TAPS Number
See Column F below
Florida Department of Education 2005-2006 Consolidated Application
Please return to:
Florida Department of Education
Bureau of Grants Management
Room 344
Turlington Building
325 West Gaines Street
Tallahassee, Florida 32399-0400
Telephone: (850) 245-0498
SunCom: 205-0498
A)
Name and Address of Eligible Applicant: ___________[Auto-filled once LEA logs-in]______
Name of Local Education Agency (LEA)
Florida 2005-2006 Consolidated Application for Selected NCLB
Programs
DOE USE ONLY
Date Received:
Budget/Project Period:
July 1, 2005 to June 30, 2006
B)
LEA Applicant Contact Information
Name of Primary LEA Contact Person:
Mailing Address:
Telephone Number:
E-mail Address:
Fax Number:
SunCom Number:
C) List of NCLB Programs
D) Programs Selected
(Must Check at least 2)
E)
Preliminary
Allocation
F)
TAPS
Number
G)
Approved Funding
H)
Project Numbers
Title I, Part A – Basic
Yes
No
06A001
Title I, Part C - Migrant
Yes
No
06A022
Title I, Part D – Local Neglected and Delinquent
Yes
No
06A027
Title I, Part F – Comprehensive School Reform
Yes
No
06A029
Title II, Part A – Teacher and Principal Training/Recruiting
Yes
No
06A052
Title II, Part D – Enhancing Education through Technology
Yes
No
06A056
Title III, Part A – English Language Acquisition
Yes
No
06C080
Title IV, Part A – Safe and Drug Free Schools
Yes
No
06A071
Title V, Part A – Innovative Programs
Yes
No
06A082
Title VI, Part B, Subpart 2 – Rural and Low Income
Yes
No
06A090
CERTIFICATION
I, ______________________________________________, (
Please Type Name)
do hereby certify that all facts, figures, and representations made in this application are true, correct, and consistent
with the statement of general assurances and specific programmatic assurances for this project. Furthermore, all applicable statutes, regulations, and procedures; administrative and programmatic
requirements; and procedures for fiscal control and maintenance of records will be implemented to ensure proper accountability for the expenditure of funds on this project. All records necessary to
substantiate these requirements will be available for review by appropriate state and federal staff. I further certify that all expenditures will be obligated on or after the effective date and prior to the
termination date of the project. Disbursements will be reported only as appropriate to this project, and will not be used for matching funds on this or any special project, where prohibited.
Further, I understand that it is the responsibility of the agency head to obtain from its governing body the authorization for the submission of this application.
H)
________________________________________________
Signature of Superintendent
DOE 100C
Revised 01/2005
John L. Winn, Commissioner
Florida 2005-2006 Consolidated Application for Selected NCLB Programs
INSTRUCTIONS FOR COMPLETING DOE FORM 100C
A.
?
Enter name of LEA submitting application.
B.
?
Enter requested information for the District’s primary contact person. This is the person responsible for coordinating the response(s) to all
questions regarding information included in this application.
C.
?
These are the selected NCLB programs eligible to be consolidated in this application.
D.
?
Enter a check mark under “Yes” or “No” for each of the NCLB programs in Column “C” to indicate the programs that were selected for
inclusion in the consolidated application.
E.
?
Enter the total amount of funds requested for each program that is intended to be included in this consolidated application.
F.
?
DOE use only.
G.
?
DOE use only
H.
?
The original signature of the appropriate agency head is required.
The agency head is the school district superintendent. An original
signature is required in order for application to be considered for funding.
•
?
Note:
Applications signed by officials other than the appropriate agency head identified above must have a letter signed by the
appropriate agency head, or documentation citing action of the governing body delegating authority to the person to sign on behalf of said
official. Attach the letter or documentation to the DOE 100C when the application is submitted
Florida 2005-2006 Consolidated Application for Selected NCLB Programs
REQUIRED COLLABORATION PROFILE
Instructions:
Each LEA electing to submit a consolidated application must complete and submit the Collaboration Profile indicates the collaborative efforts for
each program included in the consolidated application. LEAs electing to consolidate Title IV, Safe and Drug-Free Schools must identify other
federal, state, and local programs for drug abuse and violence prevention, including health programs to achieve the LEA’s goals for drug and
violence prevention.
3. Type(s) of
4. Primary Target Group(s) to be served
1. Type of Collaboration: 2. Type of Program:
Goal(s)
DA –
District
?
R –
Reading
?
PI –
Parent Involvement
Adopted State
?
SI –
School Improvement
?
Goal
?
C –
CSR
?
Elementary
Middle
High
DD –
District
Developed Goal
O –
Other, Specify___________
School
School
Students
School staff
Parents
Private
Students
Parents Private
Students
Parents
Private
staff
staff
PI
SI
FEDERAL
DA
DD
R
C
O
PK
K
1 2 3 4 5
6 7 8
9 10
11
Title I
Title II
?
Title III
?
Title IV - 21st Century Schools
?
Title IV Safe and Drug-Free Schools
?
Title V Innovation Programs
?
Title X Education of Homeless Children
?
School -to-Work
?
Comprehensive School Reform
?
Other: _________(Specify)
?
STATE
Elementary
Middle
High
Dropout Prevention
?
Supplemental Academic Instruction
?
Safe Schools
?
Department of Juvenile Justice
?
Department of Children and Families
?
Other: _________(Specify)
?
LOCAL
Elementary
Middle
High
United Way
?
Local Health Department
?
Community Agencies (must specify)
?
Coalition School Readiness
?
Other: _________(Specify)
?
12
Florida Department of Education 2005-2006 Consolidated Application
DESCRIPTION OF COLLABORATIONS
YOU HAVE SELECTED _____ COLLABORATIONS
(s)
]
Goals: [text box]
]
Collaborating Program
Type of Program
Other:
Types of Goals:
Primary Target Group(s) to be served:
Grade Level(s):
Group(s):
Description of Collaboration: [text box
Outcomes: [text box
(Note: The descriptions will auto-fill from entries on previous page. Applicant will only respond to text boxes.)
Florida Department of Education 2005-2006 Consolidated Application
GENERAL ASSURANCES
Insert check mark in each box. All boxes must be checked before moving on to next section of the application.
AGREE
[ ]
1.
The LEA assures that each selected program will be administered in accordance with all
applicable statutes, regulations, program plans, and applications.
AGREE
[ ]
2.
The LEA assures that the control of funds provided under each selected 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.
AGREE
[ ]
3.
The LEA assures that the public agency, nonprofit private agency, institution, or organization,
or Indian tribe will administer the funds and property of each selected program to the extent
required by the authorizing statutes.
AGREE
[ ]
4.
The LEA assures that the use of proper methods of administering each selected program
includes the enforcement of any obligations imposed by law on agencies, institutions,
organizations, and other recipients responsible for carrying out each program; and the correction of
deficiencies in program operations that are identified through audits, monitoring, or evaluation.
AGREE
[ ]
5.
The LEA assures full cooperation in carrying out any evaluation of each selected program
conducted by or for the state educational agency, the Secretary, or other federal officials.
AGREE
[ ]
6.
The LEA assures that the use of fiscal control and fund accounting procedures will be of the
proper disbursement of, and accounting for, federal funds paid to the LEA under each selected
program.
AGREE
[ ]
7.
The LEA assures that reports will be submitted to the state educational agency (which shall
make the reports available to the Governor) and the Secretary as the state educational agency and
Secretary may require the state educational agency and the Secretary to perform their duties under
each selected program.
AGREE
[ ]
8.
The LEA assures that it will maintain such records for each selected program, provide such
information, and afford such access to the records as the state educational agency (after
consultation with the Governor) or the Secretary may reasonably require to carry out the state
educational agency's or the Secretary's duties.
AGREE
[ ]
9.
The LEA assures that before this application was submitted, the applicant afforded a reasonable
opportunity for public comment on the application and considered such comment.
AGREE
[ ]
10. Funds received will be used to supplement and, to the extent practical, increase the level of
funds that would be made available from nonfederal sources; in no case will such funds be used to
supplant funds from nonfederal sources.
AGREE
[ ]
11. The LEA assures that funds will be used to increase the level of state, local, and other non-
federal funds that would, in the absence of funds under this subpart, be made available for
programs and activities authorized under this subpart, and in no case supplant such State, local, and
other non-Federal funds.
AGREE
[ ]
12. The Department of Education has developed and implemented a document entitled, General
Terms, Assurances and Conditions for Participation in Federal and State Programs, to comply
with:
34 CFR 76.301 of the Education Department General Administration Regulations (EDGAR)
which requires local educational agencies to submit a common assurance for participation in
federal programs funded by the U.S. Department of Education;
• applicable regulations of other Federal agencies; and
• State regulations and laws pertaining to the expenditure of state funds.
In order to receive funding, applicants must have on file with the Department of Education, Office
of the Comptroller, a signed statement by the agency head certifying applicant adherence to these
Florida 2005-2006 Consolidated Application for Selected NCLB Programs
General Assurances for Participation in State or Federal Programs. The complete text may be
found at http://www.firn.edu/doe/comptroller/gbook.htm
AGREE
13. (auto-fill LEA name) school district will abide by the General Education Provisions Act
[ ]
(GEPA).
PROGRAM SPECIFIC ASSURANCES
Title I, Part A – Basic
All assurances submitted with the Title I Local Education Agency Program Plan remain in effect and are agreed
to herein.
[Agree
F
]]
The LEA assures that it will spend an amount equal to at least twenty percent (20%) of the LEA's Title I, Part
A, allocation to implement the No Child Left Behind Choice Options, including Supplemental Education
Services, and that all students enrolled in “Schools Identified In Need of Improvement” (SINI) shall be offered
no less than two choice options, including choice with transportation. If less than the 20% of the required set-
aside is needed, the LEA shall assures that all the requirements of Florida’s NCLB Choice have been
implemented prior to re-allocating unexpended amounts.
[Agree
F
]]
The LEA assures that it will spend not less than five percent (5%) of the LEA's Title I, Part A, allocation to
implemented to ensure that all teachers and paraprofessionals in Title I schools meet the NCLB and FDOE
definition of Highly Qualified personnel.
[Agree
F
]]
The LEA assures that it will spend no less than one percent (1%) of the LEA's Title I, Part A, allocation; ninety-
five percent (95%) of which shall be distributed to schools to provide for parental involvement.
[Agree
F
]]
For LEAs that have been identified as in need of improvement, the LEA assures that schools will spend not less
than ten percent (10%) of the LEA's Title I, Part A, allocation, for the purpose of providing to the school's
teachers and principal high-quality professional development that -
(A)
directly addresses the academic achievement problem that caused the school to be identified for school
improvement;
(B)
meets the requirements for professional development activities to meet the NCLB and FDOE
definition of Highly Qualified personnel; and
(C)
is provided in a manner that affords increased opportunity for participating in that professional
development.
[Agree
F
]] [Not Applicable
F
]]
Title I, Part C – Migrant
Priority of Services: The LEA shall document that funds received under Title I, Part C, to provide services to
migratory children and youth shall give priority to migratory children who are failing, or most at risk of failing,
to meet the Sunshine State Standards and the State’s Adequate Yearly Progress (AYP) targets in reading and
mathematics, and whose education has been interrupted during the regular school year.
[Agree
F
]]
Title I, Part D – Neglected and Delinquent
Access to Title I, Part D, funding: The LEA shall ensure that every Department of Juvenile Justice (DJJ)
facility/agency in operation in the district shall be funded based on the number of delinquent youth.
[Agree
F
]]
All formal agreements regarding the program(s) to be implemented between the local educational agency and
correctional facilities and alternative schools serving children and youth involved with the juvenile justice
Florida 2005-2006 Consolidated Application for Selected NCLB Programs
system will be implemented as stated and all agreements are in effect as of the 2005-06 school year.
[Agree
F
]]
Participating schools will coordinate with facilities working with delinquent children and youth to ensure that
such children and youth are participating in an education program comparable to that being implemented at the
public school such youth would attend.
[Agree
F
]]
Participating schools will identify the characteristics (including learning difficulties, substance abuse problems,
and other special needs) of the children and youth who will be returning from correctional facilities and
appropriately identify other at-risk children and youth expected to be served by the program; the school will
coordinate existing educational programs to meet the unique educational needs of such children and youth.
[Agree
F
]]
Participating schools will partner with local businesses to develop training, curriculum-based youth
entrepreneurship education, and mentoring services for participating students.
[Agree
F
]]
Participating schools will involve parents in efforts to improve the educational achievement of their children,
assist in dropout prevention activities, and prevent the involvement of their children in delinquent activities.
[Agree
F
]]
Participating schools will work with probation officers to assist in meeting the needs of children and youth
returning from correctional facilities.
[Agree
F
]]
Participating schools will make practical efforts to ensure correctional facilities working with children and
youth are aware of a child's or youth's existing individualized education program.
[Agree
F
]]
Participating schools will take steps to find alternative placements for children and youth interested in
continuing their education but who are unable to participate in a regular public school program.
[Agree
F
]]
Title II, Part A – Teacher and Principal Training and Recruiting Fund
The LEA assures that it will target funds to schools within the jurisdiction of the LEA that have the lowest
proportion of highly qualified teachers, have the largest average class size, or are identified as in need of
improvement.
[Agree
F
]]
Title III, Part A – English Language Acquisition
All assurances submitted with the District LEP Plan remain in effect and are agreed to herein.
[Agree
F
]]
The LEA assures that the needs of school systems of all sizes and in all geographic areas, including school
systems with rural and urban schools are addressed.
[Agree
F
]]
The LEA assures that eligible entities will be of sufficient size and scope to allow such entities to carry out
high-quality language instruction educational programs for limited English proficient children.
[Agree
F
]]
The LEA assures that an eligible entity receiving a subgrant under this subpart use the subgrant in ways that
will build such recipient's capacity to continue to offer high-quality language instruction educational programs
that assist limited English proficient children in meeting challenging State academic content and student
academic achievement standards once assistance under this subpart is no longer available.
[Agree
F
]]
The LEA assures that no more that two percent (2%) will be expended on costs associated with administering
this program.
[Agree
F
]]
Florida 2005-2006 Consolidated Application for Selected NCLB Programs
Title IV, Part A – Safe and Drug Free Schools
The LEA assures that the activities or programs funded comply with the principles of effectiveness described in
Section 4115(a), and foster a safe and drug-free learning environment that supports academic achievement
[Section 4114 (d)(1) of the No Child Left Behind Act of 2001].
The LEA assures that drug and violence prevention programs supported under this subpart convey a clear and
consistent message that acts of violence and the illegal use of drugs are wrong and harmful.
[Agree
F
]]
The LEA assures that the applicant has, or the schools to be served have, a plan for keeping schools safe and
drug-free that includes--
(A) appropriate and effective school discipline policies that prohibit disorderly conduct, the illegal
possession of weapons, and the illegal use, possession, distribution, and sale of tobacco, alcohol, and
other drugs by students;
(B) security procedures at school and while students are on the way to and from school;
(C) prevention activities that are designed to create and maintain safe, disciplined, and drug-free
environments;
(D) a crisis management plan for responding to violent or traumatic incidents on school grounds; and
(E) a code of conduct policy for all students that clearly states the responsibilities of students, teachers,
and administrators in maintaining a classroom environment that--
(i) allows a teacher to communicate effectively with all students in the class;
(ii) allows all students in the class to learn;
(iii) has consequences that are fair, and developmentally appropriate;
(iv) considers the student and the circumstances of the situation; and
(v) is enforced accordingly.
[Agree
F
]]
The LEA assures that the application and any waiver request under section 4115(a)(3) will be available for
public review after submission of the application. [Section 4115(a)(3) of the No Child Left Behind Act of 2001]
[Agree
F
]]
Florida 2005-2006 Consolidated Application for Selected NCLB Programs
CONSOLIDATED PROGRAM DESCRIPTIONS
Instructions: School districts electing to submit a consolidated application are required to complete the
Consolidated Program Description and the Program Specific Descriptions, if such programs are selected. All
LEAs are advised to closely review the Program Specific Requirements section of this application prior to
completing Consolidated Program Descriptions and Program Specific Descriptions.
1.
?
Describe the evidence of current and appropriate needs assessment conducted relative to the purposes of
these funds and to the selected programs that the LEA plans to implement. Description must include
reference to method used to conduct needs assessment for each of the NCLB programs included in the
LEA’s consolidated application.
[Text Box]
2.
?
Describe the goals, measurable objectives and anticipated annual outcomes to increase student achievement.
Description must, at a minimum address academic achievement of each student subgroup targeted by this
application; proficiency achievement rates, and provision of highly qualified staff.
Goals, objectives and
strategies must be specific, measurable, attainable, realistic and time bound
and tied to student
achievement in both reading and mathematics.
[Text Box]
LEAs electing to consolidate any one of the following programs: Title I, Part A; Title I, Part C; Title I, Part D;
Title III are required to complete the chart provided below:
TARGET GROUP
READING
MATHEMATICS
[FDOE’s AYP and State’s NCLB
[Just Read Florida and Florida Center for
[Bureau of School Improvement's web-
Consolidated Application]
Reading Research]
page for resources & best practices]
Children and youth served through
Goal(s):
Goal(s):
Title I schoolwide or targeted
Objective(s):
Objective(s):
assistance. [Title I, Parts A & D
Strategies:
Strategies:
only]
Educationally/Economically
Goal(s):
Goal(s):
Disadvantaged (Students served in
Objective(s):
Objective(s):
schoolwide or targeted assistance
Strategies:
Strategies:
programs under Title I, Part A)
[Title I, Part A only]
Migrant children and youth [Title I,
Goal(s):
Goal(s):
Part C only]
Objective(s):
Objective(s):
Strategies:
Strategies:
Current and former limited English
Goal(s):
Goal(s):
proficient students.
(Former LEP who
Objective(s):
Objective(s):
have exited within 2 years)
[Title III
Strategies:
Strategies:
only]
Homeless children and youth [Title
Goal(s):
Goal(s):
I, Parts A & C]
Objective(s):
Objective(s):
Strategies:
Strategies:
Neglected and delinquent children
Goal(s):
Goal(s):
and youth [Title I, Part A & D]
Objective(s):
Objective(s):
Strategies:
Strategies:
NOTE: Goals, objectives and strategies provided for LEAs identified as in need of improvement must be linked to those
described in the District Intervention and Assistance Plan and the school improvement plans for schools identified as in need
of improvement.
Florida 2005-2006 Consolidated Application for Selected NCLB Programs
3.
?
Describe how the LEA will evaluate the outcomes based on the measureable objectives in this application.
4.
?
Describe how the activities proposed in this application will be conducted using
scientifically based
researched programs
,
strategies
and activities.
[Text Box]
5.
?
Describe how the LEA will provide technical assistance and support for the effective implementation of the
school reforms and/or programs based on scientifically based research and effective practices selected by
the schools.
[Text Box]
6.
?
Describe how the LEA will provide assistance to schools for the implementation and support of a
comprehensive system that effectively uses technology in elementary schools and secondary schools to
improve student academic achievement. [Text Box]
7.
?
Describe how the activities in this project will support Florida’s reading initiative.
[Text Box]
8.
?
Describe how information about this application will be disseminated and marketed to appropriate
populations.
[Text Box]
9.
?
Describe how LEA will increase student academic achievement through strategies such as improving
teacher and principal quality and increasing the number of highly qualified teachers in the classroom and
highly qualified principals and assistant principals. [
Text Box
]
10. Describe how the LEA will report on outcomes to parents and the community in a language or mode of
communication they understand (unless clearly not feasible).
[Text Box]
11. Describe how the LEA will ensure the involvement of parents/guardians.
?
Identify if there are any programs
or activities, regardless of funding source, conducted specifically for parents or any programs or activities
for which parents are the primary focus/target. Description must address how parents will be involved in
programs administered by the LEA and included in this consolidated application and must also include
parents/guardians involvement in the LEA’s drug and violence prevention programs.
[Text Box]
PROGRAM SPECIFIC DESCRIPTIONS
TITLE I, PART C, MIGRANT EDUCATION
Priority of Services: The LEA must document that funds received under Title I, Part C are prioritized to
specifically meet the unique needs of migratory children who are failing, or most at risk of failing to meet the
Sunshine State Standards and the State’s Adequate Yearly Progress (AYP) targets in reading and mathematics,
and whose education has been interrupted during the regular school year. Describe how the LEA conducted a
needs assessment to identify “Priority of Services” and how the needs assessment will be used to implement
programs and services for these students
. [Text Box]
TITLE IV, SAFE AND DRUG-FREE SCHOOLS
Needs Assessment and Prioritized Needs: The LEA must document that funds received under Title IV, Safe and
Drug-Free Schools are prioritized based on a comprehensive needs assessment which is based on objective data
regarding the incidence of violence and illegal drug use in the schools served, including but not limited to an
analysis of the conditions and consequences of serious discipline problems among students attending such
schools. Describe how the LEA conducted a needs assessment, what data sources were used and how needs
were prioritized. [Text Box]
Florida 2005-2006 Consolidated Application for Selected NCLB Programs
SDFS Program Activity Profile:
?
LEAs must submit a program activity profile for each of the programs funded under Title IV that will be
?
implemented in 2005-06 school year.
?
The SDFS Program Activity Profile Reporting Form is provided for informational purposes only; SDFS
?
Program Activity Profile is to be completed on-line.
?
PROGRAM SPECIFIC REQUIREMENTS
TITLE I PART A - BASIC
Public School Eligibility Survey
LEAs must submit the Public School Eligibility Survey (PSES) using the on-line 2005-2006 Title I, Part A
Application and will have the option to upload the PSES to the server by following the instructions provided in
the online application.
[The PSES form, attached for informational purposes only]
Activities to Support Required Set-Asides:
The LEA must submit the sections of the on-line application which support full implementation of the Required
Set-Asides for Title I Schools Identified in Need of Improvement. Goals, objectives and strategies for each of
the following:
Highly Qualified
?
Parental Involvement
?
Title I Schools In Need of Improvement
?
Florida’s NCLB Choice Options
?
Alignment to School Improvement Process
?
Maintenance of Effort Requirement Form
LEAs must submit the Maintenance of Effort (MOE) using the using the on-line 2005-2006 Title I, Part A
Application.
[Provided as separate form and must be completed if LEA elects to consolidated Title I, Part A]
Support for Eligible Students in Private Schools
LEAs receiving funds under Title I, Part A must document provision of eligible students in private schools.
LEA must select either tiering or non-tiering method.
[Provided as separate form and must be completed if LEA
elects to consolidated Title I, Part A]
Support for Early Childhood Services
LEAs receiving funds under Title I, Part A, must identify the agency serving prekindergarten children and the
amount of funds allocated to provide such services. Note: If the table is left blank, the LEA must provide
documentation with this application to support why services are not being provided through Title I, Part A; to
support early childhood programs.
TITLE I, PART C, MIGRANT
Support for Early Childhood Services
LEAs receiving funds under Title I, Part C, must identify the agency serving prekindergarten migrant children
and the amount of funds allocated to provide such services. Note: If the table is left blank, the LEA must
provide documentation with this application to support why services are not being provided through Title I, Part
C; to support early childhood programs.
TITLE IV, PART A – SAFE AND DRUG FREE SCHOOLS
1.
Funded activities and programs must follow the Principles of Effectiveness defined in Title IV Section 4115
as follows:
Florida 2005-2006 Consolidated Application for Selected NCLB Programs
“(A) be based on an assessment of objective data regarding the incidence of violence and illegal drug use in the elementary
schools and secondary schools and communities to be served, including an objective analysis of the current conditions and
consequences regarding violence and illegal drug use, including delinquency and serious discipline problems, among students who
attend such schools (including private school students who participate in the drug and violence prevention program) that is based on
ongoing local assessment or evaluation activities;
(B) be based on an established set of performance measures aimed at ensuring that the elementary schools and secondary
schools and communities to be served by the program have a safe, orderly, and drug-free learning environment;
(C) be based on scientifically based research that provides evidence that the program to be used will reduce violence and
illegal drug use;
(D) be based on an analysis of the data reasonably available at the time, of the prevalence of risk factors, including high or
increasing rates of reported cases of child abuse and domestic violence; protective factors, buffers, assets; or other variables in schools
and communities in the State identified through scientifically based research; and
(E) include meaningful and ongoing consultation with and input from parents in the development of the application and
administration of the program or activity.
(2) PERIODIC EVALUATION. –
(A) REQUIREMENT. – The program or activity shall undergo a periodic evaluation to assess its progress toward reducing
violence and illegal drug use in schools to be served based on performance measures described in section 4114(d)(2)(B).
(B) USE OF RESULTS. – The results shall be used to refine, improve, and strengthen the program, and to refine the
performance measures, and shall also be made available to the public upon request, with public notice of such availability provided.
(3) WAIVER. – A local educational agency may apply to the State for a waiver of the requirement of subsection (a)(1)(C) to allow
innovative activities or programs that demonstrate substantial likelihood of success.”
The School District's SDFS Advisory Council must have a minimum of two meetings per year, disseminate
information about drug and violence prevention, participate in program planning and review program evaluation
and other relevant materials and make recommendations to the school district on how to improve such agency's
drug and violence prevention programs.
An annual program evaluation plan will be due July 29, 2005. This program evaluation plan will require
original signature of the Superintendent. Reporting format and instructions for submission will be provided
under separate cover.
A cap of 2% may be used for administrative costs.
Florida Department of Education 2005-2006 Consolidated Application
List of Attachments
Other forms for selected programs included in this application for informational purposes:
¾
Title I, Part A – Basic
Forms are provided for informational purposes only, LEAs are required to complete on-line reporting format.
9
Public School Eligibility Survey
9
Description of LEA Activities to Support Required Set-Asides
9
Title I Schools Identified as In-Need of Improvement
9
Florida’s NCLB Choice Options
9
Maintenance of Effort
9
Support for Eligible Students in Private Schools
9
Support for Early Childhood Education
¾
Title I, Part C – Migrant
Form is provided for informational purposes only, LEAs are required to complete on-line reporting format.
9
Support for Early Childhood Education
¾
Title IV, Part A – Safe and Drug Free Schools
Forms are provided for informational purposes only, LEAs are required to complete on-line reporting format.
9
SDFS Program Activity Profile
9
Gun-Free Schools Report
____________________________________________________
___________________
Florida 2005-2006 Consolidated Application for Selected NCLB Programs
APPLICANT MUST SUBMIT A SEPARATE BUDGET PAGE FOR EACH SELECTED PROGRAM
A)
NAME OF THE NCLB PROGRAM
TAPS NUMBER
:
SEE COLUMN F ON DOE FORM 100C
B)_______[AUTO FILL WITH DISTRICT NAME]
NAME OF ELIGIBLE RECIPIENT
C)______________________________________________________
Project Number (
DOE USE ONLY
)
FLORIDA DEPARTMENT OF EDUCATION
BUDGET NARRATIVE FORM
(1)
FUNCTION
(2)
OBJECT
(3)
(4)
FTE
(5)
AMOUNT
$
ACCOUNT TITLE AND NARRATIVE
POSITION
C) TOTAL
DOE 101
Rev. 01/2005 John L. Winn, Commissioner
Florida 2005-2006 Consolidated Application for Selected NCLB Programs
Instructions Budget Narrative Form
APPLICANT MUST SUBMIT A SEPARATE BUDGET PAGE FOR EACH PROGRAM SELECTED
This form should be completed based on the instructions outlined below, unless instructed otherwise in the Request for Proposal (RFP) or Request
for Application (RFA).
A.
?
Enter the name of the NCLB program.
B.
?
Enter Name of Eligible Recipient.
C.
?
For DOE use only.
Project Number to be added by FDOE.
COLUMN 1
FUNCTION:
SCHOOL DISTRICTS ONLY:
Use the four digit function codes as required in the Financial and Program Cost Accounting and Reporting for Florida Schools
Manual.
COLUMN 2
OBJECT:
SCHOOL DISTRICTS:
Use the three digit object codes as required in the Financial and Program Cost Accounting and Reporting for Florida Schools Manual.
COMMUNITY COLLEGES:
Use the first three digits of the object codes listed in the Accounting Manual for Florida’s Public Community Colleges.
UNIVERSITIES AND STATE AGENCIES:
Use the first three digits of the object codes listed in the Florida Accounting Information Resource Manual.
OTHER AGENCIES:
Use the object codes as required in the agency’s expenditure chart of accounts.
COLUMN 3
-
ALL APPLICANTS:
?
ACCOUNT TITLE:
Use the account title that applies to the object code listed in accordance with the agency's accounting system.
?
NARRATIVE:
Provide a detailed narrative for each object code listed. For example:
•
?
SALARIES
- describe the type(s) of positions requested. Use a separate line to describe each type of position.
•
?
OTHER PERSONAL SERVICES
– describe the type of service(s) and an estimated number of hours for each type of position. OPS is defined as
compensation paid to persons, including substitute teachers not under contract, who are employed to provide temporary services to the
program.
•
?
PROFESSIONAL/TECHNICAL SERVICES
- describe services rendered by personnel, other than agency personnel employees, who provide
specialized skills and knowledge.
•
?
CONTRACTUAL SERVICES AND/OR INTER-AGENCY AGREEMENTS
- provide the agency name and description of the service(s) to be rendered.
•
?
TRAVEL
- provide a description of each type of travel to be supported with project funds, such as conference(s), in district or out of district,
and out of state. Do not list individual names. List individual position(s) when travel funds are being requested to perform necessary activities.
•
?
CAPITAL OUTLAY
- provide the type of items/equipment to be purchased with project funds.
•
?
INDIRECT COST
- provide the percentage rate being used. Use the current approved rate. (Reference the DOE Green Book for additional
guidance regarding indirect cost.)
COLUMN 4 – MUST BE COMPLETED FOR ALL SALARIES AND OTHER PERSONAL SERVICES.
FTE
- Indicate the Full Time Equivalent (FTE based on the standard workweek for the type of position) number of positions to be funded.
Determine FTE by dividing the standard number of weekly hours (e.g., 35 hours) for the type of position (e.g., teacher aide) into the actual work
hours to be funded by the project.
COLUMN 5 - AMOUNT -
Provide the budget amount requested for each object code.
C.
?
TOTAL -
Provide the total for Column (4) on the last page
.
Must be the same amount as requested on the DOE-100C.
Florida 2005-2006 Consolidated Application for Selected NCLB Programs
TITLE I, PART A: PUBLIC SCHOOL ELIGIBILITY SURVEY
FORM PROVIDED FOR INFORMATION PURPOSES ONLY – PSES MUST BE COMPLETED USING ON-LINE APPLICATION
Name of LEA: __________________________________
(1) Date Certain: _____/_____/_____
All Schools
School Name
School
Number
Grade
Span
Number of
Children
Attending
Number of Children
from Low
Income Families
Selection
Code
Program
Type
(9)
Allocation
(2)
(3)
(4)
Public Schools
(5)
Number
(6)
Percent
(7)
(8)
TA
SW
PPA*
(10)
TSA
**
(11)
(12)
(13)
(14)
*
Per Pupil Allocation
** Total School Allocation
Florida 2005-2006 Consolidated Application for Selected NCLB Programs
INSTRUCTIONS FOR PUBLIC SCHOOL ELIGIBILITY SURVEY (PSES)
REMINDER: LEAs must submit the PSES the using the on-line 2005-2006 Title I, Part A Application or using an electronic spreadsheet in Microsoft EXCEL. Form is included only to
provide the format which must be followed if LEA elects to submit PSES in an electronic format (MS Excel). Hardcopies submitted via Fax or mail; or electronic copies submitted using
software other than MS Excel will not be accepted.
(1)
Indicate date survey was made. The last day of the February FTE count is recommended as the date certain; however, any date is acceptable providing the student
attendance can be documented.
(2)
List ALL schools in rank order: from highest to lowest poverty rates. (Use as many pages as needed. Check against the listings in the latest DOE Education Directory.)
(3)
Use the number in the DOE Education Directory.
(4)
( List the grade span as per the DOE Education Directory.
(5)
Indicate the NUMBER in attendance on survey date, excluding Prekindergarten students. [If ESE 135, School Funding Certification, is used, double the number.]
(6)
Indicate the NUMBER based on one of the following: the number of children ages 5 - 17, in poverty based on the most recent census data; children eligible for free/reduced
priced lunches; children in families receiving AFDC; children eligible for Medicaid assistance OR a composite of the above on Date Certain, excluding prekindergarten
students.
(7)
Compute the PERCENT and round to the nearest whole number. [Divide Column (6) by Column (5) and multiply by 100.]
(8)
Use the following alphabetical code(s) to indicate school eligibility and selection for service:
A
School poverty rate exceeds 75% poverty
B
School poverty rate falls at or above district wide average of poverty [school is below 75% poverty level, but above district wide
average poverty level]
)
C
School grade span is not served through Title I, Part A [School within this grade span must be below 75% poverty level]
(1
D
School has been selected based on the 35 percent rule
E
School has been skipped based on the requirements established in Section 1113(b)(1)(D). School received funding under a different
)
program which exceeds both PSA and TSA [Must meet requirements of Section 1113 (b) (1) (D)]
(2
)
F
School has been selected based on feeder schools
(3
?
G
School with poverty rate below the districtwide average selected for a continuation of schoolwide project (below 40 percent)
?
H
School selected is serving neglected and delinquent students, including Department of Juvenile Justice (DJJ) facilities.
?
)
I
School with poverty rate below the districtwide average and not served due to district’s allocation process.
(4
Additional Documentation Required:
(1)
LEA must include description of how and what resources will be used to meet the unique needs of economically disadvantaged students in schools
with grade spans that LEA elects not serve under Title I.
(2)
LEA must include description identifying the program type, amount of funding and source of funding.
(3)
LEA must include school name(s) and school number(s) of feeder pattern school(s)
?
(4).
LEA must provide description of allocation process and justification supporting the reason(s) why the school is not funded under Title I, Part A
?
Florida 2005-2006 Consolidated Application for Selected NCLB Programs
(9)
Indicate Program Type, targeted assistance or schoolwide, by marking an “X” in the appropriate column
(10)
Indicate TOTAL per pupil allocation.
(11)
Indicate TOTAL school allocation.
(12)
Indicate TOTAL public school students.
(13)
Indicate district wide TOTALS for ALL schools.
(14)
Indicate PERCENT: divide Item (13) by Item (12) and multiply by 100 [round to the nearest whole number].
*District Option: Prekindergarten handicapped students may be included as long as they are included in all schools district wide.
_____________
_____________
Florida 2005-2006 Consolidated Application for Selected NCLB Programs
District/Agency:
MAINTENANCE OF EFFORT REQUIREMENT
Auto-Filed
Complete either Method 1 or Method 2.
METHOD 1. AGGREGATE EXPENDITURES
2004-05 *2003-04
Total State and Local Expenditures
$ _____________
$ _____________
(
Excluding all federal funds and grants
)
Less: (Nonallowable Expenditures)
Community Services ....................................................................................................
Capital Outlay...............................................................................................................
Debt Services ...............................................................................................................
$ _____________
$ _____________
$ _____________
$ _____________
$ _____________
$ _____________
School Nonrecurring Incentives or Bonus Programs ...................................................
Subtotal: (Nonallowable Expenditures) .............................................................................
Total Allowable Expenditures .............................................................................................
$ _____________
$ _____________
$ _____________
$ _____________
$ _____________
$ _____________
_____________ %
METHOD 2. PER PUPIL FISCAL EFFORT
2004-05 2003-04
Total Allowable Expenditures .............................................................................................
Unweighted FTE .................................................................................................................
$ _____________
$ _____________
Per Student Cost ................................................................................................................
Percentage ........................................................................................................................
$ _____________
_____________ %
$ _____________
_____________ %
* If the figures in this column do not agree with those submitted in the Fiscal Year 2004-2005 application, please attach the revised, updated maintenance of effort page for Fiscal
Year 2003-04.
Florida 2005-2006 Consolidated Application for Selected NCLB Programs
TITLE I, PART A: SUPPORT FOR ELIGIBLE STUDENTS IN PRIVATE SCHOOLS
NON-TIERING
N/A
Nonpublic School Name
(2)
Grade
Span
(3)
Number of Children
from Low Income
Families
(4)
Per Pupil Allocation
(5)
Dollars
Generated
(6)
Dollars Allocated
(if Pooling)*
(7)
TOTALS
]
TIERING
N/A
Nonpublic School Name
(2)
Grade
Span
(3)
Number of Children
from Low Income
Families
(4)
Per Pupil Allocation
(5)
multiple columns for
differing PPAs
Dollars
Generated
(6)
Dollars Allocated
(if Pooling)*
(7)
TOTALS
Florida 2005-2006 Consolidated Application for Selected NCLB Programs
TITLE I, PART A AND PART C: SUPPORT FOR EARLY CHILDHOOD SERVICES
Please provide the following information regarding the Title I, Part A and Title I, Part C-funded early childhood
activities being conducted in your district. Note: If the table is left blank, the LEA must provide documentation
with this application to support why services are not being provided through Title I, Part A; and Title I, Part C,
to support early childhood programs.
N/A If checked, LEA must provide description of how services to prekindergarten services are provided.
List the name(s) of the
List the site(s)
Amount of Title I,
Amount of Title I,
Indicate the number
program(s) that provide
where the
Part A Funds
Part C Funds
of students to be
early childhood services
program is
Allocated to
Allocated to
served at each site by
housed
Support Early
Support Early
age span
Childhood
Childhood
Programs
Programs
Age 3
Age 4
TOTALS:
Add text box for required documentation to support why services are not being provided through Title I, Part A;
and Title I, Part C, to support early childhood programs.
JUSTIFICATION: [Text Box]
Florida 2005-2006 Consolidated Application for Selected NCLB Programs
SDFS Program Activity Profile (Section V of the On-line Application
Complete this section for each SDFS funded program you plan on implementing during the 2005-2006 year.
Go to Proven Programs Main
|
Go to Promising Programs Main
Add Promising Program
l
Other
)
Middle
High
pk
k
1
2
3
4
5
6
7
8
9
10
11
12
pk
k
1
2
3
4
5
6
7
8
9
10
11
12
pk
k
1
2
3
4
5
6
7
8
9
10
11
12
pk
k
1
2
3
4
5
6
7
8
9
10
11
12
pk
k
1
2
3
4
5
6
7
8
9
10
11
12
El
High:
):
1. Program Name:
2. For a Promising Program you must provide the following information:
Rationale for why using promising versus proven?
Number of years used:
If this is the 3rd of year of imp ementation, provide effectiveness data from the evaluation.
3. Type of Program
Student ATOD Use Prevention
Parent Involvement
Student Violence Prevention
If other, please specify:
4. Primary Target Group(s to be served:
Elementary
Students
School Staff:
Parents
Private
Other
if other, specify:
Total schools
served
ementary:
Middle:
5. Targeted Changes (check all that apply
Florida 2005-2006 Consolidated Application for Selected NCLB Programs
Attitude
l
a.
i
b.
l
c.
ill
d.
i
e.
i
f.
Yes
No
i
g.
li
i l
itle IV funds.
Behavior/Skills
Know edge
Perceptions
6. Implementation Protocol for this program.
In how many school, in what grade(s) and during what time period or content area w ll the program be
implemented?
Who is responsible at the school level for implementing this program? (Examp e - 9th grade life management
skills teachers, guidance counselors, etc?)
How w personnel responsible for implementation be trained?
What are the instruments/checklists and/or processes that w ll be used to track the implementation of the
program.
Provide the fidelity instruments/checklists as a Word file or PDF file, if possible.
Describe the process/procedures that w ll be used to monitor the quality of implementation?
Was this program formally evaluated?
If yes, describe the strategies that w ll be used to improve the implementation gaps identified by the program
evaluation.
Should the program identified in this app cation not be implemented, describe the alternative program/programs
that w ll be imp emented using T
Florida 2005-2006 Consolidated Application for Selected NCLB Programs
Yes
No
i
Yes
No
s
i
7. Program Evaluation*
a. Are you going to evaluate this program?
b. What preparations for the evaluation have begun?
c. Are you go ng to use an outside evaluator?
ave
* In the SDFS application, an assurance for the program evaluation w ll need to be signed.
Florida 2005-2006 Consolidated Application for Selected NCLB Programs
Federal Gun-Free Schools Act Local Education Agency Activities Survey
Fiscal Year: 2004-2005
Select this box if this was a Gun-Free School Year for the entire __________ County School
District.
(If your school district was Gun-Free this year, please complete Section II of this survey only)
Section I: School Level Data
Directions: You must complete this form for each school that a student has been found to have
brought a firearm to school or possessed a firearm as defined by 18 U.S.C. 921 at school during the
2004-2005 school year.
1a.
Please indicate the number of students who were found to have brought a firearm to school or
possessed a firearm at school. Include all infractions in your answer.
School Level
_____________________________________
(Elementary, Middle or High School)
Select a School
_____________________________________
?
Number of Students who brought/possessed a Handgun _____________________________________
(Enter “0” if there are no students or “MD” for missing data)
?
Type of Handgun
_____________________________________
?
(Enter NA for none, or “MD” for missing data)
?
Number of Students who brought/possessed a Rifle/Shotgun
_____________________________________
?
(Enter “0” if there are no students or “MD” for missing data)
?
Type of Rifle/Shotgun
_____________________________________
?
(Enter NA for none, or “MD” for missing data)
?
Number of Students who brought/possessed Other Firearm
_____________________________________
?
(Enter “0” if there are no students or “MD” for missing data)
?
Type of Firearm
_____________________________________
?
(Enter NA for none, or “MD” for missing data)
?
1b.
How many of the incidences reported in Item 1a were terminated before an expulsion disposition? ________________
?
Please provide an explanation for each incident reported in 1b.
?
Notes:
Any student found to have brought a firearm (meeting the definition at 18 U.S.C. 921) to school or possessed a firearm at school
should be reported as an infraction, even if the expulsion is shortened or no penalty is imposed. Any incidents in which a student covered by
the provisions of IDEA brought a firearm to school or possessed a firearm at school should also be included, even if it is determined that the
incident is a manifestation of the student’s disability. Modifications of the one-year expulsion requirement should also be reported in Question
2 of this report.
If a single student is found to have brought or possessed more than one firearm, report the student as a single incident. A note that explains
the circumstances surrounding the incident, including the types of firearms that were removed from the student should be described in the
data caveat section of this report.
If the same student is involved in more than one incident that involves bringing or possessing a firearm, each incident would be
counted as one incident. A note explaining the circumstances surrounding the incident, including information about the disposition of
that student, should be described in the data caveat section of this report.
Florida 2005-2006 Consolidated Application for Selected NCLB Programs
2.
MODIFIED EXPULSIONS
How many of the incidences reported in Item 1a were shortened to a term of less than one year by the
Superintendent of an LEA under the case-by-case modification provisions of Section 4141(b)(1) of the GFSA?________________
2a.
?
Number of Modified Expulsions
________________
2b.
?
Number of Expulsions Not Modified
________________
3.
?
ALTERNATIVE PLACEMENTS
How many of the incidences reported in Items 2a and Item 2b resulted in a referral of the student to an
alternative school or program for the school listed in 1a?
________________
3a.
?
Number of Alternative Placements among students with modified expulsions:
________________
3b.
?
Number of Alternative Placements among students with expulsions NOT MODIFIED
________________
4.
?
STUDENTS WITH DISABILITIES
How many of the modifications reported in Item 2a were for students with and without disabilities as defined in
Section 602(a)(1) of the IDEA (see below) for the school listed in 1a?
________________
Note: The total figure shown in the table below should EQUAL the total number of modified expulsions reported in Item 2a.
4a.
Number of Modifications for students with disabilities
?
________________
4b.
Number of Modifications for students who are not disabled
?
________________
The GFSA explicitly states that the Act must be construed in a manner consistent with the Individuals with Disabilities Education Act (IDEA).
Compliance with the GFSA can be achieved consistent with the IDEA as long as discipline of such students is determined on a case-by-case
basis under the GFSA provision that permits modification of the expulsion requirement on a case-by-case basis. A student with a disability
who brings a firearm to school, or possesses a firearm at school, may be removed from school for ten school days or less, and in accordance
with State law, placed in an interim alternative educational setting that is determined by the student’s individualized education program team,
for up to 45 calendar days. If the student’s parents initiate due process proceedings under the IDEA, the student must remain in that interim
alternative educational setting during authorized review proceedings, unless the parents and school district can agree on a different
placement. Before an expulsion can occur, the IDEA requires a determination by a group of persons knowledgeable about the student on
whether the bringing of a firearm to school, or the possession of a firearm at school, was a manifestation of the student’s disability. A student
with a disability may be expelled only if this group of persons determines that the bringing of a firearm to school, or the possession of a
firearm at school, was not a manifestation of the student’s disability, and the school follows applicable IDEA procedural safeguards before
the expulsion occurs. Under IDEA, students with disabilities who are expelled in accordance with these conditions must continue to receive
educational services during the expulsion period. Under Section 602 (a)(1) of the IDEA, the term “children with disabilities” is defined as:
children --
(i) with mental retardation, hearing impairments including deafness, speech or language impairments, visual impairments, including
blindness, serious emotional disturbance, orthopedic impairments, autism, traumatic brain injury, other health impairments, or
specific learning disabilities; and
(ii) who, by reason thereof, need special education and related services
SECTION II: LEA Compliance with Gun-Free Schools Act (GFSA)
1.
?
This is to assure that
__________
County School District is in compliance with GFSA Section
1006.13(2)(a), FS, that requires that a student who brings a firearm to school, or possesses a firearm at
school, be expelled for one year.
Yes
No
2.
?
This is to assure that __________County School District is in compliance with the requirement in Section
4141(h) that an LEA receiving ESEA funds have in place a policy requiring referral to the criminal justice or
juvenile delinquency system of any student who brings a firearm to a school, or possesses a firearm at
school.
Note: If your district is in compliance with Section 1006.13(2)(a), FS.
Yes
No