1. Nonpublic School Name
  2. Grade Span
  3. Number of Children from Low Income
  4. Families (4)
  5. Per Pupil Allocation
  6. Dollars Generated
  7. Dollars Allocated
  8. (if pooling)*
    1. Copy form as needed
  9. Nonpublic School Name
  10. Grade Span
  11. Number of Children from Low
  12. income Families (4)
  13. Per Pupil Allocation
  14. Dollars Generated
  15. Total Dollars
  16. Generated (7)
      1. Dollars Allocated (if pooling)
      2. Tier A
      3. Tier B
      4. Tier C
      5. Tier D
      6. Tier A
      7. Tier B
      8. Tier C
      9. Tier D Tier E
    1. Copy form as needed
    2. Poverty indexes PPA

TITLE I, PART A ALLOCATIONS FOR NONPUBLIC SCHOOL PARTICIPANTS
FISCAL YEAR 2002-2003
(1)
Date Certain
: ___/___/_____
District/Agency
: ________________________________________
Non Tiering
(See definition on the following page)
Nonpublic School Name
(2)

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Grade
Span
(3)

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Number of Children
from Low Income

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Families
(4)

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Per Pupil
Allocation
(5)

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Dollars
Generated
(6)

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Dollars
Allocated

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(if pooling)*
(7)
TOTAL
$ $
(8)
‡
 
Pooling
‡
  
Not Pooling (Check one)
*See definition on the following page
Copy form as needed
C:\Documents and Settings\miltonc\Local Settings\Temporary Internet Files\OLK2\TITLE I FUND ALLOCATION.ATTACHMTS..doc

INSTRUCTIONS FOR TITLE I, PART A ALLOCATIONS FOR NONPUBLIC SCHOOL PARTICIPANT FORM
NON TIERING
*
(1)
?
Indicate the 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 the nonpublic schools attended by eligible students for Title I, Part A Program.
(3)
Indicate, by school, the grade span(s) for children to be counted in item 4.
(4)
Indicate, by school, the number of children from low-income families in eligible attendance areas.
(5)
?
Indicate, by school, per pupil allocation (PPA). The PPA must be the same as the PPA of the attendance area of the public
school the students would have attended.
(6)
Indicate, by school, DOLLARS generated (Multiply Item (4) by Item (5).
(7)
Indicate, by school, the amount of funds allocated.
(8)
?
Check one: pooling or not-pooling. If the amount of funds generated by eligible students from each private school is used to
serve only students attending that school, there is no pooling. If, on the other hand, the district puts all funds generated by
all eligible private school participants in a single account and serves these students based on need with input from the
private school officials, the district is using the pooling method.
*If the per pupil allocation (PPA) is the same for all public schools, there is no tiering.
* DEFINITION: Tiering refers to differentiation of allocations to eligible schools. See example below.
Example:
Poverty indexes PPA
100% - 90%
?
$500
89% - 80%
$300
79% - 70%
$250
If the LEA is using a tiered allocation structure, complete the Tiering Form.
C:\Documents and Settings\miltonc\Local Settings\Temporary Internet Files\OLK2\TITLE I FUND ALLOCATION.ATTACHMTS..doc

TITLE I, PART A ALLOCATIONS FOR NONPUBLIC SCHOOL PARTICIPANTS
SCHOOL YEAR 2002-2003
Tiering
(See definition on the following page)
(1)
Date Certain:
___/___/_____
District/Agency
: ________________________________________

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Nonpublic School Name
(2)

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Grade
Span
(3)

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Number of
Children from Low

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income Families
(4)

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Per Pupil
Allocation
(5)

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Dollars
Generated
(6)

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Total
Dollars

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Generated
(7)
Dollars
Allocated
(if pooling)
(8)
School Name
Tier A
Tier B
Tier C
Tier D
Tier E
Sub-Total
$ $
School Name
Tier A
Tier B
Tier C
Tier D
Tier E
Sub-Total
$
(9)
‡
 
Pooling
‡
Not Pooling (
Check one
)
*
See definition on the following page
Copy form as needed
C:\Documents and Settings\miltonc\Local Settings\Temporary Internet Files\OLK2\TITLE I FUND ALLOCATION.ATTACHMTS..doc

INSTRUCTIONS FOR ALLOCATION FOR NONPUBLIC SCHOOL PARTICIPANT FORM
SCHOOL YEAR 2002-2003
TIERING
*
(1)
?
Indicate the 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 the nonpublic schools attended by eligible students for Title I, Part A Program. If more than two schools, copy the form as needed.
(3)
Enter the grade span only for the school and not for the tiers.
(4)
?
Indicate, by school, the number of children from low-income families in eligible attendance areas. Give the number of eligible students
for each tier.
(5)
Indicate, by school, per pupil allocation (PPA) for each tier.
(6)
Indicate, by school, DOLLARS generated for each tier (Multiply Item (4) by Item (5).
(7)
Add the amounts for all the tiers and enter the sub-total in the blank space under total dollars generated.
(8)
?
Indicate, by school, the amount of funds allocated in the blank space under dollars allocated. If the LEA is not pooling funds for
allocation based on needs, the total dollars generated must equal the total dollars allocated
(9)
?
Check one: pooling or not-pooling. Pooling occurs when the LEA put in one account the funds generated by eligible students who
attend private schools and distribute the funds based on needs as agreed with respective private school officers.
*If the per pupil allocation (PPA) is the same for all public schools, there is no tiering.
Tiering
refers to differentiation of allocations to eligible schools. See example below.
Example:
Poverty indexes
PPA
100% - 90%
$500
89% - 80%
$300
79% - 70%
$250
If the LEA is using a non-tiered allocation structure, complete the Non-Tiering Form.
C:\Documents and Settings\miltonc\Local Settings\Temporary Internet Files\OLK2\TITLE I FUND ALLOCATION.ATTACHMTS..doc

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