the following guidelines, provisions, and assurances. Note that provisions and assurances specific to this program are listed separately, in Part 3 of this schedule, and require a separate certification.XAcceptance and Compliance FORMCHECKBOX I certify my acceptance of and compliance with the General and Fiscal Guidelines. FORMCHECKBOX I certify my acceptance of and compliance with the program guidelines for this grant. FORMCHECKBOX I certify my acceptance of and compliance with all General Provisions and Assurances requirements. FORMCHECKBOX I certify that I am not debarred or suspended. I also certify my acceptance of and compliance with all Debarment and Suspension Certification requirements. FORMCHECKBOX I certify that this organization does not spend federal appropriated funds for lobbying activities and certify my acceptance of and compliance with all Lobbying Certification requirements. FORMCHECKBOX I certify my acceptance of and compliance with No Child Left Behind Act of 2001 Provisions and Assurances requirements.Schedule #2—Required Attachments and Provisions and AssurancesCounty-district number or vendor ID: FORMTEXT ?????Amendment # (for amendments only): FORMTEXT ????Part 3: Program-Specific Provisions and Assurances FORMCHECKBOX I certify my acceptance of and compliance with all program-specific provisions and assurances listed below.#Provision/Assurance1.The applicant provides assurance that program funds will supplement (increase the level of service), and not supplant (replace) state mandates, State Board of Education rules, and activities previously conducted with state or local funds. The applicant provides assurance that state or local funds may not be decreased or diverted for other purposes merely because of the availability of these funds. The applicant provides assurance that program services and activities to be funded from this grant will be supplementary to existing services and activities and will not be used for any services or activities required by state law, State Board of Education rules, or local policy. 2.The applicant provides assurance that the application does not contain any information that would be protected by the Family Educational Rights and Privacy Act (FERPA) from general release to the public.3.The applicant provides assurance to collect all required data and report on Priority school participation in ESC activities offered under the Priority School Support Activity Plan Major activities delivered during the reporting period.4.The applicant provides assurance to collect documentation on the progress monitoring and performance of priority schools.5.The applicant provides assurance that it will carry out the full scope of the program as described in the Program Guidelines.6.The applicant shall provide the Texas Education Agency, upon request, any additional expenditure and performance data necessary to assess the success of the program.Schedule #4—Request for AmendmentCounty-district number or vendor ID: FORMTEXT ?????Amendment # (for amendments only): FORMTEXT ????Part 1: Submitting an AmendmentThis schedule is used to amend a grant application that has been approved by TEA and issued a Notice of Grant Award (NOGA). Do not submit this schedule with the original grant application. Refer to the instructions to this schedule for information on what schedules must be submitted with an amendment.An amendment may be submitted by mail or by fax. Do not submit the same amendment by both methods. Amendments submitted via email will not be accepted. If the amendment is mailed, submit three copies of each schedule pertinent to the amendment to the following address: Document Control Center, Grants Administration Division, Texas Education Agency, 1701 N. Congress Ave., Austin, TX 78701-1494.If the amendment is faxed, submit one copy of each schedule pertinent to the amendment to either of the following fax numbers: (512) 463-9811 or (512) 463-7915.The last day to submit an amendment to TEA is listed on the TEA Grant Opportunities page. An amendment is effective on the day TEA receives it in substantially approvable form. All amendments are subject to review and approval by TEA.Part 2: When an Amendment Is RequiredFor all grants, regardless of dollar amount, prior written approval is required to make certain changes to the application. Refer to the “When to Amend the Application” guidance posted in the Amendment Submission Guidance section of the Grants Administration Division Administering a Grant page to determine when an amendment is required for this grant. Use that guidance to complete Part 3 and Part 4 of this schedule.Part 3: Revised BudgetABCD#Schedule #Class/Object CodeGrand Total from Previously Approved BudgetAmount DeletedAmount AddedNew Grand Total1.Schedule #7: Payroll6100$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????2.Schedule #8: Contracted Services6200$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????3.Schedule #9: Supplies and Materials6300$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????4.Schedule #10: Other Operating Costs6400$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????5.Total direct costs:$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????6.Indirect cost ( FORMTEXT ??%):$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????7.Total costs:$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????Schedule #4—Request for Amendment (cont.)County-district number or vendor ID: FORMTEXT ?????Amendment # (for amendments only): FORMTEXT ????Part 4: Amendment JustificationLine #Schedule # Being AmendedDescription of ChangeReason for Change1.2.3.4.5.6.7.Schedule #5—Program Executive SummaryCounty-district number or vendor ID: FORMTEXT ?????Amendment # (for amendments only): FORMTEXT ????Provide a brief overview of the program you plan to deliver. Refer to the Program-Specific instructions for a description of the requested elements of the summary. Response is limited to space provided, front side only, font size no smaller than 10 point Arial.ESC Priority School Support Program2017-2018 PROJECT ADMINISTRATIONESC project administrator and primary TEA contact:Project administrator email address:Project administrator phone number:ESC Priority School Support Program 2017-2018 ACTIVITY PLANActivity specifiedBeginning date of activityEnd date of activity12345678910Schedule #5—Program Executive Summary (cont.)County-district number or vendor ID: FORMTEXT ?????Amendment # (for amendments only): FORMTEXT ????Provide a brief overview of the program you plan to deliver. Refer to the Program-Specific instructions for a description of the requested elements of the summary. Response is limited to space provided, front side only, font size no smaller than 10 point Arial.ESC Priority School Support Program 2017-2018 ACTIVITY PLAN (cont.)Activity specifiedBeginning date of activityEnd date of activity11121314151617?1819202122Schedule #6—Program Budget SummaryCounty-district number or vendor ID: FORMTEXT ?????Amendment # (for amendments only): FORMTEXT ????Program authority: P.L. 107-110, ESEA as amended by NCLB Act of 2001, Title I, Part AGrant period: Stamp-in Date – August 31, 2018. Pre-award costs are permitted from December 1, 2017, to stamp-in date.Fund code: 211Budget Summary Schedule #TitleClass/ Object CodeProgram CostAdmin CostTotal Budgeted CostPre-Award CostSchedule #7Payroll Costs (6100)6100$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????Schedule #8Professional and Contracted Services (6200)6200$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????Schedule #9Supplies and Materials (6300)6300$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????Schedule #10Other Operating Costs (6400)6400$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????Total direct costs:$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ????? FORMTEXT Percentage% indirect costs (see note):N/A$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????Grand total of budgeted costs (add all entries in each column):$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????Administrative Cost CalculationEnter the total grant amount requested:$ FORMTEXT ?????Percentage limit on administrative costs established for the program (8%):× .08Multiply and round down to the nearest whole dollar. Enter the result. This is the maximum amount allowable for administrative costs, including indirect costs:$ FORMTEXT ?????NOTE: Indirect costs are calculated and reimbursed based on actual expenditures when reported in the expenditure reporting system, regardless of the amount budgeted and approved in the grant application. If indirect costs are claimed, they are part of the total grant award amount. They are not in addition to the grant award amount.Indirect costs are not required to be budgeted in the grant application in order to be charged to the grant. Do not submit an amendment solely for the purpose of budgeting indirect costs.Schedule #7—Payroll Costs (6100)County-district number or vendor ID: FORMTEXT ?????Amendment # (for amendments only): FORMTEXT ????Employee Position TitleEstimated # of Positions 100% Grant FundedEstimated # of Positions <100% Grant FundedGrant Amount BudgetedPre-AwardAcademic/Instructional1Teacher FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????2Educational aide FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????3Tutor FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????Program Management and Administration4Project director FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????5Project coordinator FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????6Teacher facilitator FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????7Teacher supervisor FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????8Secretary/administrative assistant FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????9Data entry clerk FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????10Grant accountant/bookkeeper FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????11Evaluator/evaluation specialist FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????Auxiliary12Counselor FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????13Social worker FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????14Community liaison/parent coordinator FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????Education Service Center (to be completed by ESC only when ESC is the applicant)15ESC specialist/consultant FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????16ESC coordinator/manager/supervisor FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????17ESC support staff FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????18ESC other FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????19ESC other FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????20ESC other FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????Other Employee Positions21 FORMTEXT Title FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????22 FORMTEXT Title FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????23 FORMTEXT Title FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????24Subtotal employee costs:$ FORMTEXT ?????$ FORMTEXT ?????Substitute, Extra-Duty Pay, Benefits Costs256112Substitute pay$ FORMTEXT ?????$ FORMTEXT ?????266119Professional staff extra-duty pay$ FORMTEXT ?????$ FORMTEXT ?????276121Support staff extra-duty pay$ FORMTEXT ?????$ FORMTEXT ?????286140Employee benefits$ FORMTEXT ?????$ FORMTEXT ?????2961XXTuition remission (IHEs only) $ FORMTEXT ?????$ FORMTEXT ?????30Subtotal substitute, extra-duty, benefits costs$ FORMTEXT ?????$ FORMTEXT ?????31Grand total (Subtotal employee costs plus subtotal substitute, extra-duty, benefits costs):$ FORMTEXT ?????$ FORMTEXT ?????For budgeting assistance, see the Allowable Cost and Budgeting Guidance section of the Grants Administration Division on Administering a Grant page.Schedule #8—Professional and Contracted Services (6200)County-district number or vendor ID: FORMTEXT ?????Amendment # (for amendments only): FORMTEXT ????NOTE: Specifying an individual vendor in a grant application does not meet the applicable requirements for sole-source providers. TEA’s approval of such grant applications does not constitute approval of a sole-source provider.Professional and Contracted Services Requiring Specific ApprovalExpense Item DescriptionGrant Amount BudgetedPre-Award6269Rental or lease of buildings, space in buildings, or land$ FORMTEXT ?????$ FORMTEXT ????? FORMTEXT Specify purpose:Subtotal of professional and contracted services (6200) costs requiring specific approval:$ FORMTEXT ?????$ FORMTEXT ?????Professional and Contracted Services#Description of Service and PurposeGrant Amount BudgetedPre-Award1 FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????2 FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????3 FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????4 FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????5 FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????6 FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????7 FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????8 FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????9 FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????10 FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????11 FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????12 FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????13 FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????14 FORMTEXT ?????$ FORMTEXT ?????$ FORMTEXT ?????Subtotal of professional and contracted services:$ FORMTEXT ?????$ FORMTEXT ?????Remaining 6200—Professional and contracted services that do not require specific approval:$ FORMTEXT ?????$ FORMTEXT ?????(Sum of lines a, b, and c) Grand total$ FORMTEXT ?????$ FORMTEXT ?????For budgeting assistance, see the Allowable Cost and Budgeting Guidance section of the Grants Administration Division Administering a Grant page.Schedule #9—Supplies and Materials (6300)County-District Number or Vendor ID: FORMTEXT ?????Amendment number (for amendments only): FORMTEXT ????Expense Item DescriptionGrant Amount BudgetedPre-Award6300Total supplies and materials that do not require specific approval: $ FORMTEXT ?????$ FORMTEXT ?????Grand total:$ FORMTEXT ?????$ FORMTEXT ?????For budgeting assistance, see the Allowable Cost and Budgeting Guidance section of the Grants Administration Division Administering a Grant page.Schedule #10—Other Operating Costs (6400)County-District Number or Vendor ID: FORMTEXT ?????Amendment number (for amendments only): FORMTEXT ????Expense Item Description Grant Amount BudgetedPre-Award6411Out-of-state travel for employees. Must be allowable per Program Guidelines and grantee must keep documentation locally. $ FORMTEXT ?????$ FORMTEXT ?????6412Travel for students to conferences (does not include field trips). Requires pre-authorization in writing. $ FORMTEXT ?????$ FORMTEXT ?????Specify purpose: FORMTEXT ?????6412/6494Educational Field Trip(s). Must be allowable per Program Guidelines and grantee must keep documentation locally. $ FORMTEXT ?????$ FORMTEXT ?????6413Stipends for non-employees other than those included in 6419 $ FORMTEXT ?????$ FORMTEXT ?????6419Non-employee costs for conferences. Requires pre-authorization in writing. $ FORMTEXT ?????$ FORMTEXT ?????6411/6419Travel costs for officials such as Executive Director, Superintendent, or Local Board Members. Allowable only when such costs are directly related to the grant. Must be allowable per Program Guidelines and grantee must keep out-of-state travel documentation locally. $ FORMTEXT ?????$ FORMTEXT ?????6495Cost of membership in civic or community organizations $ FORMTEXT ?????$ FORMTEXT ?????Specify name and purpose of organization: FORMTEXT ?????64XXHosting conferences for non-employees. Must be allowable per Program Guidelines, and grantee must keep documentation locally. $ FORMTEXT ?????$ FORMTEXT ?????Subtotal other operating costs requiring specific approval:$ FORMTEXT ?????$ FORMTEXT ?????Remaining 6400—Other operating costs that do not require specific approval:$ FORMTEXT ?????$ FORMTEXT ?????Grand total:$ FORMTEXT ?????$ FORMTEXT ?????In-state travel for employees does not require specific approval. For budgeting assistance, see the Allowable Cost and Budgeting Guidance section of the Grants Administration Division Administering a Grant page.Schedule #17—Responses to TEA Program RequirementsCounty-district number or vendor ID: FORMTEXT ?????Amendment # (for amendments only): FORMTEXT ????TEA Program Requirement 1: Deliver a region-wide Priority School Support project activity plan that offers and/or develops appropriate training, resources, services, and events to support the needs of priority schools, including activities that support improvement efforts in reading/math safeguard performance in the seven federal student groups. Response is limited to space provided, front side only. Use Arial font, no smaller than 10 point. FORMTEXT Click and type here to enter response.TEA Program Requirement 2: Collect and maintain data related to: priority school participation in ESC activities offered under the Priority School Support Activity Plan, priority school progress in performance related to their reason for identification, and priority school progress in implementing selected targeted interventions to address achievement gaps. Response is limited to space provided, front side only. Use Arial font, no smaller than 10 point. FORMTEXT Click and type here to enter response.Schedule #17—Responses to TEA Program Requirements (cont.)County-district number or vendor ID: FORMTEXT ?????Amendment # (for amendments only): FORMTEXT ????TEA Program Requirement 3: Verify presence of selected targeted interventions related to reason for priority school identification in each school’s annual improvement plan. Response is limited to space provided, front side only. Use Arial font, no smaller than 10 point. FORMTEXT Click and type here to enter response.TEA Program Requirement 4: Offer ongoing, continuous training/support around the Texas Accountability Intervention System (TAIS) continuous improvement framework that is aligned around the ESEA turnaround principles to priority schools. Use Arial font, no smaller than 10 point. FORMTEXT Click and type here to enter response.Schedule #18—Equitable Access and ParticipationCounty-District Number or Vendor ID: FORMTEXT ?????Amendment number (for amendments only): FORMTEXT ????No Barriers#No BarriersStudentsTeachersOthers000The applicant assures that no barriers exist to equitable access and participation for any groups FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Barrier: Gender-Specific Bias#Strategies for Gender-Specific BiasStudentsTeachersOthersA01Expand opportunities for historically underrepresented groups to fully participate FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX A02Provide staff development on eliminating gender bias FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX A03Ensure strategies and materials used with students do not promote gender bias FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX A04Develop and implement a plan to eliminate existing discrimination and the effects of past discrimination on the basis of gender FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX A05Ensure compliance with the requirements in Title IX of the Education Amendments of 1972, which prohibits discrimination on the basis of gender FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX A06Ensure students and parents are fully informed of their rights and responsibilities with regard to participation in the program FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX A99 FORMTEXT Other (specify) FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Barrier: Cultural, Linguistic, or Economic Diversity#Strategies for Cultural, Linguistic, or Economic DiversityStudentsTeachersOthersB01Provide program information/materials in home language FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX B02Provide interpreter/translator at program activities FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX B03Increase awareness and appreciation of cultural and linguistic diversity through a variety of activities, publications, etc. FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX B04Communicate to students, teachers, and other program beneficiaries an appreciation of students’ and families’ linguistic and cultural backgrounds FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX B05Develop/maintain community involvement/participation in program activities FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX B06Provide staff development on effective teaching strategies for diverse populations FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX B07Ensure staff development is sensitive to cultural and linguistic differences and communicates an appreciation for diversity FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX B08Seek technical assistance from education service center, technical assistance center, Title I, Part A school support team, or other provider FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX B09Provide parenting training FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX B10Provide a parent/family center FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX B11Involve parents from a variety of backgrounds in decision making FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Schedule #18—Equitable Access and Participation (cont.) County-District Number or Vendor ID: FORMTEXT ?????Amendment number (for amendments only): FORMTEXT ????Barrier: Cultural, Linguistic, or Economic Diversity (cont.)#Strategies for Cultural, Linguistic, or Economic DiversityStudentsTeachersOthersB12Offer “flexible” opportunities for parent involvement including home learning activities and other activities that don’t require parents to come to the school FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX B13Provide child care for parents participating in school activities FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX B14Acknowledge and include family members’ diverse skills, talents, and knowledge in school activities FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX B15Provide adult education, including GED and/or ESL classes, or family literacy program FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX B16Offer computer literacy courses for parents and other program beneficiaries FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX B17Conduct an outreach program for traditionally “hard to reach” parents FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX B18Coordinate with community centers/programs FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX B19Seek collaboration/assistance from business, industry, or institutions of higher education FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX B20Develop and implement a plan to eliminate existing discrimination and the effects of past discrimination on the basis of race, national origin, and color FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX B21Ensure compliance with the requirements in Title VI of the Civil Rights Act of 1964, which prohibits discrimination on the basis of race, national origin, and color FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX B22Ensure students, teachers, and other program beneficiaries are informed of their rights and responsibilities with regard to participation in the program FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX B23Provide mediation training on a regular basis to assist in resolving disputes and complaints FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX B99 FORMTEXT Other (specify) FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Barrier: Gang-Related Activities#Strategies for Gang-Related ActivitiesStudentsTeachersOthersC01Provide early intervention FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX C02Provide counseling FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX C03Conduct home visits by staff FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX C04Provide flexibility in scheduling activities FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX C05Recruit volunteers to assist in promoting gang-free communities FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX C06Provide mentor program FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX C07Provide before/after school recreational, instructional, cultural, or artistic programs/activities FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Schedule #18—Equitable Access and Participation (cont.) County-District Number or Vendor ID: FORMTEXT ?????Amendment number (for amendments only): FORMTEXT ????Barrier: Gang-Related Activities (cont.)#Strategies for Gang-Related ActivitiesStudentsTeachersOthersC08Provide community service programs/activities FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX C09Conduct parent/teacher conferences FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX C10Strengthen school/parent compacts FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX C11Establish collaborations with law enforcement agencies FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX C12Provide conflict resolution/peer mediation strategies/programs FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX C13Seek collaboration/assistance from business, industry, or institutions of higher education FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX C14Provide training/information to teachers, school staff, and parents to deal with gang-related issues FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX C99 FORMTEXT Other (specify) FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Barrier: Drug-Related Activities#Strategies for Drug-Related ActivitiesStudentsTeachersOthersD01Provide early identification/intervention FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX D02Provide counseling FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX D03Conduct home visits by staff FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX D04Recruit volunteers to assist in promoting drug-free schools and communities FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX D05Provide mentor program FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX D06Provide before/after school recreational, instructional, cultural, or artistic programs/activities FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX D07Provide community service programs/activities FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX D08Provide comprehensive health education programs FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX D09Conduct parent/teacher conferences FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX D10Establish school/parent compacts FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX D11Develop/maintain community collaborations FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX D12Provide conflict resolution/peer mediation strategies/programs FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX D13Seek collaboration/assistance from business, industry, or institutions of higher education FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX D14Provide training/information to teachers, school staff, and parents to deal with drug-related issues FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX D99 FORMTEXT Other (specify) FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Barrier: Visual Impairments#Strategies for Visual ImpairmentsStudentsTeachersOthersE01Provide early identification and intervention FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX E02Provide program materials/information in Braille FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Schedule #18—Equitable Access and Participation (cont.) County-District Number or Vendor ID: FORMTEXT ?????Amendment number (for amendments only): FORMTEXT ????Barrier: Visual Impairments#Strategies for Visual ImpairmentsStudentsTeachersOthersE03Provide program materials/information in large type FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX E04Provide program materials/information in digital/audio formats FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX E05Provide staff development on effective teaching strategies for visual impairment FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX E06Provide training for parents FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX E07Format materials/information published on the internet for ADA accessibility FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX E99 FORMTEXT Other (specify) FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Barrier: Hearing Impairments #Strategies for Hearing ImpairmentsF01Provide early identification and intervention FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX F02Provide interpreters at program activities FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX F03Provide captioned video material FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX F04Provide program materials and information in visual format FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX F05Use communication technology, such as TDD/relay FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX F06Provide staff development on effective teaching strategies for hearing impairment FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX F07Provide training for parents FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX F99 FORMTEXT Other (specify) FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Barrier: Learning Disabilities#Strategies for Learning DisabilitiesStudentsTeachersOthersG01Provide early identification and intervention FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX G02Expand tutorial/mentor programs FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX G03Provide staff development in identification practices and effective teaching strategies FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX G04Provide training for parents in early identification and intervention FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX G99 FORMTEXT Other (specify) FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Barrier: Other Physical Disabilities or Constraints#Strategies for Other Physical Disabilities or ConstraintsStudentsTeachersOthersH01Develop and implement a plan to achieve full participation by students with other physical disabilities or constraints FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX H02Provide staff development on effective teaching strategies FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX H03Provide training for parents FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX H99 FORMTEXT Other (specify) FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Schedule #18—Equitable Access and Participation (cont.) County-District Number or Vendor ID: FORMTEXT ?????Amendment number (for amendments only): FORMTEXT ????Barrier: Inaccessible Physical Structures#Strategies for Inaccessible Physical StructuresStudentsTeachersOthersJ01Develop and implement a plan to achieve full participation by students with other physical disabilities/constraints FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX J02Ensure all physical structures are accessible FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX J99 FORMTEXT Other (specify) FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Barrier: Absenteeism/Truancy#Strategies for Absenteeism/TruancyStudentsTeachersOthersK01Provide early identification/intervention FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX K02Develop and implement a truancy intervention plan FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX K03Conduct home visits by staff FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX K04Recruit volunteers to assist in promoting school attendance FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX K05Provide mentor program FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX K06Provide before/after school recreational or educational activities FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX K07Conduct parent/teacher conferences FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX K08Strengthen school/parent compacts FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX K09Develop/maintain community collaborations FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX K10Coordinate with health and social services agencies FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX K11Coordinate with the juvenile justice system FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX K12Seek collaboration/assistance from business, industry, or institutions of higher education FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX K99 FORMTEXT Other (specify) FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Barrier: High Mobility Rates#Strategies for High Mobility RatesStudentsTeachersOthersL01Coordinate with social services agencies FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX L02Establish collaborations with parents of highly mobile families FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX L03Establish/maintain timely record transfer system FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX L99 FORMTEXT Other (specify) FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Barrier: Lack of Support from Parents#Strategies for Lack of Support from ParentsStudentsTeachersOthersM01Develop and implement a plan to increase support from parents FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX M02Conduct home visits by staff FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Schedule #18—Equitable Access and Participation (cont.) County-District Number or Vendor ID: FORMTEXT ?????Amendment number (for amendments only): FORMTEXT ????Barrier: Lack of Support from Parents (cont.)#Strategies for Lack of Support from ParentsStudentsTeachersOthersM03Recruit volunteers to actively participate in school activities FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX M04Conduct parent/teacher conferences FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX M05Establish school/parent compacts FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX M06Provide parenting training FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX M07Provide a parent/family center FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX M08Provide program materials/information in home language FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX M09Involve parents from a variety of backgrounds in school decision making FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX M10Offer “flexible” opportunities for involvement, including home learning activities and other activities that don’t require coming to school FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX M11Provide child care for parents participating in school activities FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX M12Acknowledge and include family members’ diverse skills, talents, and knowledge in school activities FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX M13Provide adult education, including GED and/or ESL classes, or family literacy program FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX M14Conduct an outreach program for traditionally “hard to reach” parents FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX M15Facilitate school health advisory councils four times a year FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX M99 FORMTEXT Other (specify) FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Barrier: Shortage of Qualified Personnel#Strategies for Shortage of Qualified PersonnelStudentsTeachersOthersN01Develop and implement a plan to recruit and retain qualified personnel FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX N02Recruit and retain personnel from a variety of racial, ethnic, and language minority groups FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX N03Provide mentor program for new personnel FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX N04Provide intern program for new personnel FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX N05Provide an induction program for new personnel FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX N06Provide professional development in a variety of formats for personnel FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX N07Collaborate with colleges/universities with teacher preparation programs FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX N99 FORMTEXT Other (specify) FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Barrier: Lack of Knowledge Regarding Program Benefits#Strategies for Lack of Knowledge Regarding Program BenefitsStudentsTeachersOthersP01Develop and implement a plan to inform program beneficiaries of program activities and benefits FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX P02Publish newsletter/brochures to inform program beneficiaries of activities and benefits FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Schedule #18—Equitable Access and Participation (cont.) County-District Number or Vendor ID: FORMTEXT ?????Amendment number (for amendments only): FORMTEXT ????Barrier: Lack of Knowledge Regarding Program Benefits (cont.)#Strategies for Lack of Knowledge Regarding Program BenefitsStudentsTeachersOthersP03Provide announcements to local radio stations, newspapers, and appropriate electronic media about program activities/benefits FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX P99 FORMTEXT Other (specify) FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Barrier: Lack of Transportation to Program Activities#Strategies for Lack of TransportationStudentsTeachersOthersQ01Provide transportation for parents and other program beneficiaries to activities FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Q02Offer “flexible” opportunities for involvement, including home learning activities and other activities that don’t require coming to school FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Q03Conduct program activities in community centers and other neighborhood locations FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Q99 FORMTEXT Other (specify) FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Barrier: Other Barriers#Strategies for Other BarriersStudentsTeachersOthersZ99 FORMTEXT Other barrier FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMTEXT Other strategyZ99 FORMTEXT Other barrier FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMTEXT Other strategyZ99 FORMTEXT Other barrier FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMTEXT Other strategyZ99 FORMTEXT Other barrier FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMTEXT Other strategyZ99 FORMTEXT Other barrier FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMTEXT Other strategyZ99 FORMTEXT Other barrier FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMTEXT Other strategyZ99 FORMTEXT Other barrier FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMTEXT Other strategyZ99 FORMTEXT Other barrier FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMTEXT Other strategyZ99 FORMTEXT Other barrier FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMTEXT Other strategyZ99 FORMTEXT Other barrier FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMTEXT Other strategy ................
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