1. NO CHILD LEFT BEHIND
      2. SUPPLEMENTAL EDUCATIONAL SERVICES
        1. REQUEST FOR APPLICATIONS
      3. 2006-07 School Year
      4. Shonda O’Neal
      5. Florida Department of Education
        1. Estimated tutor/student ratio: 1 tutor per _____ students
        2. Estimated tutor/student ratio: 1 tutor per _____ students
        3. Estimated tutor/student ratio: 1 tutor per _____ students
      6. Shonda O’Neal
      7. Florida Department of Education

 
 
 
 
 
 
 
 
 
 
 
 
 
 
NO CHILD LEFT BEHIND
SUPPLEMENTAL EDUCATIONAL SERVICES
Public Law 107-110, Title I, Part A Section 1116(e)
 
 
REQUEST FOR APPLICATIONS
 
2006-07 School Year
 
 
 
 
 
 
 
 
 
 
 
 
 
 
John L. Winn, Commissioner
Florida Department of Education
325 West Gaines Street, Suite 314
Tallahassee, Florida 32399-0400

Table of Contents/Check List
 
Subject Page
No.
For
Completion
1.0 BACKGROUND
5
  
1.1 General Information
5
  
1.2 Purpose
5
  
 
  
  
2.0 APPLICATION INSTRUCTIONS
5
  
2.1 Submission Deadlines
5
  
2.1.1 On-line Application
5
  
2.1.2 Assurances and Printed Documentation
6
  
2.2 Technical Assistance
6
  
2.3 Method of Review
7
  
2.4 Method of Announcement
7
  
 
  
  
3.0 SPECIFICATIONS
7
  
3.1 Eligible Service Providers
7
  
3.2 Eligibility Requirements
8
  
3.3 Responsibilities
9
  
3.3.1 Responsibilities of
the Florida Department of
Education
9
  
3.3.2 Responsibilities of the School Districts
9
  
3.3.3 Responsibilities of
the Approved Providers
10
  
3.4 Funding
11
  
3.5 Duration
12
  
3.6 Monitoring
12
  
3.7 Evaluation
12
  
3.8 Removal from the State-Approved List
12
  
 
  
  
4.0 RESOURCES
13
  
 
  
  
5.0 TIMELINE OF SERVICES AND PROCEDURES
14
  
 
  
  
6.0 APPLICATION PROPOSAL
15
  
6.1 Contact Information
15
  
6.2 Applicant Status
16
  
6.3 School District(s) to be Served
16
  
6.4 Applicant Classification
17
  
6.5 ACADEMIC AND INSTRUCTIONAL INFORMATION
17
  
6.5.1 Subject Area(s)
17
  
6.5.2 Staff Qualifications
18
  
6.5.3 Type of Instruction
18
 
  
6.5.4 Grade Levels to be Served
18
 
  
- 2 -

 
Subject Page
No.
For
Completion
6.6 SES PROVISIONS
18
  
6.6.1 Student Capacity
18
 
  
6.6.2 Location of Services
19
 
  
6.6.3 Transportation
19
 
  
6.6.4 Operations
19
  
6.7 COST OF SERVICE
20
  
6.7.1 Rate For Provision of SES
20
  
6.8 FISCAL SOUNDNESS
21
 
  
6.8.1 Document Financial Soundness
21
 
  
DOCUMENTATION TO MAIL OR HAND DELIVER:
 
  
  
1. Copy of liability insurance cover page with the
company name and policy number
21
 
  
2. Copy of evidence of fiscal soundness:
¾
 
Most recent tax return
¾
 
Annual financial statements
¾
 
Fiscal audits
¾
 
Financial letters of credit
¾
 
Dunn and Bradstreet reports
¾
 
Profit/Loss statements
21
 
  
3. Evidence of legal qualification to do business
in Florida
21
 
  
4. Verification of business or non-profit status
21
 
  
5. Signed statement that organization has not
been suspended or disbarred from receiving
federal funding
21
 
  
6. Statement of lawsuits filed against
organization
21
 
  
7. Statement of denied approval or removed
approval status from another state
21
 
  
8. Statement of unresolved complaints with the
Better Business Bureau
21
 
  
 
  
  
7.0 APPLICATION NARRATIVE
21
  
7.1 Demonstrated record of effectiveness
21
  
7.2 Services consistent with instructional program of school
district and Florida Sunshine State Standards
22
  
7.3 High quality, research-based, instructional strategies
22
  
7.4 Set measurable achievement goals, adhere to
timelines, report student’s progress
23
  
7.5 Capacity and resources, compliance of applicable
federal, state, local health, safety, and civil rights laws
23
  
 
 
- 3 -

Subject Page
No.
For
Completion
8.0 REVIEW RUBRIC
25
  
8.1 Demonstrated record of effectiveness
25
  
8.2 Services consistent with instructional program of school
district and Florida Sunshine State Standards
26
  
8.3 High quality, research-based instructional strategies
28
  
8.4 Set measurable achievement goals, adhere to
timelines, report student’s progress
29
  
8.5 Capacity and resources, compliance of applicable
federal, state, local health, safety, and civil rights laws
32
  
 
  
  
DOCUMENTATION TO MAIL OR HAND DELIVER:
  
  
Cover Page for mail or hand delivered
 
documentation 35
  
ATTACHMENT A: General Assurances with original signature
36
  
ATTACHMENT B: Internet Statement of Assurances with original
signature
39
Letter Designating Signature Authority:
If signatures on Attachment A and/or Attachment B are not of the
head of the applying agency, attach letter signed by agency head or
documentation citing action of governing body authorizing the person
to sign on behalf of said official.
38, 40
  
- 4 -

SUPPLEMENTAL EDUCATIONAL SERVICES (SES) PROVIDERS
 
2006-07 REQUEST FOR APPLICATIONS (RFA)
 
 
1.0 BACKGROUND
 
1.1 General Information
 
Supplemental educational services (SES) are defined as tutoring or other supplemental
academic enrichment services in reading/language arts and mathematics that are
provided beyond the normal school day and are of high quality, research based, and
specifically designed to increase academic achievement of students in schools in need
of improvement.
 
A Title I school that is in its second year of school improvement [a school that has not
met adequate yearly progress (AYP) for three years] or is in corrective action or
identified for restructuring must offer SES to eligible students. Students from low-
income families (participating in the Free or Reduced Price Lunch program) are eligible
for SES. If the school district determines that the amount of funds is insufficient to
provide these services to all eligible students whose parents requested the services, the
school district must develop a process to prioritize the services to the lowest-achieving
students.
 
1.2 Purpose
 
This Request for Applications (RFA) is for the annual selection and approval of
providers of SES to provide high-quality, research-based instruction designed to
increase academic achievement for eligible students who are enrolled in Title I schools
that are identified in their second year of need of improvement, or are in corrective
action, or restructuring for the 2006-07 school year.
 
This document outlines the details regarding provider requirements, responsibilities, and
how the applications will be reviewed. Applications will be approved if they meet the
criteria as stated within this RFA. The list of Florida’s approved providers of SES will be
maintained and monitored by the Florida Department of Education (FDOE).
 
 
2.0 APPLICATION INSTRUCTIONS
 
2.1 Submission Deadlines
 
2.1.1 On-line Application
 
All new and renewing applicants for the state’s 2006-07 approved SES provider list
must submit a complete application via the web-based application system which can be
accessed on the FDOE website for Supplemental Educational Services at
- 5 -

 
www.firn.edu/doe/flbpso. The deadline for online submission of an application is 5:00
p.m. Eastern Daylight Saving Time on
May 12, 2006
. Applications received by mail,
electronic mail (email), or by facsimile (fax) will not be considered.
 
2.1.2 Assurances and Printed Documentation
 
In addition to the online submission of an application, all new and renewing applicants
for the state’s 2006-07 approved SES provider list must mail or hand deliver a printed
copy of all assurance pages (with original signatures on Attachment A and Attachment
B) and all other documentation required within this RFA. The assurance pages must
have no revisions, additions, or deletions and must bear an original signature of the
agency head in blue ink color to distinguish it from a copy. Assurances signed by
officials other than the head of the providing agency must have a letter signed by the
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 with
the signed assurance pages.
 
The assurance pages and required documents must be received by the FDOE office
below no later than 5:00 p.m. Eastern Daylight Saving Time on or before
May 12, 2006
.
  
Any missing, incomplete, or altered assurance pages or documents received after May
12, 2006, will result in an unapproved application. Applicants may wish to mail the
documents via certified, return-receipt mail. It is the responsibility of the sender to
ensure that all assurances and documentation are received by the stated deadline.
 
MAIL TO:
Shonda O’Neal
Florida Department of Education
Bureau of Public School Options
325 West Gaines Street, Room 314
Tallahassee, FL 32399-0400
 
2.2 Technical Assistance
 
Questions regarding this RFA or the procedures for submitting a complete application
may be e-mailed to Kay Caster at kay.caster@fldoe.org. Include in the subject line of
the e-mail message:
RFA Question
. Questions will be answered on the FDOE
website for SES at www.firn.edu/doe/flbpso.
 
FDOE will provide an opportunity for all interested applicants to ask questions regarding
the application process in early April 2006. Additional information regarding this
technical assistance event will be posted on the FDOE website for SES at
www.firn.edu/doe/flbpso.
 
 
 
- 6 -

2.3 Method of Review
 
 
A committee of state and school district educational administrators, program specialists,
and instructors familiar in the selection of applications and with the NCLB, Title I, Part A
provisions and in SES instruction and delivery of services will review each application
and make recommendations for the approval of providers of SES for the 2006-07 school
year. Selection will be based on accurate completion of requested information and
data, compliance with all provider eligibility requirements, and agreement with
assurances set forth in the document. Successful applications are those that obtain at
least 70 points out of the maximum 100 points for the application narrative. It is
anticipated that the selection will be finalized in May 2006.
 
 
2.4 Method of Announcement
 
All applicants will be notified of their approved or unapproved status of their application.
Additionally, the list of the state-approved SES providers for the 2006-07 school year
will be announced via FDOE’s Paperless Communications System. To receive this
announcement via the Paperless Communications System, register at
www.firn.edu/doe/menu/communications.htm.
 
The list of the 2006-07 state-approved SES providers will be posted on the FDOE
website for SES at www.firn.edu/doe/flbpso.
 
3.0 SPECIFICATIONS
 
3.1 Eligible Service Providers
 
Eligible service providers may be non-profit entities, for-profit entities, or local
educational agencies. Entities eligible to apply to provide SES may include:
 
Individuals
For-profit companies
Non-profit organizations
Community-based/faith-based organizations
Institutions of higher education
Local educational agencies such as Florida public school districts, university
laboratory schools, Florida School for the Deaf and the Blind, and Florida Virtual
School. Applicants must not be identified as in need of improvement, or in
corrective action, or restructuring
Public schools that are not identified as in need of improvement, or in corrective
action, or restructuring
Charter schools that are not identified as in need of improvement, or in corrective
action, or restructuring
Private schools
21
st
Century Community Learning Centers that are not affiliated with school districts
that are identified as in need of improvement, or in corrective action, or restructuring
- 7 -

Public libraries
Distance learning services (internet-based services)
Family literacy programs/Even Start programs
Child care centers serving school-age students
Regional educational consortia
 
A school district or school identified as in need of improvement, or in corrective
action, or restructuring may not apply for approval to be an SES provider. If a school
district or school that is not currently in need of improvement has been approved as
an SES provider for the 2006-07 school year, and subsequently is identified as in
need of improvement at the end of the 2005-06 year, the school district or school will
be removed from the state-approved SES provider list.
 
3.2 Eligibility Requirements
 
To be eligible to be state-approved SES providers, applicants must:
 
Demonstrate a record of effectiveness in providing academic programs for students
for at least three years, or be able to demonstrate the capacity to effectively provide
the services through qualified staff, appropriate research-based curriculum, and an
established infrastructure
Demonstrate high probability of increasing the academic achievement of eligible
students on state assessments and attaining proficiency in meeting Florida’s
academic content standards by providing instruction that is of high quality, research
based, and aligned with Florida’s academic content standards (Sunshine State
Standards)
 
Provide instruction in addition to that which is provided during the school day
 
Instruct with a tutorial staff who meet minimum standards for Title I
paraprofessionals such as
 
¾
 
an earned secondary school diploma or its recognized equivalent
 
¾
 
completed two years of study at an institution of higher education (equivalent to
60 semester hours)
 
¾
 
obtained an Associate Degree or higher degree, or
 
¾
 
have passed a local paraprofessional academic assessment
 
Instruct with a tutor/student ratio of no more than 1:10
 
Meet all applicable federal, state, and local health, safety, and civil rights laws
 
Provide SES that are secular, neutral, and nonideological
 
Demonstrate financial soundness and stability
 
Understand and agree to abide by the terms stated within this Request for
Applications.
 
- 8 -

 
3.3 Responsibilities
 
3.3.1 Responsibilities of the Florida Department of Education (FDOE)
 
FDOE must:
 
Define Annual Yearly Progress (AYP), which is the minimum performance that
school districts and schools must reach each year on state assessments and other
measures, and identify schools that do not make AYP
Notify annually potential providers of SES regarding the opportunity to provide
services and the procedures for applying to become state-approved to deliver SES
Develop and apply objective criteria in t
he application process for selecting providers
Promote maximum participation by providers to ensure that parents have as many
choices as possible
Identify providers that offer high-quality, research-based tutoring services that are
aligned with the state standards
Maintain an updated list of state-approved providers, sorted by school districts, from
which parents may select
Develop and implement standards and techniques for monitoring the quality and
effectiveness of the services to be offered by approved providers. Such standards
and techniques, as well as any findings resulting from such monitoring, must be
publicly reported.
Develop procedures for withdrawing approval from providers that fail for two
consecutive years to contribute to increasing the academic proficiency of the
students they serve under this program.
 
 
3.3.2 Responsibilities of the School Districts
 
School districts must:
 
Identify eligible students
Notify parents annually in an understandable and uniform format, and to the extent
practicable, in a language and translation that the parents can understand regarding:
¾
 
the availability of SES
¾
 
the approved providers whose services are available to serve within the school
district
¾
 
the services, qualifications, and demonstrated effectiveness of each approved
provider
Help parents choose a provider, if requested
Enter into a contractual agreement with providers selected by the parents on behalf
of their students. Through a Parent/District/Provider Agreement (PDPA), the school
district, the parents, and the provider, must develop and identify specific academic
achievement goals for the student, measures of student progress, and a timetable
for improving achievement.
- 9 -

Prioritize SES for the lowest-achieving eligible students, if parents’ requests for SES
exceed the available funds
Protect the privacy of students who receive SES.
 
3.3.3 Responsibilities of the Approved Providers
 
 
Approved providers of SES must:
 
Provide tutoring or other supplemental academic enrichment services in
reading/language arts and mathematics that are provided beyond the normal
school day that are of high quality, research based, and specifically designed to
increase the academic achievement of students. Homework assistance is not a
form of supplemental educational services.
Ensure that the instruction provided is aligned with Florida’s academic content
standards and in the case of a student with disabilities, is consistent with the
Individuals with Disabilities Education Act as amended in 2004
Regularly notify parents and the appropriate schools regarding the academic
progress of students receiving SES
Enter into a contract with the local school district that includes:
¾
provisions for termination of the contract
¾
provisions for payment for services
¾
an assurance that the identity of any student eligible for or receiving services will
not be disclosed without prior written consent of the student’s parents
Enter into an agreement (PDPA) with the local school district and parents for
each student that includes:
¾
specific student achievement goals
¾
how the student’s progress will be measured
¾
timetable for improving achievement
¾
consistency with individualized educational program plans for students with
disabilities
Meet all applicable federal, state, and local health, safety, and civil rights laws
Be financially sound
Ensure that all instruction and content are secular, neutral, and nonideological
Comply with the eligibility requirements and assurances set forth in this RFA
Comply with all reporting requirements and timelines for submitting reports to the
school district and FDOE
Deliver services consistent with the approved application and the signed contract
with each district. State-approved providers must serve the minimum number of
students at each site in each school district for which it is approved and for which
a signed contract has specified the minimum number of students to be enrolled at
each site. If a provider refuses to serve the minimum number of students enrolled
at each site for which it was approved and contracted, the provider will be
removed immediately from the approved list for the current school year for that
school district, and will be ineligible to apply for approval to provide services in the
state for the following year.
 
 
- 10 -

3.4 Funding
 
School districts must spend an amount equal to twenty percent (20%) of their Title I
funds for school choice, an amount equal to five percent (5%) of their allocation to
provide or pay for transportation; an amount equal to five percent (5%) of their allocation
to provide SES; and an amount equal to the remaining ten percent (10%) of their
allocation for transportation, SES, or both. If sufficient funds are not available to provide
state-approved SES to all eligible students whose parents request the services, school
districts must give priority to the lowest-performing eligible students. School districts
must prioritize on the basis of the academic achievement of individual students. School
districts are required to pay the per-student amount or the actual cost of the SES,
whichever is less.
 
Each applicant must account for, in the rate per hour indicated in its approved
application, expenses that it will incur in the provision of SES. All budgeted expenses
must be detailed within the contract agreement between the school district and the
approved provider and must be consistent with the rate submitted within the approved
application.
 
Note:
School districts are
 
not required to provide transportation for students being
served. Also, school districts are not required to provide space or resources
 
(e.g., staff,
computers, copiers, facility). A school district or school may enter into an agreement, if
it so chooses, with the provider for the use of its resources and transportation services.
However, a school district
 
may require additional fees for this use, and the provider
must ensure that there will be on-site supervision of students at all times.
 
 
Consideration in determining the stated rate per hour should include:
 
Tutor/student ratio
Variation in per-student allocations among school districts in the state
Variation in the cost of doing business among school districts in the state
Number of instructional hours
Qualifications (and therefore cost) of the tutoring staff
Cost of personnel expenses
Cost of instructional materials and equipment such as books, computers,
manipulatives, etc.
Amount of rent charged by the school district and other landlords (including
variations throughout the state)
Cost for transportation,
if providing transportation
Cost of developing the PDPAs, including all assessment and evaluation costs that
precede any tutoring services
School district’s payment policies regarding attendance and missed sessions
Employee criminal background checks
Cost of liability insurance
Administrative expenses
 
- 11 -

A mandatory one day SES technical assistance meeting sponsored by FDOE, to be
held in the summer 2006. Non-attendance may result in removal from the state-
approved SES provider list.
 
3.5 Duration
 
Students must begin receiving services as soon as possible in the school year. To
accomplish this objective, each school district must notify and request a letter of intent
to provide services in the district from each provider approved to serve that district. The
school district must notify and request providers’ intent to serve students within ten days
following the release of the 2006 AYP data from FDOE. Subsequently, each state-
approved SES provider and school district must complete a signed contract within 45
days of receiving notification from the provider its intent to provide SES to students
within that district. Providers must be prepared to provide regularly scheduled services
no later than October 1 of each school year. A provider must continue to provide SES
to eligible students who are receiving such services until the end of the school year in
which such services were first received or until the per-student allocation is fulfilled.
 
3.6 Monitoring
 
FDOE, in cooperation with the applicable school district, is required to monitor the
quality and effectiveness of the services offered by each approved provider. All
approved providers must complete monitoring procedures by the school districts and
FDOE. Failure to comply with monitoring procedures may result in removal from the
state-approved SES provider list.
 
3.7 Evaluation
 
A formal evaluation will be conducted by FDOE of each provider to measure students’
progress in reading/language arts and mathematics. Effective supplemental
educational services mean that providers show significant academic progress with at
least eighty percent (80%) of the students who received SES. Academic progress will
be determined based on student learning gains on assessments identified by the state.
For example, learning gains for students in fourth through twelfth grade will be
determined using student learning gains on the Florida Comprehensive Assessment
Test (FCAT). The state will identify a state assessment instrument to be used to
determine student learning gains for students in kindergarten through third grade at no
cost to the provider. Any provider that fails for two consecutive years to meet the
threshold will be removed from the state-approved list. Evaluation results regarding the
quality and effectiveness of provided services will be publicly reported.
 
3.8 Removal from the State-Approved List
 
FDOE may remove a provider from the approved list if the provider fails for two
consecutive years to contribute to increasing the academic proficiency of students to
whom it provides services. Also, FDOE has the discretion to immediately remove a
 
- 12 -

provider from the approved list if the provider fails to meet provider eligibility
requirements, provider responsibilities, general and internet assurances, or for other
good cause such as refusing to deliver services to school districts in which the
provider is approved by the state. State-approved providers must serve the
minimum number of students at each site in each school district for which it is
approved and for which a signed contract has specified the minimum number of
students to be enrolled at each site. If a provider refuses to serve the minimum
number of students enrolled at each site for which it was approved and contracted,
the provider will be removed immediately from the approved list for the current school
year for that school district, and will be ineligible to apply for approval to provide
services in the state for the following year.
 
 
4.0 RESOURCES
 
Additional information can be found at:
 
Florida Department of Education website for Supplemental Educational Services:
www.firn.edu/doe/flbpso
 
NCLB Legislation Title I - Improving The Academic Achievement of the
Disadvantaged Part A - Improving Basic Programs Operated by Local Educational
Agencies, Section 1116: Academic Assessment and Local Educational Agency and
School Improvement. [see (e) Supplemental Educational Services]:
http://www.ed.gov/policy/elsec/leg/esea02/pg2.html#sec1116
NCLB Supplemental Educational Services Non-Regulatory Guidance
(issued June
13, 2005)
:
  
www.ed.gov/policy/elsec/guid/suppsvcsguid.doc
Sunshine State Standards: www.firn.edu/doe/curric/prek12/index.html)
 
2004-05 Title I Schools with 2005 AYP, School Grade Data, and Identified In Need
Of Improvement Data: www.firn.edu/doe/title1/pdf/2004_05_titleI_7_22_05.pdf
 
Federal No Child Left Behind - Adequate Yearly Progress (AYP) Report (by school,
school district or state): http://web.fldoe.org/NCLB/default.cfm
Florida Guide to Calculating Adequate Y
early Progress (AYP) technical assistance
paper: http://web.fldoe.org/NCLB/pdf/0405ayp-tap.pdf
The Education Industry Association's Code of Professional Conduct and Business
Ethics for Supplemental Educational Services Providers
(amended November 15,
2005)
www.educationindustry.org/documents/Code_of_Standards_and_Ethics_11-
15-05.pdf
 
Florida Comprehensive Assessment Test®:
http://myfloridaeducation.com/doe/sas/fcat.htm
Just Read, Florida!: www.justreadflorida.com/
The Florida Center for Reading Research: www.fcrr.org/
 
 
- 13 -

5.0 TIMELINE OF SERVICES AND PROCEDURES
 
 
Date/Timeframe
 
Major Activity
 
 
April
 
RFA questions and answers posted at www.firn.edu/doe/flbpso
 
Participate in an RFA technical assistance opportunity for interested
applicants
 
 
May
 
Apply to become a state-approved provider
 
Mail or hand deliver signed assurance pages and required documentation
for application review
 
 
June
 
 
FDOE announces providers who are approved or unapproved
 
 
FDOE releases AYP results and identifies schools that have not achieved
AYP for three or more years and must offer SES to eligible students
 
School districts receive preliminary per-student allocations from FDOE
 
Each school district initiates the contractual process by notifying each
state-approved provider for a return of its agreement to provide services
 
State-approved provider applications posted on the SES website at
www.firn.edu/doe/flbpso
 
 
June - August
 
 
Attend a mandatory SES technical assistance meeting
 
 
July - September
 
 
School districts and state-approved providers complete contracts
 
Providers coordinate with school districts to develop parent outreach,
PDPAs, background checks, and assignment of students
 
Implement plan to hire and train employees
 
Develop infrastructure to serve students
 
Participate in provider fairs, if applicable
 
 
September –
October
 
 
Begin providing supplemental educational services to students
 
 
 
- 14 -

 
 
 
Date/Timeframe
 
Major Activity
 
 
Ongoing
 
Submit invoices and attendance records for payment
 
Provide student’s academic progress at regularly scheduled intervals, in an
understandable format, for each student’s parents, school, and school
district in accordance with PDPA
 
Participate in scheduled FDOE conference calls
 
Participate in monitoring and evaluation reporting
 
 
 
6.0 APPLICATION PROPOSAL
 
An approved SES provider must enter into a contract with each school district in which it
is approved before providing services to students. The application, if approved, is the
basis upon which a contract is made. Please consider each of the responses carefully
as these responses will become the terms of the contract signed with the school district.
In addition, FDOE will monitor each provider to ensure that the implementation of the
program is consistent with the approved application.
 
 
6.1 Contact Information
 
Name of Company or Agency:
 
Federal Employer Identification Number (FEIN) or Federal Tax Identification Number
 
Name of Contact Person (director or manager for each SES location):
 
Title:
 
Mailing Address:
 
City/State/Zip Code:
 
Telephone Number:
 
Fax Number:
 
E-mail Address (REQUIRED):
 
Organization Website:
 
- 15 -

 
6.2 Applicant Status:
 
 
Applying as a
NEW
provider
  
Applying as a
RENEWING
provider
 
Applicants Submitting as Renewing Providers:
Which year(s) has the applicant been approved for providing SES in Florida?
Under what business name(s):_____________________________________________
Serving which school district(s):____________________________________________
 
Is the applicant an approved provider for SES in any other state?
Yes Identify the states: ________________________
No
 
6.3 School District(s) to be Served (select all school districts in which the
applicant requests approval and agrees to provide SES):
 
Indicate the school district(s) for which the applicant will provide services. A list of
2004-05 Title I schools, by district, with 2005 AYP and School In Need of Improvement
(SINI) status, can be accessed at
www.firn.edu/doe/title1/pdf/2004_05_titleI_7_22_05.pdf. From this report, the 2005-06
Title I schools that are in year two and three SINI status, were required to offer SES to
eligible students. This list will be updated with 2006 AYP data and is expected to be
released in early summer. For 2006-07 planning purposes, any school on this list that
remains in SINI status will be required to offer the option of state-approved SES to
eligible students. A school that currently must offer SES to eligible students will
continue to be required to offer this option until the school has made AYP for two
consecutive years.
 
**NOTE**:
State-approved providers must serve the minimum number of students at
each site in each school district for which it is approved and for which a signed contract
has specified the minimum number of students to be enrolled at each site. If a provider
refuses to serve the minimum number of students enrolled at each site for which it was
approved and contracted, the provider will be removed immediately from the approved
list for the current school year for that school district, and will be ineligible to apply for
approval to provide services in the state for the following year.
 
 
Alachua
Flagler
Lake
Pinellas
Baker
Franklin
Lee
Polk
Bay
Gadsden
Leon
Putnam
Bradford
Gilchrist
Levy
St. Johns
Brevard
Glades
Liberty
St. Lucie
Broward
Gulf
Madison
Santa Rosa
Calhoun
Hamilton
Manatee
Sarasota
Charlotte
Hardee
Marion
Seminole
Citrus
Hendry
Martin
Sumter
 
- 16 -

Clay
Hernando
Monroe
Suwannee
Collier
Highlands
Nassau
Taylor
Columbia
Hillsborough
Okaloosa
Union
Dade
Holmes
Okeechobee
Volusia
DeSoto
Indian River
Orange
Wakulla
Dixie
Jackson
Osceola
Walton
Duval
Jefferson
Palm Beach
Washington
Escambia
Lafayette
Pasco
FAMU Lab School
 
6.4 Applicant Classification (check the category that best describes the
applicant’s organization)
 
 
Individual
 
For-profit company
 
Non-profit organization
 
Community based/faith-based organization
 
Institution of higher education
 
Local educational agency such as a Florida public school district, a university
laboratory school, Florida School for the Deaf and the Blind, and Florida Virtual School,
that is not identified as in need of improvement, or in corrective action, or restructuring
Public school that is not identified as in need of improvement, or in corrective action,
or restructuring
 
Charter school that is not identified as in need of improvement, or in corrective
action, or restructuring
 
Private school
 
21
st
Century Community Learning Center that is not affiliated with a school district
that is identified as in need of improvement, or in corrective action, or restructuring
 
Public library
 
Distance learning service (internet-based service)
 
Family literacy program/Even Start program
 
Child care center serving school-age students
 
Regional educational consortium
 
Other (Describe)
 
A school district or school that is identified as in need of improvement, or in corrective
action, or restructuring may not apply for approval to be an SES provider. If a school
district or school is not currently in need of improvement, becomes approved as an
SES provider for the 2006-07 school year, and subsequently is identified as in need
of improvement at the end of 2005-06; the school district or school will be removed
from the state-approved SES provider list.
 
6.5 ACADEMIC AND INSTRUCTIONAL INFORMATION
 
6.5.1 Subject Area(s) (check all that apply):
 
Reading/Language Arts
Mathematics
 
- 17 -

 
 
6.5.2 Staff Qualifications (check all that apply)
 
Meet Title I standards for paraprofessionals, such as an earned secondary school
diploma and have two years of college (equivalent to 60 semester hours) or an
Associate's Degree, or have passed a local paraprofessional academic assessment
 
Have experience in teaching students with specific disabilities
 
Have experience in teaching students with limited English proficiency (LEP)
 
Have the ability to speak languages other than English
Spanish
Haitian Creole
Other (Identify):
 
Are qualified with a reading certification or endorsement
 
Are qualified as state
 
certified/licensed teachers
 
6.5.3 Type of Instruction (check all that apply):
 
 
Small group instruction (not to exceed five students)
Estimated tutor/student ratio: 1 tutor per _____ students
 
 
Large group instruction (not to exceed ten students)
Estimated tutor/student ratio: 1 tutor per _____ students
 
 
Distance learning instruction (on-line, internet-based instruction)
Estimated tutor/student ratio: 1 tutor per _____ students
 
 
Individual tutoring
 
6.5.4 Grade Levels to be Served (check all that apply):
K
1
2
3
4
5
6
7
8
9
10
11
12
 
 
6.6 SES PROVISIONS
 
6.6.1 Student Capacity
 
State-approved providers must serve the minimum number of students at each site in each
school district for which it is approved and for which a signed contract has specified the
minimum number of students to be enrolled at each site. If a provider refuses to serve the
minimum number of students enrolled at each site for which it was approved and contracted,
the provider will be removed immediately from the approved list for the current school year for
that school district, and will be ineligible to apply for approval to provide services in the state
for the following year.
 
___ Indicate the minimum number of students that the applicant would serve at each site
___ Indicate the maximum number of students that the applicant would serve at each site
 
- 18 -

 
___ Indicate the minimum number of students that the applicant would serve at each school
district
___ Indicate the maximum number of students that the applicant would serve at each school
district
 
Yes
No Capacity to serve students with disabilities or 504 plans
Yes
No Capacity to serve students with limited English proficiency
 
6.6.2. Location of Services (check where services will take place)
 
School campus
Provider facility
Faith-based center (e.g., church, temple, mosque, etc.)
Community based center
Student’s home (distance learning services only)
Public site such as public library (describe):
Other (describe):
 
6.6.3 If services are provided at a site other than the student’s school, will the
applicant provide transportation?
 
Yes, transportation will be provided for each student enrolled. Describe
transportation service to be provided: ___________________________________
No, transportation will not be provided to students.
 
6.6.4 Operations
 
Days of Operation (Check all that apply):
 
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
 
Frequency of SES sessions for each student:
 
Every Day
Once a Week
Twice a Week
Three Times a Week
Other (Describe):
 
Average length of each service session (hours/minutes):
 
2 Hours
1 Hour
30 Minutes
Other (specific, no ranges):
 
Times of Service (Check all that apply)
:
 
Before school
Summer (Identify dates, such as June 1 – August 4, 2006)
After School
 
- 19 -

Weekends
Other (Describe):
 
 
6.7 COST OF SERVICE
 
For the 2005-06 school year, the statewide average cost per pupil for SES is $1,240.81.
 
**Note** the allowable range is between $5.00 and up to $80.00 per hour for each
student, per hour and per type of instruction.
 
 
Expenses that the approved provider incurs in the provision of SES must be accounted
for in the stated rate per student, per hour of instruction, and for each type of instruction
as indicated in its application under
6.5.3 Type of Instruction
. The rate submitted in
the application must be used in all school districts in which the applicant is approved to
serve. All budgeted expenses must be detailed within the school board’s approved
contract between the school district and the provider and reflect the rate submitted
within this application.
 
Consideration of expenses should include, but are not limited to:
 
Tutor/student ratio
Variation in per-student allocations among school districts in the state
Variation in the cost of doing business among school districts in the state
Number of instructional hours
Qualifications (and therefore cost) of the tutoring staff
Cost of all personnel expenses
Cost of instructional materials and equipment such as books, computers,
manipulatives, etc.
Amount of rent charged by the school district and other landlords (including
variations throughout the state)
Cost for transportation, if applicable
Cost of developing the PDPAs, including all assessment and evaluation costs that
precede any tutoring services
School district’s payment policies regarding attendance and missed sessions
Employee criminal background checks
Cost of liability insurance
Administrative expenses
A mandatory one-day SES technical assistance meeting sponsored by FDOE, to be
held in the summer 2006. Non-attendance may result in removal from the state-
approved SES provider list.
 
6.7.1 Rate for Provision of SES: Per Student, Per Hour, Per Type of Instruction
Indicate one rate to serve SES for each student, per hour and for each type of
instruction as indicated in this application for
6.5.3 Type of Instruction
(small group
instruction, large group instruction, distance learning (internet-based) instruction, and/or
individual tutoring).
 
- 20 -

 
RATE FOR EACH STUDENT FOR EACH HOUR:
$______
Small group instruction
 
$______
Large group instruction
 
$______
Distance learning (internet-based) instruction
 
$______
Individual tutoring
 
 
6.8 FISCAL SOUNDNESS
 
6.8.1 Provider must document financial soundness [NCLB, Section
1116(e)(12)(B)(iii)].
 
Applicants must provide the following
 
to be mailed or hand delivered, and received by
the FDOE office no later than 5:00 p.m. Eastern Daylight Saving Time on
May 12, 2006
.
Limit to a total of 15 pages.
 
1. Copy of the cover page of applicant’s liability insurance, with the company name
and policy number.
 
2. Copy of the organization’s most recent tax return or other evidence of fiscal
soundness such as annual financial statements, fiscal audits, financial letters of
credit, Dunn and Bradstreet reports, profit/loss statements, etc.
 
3. Evidence that the applicant is legally qualified to do business in Florida.
4. Verification of business status or non-profit status. For example: Internal
Revenue Service (IRS) letter with FEIN or certificate issued by government.
5. Signed statement that the organization has not been suspended or disbarred
from receiving federal funding.
6. If lawsuits have been filed against the organization for educational and/or fiscal
mismanagement, civil rights violations, criminal act(s), or other reason(s);
provide information on the lawsuit(s) filed and the outcome for each instance.
 
7. If the organization has been denied approval or its approval status was removed
as an SES provider in another state, identify such state(s) and the reason(s) for
such denial or removal.
 
8. If the organization has any known unresolved complaints with the Better
Business Bureau, provide an explanation of the complaint(s) and results.
 
 
 
 
 
 
 
 
 
 
7.0 APPLICATION NARRATIVE
 
 
- 21 -

THE FOLLOWING ITEMS WILL BE SCORED. APPLICATIONS MUST SCORE AT
LEAST 70 POINTS OUT OF 100 TO BE CONSIDERED APPROVABLE.
 
7.1 The provider must have a demonstrated record of effectiveness in increasing
the student academic achievement toward meeting the state achievement
standards [NCLB, Section 1116(e)(12)(B)(i)]. Describe the following:
 
1. Specific quantitative
and qualitative evidence that the proposed program has
accelerated the academic achievement in reading/language arts and/or mathematics
of identified Title I students, at-risk students, students with disabilities, and students
with limited English proficiency (LEP). Include a description of the methodology
used to collect this evidence (measures and analysis used, comparison groups,
etc.).
 
2. Specific evidence that the proposed program has a positive impact on student
achievement as demonstrated through a state, local school system, or other
independent, valid, and reliable performance test, particularly for low-income
underachieving students. Cite available research studies as appropriate and provide
specific data.
 
7.2 The provider must ensure that supplemental educational services are
consistent with the instructional program of the local educational agency and the
academic standards set forth by the state (Sunshine State Standards) [NCLB,
Sections 1116(e)(5)(B) and 1116(e)(12)(B)(ii)]. Describe the following:
 
1. The proposed approach or model of instruction (e.g., small group instruction, large
group instruction, distance learning internet-base, or individual tutoring) and how the
approach or model of instruction will ensure student achievement.
 
2. The capacity to provide supplemental educational services that are consistent with
the instructional program of the local school district and with Florida’s Sunshine
State Standards. Instructional content and methods must be designed to help
students achieve proficiency in meeting state achievement standards. When
possible, cite examples of the specific state standards addressed by the proposed
program. For example: reading standards should include phonemic awareness,
phonics, vocabulary development, reading fluency, and reading comprehension
strategies; mathematics standards should include number sense, measurement,
geometry and spatial sense, algebraic thinking, and data analysis and probability.
For information on Florida’s Sunshine State Standards, see
www.firn.edu/doe/curric/prek12/index.html.
 
3. How the applicant will coordinate supplemental educational services with the
classroom instructional program of the student receiving the services. Homework
assistance is not a form of SES.
 
 
- 22 -

4. How the applicant will ensure that the instructional materials used to provide
services to students are appropriate for each student’s grade level and proficiency
level. If assistance in reading will be provided, describe immediate intensive reading
intervention strategies. See //www.justreadflorida.com/ for more information.
 
7.3 The provider must document that the instructional strategies used by the
provider are high quality, based upon research, and designed to increase student
academic achievement of eligible students and attain proficiency in meeting the
state’s academic achievement standards [NCLB, Section 1116(e)(12)(C)(ii)].
Describe the following:
 
1. How the key instructional practices and major design elements of the proposed
program are of high quality, based on research, and specifically designed to
increase academic achievement of eligible students. Examples of major elements
may include mode of instruction, class size, time on task, or resource materials.
 
2. How the program and instruction are focused, intensive, and tailored to meet the
individual needs of students, including special populations (e.g., students with
disabilities and limited English proficiency language learners).
 
7.4 The provider must set measurable achievement goals for each student in
consultation with each student’s parents and the school district and adhere to the
timetable for improving the student’s achievement on the Parent/District/Provider
Agreement (PDPA). The provider must measure the student’s progress, and
regularly inform the student’s parents and teachers regarding the progress of the
student in improving academic achievement as outlined in the PDPA [NCLB,
Sections 1116(e)(3)(A) and (B)]. Describe the following:
 
 
1. The specific process the applicant will use to assess and diagnose student needs,
identify skill or knowledge gaps, and prescribe an instructional program based on the
student’s individual needs. Identify what assessments will be used and why.
  
2. How the applicant will set measurable objectives and timelines for the development
of each student’s PDPA to ensure supplemental educational services are provided
to students as soon as possible in the school year, but no later than October 1 of
each school year.
 
3. The specific process the applicant will use to evaluate, monitor, and track student
progress on a continuous and regular basis.
 
4. The procedures and timelines to be used to report student progress to parents (in
the parents’ native language, if feasible), teachers, and appropriate school district
staff.
 
 
- 23 -

 
- 24 -
5. How student attendance and participation will be collected, verified, and reported to
the school district. Include strategies for improving the attendance of students who
are habitually absent.
 
7.5 The provider must have the capacity and resources, including financial
soundness and compliance with applicable federal, state, and local health, safety,
and civil rights, to provide supplemental services to students [NCLB, Sections
1116(e)(12)(b)(iii) and (e)(5)(C)]. Describe the following:
 
1. Minimum qualifications of the personnel who will provide instruction. Include how
the applicant determines that instructors are qualified to effectively work with
students who are performing below grade level.
 
2. Process for recruiting, hiring, and training of high-quality staff.
 
3. Ongoing training and support provided to tutors to ensure that they effectively
administer the program with fidelity.
 
4. Procedures that will be used to maintain, monitor, and notify the school district
regarding personnel updates related to applicant’s staff changes.
 
5. Procedures to be used for completion of, and compliance with, staff background
checks and fingerprinting for those employees providing direct services to students.
 
6. Location, facilities, and equipment, including technology, to be used in the provision
of SES.
 
7. Capacity for the applicant to provide appropriate SES to eligible students with
disabilities, students covered under Section 504, and/or students with limited English
proficiency.
 

8.0 REVIEW RUBRIC
 
 
Essential Components
 
 
Limited or No
Evidence (0-1 point)
 
 
Moderate Evidence
(2-3 points)
 
Strong Evidence
(4-5 points)
8.1 Demonstrated record of effectiveness
  
  
  
 
Specific quantitative and qualitative evidence that the proposed program
has accelerated the academic achievement in reading/language arts
and/or mathematics of identified Title I students, at-risk students,
students with disabilities, and students with limited English proficiency
(LEP). Include a description of the methodology used to collect this
evidence (measures and analysis used, comparison groups, etc.)
 
 
Evidence and analysis
fails to demonstrate
program’s
effectiveness in
accelerating academic
achievement.
 
Provides some
evidence and analysis
of qualitative and
quantitative data that
demonstrate the
program’s
effectiveness in
accelerating academic
achievement.
 
 
Qualitative and
quantitative evidence
demonstrates
effectiveness in the
proposed programs
ability to accelerate
academic
achievement.
 
Specific evidence that the proposed program has a positive impact on
student achievement as demonstrated through a state, local school
system, or other independent, valid, and reliable performance test,
particularly for low-income underachieving students. Cite available
research studies as appropriate and provide specific data.
 
 
Proposed program has
no or little
demonstration of
positive impact on
student achievement
through a state, local
school system, or other
independent, valid, and
reliable performance
test, particularly for
low-income
underachieving
students. Provide no
or little research or
data that is appropriate
or supportive of
proposed program.
 
Proposed program has
minimal demonstration
of positive impact on
student achievement
through a state, local
school system, or other
independent, valid, and
reliable performance
test, particularly for
low-income
underachieving
students. Some
research support or
data provided that is
appropriate or
supportive of the
proposed program.
 
Proposed program has
compelling evidence,
through appropriate
and significant
research and data, to
demonstration a
positive impact on
student achievement
through a state, local
school system, or other
independent, valid, and
reliable performance
test, particularly for
low-income
underachieving
students.
25

 
 
Essential Components
 
 
Limited or No Evidence
(0-1 point)
 
 
Moderate Evidence
(2-3 points)
 
Strong Evidence
(4-5 points)
8.2 Ensured services are consistent with school district and
Sunshine State Standards
 
  
  
 
The proposed approach or model of instruction (e.g., small group
instruction, large group instruction, distance learning/internet-based or
individual tutoring) and how the approach or model of instruction will
ensure student achievement.
 
 
The proposed approach
or model of instruction
provides no or little
consistency with school
district and Sunshine
State Standards.
 
The proposed
approach or model of
instruction provides
some consistency with
school district and
Sunshine State
Standards.
 
The proposed
approach or model of
instruction provides
clear and direct
consistency with
school district and
Sunshine State
Standards.
 
 
The capacity to provide supplemental educational services that are
consistent with the instructional program of the local school district and with
Florida’s Sunshine State Standards. Instructional content and methods
must be designed to help students achieve proficiency in meeting state
achievement standards. When possible, cite examples of the specific
standards addressed by the proposed program. For example: reading
standards should include phonemic awareness, phonics, vocabulary
development, reading fluency, and reading comprehension strategies;
mathematics standards should include number sense, measurement,
geometry and spatial sense, algebraic thinking, and data analysis and
probability. For information on Florida’s Sunshine State Standards, see
www.firn.edu/doe/curric/prek12/index.html.
 
 
No evidence or
substantially lacks
capacity to provide
supplemental
educational services
consistent with the
instructional program of
the local school district
and with Florida’s
Sunshine State
Standards.
 
Some capacity to
provide supplemental
educational services
consistent with the
instructional program of
the local school district
and with Florida’s
Sunshine State
Standards.
 
Clearly demonstrates
capacity to provide
supplemental
educational services
consistent with the
instructional program
of the local school
district and with
Florida’s Sunshine
State Standards.
26

 
 
Essential Components
 
 
Limited or No Evidence
(0-1 point)
 
 
Moderate Evidence
(2-3 points)
 
Strong Evidence
(4-5 points)
 
How the applicant will coordinate supplemental educational services with
the classroom instructional program of the student receiving the services.
Homework assistance is not a form of SES.
 
 
No or little coordination
of supplemental
educational services with
the classroom
instructional program of
the student receiving the
services.
 
 
Some coordination of
supplemental
educational services
with the classroom
instructional program of
the student receiving
the services.
 
 
Direct and
appropriate
coordination and
alignment of
supplemental
educational services
with the classroom
instructional program
of the student
receiving the
services.
 
 
How the applicant will ensure the instructional materials used to provide
services to students are appropriate for each student’s grade level and
proficiency level. If assistance in reading will be provided, describe
immediate intensive reading intervention strategies. See
www.justreadflorida.com/ for more information.
 
 
No supportive evidence
or substantially lacks
appropriate instructional
materials to provide
services to students
appropriate for each
student’s grade level and
proficiency level. If
assistance in reading will
be provided, the
proposed program offers
little or no immediate
intensive reading
intervention strategies to
improve students’
reading abilities to grade
level performance.
 
Some appropriate use
of instructional
materials that support
services to students at
each student’s grade
level and proficiency
level. If assistance in
reading will be
provided, the proposed
program offers some
immediate intensive
reading intervention
strategies to improve
students’ reading
abilities to grade level
performance.
 
Clear, focused and
appropriate use of
instructional
materials to provide
services to students
for each student’s
grade level and
proficiency level. If
assistance in reading
will be provided, the
proposed program
sufficient immediate
intensive reading
intervention
strategies to improve
students’ reading
abilities to grade level
27

 
Essential Components
 
 
Limited or No Evidence
(0-1 point)
 
 
Moderate Evidence
(2-3 points)
 
Strong Evidence
(4-5 points)
8.3 Documented high quality, research-based instructional strategies
  
  
  
 
How the key instructional practices and major design elements of the
program are of high quality, based on research, and specifically designed
to increase academic achievement of eligible students. Examples of major
elements may include mode of instruction, class size, time on task, or
resource materials.
 
 
Key instructional
practices and major
design elements have no
supportive or lacks
substantially evidence of
high quality, based on
research, and specifically
designed to increase
academic achievement
of eligible students.
 
Key instructional
practices and major
design elements have
some supportive or
substantial evidence of
high quality, based on
research, and
specifically designed to
increase academic
achievement of eligible
students.
 
Key instructional
practices and major
design elements
have clear and
compelling
supportive or
substantial evidence
of high quality, based
on research, and
specifically designed
to increase academic
achievement of
eligible students.
 
How the proposed program and instruction are focused, intensive, and
tailored to meet the individual needs of students, including special
populations (e.g., students with disabilities and limited English proficiency
language learners).
 
 
Little or no focused,
intensive, and tailored
components in the
proposed program to
meet the individual
needs of students,
including special
populations.
 
Some focused,
intensive, and tailored
components in the
proposed program to
meet the individual
needs of students,
including special
populations.
 
Clear and substantial
focused, intensive,
and tailored
components in the
proposed program to
meet the individual
needs of students,
including special
populations.
28

 
 
Essential Components
 
 
Limited or No Evidence
(0-1 point)
 
 
Moderate Evidence
(2-3 points)
 
Strong Evidence
(4-5 points)
8.4 Set measurable achievement goals, adhere to timetable, and
report students’ progress
 
  
  
 
The specific process the applicant will use to assess and diagnose student
needs, identify skill or knowledge gaps, and prescribe an instructional
program based on the student’s individual needs. Identify what
assessments will be used and why.
 
 
Little or substantially
lacks adequate process
to assess and diagnose
student needs, identify
skill or knowledge gaps
to prescribe an
appropriate instructional
program based on the
student’s individual
needs.
 
Minimal process to
assess and diagnose
student needs, identify
skill or knowledge gaps
that may prescribe an
appropriate
instructional program
based on the student’s
individual needs.
 
Complete and
focused process to
assess and diagnose
student needs,
identify skill or
knowledge gaps that
will ensure a well
prescribed and
appropriate
instructional program
based on the
student’s individual
needs.
 
How the applicant will set measurable objectives and timelines for the
development of each student’s PDPA to ensure supplemental educational
services are provided to students as soon as possible in the school year,
but no later than October 1 each school year.
 
 
No or lacks substantially
evidence that the
applicant can and will
deliver SES in a timely
manner as soon as
possible in the school
year, but no later than
October 1 each school
year.
 
Minimal evidence that
the applicant can and
will deliver SES in a
timely manner as soon
as possible in the
school year, but no
later than October 1
each school year.
 
Identifies effectively
and appropriately
how the applicant
can and will deliver
SES in a timely
manner as soon as
possible in the school
year, but no later
than October 1 each
school year.
 
29

 
 
Essential Components
 
 
Limited or No Evidence
(0-1 point)
 
 
Moderate Evidence
(2-3 points)
 
Strong Evidence
(4-5 points)
 
The specific process the applicant will use to evaluate, monitor, and track
student progress on a continuous and regular basis.
 
 
No or substantially lacks
specific process to
effectively and
appropriately evaluate,
monitor, and track
student progress on a
continuous and regular
basis.
 
Minimal process with
some specifics to
effectively and
appropriately evaluate,
monitor, and track
student progress on a
continuous and regular
basis.
 
Complete and
appropriate process
to effectively and
appropriately
evaluate, monitor,
and track student
progress on a
continuous and
regular basis.
 
The procedures and timelines to be used to report student progress to
parents (in the parents’ native language, if feasible), teachers, and
appropriate school district staff.
 
 
No or substantially lacks
procedures and timelines
to report student
progress to parents (in
the parents’ native
language, if feasible),
teachers, and
appropriate school
district staff.
 
Minimal procedures
and timelines to report
student progress to
parents (in the parents’
native language, if
feasible), teachers, and
appropriate school
district staff.
 
Complete and
appropriate
procedures and
timelines to report
student progress to
parents (in the
parents’ native
language, if feasible),
teachers, and
appropriate school
district staff.
30

 
 
Essential Components
 
 
Limited or No Evidence
(0-1 point)
 
 
Moderate Evidence
(2-3 points)
 
Strong Evidence
(4-5 points)
 
How student attendance and participation will be collected, verified, and
reported to the school district. Include strategies for improving the
attendance of students who are habitually absent.
 
 
No or substantially lacks
process for collection,
verification, and reporting
of student attendance
and participation to the
school district. No or
substantially lacks
strategies that will
improve the attendance
of students who are
habitually absent.
 
Minimal process for
collection, verification,
and reporting of
student attendance and
participation to the
school district. Some
appropriate strategies
that may improve the
attendance of students
who are habitually
absent.
 
Indicates specific and
comprehensive
process for
collection,
verification, and
reporting of student
attendance and
participation to the
school district, with
appropriate
strategies that will
improve the
attendance of
students who are
habitually absent.
 
 
Minimum qualifications of the personnel who will provide instruction.
Include how the applicant determines that instructors are qualified to
effectively work with students who are performing below grade level.
 
 
No or inadequate
qualifications in
personnel who will
provide instruction. Little
or substantially lacks a
method for determining
that instructors are
qualified to effectively
work with students who
are performing below
grade level.
 
Some or minimal
qualifications found in
personnel who will
provide instruction.
Minimal method for
determining that
instructors are qualified
to effectively work with
students who are
performing below
grade level.
 
Provides extensive
method of
determining
appropriate
qualifications for
determining that
instructors are
qualified to effectively
work with students
who are performing
below grade level.
31

 
 
Essential Components
 
 
Limited or No Evidence
(0-1 point)
 
 
Moderate Evidence
(2-3 points)
 
Strong Evidence
(4-5 points)
8.5 Capacity and resources, and compliance with applicable federal,
state, and local health, safety, and civil rights
 
  
  
 
Process for recruiting, hiring, and training of high quality staff.
 
 
No or substantially lacks
an appropriate process
for recruiting, hiring, and
training of high quality
staff.
 
Minimal process for
recruiting, hiring, and
training of high quality
staff.
 
Provides criteria and
job descriptions and
other means for
successful process
for recruiting, hiring,
and training of high
quality staff.
 
Ongoing training and support provided to tutors to ensure that they
effectively administer the program with fidelity.
 
 
No or substantially lacks
ongoing training and
support for tutors to
ensure that they
effectively administer the
program with fidelity.
 
Some ongoing training
and support for tutors
to may be assist them
effectively administer
the program with
fidelity.
 
Comprehensive plan
for ongoing training
and support to
sufficiently ensure
that tutors will
effectively administer
the program with
fidelity.
 
Procedures that will be used to maintain, monitor, and notify the school
district regarding personnel updates related to applicant’s staff changes.
 
 
No or substantially lacks
procedures that will
adequately maintain,
monitor, and notify the
school district regarding
personnel updates
related to applicant’s
staff changes.
 
Some procedures that
may adequately
maintain, monitor, and
notify the school district
regarding personnel
updates related to
applicant’s staff
changes.
 
Effective procedures
that will appropriately
maintain, monitor,
and notify the school
district regarding
personnel updates
related to applicant’s
staff changes.
32

 
 
Essential Components
 
 
Limited or No Evidence
(0-1 point)
 
 
Moderate Evidence
(2-3 points)
 
Strong Evidence
(4-5 points)
 
Procedures to be used for completion of, and compliance with, staff
background checks and fingerprinting for those employees providing direct
services to students.
 
 
No or substantially lacks
procedures for
completion of, and
compliance with, staff
background checks and
fingerprinting for those
employees providing
direct services to
students.
 
 
Minimal procedures for
completion of, and
compliance with, staff
background checks
and fingerprinting for
those employees
providing direct
services to students.
 
 
Complete and
appropriate
procedures for
completion of, and
compliance with, staff
background checks
and fingerprinting for
those employees
providing direct
services to students.
 
 
Location, facilities, and equipment, including technology, to be used in the
provision of SES
 
Lacks or inadequate
location, facilities, and
equipment, including
technology, for the safe
and appropriate provision
of SES.
Minimal location,
facilities, and
equipment, including
technology that may be
adequate for the safe
and appropriate
provision of SES.
Excellent use of
location, facilities,
equipment, and
technology that will
be conducive for the
safe and appropriate
provision of SES.
33

34
 
 
Essential Components
 
 
Limited or No Evidence
(0-1 point)
 
 
Moderate Evidence
(2-3 points)
 
Strong Evidence
(4-5 points)
 
Capacity for the applicant to provide appropriate SES to eligible students
with disabilities, students covered under Section 504, and/or students with
limited English proficiency.
 
 
No or substantially lacks
capacity to provide
appropriate SES to
eligible students with
disabilities, students
covered under Section
504, and/or students with
limited English
proficiency.
 
 
Minimal capacity that
may provide
appropriate SES to
eligible students with
disabilities, students
covered under Section
504, and/or students
with limited English
proficiency.
 
 
Sufficient capacity
that will provide
appropriate SES to
eligible students with
disabilities, students
covered under
Section 504, and/or
students with limited
English proficiency.
 
 

 
COVER PAGE
 
PRINT THIS PAGE TO USE AS THE COVER PAGE FOR MAILING SIGNED
ASSURANCE PAGES (ATTACHMENTS A AND B), AND ALL OTHER REQUIRED
DOCUMENTATION.
 
The cover page, signed assurance pages (Attachments A and B) and all other required
documentation, must be in receipt by the FDOE office below, either by mail or hand
delivery, no later than 5:00 p.m. Eastern Daylight Saving Time on
May 12, 2006
.
 
Shonda O’Neal
Florida Department of Education
Bureau of Public School Options
325 West Gaines Street, Room 314
Tallahassee, FL 32399-0400
 
Name of Company or Agency:
 
Federal Employer Identification Number (FEIN) or Federal Tax Identification
Number, if applicable:
 
Name of Contact Person (director or manager for each SES location):
 
Title:
 
Mailing Address:
 
City/State/Zip Code:
 
Telephone Number:
 
Fax Number:
 
E-mail Address (REQUIRED):
 
35

ATTACHMENT A: GENERAL ASSURANCES
 
The following assurances are required of all applicants to become supplemental
educational services providers. Please print this attachment, sign in blue ink, and mail
to the address stated on the previous page.
 
Assurances signed by officials other than the head of the providing agency must have a
letter signed by the 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 assurance pages.
 
As the duly authorized representative of this applicant, I certify compliance with
all of the following assurances:
 
1. Applicant assures that the program submitted herein is the program to be offered to
enrolled students. If the program presented for instruction to students is not the
same as submitted herein, FDOE reserves the right to remove the organization from
the approved list of providers.
 
2. Applicant agrees to deliver services at all times in accordance with the terms of this
Request for Applications (RFA), and the information submitted by the applicant in its
application. If the applicant fails to meet these terms, it may be removed the state-
approved list of SES providers. Applicant agrees to abide by the conditions set forth
in the contract with the school district, including the payment schedule, rates, and
any facility user fee arranged with the school district, that complies with Section
1116(e)(3) and (6) of the No Child Left Behind Act of 2001 pertaining to agreements
and amounts for SES. If the applicant operates multiple sites, applicant agrees to
provide services only at individual sites that meet all criteria independently.
 
3. Applicant agrees to deliver services to the minimum number of students at each site
in each school district for which it is approved and for which a signed contract has
specified the minimum number of students to be enrolled at each site. If the
applicant refuses to serve the minimum number of students enrolled at each site for
which it was approved and contracted, the applicant will be removed immediately
from the approved list for the current school year for that school district, and will be
ineligible to apply for approval to provide services in the state for the following year.
 
4. Applicant agrees to abide by ethical business practices, as adopted by the
Education Industry Association in its Code of Professional Conduct and Business
Ethics for Supplemental Educational Services Providers (
See
 
http://www.educationindustry.org/documents/Code_of_Standards_and_Ethics_11-
15-05.pdf)
for the Education Industry Association’s Code of Professional Conduct
and Business Ethics
 
for Supplemental Educational Services Providers, Amended
November 15, 2005.
 
 
36

5. Applicant agrees to provide auditable documentation of services provided to each
student, including enrollment, attendance, assessments, etc. Applicant and its
contractors will maintain books and records relating to the provision of SES and
necessary to support amounts charged to school districts for SES. Books and
records, including information stored in databases or other computer systems, will
be maintained by the applicant and its contractors for a period of five years after the
date of final payment under the school district’s agreement. Books and records
required to be maintained hereunder will be available for review or audit, either on-
site or as otherwise requested by district, state, and federal agencies. Books and
records required to be maintained hereunder will be available for review or audit to
agency representatives during normal business hours, with or without notice from
district, state, and federal agencies. The applicant and its representatives will fully
cooperate with any such review or audit.
 
6. Applicant will assure that SES are available in locations accessible to individuals
with disabilities, to the extent required by section 504 of the Rehabilitation Act of
1973 (29 U.S.C. §794) and the Americans with Disabilities Act (42 U.S.C. §§12101
et seq.)
 
7. Applicant will not apply additional admission criteria on eligible students other than
permitted under the No Child Left Behind Act, Public Law 107-110, Title I, Part A
Section 1116(e).
 
8. Applicant will notify the school district and FDOE of any changes in contact
information. If the contact information is not current and FDOE cannot reach the
applicant, as an approved provider, the applicant will be removed from approval list
within 60 days.
 
9. Applicant agrees to limit its distribution of any incentives to students, other than that
which directly relates to academic services provided, and not to exceed a monetary
value as designated in the contract with the school district.
 
10. Applicant agrees that it may be removed from the list if any false information is found
to have been provided in its application or to parents.
 
11. Applicant shall agree to be responsible for payment of all taxes and fees resulting
from payment from school districts for services.
 
12. Applicant assures that all instruction and content are secular, neutral, and non-
ideological.
 
13. All documents contained in or submitted with the application shall become the
exclusive property of FDOE and may be distributed or displayed in any manner
deemed necessary by the agency.
 
14. Applicant understands that its status as an approved provider is non-transferable.
37

 
15. Applicant agrees that it is an independent entity separate from FDOE, and that
FDOE is not obligated to approve an application, provide funds, or endorse any
application submitted. This application does not commit FDOE to pay any costs
incurred.
 
16. To the fullest extent permitted by law, the applicant and its organization agree to
indemnify, defend and hold harmless FDOE, the State of Florida, and their
respective agents, officers and employees from and against any and all claims,
demands, suits, liabilities, injuries (personal or bodily), property damage, causes of
action, losses, costs, expenses, damages or penalties, including without limitation
reasonable defense costs and legal fees arising or resulting from, or occasioned by
or in connection with (i) any bodily injury or property damage resulting or arising from
any act or omission to act (whether negligent, willful, wrongful or otherwise) by the
applicant or its organization, its subcontractors, anyone directly or indirectly
employed by them or anyone for whose acts they may be liable; (ii) failure by the
applicant and its organization or its subcontractors to comply with any laws or
regulations applicable to the performance of SES; (iii) the breach of any
representation or assurance provided by the applicant and its organization in this
application; or (iv) any act of infringement of any existing patent or copyright or any
unauthorized use of any trade secret.
 
I, THE UNDERSIGNED, CERTIFY
that I am an individual authorized to act on behalf of
the organization in submitting this application and assurances and that all of the
information provided herein is true and accurate, to the best of my knowledge. I
understand that, if any of the information contained herein is found to have been
deliberately misrepresented, that may constitute grounds for denying the applicant’s
request for approval to be placed on the list of approved supplemental educational
services providers or for removal from that same list. I further certify that the
organization will comply with all of the assurances set forth herein. Failure to comply
with the assurances during the school year may result in removal from the state-
approved list and potential ineligibility to apply for approval for the following school year.
 
____________________________________ _______________________________
Signature of Applicant Date signed
 
____________________________________ _______________________________
Printed Name Name of Agency/Company/Group
 
Note:
1. Printed name and original signature must match.
2. Use blue ink color for original signature.
3. "By”, “for," or initials will not be accepted.
4. Rubber stamp signatures will not be accepted.
38

ATTACHMENT B: INTERNET STATEMENT OF ASSURANCES
 
The following assurances are required of all applicants for approval as supplemental
educational services providers. Please print this attachment, sign in blue ink, and mail
with the Cover Page to the address stated previously.
 
Assurances signed by officials other than the head of the providing agency must have a
letter signed by the 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 assurance pages.
 
The Internet is an electronic network connecting thousands of computer networks and
millions of individual subscribers all over the world. Access to the Internet will allow
students to explore the rich resources of thousands of university libraries, governmental
databases, and other on-line sources while exchanging electronic mail with Internet
users throughout the world. However, use of the Internet, because it may lead to any
publicly available fileserver in the world, may open classrooms to electronic information
resources that have not been screened by educators for use by students. Some items
accessible via the Internet may contain material that is inaccurate, defamatory, or
offensive.
 
The following guidelines define "appropriate use" of the Internet.
 
1. Transmitting any material in violation of any U.S. or state regulation or school board
policy is prohibited. This includes, but is not limited to, copyrighted material and
threatening or obscene material.
2. All content transmitted via e-mail or the Internet shall be secular, neutral, and non-
ideological.
3. Hate mail, harassment, discriminatory remarks, and other antisocial behaviors are
unacceptable in Internet and other network communication.
4. All information accessible via the Internet should be assumed to be private property
and subject to copyright protection. Internet sources should be credited
appropriately, as with the use of any copyrighted material.
5. Applicant has a responsibility to respect the privacy and property of students.
Applicant should not intentionally seek information about, obtain copies of, or modify,
files, data, or passwords of other users.
6. For the safety of students, applicant must not request or provide any personal
information, such as addresses, phone numbers, or photographs.
7. Applicant should not expect that files are private. State and school district
representatives, including school administrators, as well as parents, may review files
and communications at any time to ensure that the network is being used
responsibly. Applicant must gain written parental permission before communicating
with students under the age of 13
1
via e-mail or the Internet.
1
As defined in Title XIII – Children’s Online Privacy Protection Act of 1998
 
39

8. If students will be using a school computer to access information from an applicant,
the applicant must abide by all school and school district policies and procedures
regarding computer/Internet use.
 
PENALTY FOR VIOLATION OF INTERNET RESPONSIBILITIES:
 
Failure to follow appropriate practices will result in immediate removal of the
applicant from the Florida Department of Education’s Approved Supplemental
Educational Services Provider List.
When applicable, law enforcement agencies
may be involved.
  
 
I, the undersigned, as a representative of _______________________________, agree
that all tutors/instructors employed by this organization will be notified of all guidelines
regarding appropriate use of the Internet and will agree to abide by them.
 
 
____________________________________ _______________________________
Signature of Applicant Date signed
 
____________________________________ _______________________________
Printed Name Name of Agency/Company/Group
 
Note:
1. Printed name and original signature must match.
2. Use blue ink for original signature.
3. "By", "for," or initials will not be accepted.
4. Rubber stamp signatures will not be accepted.
 
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