superintendent of public instruction department of … · 2020. 2. 18. · sections 4105(a)(2),...

19
Dr. Jennifer McCormick Superintendent of Public Instruction DEPARTMENT OF EDUCATION WoMIJtij To~fi',§i~ Part 1: Grantee Information 2400 New Albany Floyd County Schools [email protected] 812-542-2113 Dr. Brad Snyder Dr. Louie Jensen [email protected] $95,941.00 - 70133 1 Applicants are required to have a W9, Direct Deposit form, and Bidder Number on file with the Indiana Department of Education prior to application review. Submit applications via email to: [email protected] I

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Page 1: Superintendent of Public Instruction DEPARTMENT OF … · 2020. 2. 18. · Sections 4105(a)(2), 4105(a)(3), and 4106(b) indicate that a State educational agency shall not award a

Dr Jennifer McCormick Superintendent of Public Instruction

DEPARTMENT OF EDUCATION WoMIJtij To~fisecti~ Part 1 Grantee Information

2400New Albany Floyd County Schools

ljensennafcsk12inus

812-542-2113

Dr Brad Snyder

Dr Louie Jensen

bsyndernafcsk12inus

$9594100

- 70133 1

Applicants are required to have a W9 Direct Deposit form and Bidder Number on file with the Indiana Department of Education prior to

application review

Submit applications via email to titleivdoeingov

I

Eligibility

bull All LEAs and public charter schools are eligible to apply for Title IV Part A funds in FFY 17 After FFY 17 only those LEAs that have not

received Title IV Part A funds in the previous two years will be eligible unless all eligible LEAs who applied are served For example if an

LEA receives Title IV Part A funds in FFY 17 the same LEA will be eligible to apply for FFY 20 funds

bull Sections 4105(a)(2) 4105(a)(3) and 4106(b) indicate that a State educational agency shall not award a sub grant if the amount of the sub

grant is less than $10000 In order to apply for an individual Title IV grant application a LEA must have a minimum allocation of $10000

LEAs that do not meet the $10000 threshold may form a consortium to apply for funds If a consortium is formed a fiscal agent must be

designated LEAs applying for funds as a consortium shall submit a single application and designate one LEA to serve as fiscal agent

Application Type

Select one of the following options

~ Individual LEA Application IJlEA Consortium Application If participating in a LEA Consortium please indicate the consortiums fiscal agent If participating in a LEA Consortium please list the participating members and corresponding corporation numbers

Important Grant Information

bull Expected number of subgrantees Awarded 100

bull Anticipated funding award Minimum of $10000 Proposed Maximum of $100000

bull Availability of funding and the number of high-quality subgrants will impact the number of awards and their award amounts The award

amounts must be proportional to the LEAs population and demographics Once the competition and subgrantees are approved the

IDOE will consult with individual successful subgrantees to amend or finalize their respective budgets

Part 3 LEA and School Assurance and Waivers

The LEAEligible Entity must provide the following assurances in its application

The LEAEligible Entity must be able to provide upon request evidence of compliance with each assurance

1 Assurance that the LEA will complete all activities and requirements by the state including an emphasis on the following through a needs assessment to ensure access to a well-rounded education improvement of school conditions for student learning to create a healthy and safe school environment or access to personalized learning through technology Science Technology Engineering and Mathematics (STEM) or Reading or Career amp Technical Education or International Baccalaureate (1B) Dual Credit and Advanced Placement or SocialEmotional and whole child supports

2 Establish and maintain fiscal control and fund accounting procedures as set forth in 34 CFR Part 7 and in applicable federal and state laws and regulations 3 An LEA that is awarded a grant shall spend no more than 25 of its funding on technology infrastructure 4 The Title IV A funds will be used only to supplement and not supplant state and local funds a school would otherwise receive S Prior written approval must be received from the Indiana Department of Education before implementing any project changes with respect to the purposes for which the proposed funds are awarded 6 Retain all records of the financial transactions and accounts relating to the proposed project for a period of three years after termination of the grant agreement and shall make such records available for

inspection and audit as necessary 7 The LEA or consortium will prioritize the distribution of funds to schools served by the LEA or consortium by one of the following schools that are among the schools with the greatest needs as determined by

such local education agency or consortium have the highest percentages or numbers of children counted under section 1124(c) are identified for comprehensive support and improvement are implementing targeted support and improvement plans are identified as persistently dangerous public elementary school or secondary schools

8 The district will help the school choose and sustain effective instructional strategies and methods and ensure that the school staff receives high quality professional development relevant to the implementation of instructional strategies The chosen strategies must be grounded in evidence-based research and address the specific instruction or other issues such as attendance or graduation rate that caused the school to be identified for school improvement

9 Comply with section 8501-8504 regarding equitable participation of private school children and teachers 10 Engage in consultation with stakeholders in the area served by the LEA regarding the focus areas and content of this grant Stakeholders must include but are not limited to parents teachers principals

students school leaders charter school representatives specialized instructional support personnel Indian tribes (when applicable) local government representatives and community-based organizations 11 The Indiana Department of Education may as they deem necessary supervise evaluate and provide guidance and direction to the district and school in the management of the activities performed under this

plan 12 The schools and district shall adhere to Indiana Department of Education reporting and evaluation requirements in a timely and accurate manner 13 The LEA certifies that it has verified the state and federal suspension and debarment status for all subcontractors receiving funds under the fund associated with this application and shall be solely responsible

for any recoupment penalties or costs that might arise from use of a suspended or debarred subcontractor The LEA shall immediately notify the State if any subcontractor becomes debarred or suspended and shall at the States request take all steps required by the State to terminate its contractual relationship with the subcontractor for work to be performed and supported by funding from the application

14 A Request for Amendment to Title IV Part A Grant Application will be submitted under these circumstances 1) a 10 funding change in a budget category andor 2) a change in the scope of activities within a category

15 The School CorporationCharter School certifies that it is currently registered in the System of Award Management (SAM httpsljwwwsamgov) database

a) The LEA has expended $750000 in federal funds between July 01 2016 and June 30 2017 Yes 121 No 0 b) If yes the LEA has received a single audit or program specific audit (2 CFR 200501) Yes O No 121

Superintendent Signature ~ ~ Date tobulllbulllr

Federal Grant Administrator Signature ~~ Date lt) - 2- ( 1

Treasurer Signature CLJ----S~ _____________ Date I() - J - I r1--lf

omprehensive Needs Assessment (CNA) 1n LEA must complete an assessment of local needs to ensure that Title IV A interventions are targeted to meet the needs for improvement in access to and opportunities for a well-round middotducation for all students school conditions for student learning in order to create a healthy and safe school environment and access to personalized learning experiences supported echnology and professional development for the effective use of data and technology This Comprehensive Needs Assessment (CNA) must ensure that chosen interventions are aligned w gtcal needs the evidence base and local capacity are considered when selecting a strategy a robust implementation plan exists with adequate resources and reflection informs next ste1 Section 4106)

Program Goals amp Objectives Consultation Briefly describe what will be accomplished through the proposed initiatives through Title IV A Our proposal is the result of collaborating with all stakeholders (checked boxes) reviewing survey and student data We have two proposed initiatives that will be funded by this grant First initiative focus A) is to provide financial assistance to our textbook assistance students to take AP and 18 exams ESSA has taken away a large part of the financial assistance for these students The second proposed initiative (focus C) is providing professional development for our middle school teachers one-Learning In 2013 New Albany-Floyd County Consolidated School Corporation began a 11 iPad initiative in both high schools This initiative necessitated the placement of an e-Learning coach to be hired The elearning coach helped teachers incorporate iPads into their day-to-day lesson planning In the Fall of 2017 NAFCS distributed iPads to all 800 8th grade students As with our high schools our three middle schools need elearning support and guidance for our teachers Our goal will be to implement iPads to all 7th graders in the Fall of 2018 and classroom sets of iPads to our 5th and 6th graders in the Fall of 2019 The elearning coach will be critically important as it relates to the effective integration of technology into our classrooms

Identify the stakeholders who were consulted in the design of the Title IV A plan and describe the manner in which it occurred in the space below NOTE The text entry below describing the consultation activities is a required component

~ Teachers

~ Principals

~ Other school leaders and professionals CParaprofessionals Dnstructional support personnel

~ Parents

~ Community partners ~ Other _Five Star Technologies ____

Data Sources amp Measures The above stakeholders participated in meetings Include specific educator andor student data analyzed to determine needs with school administrators along with being Proposed initiative 1 (Focus A) Last year we had over 900 students take AP and 18 exams of which 50 of students received financial surveyed on specific issues concerning the assistance from the federal and state governments ESSA has removed part of this funding for the upcoming year and our state has proposed initiatives The IMPACT study was not yet issued the guidelines for assistance this year We need to continue providing assistance to those students who qualify in order conducted by Five-Star Technologies our 11 for them to participate in these programs In addition through survey data of our parents and students about the 18 Diploma consultant Programme they cited the number one reason for not participating were the financial costs of the 18 Programme Our state currently does not provide assistance for students participating in 18 courses Proposed initiative 2 (Focus C) Before implementing the 11 initiative in the middles schools we hired Five Star Technologies to conduct a study on what would be needed to successfully implement the 11 initiative Data from an IMPACT study conducted by FiveshyStar Technologies showed that a vast majority of our teachers felt as though they needed additional trainingsupport as it related to iPad integration

Prioritized Needs

Describe the needs (NOT activities) determined through an analysis of the data include in the description an explanation ofhow the LEA will prioritize funds for schools with the highest need Focus A The cost of an AP exam is $94 and the cost of an 18 exam is $119 With reduction of federal assistance from ESSA we will prioritize our needs on focusing on students who qualify for textbook assistance who are wanting to take these classes and exams We will provide financial assistance to those students Focus C As a result of the IMPACT study (teacher interviews classroom observations and survey data) conducted by Five Star Technologies teachers reported that they lack knowledge of the functionality of the iPad the use of digital tools in the classroom and the use of a Learning Management Platform This grant will fund a e-Learning coaches for the middle school

DIRECTIONS You may reference the menu of interventions from Part 4 above identify how the applicant will address providing all students with access to a well-rounded education social and emotional supports andor technology integration You may add additional spaces for activities if needed

Describe the Title IV A-funded activities and programming used to support well-rounded education for all students social and emotional supports and or

technology integration [Sec 4106) The funds will provide financial assistance for AP and IB exams for those students who qualify under textbook assistance In addition the funds will also be used to hire for two years e-Learning coaches for the middle schools

Describe the rationale tied to the Needs Assessment Stakeholder Input andor Data The rational for the APIB initiative is the result of ESSA decreasing funding for students who need the assistance The rationale for thee-learning coaches was the result of the IMPACT Study conducted by Five Star Technologies last spring with our middle school teachers Describe the program objectives and intended outcomes

The APIB initiative objective is to remove the financial barrier for those students who need assistance to take these classesexams Thee-learning initiative objective is to build capacity in all middle school teachers in the areas of iPad functionality the use of digital tools in the classroom and the

_llSe of_a lean1lng Management igtJatfor_111 Describe how and with what frequency your program will be evaluated for effectiveness and the individual(s) responsible for evaluation The APIB initiative will be evaluated by the Assistant Superintendent for High Schools on a year to year basis Thee-Learning initiative will be overseen by the ~s_s_ista_r_t Superintendent fo_r-__lYlidd~Scho_()_l_s and_will be~valu~Ed by Five Star Tecll_nologies using the IMPACT Study instrument If applicable describe any partnerships with an institution of higher education business nonprofit organization community-based organization or other public or private entity We have partnership with the following for this grant New Albany Floyd County Education Foundation for the APIB initiative and Five Star Technologies for the e-learning coaches initiative

1 Providing reimbursement to low-income students to cover costs of AP and IB exams

2 Provide educators and administrators with professional learning on the use of iPads digital tools and a Learning Management platform

A0 1 Floyd Central High School and 1 $15000 I 1 $30000

BO 2 New Albany High School 2 SlS000I I CD

AD 1 Hazelwood Middle School Highland Hills 1 $55000 2 $55000

BD Middle School and Scribner Middle School

C0

3 I AD I 3 I 3 I 3

BO

co

4 AO BO co

4 4 4

5 AO BO co

5 5 5

6 AO BO co

6 6 6

Please note that the totals for Focus Areas A B and Cmay exceed the total allocation request as an activity may fit in multiple focus areas

Total Budgeted Amount for Focus Area A $30000

Total Budgeted Amount for Focus Area B

Total Budgeted Amount for Focus Area C $55000

Percent of Total Allocation to be spent on Technology Infrastructure (includes purchasing devices equipment and software applications in order to address readiness shortfalls) Not to exceed 25 of total alocation

Total Budgeted Amount $85000

Part 7 Title IV Part A Sustainability Plan

Describe the sustainability plan detailing how proposed Title IV Part A grant activities and programming will be sustained in the absence of Title IV Part A funds This description should include

bull efforts to increase local capacity bull specific future funding sources if applicable (ie general funds Title I community partnerships)

bull intended program objectives and outcomes in future years and

bull how these outcomes will be evaluated for effectiveness Our goal is to have the New Floyd County Education Foundation (community partnership) to provide funds to offset the lack of federal assistance for students wanting to take AP 18 exams Thee-Learning coaches will be funded by our General fund in the future The goal is to build capacity in our middle school teachers one-learning that would eventually remove the need fore-learning coaches in the future

The AP18 initiative will be evaluated based on monitoring the number of students who qualify for textbook assistance who are taking these classesexams The success of thee-Learning coaches will be evaluated by the IMPACT study conducted by Five Star Technologies in the spring of each year

Part 8 Title IV Part A Non-Public Equitable Share

Nonpublic School List and Budget

Nonpublic School

Number Nonpublic School Name

Nonpublic School

Enrollment (Use same date as LEA enrollment

to determine this count)

Participating (YesNo)

Equitable Participation Amount (Use Step Ebelow)

Boys Christian Academy 789 Yes [8] No 0 $599600

8060 Our Lady Perpetural Help 297

Yes [8] No 0 $225700

8067 St Marys of the Knobs 159 Yes~ NoO $120800

BOSO Holy Family 263 YesLJ No~ $199800

YesO NoO $

YesD NoO $

Yes LJ No LJ $

YesD NoO $

Yes LJ No 0 $

YesLJ NoO $

YesO NoO $

YesO NoO $

A Total Nonpublic School Enrollment 1508 B Total LEA Enrollment t11401I

C Total Enrollment (A+ B) ~2909J D Total Allocation Minus Administrative Costs ~163ol

E Per Pupil Allocation (PPA) M (Step D divided by Step C)

Nonpublic Information Page (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

Non-Public School Name Holy Family School Non-Public School Number BOSO____________________

Mailing Address 217 West Daisy Lane New Albany IN 47150

Contact Person (and Title Jerry Ernstberger Contact Phone Number 812-944-6090 _______---------------------- ----------Contact Email Address jernstbergerholyfa mi lyeaglescom

Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

~ Email communication [gt Will not participate

[gt Telephone conversation ~ Will participate in Title IV A programming activities

~ Face-to-face meeting

EE Other_~=

rJ v P2f(c lu 10417 Signature of NonpublicSchool Official Date

Gerald A Enstsberger Printed Name of Nonpublic School Official

14

Nonpublic Information Page (To be completed by the offlclal representative from each nonpublic school following timely and meaningful consultation)

Non-PubUcSchool Name CAltISf-- AuJuw _ iOt_A Non-Public School Number ThyS-

MalllnaAddress IOOo Ac~ Ju Vd-iivAllergt1 1 Z 7 fO Contact Person (and Title)JgtN Lo-(n fJGVllS V-bull c ~ Contact Phone Number 512 middot 1t~ two Contact Emall Address dlo C~c--ls11s

Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic offldals Outcome

~mail communication Wlll not participate~ middot middot Telephone conversation Will participate In Title IV A programming activitiesI ~

~ gg

Face-to-face meeting Other__

Signature of Nonpublic ScttoorOffida

~J Printed Name of Nonpublic School Offlclal

Non-Public Information Page continued) (To be completed by the official representative from each nonpubnc school followlnamp tlmely and meaningful consultation)

Focus Area A

Clielt lla~a ~rmiddot--micro M- bull s is amp JC-1

Focus~a-~Desaibe proposed activities

~tvU~il1

- Iii$NCf F9sArealt ~a~ ll-111 _ Add additional activities os needed

Focus Area A

$ z12s-Focus Are B

$Joogt

Focus Area C s7-u

Desulbe the Title IV A-funded activities ind programming used to s~port well-rounded education for all students social and emotlonal supports and or technology Integration [sec 4106 ~$lt 711Ef Yr~~ cJ So t eJolc -rP I e)-rht 3-e)~ egt CIJ1~ lSbull-cent$ (r s~ lltJ Mtiraquo Qc-J kegto cr--s DesaibetheratlonaletledtotheNeedsAsse$$mentStakeholderlnputandor Jlltta A 1 _ bullbull u 517-a jampn-- I-lJE H-ae l)as~J 1fe NII-U 17gt rU-~ -nl 5C11$ gttNn ct- f_-r 0 ~ tvrreA_ -141 ~ tgt-4~ls Altgt I tAP-0 J-l11_ e-J__r tr1f~v 1-P~ bull -egt 5

_ I Tb - P17r _ I~ ~ Descr~theprogramobjectlvesandlntendedoutcomes

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- middot middott middot middot middot -ofcbull~-1o lgtlclCut t)wrH -5rvoeJ-r s r-1o ~t_ffr_____~c) Cf-e1~ _i nUS ~ (s41 middot

~iA((f J-(5 bullIf appllcable describe any partnetshlps with an Institution of higher education business nonprofit organization community-based organization or 0

other public or private entity -

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Nonpublic Information Page (To be completed by the official representative from each nonpublic school following tlmely and meaningful consultation)

Non-Public School Name (l~L-bto-J1jWLL~5o-fLJ-4ldc-l fWpublic School Number J3 Q bJ Q

Malling Address -=-=__-wuiu~1--JgtLamp41-LJ----------

Contact Person (and Title)__~4ltlJ-J--I-Z-ll---uopound-1=owe4-L--1-_L1a~ ct_ Contact Phone Number lttr_~ 1 7lt7p Contact Email Address tY benV1e1t 0 ( h h VJ a middot 0 rJ

I Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

riTI

nY Will not participate Will participate in Title IV A programming activities

C-J1-17Date

Email communication Telephone conversation

15

Non-Public Information Page (continued) (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

If applicable describe any partnerships with an Institution of higher education business nonprofit organization community-based organization or other public or private entity

9-2-f--1-r Date

0 ConKtEmall Address

t Cl) s s ctS ()

U)

ctStjQ15-inaJcoucsmt 05 E

Plefle Indicate howtlmely and mnnlnlful conversation occumd between the LEA and nonpublic officials

t Email communication Telephone conversation Face-to-face meeting Other__

gta c

Outcome C Cl)

~ Will not participate s21 Will participate In Title IV Aprogramming activities s

ctS ()

9 2-7 U)

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p ~ r 1Jtf FocusAreaA bullbull ~cusampeA bull ~ C)L- -151-A bull~~ ftZl(D fbulltt1_~A x1L ~ Ari + ftsii6tal ~ Focusampu1 ~ cbull~ p~ult 0bulllteu i-~i s unB

bull bull bull bull 1 bull - 778 P~dhJC ik -laquolaquo-fIC Focus Arne~==r tampbull~ J middottJGA~ ~~ $ t

Describe the Title IV Afunded acti1Wes and prmiddotomlmmlng used to supportwe~ed-u __catlonfour-a_U_stu_d_ents soda--a_nd_e_m_o_tio_na_lsu-pp_orts_~---

and orte~ologyint~ [Sec4106] cJAt ~ bull -bull eAc-c1 _ U -1-u ~ obbullbullr~~ ~

If applicable describe any partnerships with an institution of higher education business nonprofit organization community-based organization or other public or rte entity

JI Q) C C ca ()

Cl)

E ca ()

gtshy0 tJ Q) C C ca ()

en

Part 9 Title IV Part A Budget

Instructions Please be sure to complete both the Budget Overview and the Title IV Part A Budget (linked below) Both sections will be needed prior to application review

Budget Overview

Budget Request Schoo1Year2017-2018

Title IV A Activities

fa1~IArtWgtiiiitr~ 10(ije~ti~~~l112middotmiddotbull

$8500000

Nonpublic Equitable Share $9311

Administration

(Optional maximum 2 of total original allocation) $

Indirect Cost Optional)

$1630

TOTAL FUNDING REQUEST $9594100

Title IV Part A Detailed Budget

Please complete the Title IV Part A budget as an excel spreadsheet linked below and submit with your application All expenses listed in the table

above should be included in the budget and described in the narrative below the budget

Title IV Part A Budget Spreadsheet

I lt lt lt igt i l gt bull 2 gt i bullmiddotmiddot ltTitleIV Pflrt A Oiiiinal Budizet bull bullbullbullbullbullbullbullbullbullbullbullbullbullbullbull bull

bull

110 120 211-290 211-290 311-319 440 510-593 611-689 710-748 910

Expenditure Salaiv Benefits Professional Other Purchase GeneralAcrountNumber Rentals

Services Supplies Property Transfer Line Totals

Accowlt Cert Noncert Cert Non Cert Services

IIOOO Instruction $

Support 21000 Services - 5714100 $30000 $ 717000 $ 9431100

Student Improvement of

22100 lnsuuction

$(Professional Dcvclonmcnt)

22900 Otl1er Support

$Serviccs-Admin

25191 Refund of sRevenue

26000 Operationamp $Maintenance

27000 Tran~rtation $

Community 33000 Service s

Qntgtrations

60100 Transfers

$ finterfund Column

$ $ $ $ 5714100 $ $ 3000000 $ $ 717000 $ $ 9431100Totals

Subtotal $9431100 Indirect Cost Rate Subtract the amount above $25000 (per individual contracted service) from your total budget SSS000

Total after deducting Property $7170 Total Available for Indirect Costs

Amount of Indirect Cost to be used $1630 Grand Total Including lndirett Cost

Budget Narrative

DIRECTIONS Provide a narrative below on how funding is allocated Include the line number on which the funds are budgeted the itemized amountsfltems and which application category the expenditure is budgeted foe Example Other Purchase Services 22100 $1500 Guided Math Train the Trainer Conference registration and travel July 12-14 2018 Chicago IL (Focus Area A)

Supplies PropertyTechnology 2100 $2125 Math Dibel software (Focus Aera A) 2100 $3000 IXL Math resource 6-8 (Focus Area B) 2100 $720 Ready A to Z software (Focus Area C) 2100 $463 IXL EILA Leaming Progression (Focus Area A) 2100 $298 purchase of an iPad (Focus Area C)

Pronertv Eouinment Other Purchase Services (travel communication

22100 $30000 reimbursement of AP JB exams (Focus Area A) 22 IOO $55000 contracted services with Five Star Technologies (Focus Area C) 2100 $1300 Mission Control training (Focus Area A) 2100 $393 STEAM course training (Focus area A) 2100 $448 Proactive Discipline Training (Focus Area B)

Professional Services (contracted services)

Title IV Part A Staffin2

Staff Name Staff Position CertNon~ FfE Stipend YIN Split Additional Funding Source Position Description

Certified Funded YIN

Page 2: Superintendent of Public Instruction DEPARTMENT OF … · 2020. 2. 18. · Sections 4105(a)(2), 4105(a)(3), and 4106(b) indicate that a State educational agency shall not award a

Eligibility

bull All LEAs and public charter schools are eligible to apply for Title IV Part A funds in FFY 17 After FFY 17 only those LEAs that have not

received Title IV Part A funds in the previous two years will be eligible unless all eligible LEAs who applied are served For example if an

LEA receives Title IV Part A funds in FFY 17 the same LEA will be eligible to apply for FFY 20 funds

bull Sections 4105(a)(2) 4105(a)(3) and 4106(b) indicate that a State educational agency shall not award a sub grant if the amount of the sub

grant is less than $10000 In order to apply for an individual Title IV grant application a LEA must have a minimum allocation of $10000

LEAs that do not meet the $10000 threshold may form a consortium to apply for funds If a consortium is formed a fiscal agent must be

designated LEAs applying for funds as a consortium shall submit a single application and designate one LEA to serve as fiscal agent

Application Type

Select one of the following options

~ Individual LEA Application IJlEA Consortium Application If participating in a LEA Consortium please indicate the consortiums fiscal agent If participating in a LEA Consortium please list the participating members and corresponding corporation numbers

Important Grant Information

bull Expected number of subgrantees Awarded 100

bull Anticipated funding award Minimum of $10000 Proposed Maximum of $100000

bull Availability of funding and the number of high-quality subgrants will impact the number of awards and their award amounts The award

amounts must be proportional to the LEAs population and demographics Once the competition and subgrantees are approved the

IDOE will consult with individual successful subgrantees to amend or finalize their respective budgets

Part 3 LEA and School Assurance and Waivers

The LEAEligible Entity must provide the following assurances in its application

The LEAEligible Entity must be able to provide upon request evidence of compliance with each assurance

1 Assurance that the LEA will complete all activities and requirements by the state including an emphasis on the following through a needs assessment to ensure access to a well-rounded education improvement of school conditions for student learning to create a healthy and safe school environment or access to personalized learning through technology Science Technology Engineering and Mathematics (STEM) or Reading or Career amp Technical Education or International Baccalaureate (1B) Dual Credit and Advanced Placement or SocialEmotional and whole child supports

2 Establish and maintain fiscal control and fund accounting procedures as set forth in 34 CFR Part 7 and in applicable federal and state laws and regulations 3 An LEA that is awarded a grant shall spend no more than 25 of its funding on technology infrastructure 4 The Title IV A funds will be used only to supplement and not supplant state and local funds a school would otherwise receive S Prior written approval must be received from the Indiana Department of Education before implementing any project changes with respect to the purposes for which the proposed funds are awarded 6 Retain all records of the financial transactions and accounts relating to the proposed project for a period of three years after termination of the grant agreement and shall make such records available for

inspection and audit as necessary 7 The LEA or consortium will prioritize the distribution of funds to schools served by the LEA or consortium by one of the following schools that are among the schools with the greatest needs as determined by

such local education agency or consortium have the highest percentages or numbers of children counted under section 1124(c) are identified for comprehensive support and improvement are implementing targeted support and improvement plans are identified as persistently dangerous public elementary school or secondary schools

8 The district will help the school choose and sustain effective instructional strategies and methods and ensure that the school staff receives high quality professional development relevant to the implementation of instructional strategies The chosen strategies must be grounded in evidence-based research and address the specific instruction or other issues such as attendance or graduation rate that caused the school to be identified for school improvement

9 Comply with section 8501-8504 regarding equitable participation of private school children and teachers 10 Engage in consultation with stakeholders in the area served by the LEA regarding the focus areas and content of this grant Stakeholders must include but are not limited to parents teachers principals

students school leaders charter school representatives specialized instructional support personnel Indian tribes (when applicable) local government representatives and community-based organizations 11 The Indiana Department of Education may as they deem necessary supervise evaluate and provide guidance and direction to the district and school in the management of the activities performed under this

plan 12 The schools and district shall adhere to Indiana Department of Education reporting and evaluation requirements in a timely and accurate manner 13 The LEA certifies that it has verified the state and federal suspension and debarment status for all subcontractors receiving funds under the fund associated with this application and shall be solely responsible

for any recoupment penalties or costs that might arise from use of a suspended or debarred subcontractor The LEA shall immediately notify the State if any subcontractor becomes debarred or suspended and shall at the States request take all steps required by the State to terminate its contractual relationship with the subcontractor for work to be performed and supported by funding from the application

14 A Request for Amendment to Title IV Part A Grant Application will be submitted under these circumstances 1) a 10 funding change in a budget category andor 2) a change in the scope of activities within a category

15 The School CorporationCharter School certifies that it is currently registered in the System of Award Management (SAM httpsljwwwsamgov) database

a) The LEA has expended $750000 in federal funds between July 01 2016 and June 30 2017 Yes 121 No 0 b) If yes the LEA has received a single audit or program specific audit (2 CFR 200501) Yes O No 121

Superintendent Signature ~ ~ Date tobulllbulllr

Federal Grant Administrator Signature ~~ Date lt) - 2- ( 1

Treasurer Signature CLJ----S~ _____________ Date I() - J - I r1--lf

omprehensive Needs Assessment (CNA) 1n LEA must complete an assessment of local needs to ensure that Title IV A interventions are targeted to meet the needs for improvement in access to and opportunities for a well-round middotducation for all students school conditions for student learning in order to create a healthy and safe school environment and access to personalized learning experiences supported echnology and professional development for the effective use of data and technology This Comprehensive Needs Assessment (CNA) must ensure that chosen interventions are aligned w gtcal needs the evidence base and local capacity are considered when selecting a strategy a robust implementation plan exists with adequate resources and reflection informs next ste1 Section 4106)

Program Goals amp Objectives Consultation Briefly describe what will be accomplished through the proposed initiatives through Title IV A Our proposal is the result of collaborating with all stakeholders (checked boxes) reviewing survey and student data We have two proposed initiatives that will be funded by this grant First initiative focus A) is to provide financial assistance to our textbook assistance students to take AP and 18 exams ESSA has taken away a large part of the financial assistance for these students The second proposed initiative (focus C) is providing professional development for our middle school teachers one-Learning In 2013 New Albany-Floyd County Consolidated School Corporation began a 11 iPad initiative in both high schools This initiative necessitated the placement of an e-Learning coach to be hired The elearning coach helped teachers incorporate iPads into their day-to-day lesson planning In the Fall of 2017 NAFCS distributed iPads to all 800 8th grade students As with our high schools our three middle schools need elearning support and guidance for our teachers Our goal will be to implement iPads to all 7th graders in the Fall of 2018 and classroom sets of iPads to our 5th and 6th graders in the Fall of 2019 The elearning coach will be critically important as it relates to the effective integration of technology into our classrooms

Identify the stakeholders who were consulted in the design of the Title IV A plan and describe the manner in which it occurred in the space below NOTE The text entry below describing the consultation activities is a required component

~ Teachers

~ Principals

~ Other school leaders and professionals CParaprofessionals Dnstructional support personnel

~ Parents

~ Community partners ~ Other _Five Star Technologies ____

Data Sources amp Measures The above stakeholders participated in meetings Include specific educator andor student data analyzed to determine needs with school administrators along with being Proposed initiative 1 (Focus A) Last year we had over 900 students take AP and 18 exams of which 50 of students received financial surveyed on specific issues concerning the assistance from the federal and state governments ESSA has removed part of this funding for the upcoming year and our state has proposed initiatives The IMPACT study was not yet issued the guidelines for assistance this year We need to continue providing assistance to those students who qualify in order conducted by Five-Star Technologies our 11 for them to participate in these programs In addition through survey data of our parents and students about the 18 Diploma consultant Programme they cited the number one reason for not participating were the financial costs of the 18 Programme Our state currently does not provide assistance for students participating in 18 courses Proposed initiative 2 (Focus C) Before implementing the 11 initiative in the middles schools we hired Five Star Technologies to conduct a study on what would be needed to successfully implement the 11 initiative Data from an IMPACT study conducted by FiveshyStar Technologies showed that a vast majority of our teachers felt as though they needed additional trainingsupport as it related to iPad integration

Prioritized Needs

Describe the needs (NOT activities) determined through an analysis of the data include in the description an explanation ofhow the LEA will prioritize funds for schools with the highest need Focus A The cost of an AP exam is $94 and the cost of an 18 exam is $119 With reduction of federal assistance from ESSA we will prioritize our needs on focusing on students who qualify for textbook assistance who are wanting to take these classes and exams We will provide financial assistance to those students Focus C As a result of the IMPACT study (teacher interviews classroom observations and survey data) conducted by Five Star Technologies teachers reported that they lack knowledge of the functionality of the iPad the use of digital tools in the classroom and the use of a Learning Management Platform This grant will fund a e-Learning coaches for the middle school

DIRECTIONS You may reference the menu of interventions from Part 4 above identify how the applicant will address providing all students with access to a well-rounded education social and emotional supports andor technology integration You may add additional spaces for activities if needed

Describe the Title IV A-funded activities and programming used to support well-rounded education for all students social and emotional supports and or

technology integration [Sec 4106) The funds will provide financial assistance for AP and IB exams for those students who qualify under textbook assistance In addition the funds will also be used to hire for two years e-Learning coaches for the middle schools

Describe the rationale tied to the Needs Assessment Stakeholder Input andor Data The rational for the APIB initiative is the result of ESSA decreasing funding for students who need the assistance The rationale for thee-learning coaches was the result of the IMPACT Study conducted by Five Star Technologies last spring with our middle school teachers Describe the program objectives and intended outcomes

The APIB initiative objective is to remove the financial barrier for those students who need assistance to take these classesexams Thee-learning initiative objective is to build capacity in all middle school teachers in the areas of iPad functionality the use of digital tools in the classroom and the

_llSe of_a lean1lng Management igtJatfor_111 Describe how and with what frequency your program will be evaluated for effectiveness and the individual(s) responsible for evaluation The APIB initiative will be evaluated by the Assistant Superintendent for High Schools on a year to year basis Thee-Learning initiative will be overseen by the ~s_s_ista_r_t Superintendent fo_r-__lYlidd~Scho_()_l_s and_will be~valu~Ed by Five Star Tecll_nologies using the IMPACT Study instrument If applicable describe any partnerships with an institution of higher education business nonprofit organization community-based organization or other public or private entity We have partnership with the following for this grant New Albany Floyd County Education Foundation for the APIB initiative and Five Star Technologies for the e-learning coaches initiative

1 Providing reimbursement to low-income students to cover costs of AP and IB exams

2 Provide educators and administrators with professional learning on the use of iPads digital tools and a Learning Management platform

A0 1 Floyd Central High School and 1 $15000 I 1 $30000

BO 2 New Albany High School 2 SlS000I I CD

AD 1 Hazelwood Middle School Highland Hills 1 $55000 2 $55000

BD Middle School and Scribner Middle School

C0

3 I AD I 3 I 3 I 3

BO

co

4 AO BO co

4 4 4

5 AO BO co

5 5 5

6 AO BO co

6 6 6

Please note that the totals for Focus Areas A B and Cmay exceed the total allocation request as an activity may fit in multiple focus areas

Total Budgeted Amount for Focus Area A $30000

Total Budgeted Amount for Focus Area B

Total Budgeted Amount for Focus Area C $55000

Percent of Total Allocation to be spent on Technology Infrastructure (includes purchasing devices equipment and software applications in order to address readiness shortfalls) Not to exceed 25 of total alocation

Total Budgeted Amount $85000

Part 7 Title IV Part A Sustainability Plan

Describe the sustainability plan detailing how proposed Title IV Part A grant activities and programming will be sustained in the absence of Title IV Part A funds This description should include

bull efforts to increase local capacity bull specific future funding sources if applicable (ie general funds Title I community partnerships)

bull intended program objectives and outcomes in future years and

bull how these outcomes will be evaluated for effectiveness Our goal is to have the New Floyd County Education Foundation (community partnership) to provide funds to offset the lack of federal assistance for students wanting to take AP 18 exams Thee-Learning coaches will be funded by our General fund in the future The goal is to build capacity in our middle school teachers one-learning that would eventually remove the need fore-learning coaches in the future

The AP18 initiative will be evaluated based on monitoring the number of students who qualify for textbook assistance who are taking these classesexams The success of thee-Learning coaches will be evaluated by the IMPACT study conducted by Five Star Technologies in the spring of each year

Part 8 Title IV Part A Non-Public Equitable Share

Nonpublic School List and Budget

Nonpublic School

Number Nonpublic School Name

Nonpublic School

Enrollment (Use same date as LEA enrollment

to determine this count)

Participating (YesNo)

Equitable Participation Amount (Use Step Ebelow)

Boys Christian Academy 789 Yes [8] No 0 $599600

8060 Our Lady Perpetural Help 297

Yes [8] No 0 $225700

8067 St Marys of the Knobs 159 Yes~ NoO $120800

BOSO Holy Family 263 YesLJ No~ $199800

YesO NoO $

YesD NoO $

Yes LJ No LJ $

YesD NoO $

Yes LJ No 0 $

YesLJ NoO $

YesO NoO $

YesO NoO $

A Total Nonpublic School Enrollment 1508 B Total LEA Enrollment t11401I

C Total Enrollment (A+ B) ~2909J D Total Allocation Minus Administrative Costs ~163ol

E Per Pupil Allocation (PPA) M (Step D divided by Step C)

Nonpublic Information Page (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

Non-Public School Name Holy Family School Non-Public School Number BOSO____________________

Mailing Address 217 West Daisy Lane New Albany IN 47150

Contact Person (and Title Jerry Ernstberger Contact Phone Number 812-944-6090 _______---------------------- ----------Contact Email Address jernstbergerholyfa mi lyeaglescom

Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

~ Email communication [gt Will not participate

[gt Telephone conversation ~ Will participate in Title IV A programming activities

~ Face-to-face meeting

EE Other_~=

rJ v P2f(c lu 10417 Signature of NonpublicSchool Official Date

Gerald A Enstsberger Printed Name of Nonpublic School Official

14

Nonpublic Information Page (To be completed by the offlclal representative from each nonpublic school following timely and meaningful consultation)

Non-PubUcSchool Name CAltISf-- AuJuw _ iOt_A Non-Public School Number ThyS-

MalllnaAddress IOOo Ac~ Ju Vd-iivAllergt1 1 Z 7 fO Contact Person (and Title)JgtN Lo-(n fJGVllS V-bull c ~ Contact Phone Number 512 middot 1t~ two Contact Emall Address dlo C~c--ls11s

Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic offldals Outcome

~mail communication Wlll not participate~ middot middot Telephone conversation Will participate In Title IV A programming activitiesI ~

~ gg

Face-to-face meeting Other__

Signature of Nonpublic ScttoorOffida

~J Printed Name of Nonpublic School Offlclal

Non-Public Information Page continued) (To be completed by the official representative from each nonpubnc school followlnamp tlmely and meaningful consultation)

Focus Area A

Clielt lla~a ~rmiddot--micro M- bull s is amp JC-1

Focus~a-~Desaibe proposed activities

~tvU~il1

- Iii$NCf F9sArealt ~a~ ll-111 _ Add additional activities os needed

Focus Area A

$ z12s-Focus Are B

$Joogt

Focus Area C s7-u

Desulbe the Title IV A-funded activities ind programming used to s~port well-rounded education for all students social and emotlonal supports and or technology Integration [sec 4106 ~$lt 711Ef Yr~~ cJ So t eJolc -rP I e)-rht 3-e)~ egt CIJ1~ lSbull-cent$ (r s~ lltJ Mtiraquo Qc-J kegto cr--s DesaibetheratlonaletledtotheNeedsAsse$$mentStakeholderlnputandor Jlltta A 1 _ bullbull u 517-a jampn-- I-lJE H-ae l)as~J 1fe NII-U 17gt rU-~ -nl 5C11$ gttNn ct- f_-r 0 ~ tvrreA_ -141 ~ tgt-4~ls Altgt I tAP-0 J-l11_ e-J__r tr1f~v 1-P~ bull -egt 5

_ I Tb - P17r _ I~ ~ Descr~theprogramobjectlvesandlntendedoutcomes

1S bull

lt

middot-middotmiddot - -

middot~ -

middot-gtr~ middot i_middot

middot gt~tmiddot - middotJmiddot _ middot _middot_ 1 J --middot--~

f~ r-eampS -r-b~-- ~-middot bull 1 J~- ~ middotcr-c~ ~I~ J r-e middot middot middot middot

- middot middott middot middot middot -ofcbull~-1o lgtlclCut t)wrH -5rvoeJ-r s r-1o ~t_ffr_____~c) Cf-e1~ _i nUS ~ (s41 middot

~iA((f J-(5 bullIf appllcable describe any partnetshlps with an Institution of higher education business nonprofit organization community-based organization or 0

other public or private entity -

-~-

~bullbull t112s17 middot~ ate

-~_ __ middot=middot ~

bull ~

--~middotbull

middot

~

14

Nonpublic Information Page (To be completed by the official representative from each nonpublic school following tlmely and meaningful consultation)

Non-Public School Name (l~L-bto-J1jWLL~5o-fLJ-4ldc-l fWpublic School Number J3 Q bJ Q

Malling Address -=-=__-wuiu~1--JgtLamp41-LJ----------

Contact Person (and Title)__~4ltlJ-J--I-Z-ll---uopound-1=owe4-L--1-_L1a~ ct_ Contact Phone Number lttr_~ 1 7lt7p Contact Email Address tY benV1e1t 0 ( h h VJ a middot 0 rJ

I Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

riTI

nY Will not participate Will participate in Title IV A programming activities

C-J1-17Date

Email communication Telephone conversation

15

Non-Public Information Page (continued) (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

If applicable describe any partnerships with an Institution of higher education business nonprofit organization community-based organization or other public or private entity

9-2-f--1-r Date

0 ConKtEmall Address

t Cl) s s ctS ()

U)

ctStjQ15-inaJcoucsmt 05 E

Plefle Indicate howtlmely and mnnlnlful conversation occumd between the LEA and nonpublic officials

t Email communication Telephone conversation Face-to-face meeting Other__

gta c

Outcome C Cl)

~ Will not participate s21 Will participate In Title IV Aprogramming activities s

ctS ()

9 2-7 U)

oite

_~ tGmiddot0 I ~

bull

IUt4 M Ju~IAAlltl4 A-c -out Agtlt~ Pc-- Ac M ~ uJ~ 11e~tiJltI ii~ dbulllttcl _ _ ~l5P + 3~

ZXL SLA _ hfM ~

p ~ r 1Jtf FocusAreaA bullbull ~cusampeA bull ~ C)L- -151-A bull~~ ftZl(D fbulltt1_~A x1L ~ Ari + ftsii6tal ~ Focusampu1 ~ cbull~ p~ult 0bulllteu i-~i s unB

bull bull bull bull 1 bull - 778 P~dhJC ik -laquolaquo-fIC Focus Arne~==r tampbull~ J middottJGA~ ~~ $ t

Describe the Title IV Afunded acti1Wes and prmiddotomlmmlng used to supportwe~ed-u __catlonfour-a_U_stu_d_ents soda--a_nd_e_m_o_tio_na_lsu-pp_orts_~---

and orte~ologyint~ [Sec4106] cJAt ~ bull -bull eAc-c1 _ U -1-u ~ obbullbullr~~ ~

If applicable describe any partnerships with an institution of higher education business nonprofit organization community-based organization or other public or rte entity

JI Q) C C ca ()

Cl)

E ca ()

gtshy0 tJ Q) C C ca ()

en

Part 9 Title IV Part A Budget

Instructions Please be sure to complete both the Budget Overview and the Title IV Part A Budget (linked below) Both sections will be needed prior to application review

Budget Overview

Budget Request Schoo1Year2017-2018

Title IV A Activities

fa1~IArtWgtiiiitr~ 10(ije~ti~~~l112middotmiddotbull

$8500000

Nonpublic Equitable Share $9311

Administration

(Optional maximum 2 of total original allocation) $

Indirect Cost Optional)

$1630

TOTAL FUNDING REQUEST $9594100

Title IV Part A Detailed Budget

Please complete the Title IV Part A budget as an excel spreadsheet linked below and submit with your application All expenses listed in the table

above should be included in the budget and described in the narrative below the budget

Title IV Part A Budget Spreadsheet

I lt lt lt igt i l gt bull 2 gt i bullmiddotmiddot ltTitleIV Pflrt A Oiiiinal Budizet bull bullbullbullbullbullbullbullbullbullbullbullbullbullbullbull bull

bull

110 120 211-290 211-290 311-319 440 510-593 611-689 710-748 910

Expenditure Salaiv Benefits Professional Other Purchase GeneralAcrountNumber Rentals

Services Supplies Property Transfer Line Totals

Accowlt Cert Noncert Cert Non Cert Services

IIOOO Instruction $

Support 21000 Services - 5714100 $30000 $ 717000 $ 9431100

Student Improvement of

22100 lnsuuction

$(Professional Dcvclonmcnt)

22900 Otl1er Support

$Serviccs-Admin

25191 Refund of sRevenue

26000 Operationamp $Maintenance

27000 Tran~rtation $

Community 33000 Service s

Qntgtrations

60100 Transfers

$ finterfund Column

$ $ $ $ 5714100 $ $ 3000000 $ $ 717000 $ $ 9431100Totals

Subtotal $9431100 Indirect Cost Rate Subtract the amount above $25000 (per individual contracted service) from your total budget SSS000

Total after deducting Property $7170 Total Available for Indirect Costs

Amount of Indirect Cost to be used $1630 Grand Total Including lndirett Cost

Budget Narrative

DIRECTIONS Provide a narrative below on how funding is allocated Include the line number on which the funds are budgeted the itemized amountsfltems and which application category the expenditure is budgeted foe Example Other Purchase Services 22100 $1500 Guided Math Train the Trainer Conference registration and travel July 12-14 2018 Chicago IL (Focus Area A)

Supplies PropertyTechnology 2100 $2125 Math Dibel software (Focus Aera A) 2100 $3000 IXL Math resource 6-8 (Focus Area B) 2100 $720 Ready A to Z software (Focus Area C) 2100 $463 IXL EILA Leaming Progression (Focus Area A) 2100 $298 purchase of an iPad (Focus Area C)

Pronertv Eouinment Other Purchase Services (travel communication

22100 $30000 reimbursement of AP JB exams (Focus Area A) 22 IOO $55000 contracted services with Five Star Technologies (Focus Area C) 2100 $1300 Mission Control training (Focus Area A) 2100 $393 STEAM course training (Focus area A) 2100 $448 Proactive Discipline Training (Focus Area B)

Professional Services (contracted services)

Title IV Part A Staffin2

Staff Name Staff Position CertNon~ FfE Stipend YIN Split Additional Funding Source Position Description

Certified Funded YIN

Page 3: Superintendent of Public Instruction DEPARTMENT OF … · 2020. 2. 18. · Sections 4105(a)(2), 4105(a)(3), and 4106(b) indicate that a State educational agency shall not award a

Part 3 LEA and School Assurance and Waivers

The LEAEligible Entity must provide the following assurances in its application

The LEAEligible Entity must be able to provide upon request evidence of compliance with each assurance

1 Assurance that the LEA will complete all activities and requirements by the state including an emphasis on the following through a needs assessment to ensure access to a well-rounded education improvement of school conditions for student learning to create a healthy and safe school environment or access to personalized learning through technology Science Technology Engineering and Mathematics (STEM) or Reading or Career amp Technical Education or International Baccalaureate (1B) Dual Credit and Advanced Placement or SocialEmotional and whole child supports

2 Establish and maintain fiscal control and fund accounting procedures as set forth in 34 CFR Part 7 and in applicable federal and state laws and regulations 3 An LEA that is awarded a grant shall spend no more than 25 of its funding on technology infrastructure 4 The Title IV A funds will be used only to supplement and not supplant state and local funds a school would otherwise receive S Prior written approval must be received from the Indiana Department of Education before implementing any project changes with respect to the purposes for which the proposed funds are awarded 6 Retain all records of the financial transactions and accounts relating to the proposed project for a period of three years after termination of the grant agreement and shall make such records available for

inspection and audit as necessary 7 The LEA or consortium will prioritize the distribution of funds to schools served by the LEA or consortium by one of the following schools that are among the schools with the greatest needs as determined by

such local education agency or consortium have the highest percentages or numbers of children counted under section 1124(c) are identified for comprehensive support and improvement are implementing targeted support and improvement plans are identified as persistently dangerous public elementary school or secondary schools

8 The district will help the school choose and sustain effective instructional strategies and methods and ensure that the school staff receives high quality professional development relevant to the implementation of instructional strategies The chosen strategies must be grounded in evidence-based research and address the specific instruction or other issues such as attendance or graduation rate that caused the school to be identified for school improvement

9 Comply with section 8501-8504 regarding equitable participation of private school children and teachers 10 Engage in consultation with stakeholders in the area served by the LEA regarding the focus areas and content of this grant Stakeholders must include but are not limited to parents teachers principals

students school leaders charter school representatives specialized instructional support personnel Indian tribes (when applicable) local government representatives and community-based organizations 11 The Indiana Department of Education may as they deem necessary supervise evaluate and provide guidance and direction to the district and school in the management of the activities performed under this

plan 12 The schools and district shall adhere to Indiana Department of Education reporting and evaluation requirements in a timely and accurate manner 13 The LEA certifies that it has verified the state and federal suspension and debarment status for all subcontractors receiving funds under the fund associated with this application and shall be solely responsible

for any recoupment penalties or costs that might arise from use of a suspended or debarred subcontractor The LEA shall immediately notify the State if any subcontractor becomes debarred or suspended and shall at the States request take all steps required by the State to terminate its contractual relationship with the subcontractor for work to be performed and supported by funding from the application

14 A Request for Amendment to Title IV Part A Grant Application will be submitted under these circumstances 1) a 10 funding change in a budget category andor 2) a change in the scope of activities within a category

15 The School CorporationCharter School certifies that it is currently registered in the System of Award Management (SAM httpsljwwwsamgov) database

a) The LEA has expended $750000 in federal funds between July 01 2016 and June 30 2017 Yes 121 No 0 b) If yes the LEA has received a single audit or program specific audit (2 CFR 200501) Yes O No 121

Superintendent Signature ~ ~ Date tobulllbulllr

Federal Grant Administrator Signature ~~ Date lt) - 2- ( 1

Treasurer Signature CLJ----S~ _____________ Date I() - J - I r1--lf

omprehensive Needs Assessment (CNA) 1n LEA must complete an assessment of local needs to ensure that Title IV A interventions are targeted to meet the needs for improvement in access to and opportunities for a well-round middotducation for all students school conditions for student learning in order to create a healthy and safe school environment and access to personalized learning experiences supported echnology and professional development for the effective use of data and technology This Comprehensive Needs Assessment (CNA) must ensure that chosen interventions are aligned w gtcal needs the evidence base and local capacity are considered when selecting a strategy a robust implementation plan exists with adequate resources and reflection informs next ste1 Section 4106)

Program Goals amp Objectives Consultation Briefly describe what will be accomplished through the proposed initiatives through Title IV A Our proposal is the result of collaborating with all stakeholders (checked boxes) reviewing survey and student data We have two proposed initiatives that will be funded by this grant First initiative focus A) is to provide financial assistance to our textbook assistance students to take AP and 18 exams ESSA has taken away a large part of the financial assistance for these students The second proposed initiative (focus C) is providing professional development for our middle school teachers one-Learning In 2013 New Albany-Floyd County Consolidated School Corporation began a 11 iPad initiative in both high schools This initiative necessitated the placement of an e-Learning coach to be hired The elearning coach helped teachers incorporate iPads into their day-to-day lesson planning In the Fall of 2017 NAFCS distributed iPads to all 800 8th grade students As with our high schools our three middle schools need elearning support and guidance for our teachers Our goal will be to implement iPads to all 7th graders in the Fall of 2018 and classroom sets of iPads to our 5th and 6th graders in the Fall of 2019 The elearning coach will be critically important as it relates to the effective integration of technology into our classrooms

Identify the stakeholders who were consulted in the design of the Title IV A plan and describe the manner in which it occurred in the space below NOTE The text entry below describing the consultation activities is a required component

~ Teachers

~ Principals

~ Other school leaders and professionals CParaprofessionals Dnstructional support personnel

~ Parents

~ Community partners ~ Other _Five Star Technologies ____

Data Sources amp Measures The above stakeholders participated in meetings Include specific educator andor student data analyzed to determine needs with school administrators along with being Proposed initiative 1 (Focus A) Last year we had over 900 students take AP and 18 exams of which 50 of students received financial surveyed on specific issues concerning the assistance from the federal and state governments ESSA has removed part of this funding for the upcoming year and our state has proposed initiatives The IMPACT study was not yet issued the guidelines for assistance this year We need to continue providing assistance to those students who qualify in order conducted by Five-Star Technologies our 11 for them to participate in these programs In addition through survey data of our parents and students about the 18 Diploma consultant Programme they cited the number one reason for not participating were the financial costs of the 18 Programme Our state currently does not provide assistance for students participating in 18 courses Proposed initiative 2 (Focus C) Before implementing the 11 initiative in the middles schools we hired Five Star Technologies to conduct a study on what would be needed to successfully implement the 11 initiative Data from an IMPACT study conducted by FiveshyStar Technologies showed that a vast majority of our teachers felt as though they needed additional trainingsupport as it related to iPad integration

Prioritized Needs

Describe the needs (NOT activities) determined through an analysis of the data include in the description an explanation ofhow the LEA will prioritize funds for schools with the highest need Focus A The cost of an AP exam is $94 and the cost of an 18 exam is $119 With reduction of federal assistance from ESSA we will prioritize our needs on focusing on students who qualify for textbook assistance who are wanting to take these classes and exams We will provide financial assistance to those students Focus C As a result of the IMPACT study (teacher interviews classroom observations and survey data) conducted by Five Star Technologies teachers reported that they lack knowledge of the functionality of the iPad the use of digital tools in the classroom and the use of a Learning Management Platform This grant will fund a e-Learning coaches for the middle school

DIRECTIONS You may reference the menu of interventions from Part 4 above identify how the applicant will address providing all students with access to a well-rounded education social and emotional supports andor technology integration You may add additional spaces for activities if needed

Describe the Title IV A-funded activities and programming used to support well-rounded education for all students social and emotional supports and or

technology integration [Sec 4106) The funds will provide financial assistance for AP and IB exams for those students who qualify under textbook assistance In addition the funds will also be used to hire for two years e-Learning coaches for the middle schools

Describe the rationale tied to the Needs Assessment Stakeholder Input andor Data The rational for the APIB initiative is the result of ESSA decreasing funding for students who need the assistance The rationale for thee-learning coaches was the result of the IMPACT Study conducted by Five Star Technologies last spring with our middle school teachers Describe the program objectives and intended outcomes

The APIB initiative objective is to remove the financial barrier for those students who need assistance to take these classesexams Thee-learning initiative objective is to build capacity in all middle school teachers in the areas of iPad functionality the use of digital tools in the classroom and the

_llSe of_a lean1lng Management igtJatfor_111 Describe how and with what frequency your program will be evaluated for effectiveness and the individual(s) responsible for evaluation The APIB initiative will be evaluated by the Assistant Superintendent for High Schools on a year to year basis Thee-Learning initiative will be overseen by the ~s_s_ista_r_t Superintendent fo_r-__lYlidd~Scho_()_l_s and_will be~valu~Ed by Five Star Tecll_nologies using the IMPACT Study instrument If applicable describe any partnerships with an institution of higher education business nonprofit organization community-based organization or other public or private entity We have partnership with the following for this grant New Albany Floyd County Education Foundation for the APIB initiative and Five Star Technologies for the e-learning coaches initiative

1 Providing reimbursement to low-income students to cover costs of AP and IB exams

2 Provide educators and administrators with professional learning on the use of iPads digital tools and a Learning Management platform

A0 1 Floyd Central High School and 1 $15000 I 1 $30000

BO 2 New Albany High School 2 SlS000I I CD

AD 1 Hazelwood Middle School Highland Hills 1 $55000 2 $55000

BD Middle School and Scribner Middle School

C0

3 I AD I 3 I 3 I 3

BO

co

4 AO BO co

4 4 4

5 AO BO co

5 5 5

6 AO BO co

6 6 6

Please note that the totals for Focus Areas A B and Cmay exceed the total allocation request as an activity may fit in multiple focus areas

Total Budgeted Amount for Focus Area A $30000

Total Budgeted Amount for Focus Area B

Total Budgeted Amount for Focus Area C $55000

Percent of Total Allocation to be spent on Technology Infrastructure (includes purchasing devices equipment and software applications in order to address readiness shortfalls) Not to exceed 25 of total alocation

Total Budgeted Amount $85000

Part 7 Title IV Part A Sustainability Plan

Describe the sustainability plan detailing how proposed Title IV Part A grant activities and programming will be sustained in the absence of Title IV Part A funds This description should include

bull efforts to increase local capacity bull specific future funding sources if applicable (ie general funds Title I community partnerships)

bull intended program objectives and outcomes in future years and

bull how these outcomes will be evaluated for effectiveness Our goal is to have the New Floyd County Education Foundation (community partnership) to provide funds to offset the lack of federal assistance for students wanting to take AP 18 exams Thee-Learning coaches will be funded by our General fund in the future The goal is to build capacity in our middle school teachers one-learning that would eventually remove the need fore-learning coaches in the future

The AP18 initiative will be evaluated based on monitoring the number of students who qualify for textbook assistance who are taking these classesexams The success of thee-Learning coaches will be evaluated by the IMPACT study conducted by Five Star Technologies in the spring of each year

Part 8 Title IV Part A Non-Public Equitable Share

Nonpublic School List and Budget

Nonpublic School

Number Nonpublic School Name

Nonpublic School

Enrollment (Use same date as LEA enrollment

to determine this count)

Participating (YesNo)

Equitable Participation Amount (Use Step Ebelow)

Boys Christian Academy 789 Yes [8] No 0 $599600

8060 Our Lady Perpetural Help 297

Yes [8] No 0 $225700

8067 St Marys of the Knobs 159 Yes~ NoO $120800

BOSO Holy Family 263 YesLJ No~ $199800

YesO NoO $

YesD NoO $

Yes LJ No LJ $

YesD NoO $

Yes LJ No 0 $

YesLJ NoO $

YesO NoO $

YesO NoO $

A Total Nonpublic School Enrollment 1508 B Total LEA Enrollment t11401I

C Total Enrollment (A+ B) ~2909J D Total Allocation Minus Administrative Costs ~163ol

E Per Pupil Allocation (PPA) M (Step D divided by Step C)

Nonpublic Information Page (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

Non-Public School Name Holy Family School Non-Public School Number BOSO____________________

Mailing Address 217 West Daisy Lane New Albany IN 47150

Contact Person (and Title Jerry Ernstberger Contact Phone Number 812-944-6090 _______---------------------- ----------Contact Email Address jernstbergerholyfa mi lyeaglescom

Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

~ Email communication [gt Will not participate

[gt Telephone conversation ~ Will participate in Title IV A programming activities

~ Face-to-face meeting

EE Other_~=

rJ v P2f(c lu 10417 Signature of NonpublicSchool Official Date

Gerald A Enstsberger Printed Name of Nonpublic School Official

14

Nonpublic Information Page (To be completed by the offlclal representative from each nonpublic school following timely and meaningful consultation)

Non-PubUcSchool Name CAltISf-- AuJuw _ iOt_A Non-Public School Number ThyS-

MalllnaAddress IOOo Ac~ Ju Vd-iivAllergt1 1 Z 7 fO Contact Person (and Title)JgtN Lo-(n fJGVllS V-bull c ~ Contact Phone Number 512 middot 1t~ two Contact Emall Address dlo C~c--ls11s

Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic offldals Outcome

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~ gg

Face-to-face meeting Other__

Signature of Nonpublic ScttoorOffida

~J Printed Name of Nonpublic School Offlclal

Non-Public Information Page continued) (To be completed by the official representative from each nonpubnc school followlnamp tlmely and meaningful consultation)

Focus Area A

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$ z12s-Focus Are B

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Nonpublic Information Page (To be completed by the official representative from each nonpublic school following tlmely and meaningful consultation)

Non-Public School Name (l~L-bto-J1jWLL~5o-fLJ-4ldc-l fWpublic School Number J3 Q bJ Q

Malling Address -=-=__-wuiu~1--JgtLamp41-LJ----------

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I Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

riTI

nY Will not participate Will participate in Title IV A programming activities

C-J1-17Date

Email communication Telephone conversation

15

Non-Public Information Page (continued) (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

If applicable describe any partnerships with an Institution of higher education business nonprofit organization community-based organization or other public or private entity

9-2-f--1-r Date

0 ConKtEmall Address

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Part 9 Title IV Part A Budget

Instructions Please be sure to complete both the Budget Overview and the Title IV Part A Budget (linked below) Both sections will be needed prior to application review

Budget Overview

Budget Request Schoo1Year2017-2018

Title IV A Activities

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$8500000

Nonpublic Equitable Share $9311

Administration

(Optional maximum 2 of total original allocation) $

Indirect Cost Optional)

$1630

TOTAL FUNDING REQUEST $9594100

Title IV Part A Detailed Budget

Please complete the Title IV Part A budget as an excel spreadsheet linked below and submit with your application All expenses listed in the table

above should be included in the budget and described in the narrative below the budget

Title IV Part A Budget Spreadsheet

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110 120 211-290 211-290 311-319 440 510-593 611-689 710-748 910

Expenditure Salaiv Benefits Professional Other Purchase GeneralAcrountNumber Rentals

Services Supplies Property Transfer Line Totals

Accowlt Cert Noncert Cert Non Cert Services

IIOOO Instruction $

Support 21000 Services - 5714100 $30000 $ 717000 $ 9431100

Student Improvement of

22100 lnsuuction

$(Professional Dcvclonmcnt)

22900 Otl1er Support

$Serviccs-Admin

25191 Refund of sRevenue

26000 Operationamp $Maintenance

27000 Tran~rtation $

Community 33000 Service s

Qntgtrations

60100 Transfers

$ finterfund Column

$ $ $ $ 5714100 $ $ 3000000 $ $ 717000 $ $ 9431100Totals

Subtotal $9431100 Indirect Cost Rate Subtract the amount above $25000 (per individual contracted service) from your total budget SSS000

Total after deducting Property $7170 Total Available for Indirect Costs

Amount of Indirect Cost to be used $1630 Grand Total Including lndirett Cost

Budget Narrative

DIRECTIONS Provide a narrative below on how funding is allocated Include the line number on which the funds are budgeted the itemized amountsfltems and which application category the expenditure is budgeted foe Example Other Purchase Services 22100 $1500 Guided Math Train the Trainer Conference registration and travel July 12-14 2018 Chicago IL (Focus Area A)

Supplies PropertyTechnology 2100 $2125 Math Dibel software (Focus Aera A) 2100 $3000 IXL Math resource 6-8 (Focus Area B) 2100 $720 Ready A to Z software (Focus Area C) 2100 $463 IXL EILA Leaming Progression (Focus Area A) 2100 $298 purchase of an iPad (Focus Area C)

Pronertv Eouinment Other Purchase Services (travel communication

22100 $30000 reimbursement of AP JB exams (Focus Area A) 22 IOO $55000 contracted services with Five Star Technologies (Focus Area C) 2100 $1300 Mission Control training (Focus Area A) 2100 $393 STEAM course training (Focus area A) 2100 $448 Proactive Discipline Training (Focus Area B)

Professional Services (contracted services)

Title IV Part A Staffin2

Staff Name Staff Position CertNon~ FfE Stipend YIN Split Additional Funding Source Position Description

Certified Funded YIN

Page 4: Superintendent of Public Instruction DEPARTMENT OF … · 2020. 2. 18. · Sections 4105(a)(2), 4105(a)(3), and 4106(b) indicate that a State educational agency shall not award a

omprehensive Needs Assessment (CNA) 1n LEA must complete an assessment of local needs to ensure that Title IV A interventions are targeted to meet the needs for improvement in access to and opportunities for a well-round middotducation for all students school conditions for student learning in order to create a healthy and safe school environment and access to personalized learning experiences supported echnology and professional development for the effective use of data and technology This Comprehensive Needs Assessment (CNA) must ensure that chosen interventions are aligned w gtcal needs the evidence base and local capacity are considered when selecting a strategy a robust implementation plan exists with adequate resources and reflection informs next ste1 Section 4106)

Program Goals amp Objectives Consultation Briefly describe what will be accomplished through the proposed initiatives through Title IV A Our proposal is the result of collaborating with all stakeholders (checked boxes) reviewing survey and student data We have two proposed initiatives that will be funded by this grant First initiative focus A) is to provide financial assistance to our textbook assistance students to take AP and 18 exams ESSA has taken away a large part of the financial assistance for these students The second proposed initiative (focus C) is providing professional development for our middle school teachers one-Learning In 2013 New Albany-Floyd County Consolidated School Corporation began a 11 iPad initiative in both high schools This initiative necessitated the placement of an e-Learning coach to be hired The elearning coach helped teachers incorporate iPads into their day-to-day lesson planning In the Fall of 2017 NAFCS distributed iPads to all 800 8th grade students As with our high schools our three middle schools need elearning support and guidance for our teachers Our goal will be to implement iPads to all 7th graders in the Fall of 2018 and classroom sets of iPads to our 5th and 6th graders in the Fall of 2019 The elearning coach will be critically important as it relates to the effective integration of technology into our classrooms

Identify the stakeholders who were consulted in the design of the Title IV A plan and describe the manner in which it occurred in the space below NOTE The text entry below describing the consultation activities is a required component

~ Teachers

~ Principals

~ Other school leaders and professionals CParaprofessionals Dnstructional support personnel

~ Parents

~ Community partners ~ Other _Five Star Technologies ____

Data Sources amp Measures The above stakeholders participated in meetings Include specific educator andor student data analyzed to determine needs with school administrators along with being Proposed initiative 1 (Focus A) Last year we had over 900 students take AP and 18 exams of which 50 of students received financial surveyed on specific issues concerning the assistance from the federal and state governments ESSA has removed part of this funding for the upcoming year and our state has proposed initiatives The IMPACT study was not yet issued the guidelines for assistance this year We need to continue providing assistance to those students who qualify in order conducted by Five-Star Technologies our 11 for them to participate in these programs In addition through survey data of our parents and students about the 18 Diploma consultant Programme they cited the number one reason for not participating were the financial costs of the 18 Programme Our state currently does not provide assistance for students participating in 18 courses Proposed initiative 2 (Focus C) Before implementing the 11 initiative in the middles schools we hired Five Star Technologies to conduct a study on what would be needed to successfully implement the 11 initiative Data from an IMPACT study conducted by FiveshyStar Technologies showed that a vast majority of our teachers felt as though they needed additional trainingsupport as it related to iPad integration

Prioritized Needs

Describe the needs (NOT activities) determined through an analysis of the data include in the description an explanation ofhow the LEA will prioritize funds for schools with the highest need Focus A The cost of an AP exam is $94 and the cost of an 18 exam is $119 With reduction of federal assistance from ESSA we will prioritize our needs on focusing on students who qualify for textbook assistance who are wanting to take these classes and exams We will provide financial assistance to those students Focus C As a result of the IMPACT study (teacher interviews classroom observations and survey data) conducted by Five Star Technologies teachers reported that they lack knowledge of the functionality of the iPad the use of digital tools in the classroom and the use of a Learning Management Platform This grant will fund a e-Learning coaches for the middle school

DIRECTIONS You may reference the menu of interventions from Part 4 above identify how the applicant will address providing all students with access to a well-rounded education social and emotional supports andor technology integration You may add additional spaces for activities if needed

Describe the Title IV A-funded activities and programming used to support well-rounded education for all students social and emotional supports and or

technology integration [Sec 4106) The funds will provide financial assistance for AP and IB exams for those students who qualify under textbook assistance In addition the funds will also be used to hire for two years e-Learning coaches for the middle schools

Describe the rationale tied to the Needs Assessment Stakeholder Input andor Data The rational for the APIB initiative is the result of ESSA decreasing funding for students who need the assistance The rationale for thee-learning coaches was the result of the IMPACT Study conducted by Five Star Technologies last spring with our middle school teachers Describe the program objectives and intended outcomes

The APIB initiative objective is to remove the financial barrier for those students who need assistance to take these classesexams Thee-learning initiative objective is to build capacity in all middle school teachers in the areas of iPad functionality the use of digital tools in the classroom and the

_llSe of_a lean1lng Management igtJatfor_111 Describe how and with what frequency your program will be evaluated for effectiveness and the individual(s) responsible for evaluation The APIB initiative will be evaluated by the Assistant Superintendent for High Schools on a year to year basis Thee-Learning initiative will be overseen by the ~s_s_ista_r_t Superintendent fo_r-__lYlidd~Scho_()_l_s and_will be~valu~Ed by Five Star Tecll_nologies using the IMPACT Study instrument If applicable describe any partnerships with an institution of higher education business nonprofit organization community-based organization or other public or private entity We have partnership with the following for this grant New Albany Floyd County Education Foundation for the APIB initiative and Five Star Technologies for the e-learning coaches initiative

1 Providing reimbursement to low-income students to cover costs of AP and IB exams

2 Provide educators and administrators with professional learning on the use of iPads digital tools and a Learning Management platform

A0 1 Floyd Central High School and 1 $15000 I 1 $30000

BO 2 New Albany High School 2 SlS000I I CD

AD 1 Hazelwood Middle School Highland Hills 1 $55000 2 $55000

BD Middle School and Scribner Middle School

C0

3 I AD I 3 I 3 I 3

BO

co

4 AO BO co

4 4 4

5 AO BO co

5 5 5

6 AO BO co

6 6 6

Please note that the totals for Focus Areas A B and Cmay exceed the total allocation request as an activity may fit in multiple focus areas

Total Budgeted Amount for Focus Area A $30000

Total Budgeted Amount for Focus Area B

Total Budgeted Amount for Focus Area C $55000

Percent of Total Allocation to be spent on Technology Infrastructure (includes purchasing devices equipment and software applications in order to address readiness shortfalls) Not to exceed 25 of total alocation

Total Budgeted Amount $85000

Part 7 Title IV Part A Sustainability Plan

Describe the sustainability plan detailing how proposed Title IV Part A grant activities and programming will be sustained in the absence of Title IV Part A funds This description should include

bull efforts to increase local capacity bull specific future funding sources if applicable (ie general funds Title I community partnerships)

bull intended program objectives and outcomes in future years and

bull how these outcomes will be evaluated for effectiveness Our goal is to have the New Floyd County Education Foundation (community partnership) to provide funds to offset the lack of federal assistance for students wanting to take AP 18 exams Thee-Learning coaches will be funded by our General fund in the future The goal is to build capacity in our middle school teachers one-learning that would eventually remove the need fore-learning coaches in the future

The AP18 initiative will be evaluated based on monitoring the number of students who qualify for textbook assistance who are taking these classesexams The success of thee-Learning coaches will be evaluated by the IMPACT study conducted by Five Star Technologies in the spring of each year

Part 8 Title IV Part A Non-Public Equitable Share

Nonpublic School List and Budget

Nonpublic School

Number Nonpublic School Name

Nonpublic School

Enrollment (Use same date as LEA enrollment

to determine this count)

Participating (YesNo)

Equitable Participation Amount (Use Step Ebelow)

Boys Christian Academy 789 Yes [8] No 0 $599600

8060 Our Lady Perpetural Help 297

Yes [8] No 0 $225700

8067 St Marys of the Knobs 159 Yes~ NoO $120800

BOSO Holy Family 263 YesLJ No~ $199800

YesO NoO $

YesD NoO $

Yes LJ No LJ $

YesD NoO $

Yes LJ No 0 $

YesLJ NoO $

YesO NoO $

YesO NoO $

A Total Nonpublic School Enrollment 1508 B Total LEA Enrollment t11401I

C Total Enrollment (A+ B) ~2909J D Total Allocation Minus Administrative Costs ~163ol

E Per Pupil Allocation (PPA) M (Step D divided by Step C)

Nonpublic Information Page (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

Non-Public School Name Holy Family School Non-Public School Number BOSO____________________

Mailing Address 217 West Daisy Lane New Albany IN 47150

Contact Person (and Title Jerry Ernstberger Contact Phone Number 812-944-6090 _______---------------------- ----------Contact Email Address jernstbergerholyfa mi lyeaglescom

Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

~ Email communication [gt Will not participate

[gt Telephone conversation ~ Will participate in Title IV A programming activities

~ Face-to-face meeting

EE Other_~=

rJ v P2f(c lu 10417 Signature of NonpublicSchool Official Date

Gerald A Enstsberger Printed Name of Nonpublic School Official

14

Nonpublic Information Page (To be completed by the offlclal representative from each nonpublic school following timely and meaningful consultation)

Non-PubUcSchool Name CAltISf-- AuJuw _ iOt_A Non-Public School Number ThyS-

MalllnaAddress IOOo Ac~ Ju Vd-iivAllergt1 1 Z 7 fO Contact Person (and Title)JgtN Lo-(n fJGVllS V-bull c ~ Contact Phone Number 512 middot 1t~ two Contact Emall Address dlo C~c--ls11s

Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic offldals Outcome

~mail communication Wlll not participate~ middot middot Telephone conversation Will participate In Title IV A programming activitiesI ~

~ gg

Face-to-face meeting Other__

Signature of Nonpublic ScttoorOffida

~J Printed Name of Nonpublic School Offlclal

Non-Public Information Page continued) (To be completed by the official representative from each nonpubnc school followlnamp tlmely and meaningful consultation)

Focus Area A

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$ z12s-Focus Are B

$Joogt

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Nonpublic Information Page (To be completed by the official representative from each nonpublic school following tlmely and meaningful consultation)

Non-Public School Name (l~L-bto-J1jWLL~5o-fLJ-4ldc-l fWpublic School Number J3 Q bJ Q

Malling Address -=-=__-wuiu~1--JgtLamp41-LJ----------

Contact Person (and Title)__~4ltlJ-J--I-Z-ll---uopound-1=owe4-L--1-_L1a~ ct_ Contact Phone Number lttr_~ 1 7lt7p Contact Email Address tY benV1e1t 0 ( h h VJ a middot 0 rJ

I Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

riTI

nY Will not participate Will participate in Title IV A programming activities

C-J1-17Date

Email communication Telephone conversation

15

Non-Public Information Page (continued) (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

If applicable describe any partnerships with an Institution of higher education business nonprofit organization community-based organization or other public or private entity

9-2-f--1-r Date

0 ConKtEmall Address

t Cl) s s ctS ()

U)

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t Email communication Telephone conversation Face-to-face meeting Other__

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If applicable describe any partnerships with an institution of higher education business nonprofit organization community-based organization or other public or rte entity

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Part 9 Title IV Part A Budget

Instructions Please be sure to complete both the Budget Overview and the Title IV Part A Budget (linked below) Both sections will be needed prior to application review

Budget Overview

Budget Request Schoo1Year2017-2018

Title IV A Activities

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$8500000

Nonpublic Equitable Share $9311

Administration

(Optional maximum 2 of total original allocation) $

Indirect Cost Optional)

$1630

TOTAL FUNDING REQUEST $9594100

Title IV Part A Detailed Budget

Please complete the Title IV Part A budget as an excel spreadsheet linked below and submit with your application All expenses listed in the table

above should be included in the budget and described in the narrative below the budget

Title IV Part A Budget Spreadsheet

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bull

110 120 211-290 211-290 311-319 440 510-593 611-689 710-748 910

Expenditure Salaiv Benefits Professional Other Purchase GeneralAcrountNumber Rentals

Services Supplies Property Transfer Line Totals

Accowlt Cert Noncert Cert Non Cert Services

IIOOO Instruction $

Support 21000 Services - 5714100 $30000 $ 717000 $ 9431100

Student Improvement of

22100 lnsuuction

$(Professional Dcvclonmcnt)

22900 Otl1er Support

$Serviccs-Admin

25191 Refund of sRevenue

26000 Operationamp $Maintenance

27000 Tran~rtation $

Community 33000 Service s

Qntgtrations

60100 Transfers

$ finterfund Column

$ $ $ $ 5714100 $ $ 3000000 $ $ 717000 $ $ 9431100Totals

Subtotal $9431100 Indirect Cost Rate Subtract the amount above $25000 (per individual contracted service) from your total budget SSS000

Total after deducting Property $7170 Total Available for Indirect Costs

Amount of Indirect Cost to be used $1630 Grand Total Including lndirett Cost

Budget Narrative

DIRECTIONS Provide a narrative below on how funding is allocated Include the line number on which the funds are budgeted the itemized amountsfltems and which application category the expenditure is budgeted foe Example Other Purchase Services 22100 $1500 Guided Math Train the Trainer Conference registration and travel July 12-14 2018 Chicago IL (Focus Area A)

Supplies PropertyTechnology 2100 $2125 Math Dibel software (Focus Aera A) 2100 $3000 IXL Math resource 6-8 (Focus Area B) 2100 $720 Ready A to Z software (Focus Area C) 2100 $463 IXL EILA Leaming Progression (Focus Area A) 2100 $298 purchase of an iPad (Focus Area C)

Pronertv Eouinment Other Purchase Services (travel communication

22100 $30000 reimbursement of AP JB exams (Focus Area A) 22 IOO $55000 contracted services with Five Star Technologies (Focus Area C) 2100 $1300 Mission Control training (Focus Area A) 2100 $393 STEAM course training (Focus area A) 2100 $448 Proactive Discipline Training (Focus Area B)

Professional Services (contracted services)

Title IV Part A Staffin2

Staff Name Staff Position CertNon~ FfE Stipend YIN Split Additional Funding Source Position Description

Certified Funded YIN

Page 5: Superintendent of Public Instruction DEPARTMENT OF … · 2020. 2. 18. · Sections 4105(a)(2), 4105(a)(3), and 4106(b) indicate that a State educational agency shall not award a

Program Goals amp Objectives Consultation Briefly describe what will be accomplished through the proposed initiatives through Title IV A Our proposal is the result of collaborating with all stakeholders (checked boxes) reviewing survey and student data We have two proposed initiatives that will be funded by this grant First initiative focus A) is to provide financial assistance to our textbook assistance students to take AP and 18 exams ESSA has taken away a large part of the financial assistance for these students The second proposed initiative (focus C) is providing professional development for our middle school teachers one-Learning In 2013 New Albany-Floyd County Consolidated School Corporation began a 11 iPad initiative in both high schools This initiative necessitated the placement of an e-Learning coach to be hired The elearning coach helped teachers incorporate iPads into their day-to-day lesson planning In the Fall of 2017 NAFCS distributed iPads to all 800 8th grade students As with our high schools our three middle schools need elearning support and guidance for our teachers Our goal will be to implement iPads to all 7th graders in the Fall of 2018 and classroom sets of iPads to our 5th and 6th graders in the Fall of 2019 The elearning coach will be critically important as it relates to the effective integration of technology into our classrooms

Identify the stakeholders who were consulted in the design of the Title IV A plan and describe the manner in which it occurred in the space below NOTE The text entry below describing the consultation activities is a required component

~ Teachers

~ Principals

~ Other school leaders and professionals CParaprofessionals Dnstructional support personnel

~ Parents

~ Community partners ~ Other _Five Star Technologies ____

Data Sources amp Measures The above stakeholders participated in meetings Include specific educator andor student data analyzed to determine needs with school administrators along with being Proposed initiative 1 (Focus A) Last year we had over 900 students take AP and 18 exams of which 50 of students received financial surveyed on specific issues concerning the assistance from the federal and state governments ESSA has removed part of this funding for the upcoming year and our state has proposed initiatives The IMPACT study was not yet issued the guidelines for assistance this year We need to continue providing assistance to those students who qualify in order conducted by Five-Star Technologies our 11 for them to participate in these programs In addition through survey data of our parents and students about the 18 Diploma consultant Programme they cited the number one reason for not participating were the financial costs of the 18 Programme Our state currently does not provide assistance for students participating in 18 courses Proposed initiative 2 (Focus C) Before implementing the 11 initiative in the middles schools we hired Five Star Technologies to conduct a study on what would be needed to successfully implement the 11 initiative Data from an IMPACT study conducted by FiveshyStar Technologies showed that a vast majority of our teachers felt as though they needed additional trainingsupport as it related to iPad integration

Prioritized Needs

Describe the needs (NOT activities) determined through an analysis of the data include in the description an explanation ofhow the LEA will prioritize funds for schools with the highest need Focus A The cost of an AP exam is $94 and the cost of an 18 exam is $119 With reduction of federal assistance from ESSA we will prioritize our needs on focusing on students who qualify for textbook assistance who are wanting to take these classes and exams We will provide financial assistance to those students Focus C As a result of the IMPACT study (teacher interviews classroom observations and survey data) conducted by Five Star Technologies teachers reported that they lack knowledge of the functionality of the iPad the use of digital tools in the classroom and the use of a Learning Management Platform This grant will fund a e-Learning coaches for the middle school

DIRECTIONS You may reference the menu of interventions from Part 4 above identify how the applicant will address providing all students with access to a well-rounded education social and emotional supports andor technology integration You may add additional spaces for activities if needed

Describe the Title IV A-funded activities and programming used to support well-rounded education for all students social and emotional supports and or

technology integration [Sec 4106) The funds will provide financial assistance for AP and IB exams for those students who qualify under textbook assistance In addition the funds will also be used to hire for two years e-Learning coaches for the middle schools

Describe the rationale tied to the Needs Assessment Stakeholder Input andor Data The rational for the APIB initiative is the result of ESSA decreasing funding for students who need the assistance The rationale for thee-learning coaches was the result of the IMPACT Study conducted by Five Star Technologies last spring with our middle school teachers Describe the program objectives and intended outcomes

The APIB initiative objective is to remove the financial barrier for those students who need assistance to take these classesexams Thee-learning initiative objective is to build capacity in all middle school teachers in the areas of iPad functionality the use of digital tools in the classroom and the

_llSe of_a lean1lng Management igtJatfor_111 Describe how and with what frequency your program will be evaluated for effectiveness and the individual(s) responsible for evaluation The APIB initiative will be evaluated by the Assistant Superintendent for High Schools on a year to year basis Thee-Learning initiative will be overseen by the ~s_s_ista_r_t Superintendent fo_r-__lYlidd~Scho_()_l_s and_will be~valu~Ed by Five Star Tecll_nologies using the IMPACT Study instrument If applicable describe any partnerships with an institution of higher education business nonprofit organization community-based organization or other public or private entity We have partnership with the following for this grant New Albany Floyd County Education Foundation for the APIB initiative and Five Star Technologies for the e-learning coaches initiative

1 Providing reimbursement to low-income students to cover costs of AP and IB exams

2 Provide educators and administrators with professional learning on the use of iPads digital tools and a Learning Management platform

A0 1 Floyd Central High School and 1 $15000 I 1 $30000

BO 2 New Albany High School 2 SlS000I I CD

AD 1 Hazelwood Middle School Highland Hills 1 $55000 2 $55000

BD Middle School and Scribner Middle School

C0

3 I AD I 3 I 3 I 3

BO

co

4 AO BO co

4 4 4

5 AO BO co

5 5 5

6 AO BO co

6 6 6

Please note that the totals for Focus Areas A B and Cmay exceed the total allocation request as an activity may fit in multiple focus areas

Total Budgeted Amount for Focus Area A $30000

Total Budgeted Amount for Focus Area B

Total Budgeted Amount for Focus Area C $55000

Percent of Total Allocation to be spent on Technology Infrastructure (includes purchasing devices equipment and software applications in order to address readiness shortfalls) Not to exceed 25 of total alocation

Total Budgeted Amount $85000

Part 7 Title IV Part A Sustainability Plan

Describe the sustainability plan detailing how proposed Title IV Part A grant activities and programming will be sustained in the absence of Title IV Part A funds This description should include

bull efforts to increase local capacity bull specific future funding sources if applicable (ie general funds Title I community partnerships)

bull intended program objectives and outcomes in future years and

bull how these outcomes will be evaluated for effectiveness Our goal is to have the New Floyd County Education Foundation (community partnership) to provide funds to offset the lack of federal assistance for students wanting to take AP 18 exams Thee-Learning coaches will be funded by our General fund in the future The goal is to build capacity in our middle school teachers one-learning that would eventually remove the need fore-learning coaches in the future

The AP18 initiative will be evaluated based on monitoring the number of students who qualify for textbook assistance who are taking these classesexams The success of thee-Learning coaches will be evaluated by the IMPACT study conducted by Five Star Technologies in the spring of each year

Part 8 Title IV Part A Non-Public Equitable Share

Nonpublic School List and Budget

Nonpublic School

Number Nonpublic School Name

Nonpublic School

Enrollment (Use same date as LEA enrollment

to determine this count)

Participating (YesNo)

Equitable Participation Amount (Use Step Ebelow)

Boys Christian Academy 789 Yes [8] No 0 $599600

8060 Our Lady Perpetural Help 297

Yes [8] No 0 $225700

8067 St Marys of the Knobs 159 Yes~ NoO $120800

BOSO Holy Family 263 YesLJ No~ $199800

YesO NoO $

YesD NoO $

Yes LJ No LJ $

YesD NoO $

Yes LJ No 0 $

YesLJ NoO $

YesO NoO $

YesO NoO $

A Total Nonpublic School Enrollment 1508 B Total LEA Enrollment t11401I

C Total Enrollment (A+ B) ~2909J D Total Allocation Minus Administrative Costs ~163ol

E Per Pupil Allocation (PPA) M (Step D divided by Step C)

Nonpublic Information Page (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

Non-Public School Name Holy Family School Non-Public School Number BOSO____________________

Mailing Address 217 West Daisy Lane New Albany IN 47150

Contact Person (and Title Jerry Ernstberger Contact Phone Number 812-944-6090 _______---------------------- ----------Contact Email Address jernstbergerholyfa mi lyeaglescom

Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

~ Email communication [gt Will not participate

[gt Telephone conversation ~ Will participate in Title IV A programming activities

~ Face-to-face meeting

EE Other_~=

rJ v P2f(c lu 10417 Signature of NonpublicSchool Official Date

Gerald A Enstsberger Printed Name of Nonpublic School Official

14

Nonpublic Information Page (To be completed by the offlclal representative from each nonpublic school following timely and meaningful consultation)

Non-PubUcSchool Name CAltISf-- AuJuw _ iOt_A Non-Public School Number ThyS-

MalllnaAddress IOOo Ac~ Ju Vd-iivAllergt1 1 Z 7 fO Contact Person (and Title)JgtN Lo-(n fJGVllS V-bull c ~ Contact Phone Number 512 middot 1t~ two Contact Emall Address dlo C~c--ls11s

Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic offldals Outcome

~mail communication Wlll not participate~ middot middot Telephone conversation Will participate In Title IV A programming activitiesI ~

~ gg

Face-to-face meeting Other__

Signature of Nonpublic ScttoorOffida

~J Printed Name of Nonpublic School Offlclal

Non-Public Information Page continued) (To be completed by the official representative from each nonpubnc school followlnamp tlmely and meaningful consultation)

Focus Area A

Clielt lla~a ~rmiddot--micro M- bull s is amp JC-1

Focus~a-~Desaibe proposed activities

~tvU~il1

- Iii$NCf F9sArealt ~a~ ll-111 _ Add additional activities os needed

Focus Area A

$ z12s-Focus Are B

$Joogt

Focus Area C s7-u

Desulbe the Title IV A-funded activities ind programming used to s~port well-rounded education for all students social and emotlonal supports and or technology Integration [sec 4106 ~$lt 711Ef Yr~~ cJ So t eJolc -rP I e)-rht 3-e)~ egt CIJ1~ lSbull-cent$ (r s~ lltJ Mtiraquo Qc-J kegto cr--s DesaibetheratlonaletledtotheNeedsAsse$$mentStakeholderlnputandor Jlltta A 1 _ bullbull u 517-a jampn-- I-lJE H-ae l)as~J 1fe NII-U 17gt rU-~ -nl 5C11$ gttNn ct- f_-r 0 ~ tvrreA_ -141 ~ tgt-4~ls Altgt I tAP-0 J-l11_ e-J__r tr1f~v 1-P~ bull -egt 5

_ I Tb - P17r _ I~ ~ Descr~theprogramobjectlvesandlntendedoutcomes

1S bull

lt

middot-middotmiddot - -

middot~ -

middot-gtr~ middot i_middot

middot gt~tmiddot - middotJmiddot _ middot _middot_ 1 J --middot--~

f~ r-eampS -r-b~-- ~-middot bull 1 J~- ~ middotcr-c~ ~I~ J r-e middot middot middot middot

- middot middott middot middot middot -ofcbull~-1o lgtlclCut t)wrH -5rvoeJ-r s r-1o ~t_ffr_____~c) Cf-e1~ _i nUS ~ (s41 middot

~iA((f J-(5 bullIf appllcable describe any partnetshlps with an Institution of higher education business nonprofit organization community-based organization or 0

other public or private entity -

-~-

~bullbull t112s17 middot~ ate

-~_ __ middot=middot ~

bull ~

--~middotbull

middot

~

14

Nonpublic Information Page (To be completed by the official representative from each nonpublic school following tlmely and meaningful consultation)

Non-Public School Name (l~L-bto-J1jWLL~5o-fLJ-4ldc-l fWpublic School Number J3 Q bJ Q

Malling Address -=-=__-wuiu~1--JgtLamp41-LJ----------

Contact Person (and Title)__~4ltlJ-J--I-Z-ll---uopound-1=owe4-L--1-_L1a~ ct_ Contact Phone Number lttr_~ 1 7lt7p Contact Email Address tY benV1e1t 0 ( h h VJ a middot 0 rJ

I Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

riTI

nY Will not participate Will participate in Title IV A programming activities

C-J1-17Date

Email communication Telephone conversation

15

Non-Public Information Page (continued) (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

If applicable describe any partnerships with an Institution of higher education business nonprofit organization community-based organization or other public or private entity

9-2-f--1-r Date

0 ConKtEmall Address

t Cl) s s ctS ()

U)

ctStjQ15-inaJcoucsmt 05 E

Plefle Indicate howtlmely and mnnlnlful conversation occumd between the LEA and nonpublic officials

t Email communication Telephone conversation Face-to-face meeting Other__

gta c

Outcome C Cl)

~ Will not participate s21 Will participate In Title IV Aprogramming activities s

ctS ()

9 2-7 U)

oite

_~ tGmiddot0 I ~

bull

IUt4 M Ju~IAAlltl4 A-c -out Agtlt~ Pc-- Ac M ~ uJ~ 11e~tiJltI ii~ dbulllttcl _ _ ~l5P + 3~

ZXL SLA _ hfM ~

p ~ r 1Jtf FocusAreaA bullbull ~cusampeA bull ~ C)L- -151-A bull~~ ftZl(D fbulltt1_~A x1L ~ Ari + ftsii6tal ~ Focusampu1 ~ cbull~ p~ult 0bulllteu i-~i s unB

bull bull bull bull 1 bull - 778 P~dhJC ik -laquolaquo-fIC Focus Arne~==r tampbull~ J middottJGA~ ~~ $ t

Describe the Title IV Afunded acti1Wes and prmiddotomlmmlng used to supportwe~ed-u __catlonfour-a_U_stu_d_ents soda--a_nd_e_m_o_tio_na_lsu-pp_orts_~---

and orte~ologyint~ [Sec4106] cJAt ~ bull -bull eAc-c1 _ U -1-u ~ obbullbullr~~ ~

If applicable describe any partnerships with an institution of higher education business nonprofit organization community-based organization or other public or rte entity

JI Q) C C ca ()

Cl)

E ca ()

gtshy0 tJ Q) C C ca ()

en

Part 9 Title IV Part A Budget

Instructions Please be sure to complete both the Budget Overview and the Title IV Part A Budget (linked below) Both sections will be needed prior to application review

Budget Overview

Budget Request Schoo1Year2017-2018

Title IV A Activities

fa1~IArtWgtiiiitr~ 10(ije~ti~~~l112middotmiddotbull

$8500000

Nonpublic Equitable Share $9311

Administration

(Optional maximum 2 of total original allocation) $

Indirect Cost Optional)

$1630

TOTAL FUNDING REQUEST $9594100

Title IV Part A Detailed Budget

Please complete the Title IV Part A budget as an excel spreadsheet linked below and submit with your application All expenses listed in the table

above should be included in the budget and described in the narrative below the budget

Title IV Part A Budget Spreadsheet

I lt lt lt igt i l gt bull 2 gt i bullmiddotmiddot ltTitleIV Pflrt A Oiiiinal Budizet bull bullbullbullbullbullbullbullbullbullbullbullbullbullbullbull bull

bull

110 120 211-290 211-290 311-319 440 510-593 611-689 710-748 910

Expenditure Salaiv Benefits Professional Other Purchase GeneralAcrountNumber Rentals

Services Supplies Property Transfer Line Totals

Accowlt Cert Noncert Cert Non Cert Services

IIOOO Instruction $

Support 21000 Services - 5714100 $30000 $ 717000 $ 9431100

Student Improvement of

22100 lnsuuction

$(Professional Dcvclonmcnt)

22900 Otl1er Support

$Serviccs-Admin

25191 Refund of sRevenue

26000 Operationamp $Maintenance

27000 Tran~rtation $

Community 33000 Service s

Qntgtrations

60100 Transfers

$ finterfund Column

$ $ $ $ 5714100 $ $ 3000000 $ $ 717000 $ $ 9431100Totals

Subtotal $9431100 Indirect Cost Rate Subtract the amount above $25000 (per individual contracted service) from your total budget SSS000

Total after deducting Property $7170 Total Available for Indirect Costs

Amount of Indirect Cost to be used $1630 Grand Total Including lndirett Cost

Budget Narrative

DIRECTIONS Provide a narrative below on how funding is allocated Include the line number on which the funds are budgeted the itemized amountsfltems and which application category the expenditure is budgeted foe Example Other Purchase Services 22100 $1500 Guided Math Train the Trainer Conference registration and travel July 12-14 2018 Chicago IL (Focus Area A)

Supplies PropertyTechnology 2100 $2125 Math Dibel software (Focus Aera A) 2100 $3000 IXL Math resource 6-8 (Focus Area B) 2100 $720 Ready A to Z software (Focus Area C) 2100 $463 IXL EILA Leaming Progression (Focus Area A) 2100 $298 purchase of an iPad (Focus Area C)

Pronertv Eouinment Other Purchase Services (travel communication

22100 $30000 reimbursement of AP JB exams (Focus Area A) 22 IOO $55000 contracted services with Five Star Technologies (Focus Area C) 2100 $1300 Mission Control training (Focus Area A) 2100 $393 STEAM course training (Focus area A) 2100 $448 Proactive Discipline Training (Focus Area B)

Professional Services (contracted services)

Title IV Part A Staffin2

Staff Name Staff Position CertNon~ FfE Stipend YIN Split Additional Funding Source Position Description

Certified Funded YIN

Page 6: Superintendent of Public Instruction DEPARTMENT OF … · 2020. 2. 18. · Sections 4105(a)(2), 4105(a)(3), and 4106(b) indicate that a State educational agency shall not award a

Prioritized Needs

Describe the needs (NOT activities) determined through an analysis of the data include in the description an explanation ofhow the LEA will prioritize funds for schools with the highest need Focus A The cost of an AP exam is $94 and the cost of an 18 exam is $119 With reduction of federal assistance from ESSA we will prioritize our needs on focusing on students who qualify for textbook assistance who are wanting to take these classes and exams We will provide financial assistance to those students Focus C As a result of the IMPACT study (teacher interviews classroom observations and survey data) conducted by Five Star Technologies teachers reported that they lack knowledge of the functionality of the iPad the use of digital tools in the classroom and the use of a Learning Management Platform This grant will fund a e-Learning coaches for the middle school

DIRECTIONS You may reference the menu of interventions from Part 4 above identify how the applicant will address providing all students with access to a well-rounded education social and emotional supports andor technology integration You may add additional spaces for activities if needed

Describe the Title IV A-funded activities and programming used to support well-rounded education for all students social and emotional supports and or

technology integration [Sec 4106) The funds will provide financial assistance for AP and IB exams for those students who qualify under textbook assistance In addition the funds will also be used to hire for two years e-Learning coaches for the middle schools

Describe the rationale tied to the Needs Assessment Stakeholder Input andor Data The rational for the APIB initiative is the result of ESSA decreasing funding for students who need the assistance The rationale for thee-learning coaches was the result of the IMPACT Study conducted by Five Star Technologies last spring with our middle school teachers Describe the program objectives and intended outcomes

The APIB initiative objective is to remove the financial barrier for those students who need assistance to take these classesexams Thee-learning initiative objective is to build capacity in all middle school teachers in the areas of iPad functionality the use of digital tools in the classroom and the

_llSe of_a lean1lng Management igtJatfor_111 Describe how and with what frequency your program will be evaluated for effectiveness and the individual(s) responsible for evaluation The APIB initiative will be evaluated by the Assistant Superintendent for High Schools on a year to year basis Thee-Learning initiative will be overseen by the ~s_s_ista_r_t Superintendent fo_r-__lYlidd~Scho_()_l_s and_will be~valu~Ed by Five Star Tecll_nologies using the IMPACT Study instrument If applicable describe any partnerships with an institution of higher education business nonprofit organization community-based organization or other public or private entity We have partnership with the following for this grant New Albany Floyd County Education Foundation for the APIB initiative and Five Star Technologies for the e-learning coaches initiative

1 Providing reimbursement to low-income students to cover costs of AP and IB exams

2 Provide educators and administrators with professional learning on the use of iPads digital tools and a Learning Management platform

A0 1 Floyd Central High School and 1 $15000 I 1 $30000

BO 2 New Albany High School 2 SlS000I I CD

AD 1 Hazelwood Middle School Highland Hills 1 $55000 2 $55000

BD Middle School and Scribner Middle School

C0

3 I AD I 3 I 3 I 3

BO

co

4 AO BO co

4 4 4

5 AO BO co

5 5 5

6 AO BO co

6 6 6

Please note that the totals for Focus Areas A B and Cmay exceed the total allocation request as an activity may fit in multiple focus areas

Total Budgeted Amount for Focus Area A $30000

Total Budgeted Amount for Focus Area B

Total Budgeted Amount for Focus Area C $55000

Percent of Total Allocation to be spent on Technology Infrastructure (includes purchasing devices equipment and software applications in order to address readiness shortfalls) Not to exceed 25 of total alocation

Total Budgeted Amount $85000

Part 7 Title IV Part A Sustainability Plan

Describe the sustainability plan detailing how proposed Title IV Part A grant activities and programming will be sustained in the absence of Title IV Part A funds This description should include

bull efforts to increase local capacity bull specific future funding sources if applicable (ie general funds Title I community partnerships)

bull intended program objectives and outcomes in future years and

bull how these outcomes will be evaluated for effectiveness Our goal is to have the New Floyd County Education Foundation (community partnership) to provide funds to offset the lack of federal assistance for students wanting to take AP 18 exams Thee-Learning coaches will be funded by our General fund in the future The goal is to build capacity in our middle school teachers one-learning that would eventually remove the need fore-learning coaches in the future

The AP18 initiative will be evaluated based on monitoring the number of students who qualify for textbook assistance who are taking these classesexams The success of thee-Learning coaches will be evaluated by the IMPACT study conducted by Five Star Technologies in the spring of each year

Part 8 Title IV Part A Non-Public Equitable Share

Nonpublic School List and Budget

Nonpublic School

Number Nonpublic School Name

Nonpublic School

Enrollment (Use same date as LEA enrollment

to determine this count)

Participating (YesNo)

Equitable Participation Amount (Use Step Ebelow)

Boys Christian Academy 789 Yes [8] No 0 $599600

8060 Our Lady Perpetural Help 297

Yes [8] No 0 $225700

8067 St Marys of the Knobs 159 Yes~ NoO $120800

BOSO Holy Family 263 YesLJ No~ $199800

YesO NoO $

YesD NoO $

Yes LJ No LJ $

YesD NoO $

Yes LJ No 0 $

YesLJ NoO $

YesO NoO $

YesO NoO $

A Total Nonpublic School Enrollment 1508 B Total LEA Enrollment t11401I

C Total Enrollment (A+ B) ~2909J D Total Allocation Minus Administrative Costs ~163ol

E Per Pupil Allocation (PPA) M (Step D divided by Step C)

Nonpublic Information Page (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

Non-Public School Name Holy Family School Non-Public School Number BOSO____________________

Mailing Address 217 West Daisy Lane New Albany IN 47150

Contact Person (and Title Jerry Ernstberger Contact Phone Number 812-944-6090 _______---------------------- ----------Contact Email Address jernstbergerholyfa mi lyeaglescom

Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

~ Email communication [gt Will not participate

[gt Telephone conversation ~ Will participate in Title IV A programming activities

~ Face-to-face meeting

EE Other_~=

rJ v P2f(c lu 10417 Signature of NonpublicSchool Official Date

Gerald A Enstsberger Printed Name of Nonpublic School Official

14

Nonpublic Information Page (To be completed by the offlclal representative from each nonpublic school following timely and meaningful consultation)

Non-PubUcSchool Name CAltISf-- AuJuw _ iOt_A Non-Public School Number ThyS-

MalllnaAddress IOOo Ac~ Ju Vd-iivAllergt1 1 Z 7 fO Contact Person (and Title)JgtN Lo-(n fJGVllS V-bull c ~ Contact Phone Number 512 middot 1t~ two Contact Emall Address dlo C~c--ls11s

Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic offldals Outcome

~mail communication Wlll not participate~ middot middot Telephone conversation Will participate In Title IV A programming activitiesI ~

~ gg

Face-to-face meeting Other__

Signature of Nonpublic ScttoorOffida

~J Printed Name of Nonpublic School Offlclal

Non-Public Information Page continued) (To be completed by the official representative from each nonpubnc school followlnamp tlmely and meaningful consultation)

Focus Area A

Clielt lla~a ~rmiddot--micro M- bull s is amp JC-1

Focus~a-~Desaibe proposed activities

~tvU~il1

- Iii$NCf F9sArealt ~a~ ll-111 _ Add additional activities os needed

Focus Area A

$ z12s-Focus Are B

$Joogt

Focus Area C s7-u

Desulbe the Title IV A-funded activities ind programming used to s~port well-rounded education for all students social and emotlonal supports and or technology Integration [sec 4106 ~$lt 711Ef Yr~~ cJ So t eJolc -rP I e)-rht 3-e)~ egt CIJ1~ lSbull-cent$ (r s~ lltJ Mtiraquo Qc-J kegto cr--s DesaibetheratlonaletledtotheNeedsAsse$$mentStakeholderlnputandor Jlltta A 1 _ bullbull u 517-a jampn-- I-lJE H-ae l)as~J 1fe NII-U 17gt rU-~ -nl 5C11$ gttNn ct- f_-r 0 ~ tvrreA_ -141 ~ tgt-4~ls Altgt I tAP-0 J-l11_ e-J__r tr1f~v 1-P~ bull -egt 5

_ I Tb - P17r _ I~ ~ Descr~theprogramobjectlvesandlntendedoutcomes

1S bull

lt

middot-middotmiddot - -

middot~ -

middot-gtr~ middot i_middot

middot gt~tmiddot - middotJmiddot _ middot _middot_ 1 J --middot--~

f~ r-eampS -r-b~-- ~-middot bull 1 J~- ~ middotcr-c~ ~I~ J r-e middot middot middot middot

- middot middott middot middot middot -ofcbull~-1o lgtlclCut t)wrH -5rvoeJ-r s r-1o ~t_ffr_____~c) Cf-e1~ _i nUS ~ (s41 middot

~iA((f J-(5 bullIf appllcable describe any partnetshlps with an Institution of higher education business nonprofit organization community-based organization or 0

other public or private entity -

-~-

~bullbull t112s17 middot~ ate

-~_ __ middot=middot ~

bull ~

--~middotbull

middot

~

14

Nonpublic Information Page (To be completed by the official representative from each nonpublic school following tlmely and meaningful consultation)

Non-Public School Name (l~L-bto-J1jWLL~5o-fLJ-4ldc-l fWpublic School Number J3 Q bJ Q

Malling Address -=-=__-wuiu~1--JgtLamp41-LJ----------

Contact Person (and Title)__~4ltlJ-J--I-Z-ll---uopound-1=owe4-L--1-_L1a~ ct_ Contact Phone Number lttr_~ 1 7lt7p Contact Email Address tY benV1e1t 0 ( h h VJ a middot 0 rJ

I Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

riTI

nY Will not participate Will participate in Title IV A programming activities

C-J1-17Date

Email communication Telephone conversation

15

Non-Public Information Page (continued) (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

If applicable describe any partnerships with an Institution of higher education business nonprofit organization community-based organization or other public or private entity

9-2-f--1-r Date

0 ConKtEmall Address

t Cl) s s ctS ()

U)

ctStjQ15-inaJcoucsmt 05 E

Plefle Indicate howtlmely and mnnlnlful conversation occumd between the LEA and nonpublic officials

t Email communication Telephone conversation Face-to-face meeting Other__

gta c

Outcome C Cl)

~ Will not participate s21 Will participate In Title IV Aprogramming activities s

ctS ()

9 2-7 U)

oite

_~ tGmiddot0 I ~

bull

IUt4 M Ju~IAAlltl4 A-c -out Agtlt~ Pc-- Ac M ~ uJ~ 11e~tiJltI ii~ dbulllttcl _ _ ~l5P + 3~

ZXL SLA _ hfM ~

p ~ r 1Jtf FocusAreaA bullbull ~cusampeA bull ~ C)L- -151-A bull~~ ftZl(D fbulltt1_~A x1L ~ Ari + ftsii6tal ~ Focusampu1 ~ cbull~ p~ult 0bulllteu i-~i s unB

bull bull bull bull 1 bull - 778 P~dhJC ik -laquolaquo-fIC Focus Arne~==r tampbull~ J middottJGA~ ~~ $ t

Describe the Title IV Afunded acti1Wes and prmiddotomlmmlng used to supportwe~ed-u __catlonfour-a_U_stu_d_ents soda--a_nd_e_m_o_tio_na_lsu-pp_orts_~---

and orte~ologyint~ [Sec4106] cJAt ~ bull -bull eAc-c1 _ U -1-u ~ obbullbullr~~ ~

If applicable describe any partnerships with an institution of higher education business nonprofit organization community-based organization or other public or rte entity

JI Q) C C ca ()

Cl)

E ca ()

gtshy0 tJ Q) C C ca ()

en

Part 9 Title IV Part A Budget

Instructions Please be sure to complete both the Budget Overview and the Title IV Part A Budget (linked below) Both sections will be needed prior to application review

Budget Overview

Budget Request Schoo1Year2017-2018

Title IV A Activities

fa1~IArtWgtiiiitr~ 10(ije~ti~~~l112middotmiddotbull

$8500000

Nonpublic Equitable Share $9311

Administration

(Optional maximum 2 of total original allocation) $

Indirect Cost Optional)

$1630

TOTAL FUNDING REQUEST $9594100

Title IV Part A Detailed Budget

Please complete the Title IV Part A budget as an excel spreadsheet linked below and submit with your application All expenses listed in the table

above should be included in the budget and described in the narrative below the budget

Title IV Part A Budget Spreadsheet

I lt lt lt igt i l gt bull 2 gt i bullmiddotmiddot ltTitleIV Pflrt A Oiiiinal Budizet bull bullbullbullbullbullbullbullbullbullbullbullbullbullbullbull bull

bull

110 120 211-290 211-290 311-319 440 510-593 611-689 710-748 910

Expenditure Salaiv Benefits Professional Other Purchase GeneralAcrountNumber Rentals

Services Supplies Property Transfer Line Totals

Accowlt Cert Noncert Cert Non Cert Services

IIOOO Instruction $

Support 21000 Services - 5714100 $30000 $ 717000 $ 9431100

Student Improvement of

22100 lnsuuction

$(Professional Dcvclonmcnt)

22900 Otl1er Support

$Serviccs-Admin

25191 Refund of sRevenue

26000 Operationamp $Maintenance

27000 Tran~rtation $

Community 33000 Service s

Qntgtrations

60100 Transfers

$ finterfund Column

$ $ $ $ 5714100 $ $ 3000000 $ $ 717000 $ $ 9431100Totals

Subtotal $9431100 Indirect Cost Rate Subtract the amount above $25000 (per individual contracted service) from your total budget SSS000

Total after deducting Property $7170 Total Available for Indirect Costs

Amount of Indirect Cost to be used $1630 Grand Total Including lndirett Cost

Budget Narrative

DIRECTIONS Provide a narrative below on how funding is allocated Include the line number on which the funds are budgeted the itemized amountsfltems and which application category the expenditure is budgeted foe Example Other Purchase Services 22100 $1500 Guided Math Train the Trainer Conference registration and travel July 12-14 2018 Chicago IL (Focus Area A)

Supplies PropertyTechnology 2100 $2125 Math Dibel software (Focus Aera A) 2100 $3000 IXL Math resource 6-8 (Focus Area B) 2100 $720 Ready A to Z software (Focus Area C) 2100 $463 IXL EILA Leaming Progression (Focus Area A) 2100 $298 purchase of an iPad (Focus Area C)

Pronertv Eouinment Other Purchase Services (travel communication

22100 $30000 reimbursement of AP JB exams (Focus Area A) 22 IOO $55000 contracted services with Five Star Technologies (Focus Area C) 2100 $1300 Mission Control training (Focus Area A) 2100 $393 STEAM course training (Focus area A) 2100 $448 Proactive Discipline Training (Focus Area B)

Professional Services (contracted services)

Title IV Part A Staffin2

Staff Name Staff Position CertNon~ FfE Stipend YIN Split Additional Funding Source Position Description

Certified Funded YIN

Page 7: Superintendent of Public Instruction DEPARTMENT OF … · 2020. 2. 18. · Sections 4105(a)(2), 4105(a)(3), and 4106(b) indicate that a State educational agency shall not award a

DIRECTIONS You may reference the menu of interventions from Part 4 above identify how the applicant will address providing all students with access to a well-rounded education social and emotional supports andor technology integration You may add additional spaces for activities if needed

Describe the Title IV A-funded activities and programming used to support well-rounded education for all students social and emotional supports and or

technology integration [Sec 4106) The funds will provide financial assistance for AP and IB exams for those students who qualify under textbook assistance In addition the funds will also be used to hire for two years e-Learning coaches for the middle schools

Describe the rationale tied to the Needs Assessment Stakeholder Input andor Data The rational for the APIB initiative is the result of ESSA decreasing funding for students who need the assistance The rationale for thee-learning coaches was the result of the IMPACT Study conducted by Five Star Technologies last spring with our middle school teachers Describe the program objectives and intended outcomes

The APIB initiative objective is to remove the financial barrier for those students who need assistance to take these classesexams Thee-learning initiative objective is to build capacity in all middle school teachers in the areas of iPad functionality the use of digital tools in the classroom and the

_llSe of_a lean1lng Management igtJatfor_111 Describe how and with what frequency your program will be evaluated for effectiveness and the individual(s) responsible for evaluation The APIB initiative will be evaluated by the Assistant Superintendent for High Schools on a year to year basis Thee-Learning initiative will be overseen by the ~s_s_ista_r_t Superintendent fo_r-__lYlidd~Scho_()_l_s and_will be~valu~Ed by Five Star Tecll_nologies using the IMPACT Study instrument If applicable describe any partnerships with an institution of higher education business nonprofit organization community-based organization or other public or private entity We have partnership with the following for this grant New Albany Floyd County Education Foundation for the APIB initiative and Five Star Technologies for the e-learning coaches initiative

1 Providing reimbursement to low-income students to cover costs of AP and IB exams

2 Provide educators and administrators with professional learning on the use of iPads digital tools and a Learning Management platform

A0 1 Floyd Central High School and 1 $15000 I 1 $30000

BO 2 New Albany High School 2 SlS000I I CD

AD 1 Hazelwood Middle School Highland Hills 1 $55000 2 $55000

BD Middle School and Scribner Middle School

C0

3 I AD I 3 I 3 I 3

BO

co

4 AO BO co

4 4 4

5 AO BO co

5 5 5

6 AO BO co

6 6 6

Please note that the totals for Focus Areas A B and Cmay exceed the total allocation request as an activity may fit in multiple focus areas

Total Budgeted Amount for Focus Area A $30000

Total Budgeted Amount for Focus Area B

Total Budgeted Amount for Focus Area C $55000

Percent of Total Allocation to be spent on Technology Infrastructure (includes purchasing devices equipment and software applications in order to address readiness shortfalls) Not to exceed 25 of total alocation

Total Budgeted Amount $85000

Part 7 Title IV Part A Sustainability Plan

Describe the sustainability plan detailing how proposed Title IV Part A grant activities and programming will be sustained in the absence of Title IV Part A funds This description should include

bull efforts to increase local capacity bull specific future funding sources if applicable (ie general funds Title I community partnerships)

bull intended program objectives and outcomes in future years and

bull how these outcomes will be evaluated for effectiveness Our goal is to have the New Floyd County Education Foundation (community partnership) to provide funds to offset the lack of federal assistance for students wanting to take AP 18 exams Thee-Learning coaches will be funded by our General fund in the future The goal is to build capacity in our middle school teachers one-learning that would eventually remove the need fore-learning coaches in the future

The AP18 initiative will be evaluated based on monitoring the number of students who qualify for textbook assistance who are taking these classesexams The success of thee-Learning coaches will be evaluated by the IMPACT study conducted by Five Star Technologies in the spring of each year

Part 8 Title IV Part A Non-Public Equitable Share

Nonpublic School List and Budget

Nonpublic School

Number Nonpublic School Name

Nonpublic School

Enrollment (Use same date as LEA enrollment

to determine this count)

Participating (YesNo)

Equitable Participation Amount (Use Step Ebelow)

Boys Christian Academy 789 Yes [8] No 0 $599600

8060 Our Lady Perpetural Help 297

Yes [8] No 0 $225700

8067 St Marys of the Knobs 159 Yes~ NoO $120800

BOSO Holy Family 263 YesLJ No~ $199800

YesO NoO $

YesD NoO $

Yes LJ No LJ $

YesD NoO $

Yes LJ No 0 $

YesLJ NoO $

YesO NoO $

YesO NoO $

A Total Nonpublic School Enrollment 1508 B Total LEA Enrollment t11401I

C Total Enrollment (A+ B) ~2909J D Total Allocation Minus Administrative Costs ~163ol

E Per Pupil Allocation (PPA) M (Step D divided by Step C)

Nonpublic Information Page (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

Non-Public School Name Holy Family School Non-Public School Number BOSO____________________

Mailing Address 217 West Daisy Lane New Albany IN 47150

Contact Person (and Title Jerry Ernstberger Contact Phone Number 812-944-6090 _______---------------------- ----------Contact Email Address jernstbergerholyfa mi lyeaglescom

Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

~ Email communication [gt Will not participate

[gt Telephone conversation ~ Will participate in Title IV A programming activities

~ Face-to-face meeting

EE Other_~=

rJ v P2f(c lu 10417 Signature of NonpublicSchool Official Date

Gerald A Enstsberger Printed Name of Nonpublic School Official

14

Nonpublic Information Page (To be completed by the offlclal representative from each nonpublic school following timely and meaningful consultation)

Non-PubUcSchool Name CAltISf-- AuJuw _ iOt_A Non-Public School Number ThyS-

MalllnaAddress IOOo Ac~ Ju Vd-iivAllergt1 1 Z 7 fO Contact Person (and Title)JgtN Lo-(n fJGVllS V-bull c ~ Contact Phone Number 512 middot 1t~ two Contact Emall Address dlo C~c--ls11s

Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic offldals Outcome

~mail communication Wlll not participate~ middot middot Telephone conversation Will participate In Title IV A programming activitiesI ~

~ gg

Face-to-face meeting Other__

Signature of Nonpublic ScttoorOffida

~J Printed Name of Nonpublic School Offlclal

Non-Public Information Page continued) (To be completed by the official representative from each nonpubnc school followlnamp tlmely and meaningful consultation)

Focus Area A

Clielt lla~a ~rmiddot--micro M- bull s is amp JC-1

Focus~a-~Desaibe proposed activities

~tvU~il1

- Iii$NCf F9sArealt ~a~ ll-111 _ Add additional activities os needed

Focus Area A

$ z12s-Focus Are B

$Joogt

Focus Area C s7-u

Desulbe the Title IV A-funded activities ind programming used to s~port well-rounded education for all students social and emotlonal supports and or technology Integration [sec 4106 ~$lt 711Ef Yr~~ cJ So t eJolc -rP I e)-rht 3-e)~ egt CIJ1~ lSbull-cent$ (r s~ lltJ Mtiraquo Qc-J kegto cr--s DesaibetheratlonaletledtotheNeedsAsse$$mentStakeholderlnputandor Jlltta A 1 _ bullbull u 517-a jampn-- I-lJE H-ae l)as~J 1fe NII-U 17gt rU-~ -nl 5C11$ gttNn ct- f_-r 0 ~ tvrreA_ -141 ~ tgt-4~ls Altgt I tAP-0 J-l11_ e-J__r tr1f~v 1-P~ bull -egt 5

_ I Tb - P17r _ I~ ~ Descr~theprogramobjectlvesandlntendedoutcomes

1S bull

lt

middot-middotmiddot - -

middot~ -

middot-gtr~ middot i_middot

middot gt~tmiddot - middotJmiddot _ middot _middot_ 1 J --middot--~

f~ r-eampS -r-b~-- ~-middot bull 1 J~- ~ middotcr-c~ ~I~ J r-e middot middot middot middot

- middot middott middot middot middot -ofcbull~-1o lgtlclCut t)wrH -5rvoeJ-r s r-1o ~t_ffr_____~c) Cf-e1~ _i nUS ~ (s41 middot

~iA((f J-(5 bullIf appllcable describe any partnetshlps with an Institution of higher education business nonprofit organization community-based organization or 0

other public or private entity -

-~-

~bullbull t112s17 middot~ ate

-~_ __ middot=middot ~

bull ~

--~middotbull

middot

~

14

Nonpublic Information Page (To be completed by the official representative from each nonpublic school following tlmely and meaningful consultation)

Non-Public School Name (l~L-bto-J1jWLL~5o-fLJ-4ldc-l fWpublic School Number J3 Q bJ Q

Malling Address -=-=__-wuiu~1--JgtLamp41-LJ----------

Contact Person (and Title)__~4ltlJ-J--I-Z-ll---uopound-1=owe4-L--1-_L1a~ ct_ Contact Phone Number lttr_~ 1 7lt7p Contact Email Address tY benV1e1t 0 ( h h VJ a middot 0 rJ

I Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

riTI

nY Will not participate Will participate in Title IV A programming activities

C-J1-17Date

Email communication Telephone conversation

15

Non-Public Information Page (continued) (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

If applicable describe any partnerships with an Institution of higher education business nonprofit organization community-based organization or other public or private entity

9-2-f--1-r Date

0 ConKtEmall Address

t Cl) s s ctS ()

U)

ctStjQ15-inaJcoucsmt 05 E

Plefle Indicate howtlmely and mnnlnlful conversation occumd between the LEA and nonpublic officials

t Email communication Telephone conversation Face-to-face meeting Other__

gta c

Outcome C Cl)

~ Will not participate s21 Will participate In Title IV Aprogramming activities s

ctS ()

9 2-7 U)

oite

_~ tGmiddot0 I ~

bull

IUt4 M Ju~IAAlltl4 A-c -out Agtlt~ Pc-- Ac M ~ uJ~ 11e~tiJltI ii~ dbulllttcl _ _ ~l5P + 3~

ZXL SLA _ hfM ~

p ~ r 1Jtf FocusAreaA bullbull ~cusampeA bull ~ C)L- -151-A bull~~ ftZl(D fbulltt1_~A x1L ~ Ari + ftsii6tal ~ Focusampu1 ~ cbull~ p~ult 0bulllteu i-~i s unB

bull bull bull bull 1 bull - 778 P~dhJC ik -laquolaquo-fIC Focus Arne~==r tampbull~ J middottJGA~ ~~ $ t

Describe the Title IV Afunded acti1Wes and prmiddotomlmmlng used to supportwe~ed-u __catlonfour-a_U_stu_d_ents soda--a_nd_e_m_o_tio_na_lsu-pp_orts_~---

and orte~ologyint~ [Sec4106] cJAt ~ bull -bull eAc-c1 _ U -1-u ~ obbullbullr~~ ~

If applicable describe any partnerships with an institution of higher education business nonprofit organization community-based organization or other public or rte entity

JI Q) C C ca ()

Cl)

E ca ()

gtshy0 tJ Q) C C ca ()

en

Part 9 Title IV Part A Budget

Instructions Please be sure to complete both the Budget Overview and the Title IV Part A Budget (linked below) Both sections will be needed prior to application review

Budget Overview

Budget Request Schoo1Year2017-2018

Title IV A Activities

fa1~IArtWgtiiiitr~ 10(ije~ti~~~l112middotmiddotbull

$8500000

Nonpublic Equitable Share $9311

Administration

(Optional maximum 2 of total original allocation) $

Indirect Cost Optional)

$1630

TOTAL FUNDING REQUEST $9594100

Title IV Part A Detailed Budget

Please complete the Title IV Part A budget as an excel spreadsheet linked below and submit with your application All expenses listed in the table

above should be included in the budget and described in the narrative below the budget

Title IV Part A Budget Spreadsheet

I lt lt lt igt i l gt bull 2 gt i bullmiddotmiddot ltTitleIV Pflrt A Oiiiinal Budizet bull bullbullbullbullbullbullbullbullbullbullbullbullbullbullbull bull

bull

110 120 211-290 211-290 311-319 440 510-593 611-689 710-748 910

Expenditure Salaiv Benefits Professional Other Purchase GeneralAcrountNumber Rentals

Services Supplies Property Transfer Line Totals

Accowlt Cert Noncert Cert Non Cert Services

IIOOO Instruction $

Support 21000 Services - 5714100 $30000 $ 717000 $ 9431100

Student Improvement of

22100 lnsuuction

$(Professional Dcvclonmcnt)

22900 Otl1er Support

$Serviccs-Admin

25191 Refund of sRevenue

26000 Operationamp $Maintenance

27000 Tran~rtation $

Community 33000 Service s

Qntgtrations

60100 Transfers

$ finterfund Column

$ $ $ $ 5714100 $ $ 3000000 $ $ 717000 $ $ 9431100Totals

Subtotal $9431100 Indirect Cost Rate Subtract the amount above $25000 (per individual contracted service) from your total budget SSS000

Total after deducting Property $7170 Total Available for Indirect Costs

Amount of Indirect Cost to be used $1630 Grand Total Including lndirett Cost

Budget Narrative

DIRECTIONS Provide a narrative below on how funding is allocated Include the line number on which the funds are budgeted the itemized amountsfltems and which application category the expenditure is budgeted foe Example Other Purchase Services 22100 $1500 Guided Math Train the Trainer Conference registration and travel July 12-14 2018 Chicago IL (Focus Area A)

Supplies PropertyTechnology 2100 $2125 Math Dibel software (Focus Aera A) 2100 $3000 IXL Math resource 6-8 (Focus Area B) 2100 $720 Ready A to Z software (Focus Area C) 2100 $463 IXL EILA Leaming Progression (Focus Area A) 2100 $298 purchase of an iPad (Focus Area C)

Pronertv Eouinment Other Purchase Services (travel communication

22100 $30000 reimbursement of AP JB exams (Focus Area A) 22 IOO $55000 contracted services with Five Star Technologies (Focus Area C) 2100 $1300 Mission Control training (Focus Area A) 2100 $393 STEAM course training (Focus area A) 2100 $448 Proactive Discipline Training (Focus Area B)

Professional Services (contracted services)

Title IV Part A Staffin2

Staff Name Staff Position CertNon~ FfE Stipend YIN Split Additional Funding Source Position Description

Certified Funded YIN

Page 8: Superintendent of Public Instruction DEPARTMENT OF … · 2020. 2. 18. · Sections 4105(a)(2), 4105(a)(3), and 4106(b) indicate that a State educational agency shall not award a

4 AO BO co

4 4 4

5 AO BO co

5 5 5

6 AO BO co

6 6 6

Please note that the totals for Focus Areas A B and Cmay exceed the total allocation request as an activity may fit in multiple focus areas

Total Budgeted Amount for Focus Area A $30000

Total Budgeted Amount for Focus Area B

Total Budgeted Amount for Focus Area C $55000

Percent of Total Allocation to be spent on Technology Infrastructure (includes purchasing devices equipment and software applications in order to address readiness shortfalls) Not to exceed 25 of total alocation

Total Budgeted Amount $85000

Part 7 Title IV Part A Sustainability Plan

Describe the sustainability plan detailing how proposed Title IV Part A grant activities and programming will be sustained in the absence of Title IV Part A funds This description should include

bull efforts to increase local capacity bull specific future funding sources if applicable (ie general funds Title I community partnerships)

bull intended program objectives and outcomes in future years and

bull how these outcomes will be evaluated for effectiveness Our goal is to have the New Floyd County Education Foundation (community partnership) to provide funds to offset the lack of federal assistance for students wanting to take AP 18 exams Thee-Learning coaches will be funded by our General fund in the future The goal is to build capacity in our middle school teachers one-learning that would eventually remove the need fore-learning coaches in the future

The AP18 initiative will be evaluated based on monitoring the number of students who qualify for textbook assistance who are taking these classesexams The success of thee-Learning coaches will be evaluated by the IMPACT study conducted by Five Star Technologies in the spring of each year

Part 8 Title IV Part A Non-Public Equitable Share

Nonpublic School List and Budget

Nonpublic School

Number Nonpublic School Name

Nonpublic School

Enrollment (Use same date as LEA enrollment

to determine this count)

Participating (YesNo)

Equitable Participation Amount (Use Step Ebelow)

Boys Christian Academy 789 Yes [8] No 0 $599600

8060 Our Lady Perpetural Help 297

Yes [8] No 0 $225700

8067 St Marys of the Knobs 159 Yes~ NoO $120800

BOSO Holy Family 263 YesLJ No~ $199800

YesO NoO $

YesD NoO $

Yes LJ No LJ $

YesD NoO $

Yes LJ No 0 $

YesLJ NoO $

YesO NoO $

YesO NoO $

A Total Nonpublic School Enrollment 1508 B Total LEA Enrollment t11401I

C Total Enrollment (A+ B) ~2909J D Total Allocation Minus Administrative Costs ~163ol

E Per Pupil Allocation (PPA) M (Step D divided by Step C)

Nonpublic Information Page (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

Non-Public School Name Holy Family School Non-Public School Number BOSO____________________

Mailing Address 217 West Daisy Lane New Albany IN 47150

Contact Person (and Title Jerry Ernstberger Contact Phone Number 812-944-6090 _______---------------------- ----------Contact Email Address jernstbergerholyfa mi lyeaglescom

Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

~ Email communication [gt Will not participate

[gt Telephone conversation ~ Will participate in Title IV A programming activities

~ Face-to-face meeting

EE Other_~=

rJ v P2f(c lu 10417 Signature of NonpublicSchool Official Date

Gerald A Enstsberger Printed Name of Nonpublic School Official

14

Nonpublic Information Page (To be completed by the offlclal representative from each nonpublic school following timely and meaningful consultation)

Non-PubUcSchool Name CAltISf-- AuJuw _ iOt_A Non-Public School Number ThyS-

MalllnaAddress IOOo Ac~ Ju Vd-iivAllergt1 1 Z 7 fO Contact Person (and Title)JgtN Lo-(n fJGVllS V-bull c ~ Contact Phone Number 512 middot 1t~ two Contact Emall Address dlo C~c--ls11s

Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic offldals Outcome

~mail communication Wlll not participate~ middot middot Telephone conversation Will participate In Title IV A programming activitiesI ~

~ gg

Face-to-face meeting Other__

Signature of Nonpublic ScttoorOffida

~J Printed Name of Nonpublic School Offlclal

Non-Public Information Page continued) (To be completed by the official representative from each nonpubnc school followlnamp tlmely and meaningful consultation)

Focus Area A

Clielt lla~a ~rmiddot--micro M- bull s is amp JC-1

Focus~a-~Desaibe proposed activities

~tvU~il1

- Iii$NCf F9sArealt ~a~ ll-111 _ Add additional activities os needed

Focus Area A

$ z12s-Focus Are B

$Joogt

Focus Area C s7-u

Desulbe the Title IV A-funded activities ind programming used to s~port well-rounded education for all students social and emotlonal supports and or technology Integration [sec 4106 ~$lt 711Ef Yr~~ cJ So t eJolc -rP I e)-rht 3-e)~ egt CIJ1~ lSbull-cent$ (r s~ lltJ Mtiraquo Qc-J kegto cr--s DesaibetheratlonaletledtotheNeedsAsse$$mentStakeholderlnputandor Jlltta A 1 _ bullbull u 517-a jampn-- I-lJE H-ae l)as~J 1fe NII-U 17gt rU-~ -nl 5C11$ gttNn ct- f_-r 0 ~ tvrreA_ -141 ~ tgt-4~ls Altgt I tAP-0 J-l11_ e-J__r tr1f~v 1-P~ bull -egt 5

_ I Tb - P17r _ I~ ~ Descr~theprogramobjectlvesandlntendedoutcomes

1S bull

lt

middot-middotmiddot - -

middot~ -

middot-gtr~ middot i_middot

middot gt~tmiddot - middotJmiddot _ middot _middot_ 1 J --middot--~

f~ r-eampS -r-b~-- ~-middot bull 1 J~- ~ middotcr-c~ ~I~ J r-e middot middot middot middot

- middot middott middot middot middot -ofcbull~-1o lgtlclCut t)wrH -5rvoeJ-r s r-1o ~t_ffr_____~c) Cf-e1~ _i nUS ~ (s41 middot

~iA((f J-(5 bullIf appllcable describe any partnetshlps with an Institution of higher education business nonprofit organization community-based organization or 0

other public or private entity -

-~-

~bullbull t112s17 middot~ ate

-~_ __ middot=middot ~

bull ~

--~middotbull

middot

~

14

Nonpublic Information Page (To be completed by the official representative from each nonpublic school following tlmely and meaningful consultation)

Non-Public School Name (l~L-bto-J1jWLL~5o-fLJ-4ldc-l fWpublic School Number J3 Q bJ Q

Malling Address -=-=__-wuiu~1--JgtLamp41-LJ----------

Contact Person (and Title)__~4ltlJ-J--I-Z-ll---uopound-1=owe4-L--1-_L1a~ ct_ Contact Phone Number lttr_~ 1 7lt7p Contact Email Address tY benV1e1t 0 ( h h VJ a middot 0 rJ

I Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

riTI

nY Will not participate Will participate in Title IV A programming activities

C-J1-17Date

Email communication Telephone conversation

15

Non-Public Information Page (continued) (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

If applicable describe any partnerships with an Institution of higher education business nonprofit organization community-based organization or other public or private entity

9-2-f--1-r Date

0 ConKtEmall Address

t Cl) s s ctS ()

U)

ctStjQ15-inaJcoucsmt 05 E

Plefle Indicate howtlmely and mnnlnlful conversation occumd between the LEA and nonpublic officials

t Email communication Telephone conversation Face-to-face meeting Other__

gta c

Outcome C Cl)

~ Will not participate s21 Will participate In Title IV Aprogramming activities s

ctS ()

9 2-7 U)

oite

_~ tGmiddot0 I ~

bull

IUt4 M Ju~IAAlltl4 A-c -out Agtlt~ Pc-- Ac M ~ uJ~ 11e~tiJltI ii~ dbulllttcl _ _ ~l5P + 3~

ZXL SLA _ hfM ~

p ~ r 1Jtf FocusAreaA bullbull ~cusampeA bull ~ C)L- -151-A bull~~ ftZl(D fbulltt1_~A x1L ~ Ari + ftsii6tal ~ Focusampu1 ~ cbull~ p~ult 0bulllteu i-~i s unB

bull bull bull bull 1 bull - 778 P~dhJC ik -laquolaquo-fIC Focus Arne~==r tampbull~ J middottJGA~ ~~ $ t

Describe the Title IV Afunded acti1Wes and prmiddotomlmmlng used to supportwe~ed-u __catlonfour-a_U_stu_d_ents soda--a_nd_e_m_o_tio_na_lsu-pp_orts_~---

and orte~ologyint~ [Sec4106] cJAt ~ bull -bull eAc-c1 _ U -1-u ~ obbullbullr~~ ~

If applicable describe any partnerships with an institution of higher education business nonprofit organization community-based organization or other public or rte entity

JI Q) C C ca ()

Cl)

E ca ()

gtshy0 tJ Q) C C ca ()

en

Part 9 Title IV Part A Budget

Instructions Please be sure to complete both the Budget Overview and the Title IV Part A Budget (linked below) Both sections will be needed prior to application review

Budget Overview

Budget Request Schoo1Year2017-2018

Title IV A Activities

fa1~IArtWgtiiiitr~ 10(ije~ti~~~l112middotmiddotbull

$8500000

Nonpublic Equitable Share $9311

Administration

(Optional maximum 2 of total original allocation) $

Indirect Cost Optional)

$1630

TOTAL FUNDING REQUEST $9594100

Title IV Part A Detailed Budget

Please complete the Title IV Part A budget as an excel spreadsheet linked below and submit with your application All expenses listed in the table

above should be included in the budget and described in the narrative below the budget

Title IV Part A Budget Spreadsheet

I lt lt lt igt i l gt bull 2 gt i bullmiddotmiddot ltTitleIV Pflrt A Oiiiinal Budizet bull bullbullbullbullbullbullbullbullbullbullbullbullbullbullbull bull

bull

110 120 211-290 211-290 311-319 440 510-593 611-689 710-748 910

Expenditure Salaiv Benefits Professional Other Purchase GeneralAcrountNumber Rentals

Services Supplies Property Transfer Line Totals

Accowlt Cert Noncert Cert Non Cert Services

IIOOO Instruction $

Support 21000 Services - 5714100 $30000 $ 717000 $ 9431100

Student Improvement of

22100 lnsuuction

$(Professional Dcvclonmcnt)

22900 Otl1er Support

$Serviccs-Admin

25191 Refund of sRevenue

26000 Operationamp $Maintenance

27000 Tran~rtation $

Community 33000 Service s

Qntgtrations

60100 Transfers

$ finterfund Column

$ $ $ $ 5714100 $ $ 3000000 $ $ 717000 $ $ 9431100Totals

Subtotal $9431100 Indirect Cost Rate Subtract the amount above $25000 (per individual contracted service) from your total budget SSS000

Total after deducting Property $7170 Total Available for Indirect Costs

Amount of Indirect Cost to be used $1630 Grand Total Including lndirett Cost

Budget Narrative

DIRECTIONS Provide a narrative below on how funding is allocated Include the line number on which the funds are budgeted the itemized amountsfltems and which application category the expenditure is budgeted foe Example Other Purchase Services 22100 $1500 Guided Math Train the Trainer Conference registration and travel July 12-14 2018 Chicago IL (Focus Area A)

Supplies PropertyTechnology 2100 $2125 Math Dibel software (Focus Aera A) 2100 $3000 IXL Math resource 6-8 (Focus Area B) 2100 $720 Ready A to Z software (Focus Area C) 2100 $463 IXL EILA Leaming Progression (Focus Area A) 2100 $298 purchase of an iPad (Focus Area C)

Pronertv Eouinment Other Purchase Services (travel communication

22100 $30000 reimbursement of AP JB exams (Focus Area A) 22 IOO $55000 contracted services with Five Star Technologies (Focus Area C) 2100 $1300 Mission Control training (Focus Area A) 2100 $393 STEAM course training (Focus area A) 2100 $448 Proactive Discipline Training (Focus Area B)

Professional Services (contracted services)

Title IV Part A Staffin2

Staff Name Staff Position CertNon~ FfE Stipend YIN Split Additional Funding Source Position Description

Certified Funded YIN

Page 9: Superintendent of Public Instruction DEPARTMENT OF … · 2020. 2. 18. · Sections 4105(a)(2), 4105(a)(3), and 4106(b) indicate that a State educational agency shall not award a

Describe the sustainability plan detailing how proposed Title IV Part A grant activities and programming will be sustained in the absence of Title IV Part A funds This description should include

bull efforts to increase local capacity bull specific future funding sources if applicable (ie general funds Title I community partnerships)

bull intended program objectives and outcomes in future years and

bull how these outcomes will be evaluated for effectiveness Our goal is to have the New Floyd County Education Foundation (community partnership) to provide funds to offset the lack of federal assistance for students wanting to take AP 18 exams Thee-Learning coaches will be funded by our General fund in the future The goal is to build capacity in our middle school teachers one-learning that would eventually remove the need fore-learning coaches in the future

The AP18 initiative will be evaluated based on monitoring the number of students who qualify for textbook assistance who are taking these classesexams The success of thee-Learning coaches will be evaluated by the IMPACT study conducted by Five Star Technologies in the spring of each year

Part 8 Title IV Part A Non-Public Equitable Share

Nonpublic School List and Budget

Nonpublic School

Number Nonpublic School Name

Nonpublic School

Enrollment (Use same date as LEA enrollment

to determine this count)

Participating (YesNo)

Equitable Participation Amount (Use Step Ebelow)

Boys Christian Academy 789 Yes [8] No 0 $599600

8060 Our Lady Perpetural Help 297

Yes [8] No 0 $225700

8067 St Marys of the Knobs 159 Yes~ NoO $120800

BOSO Holy Family 263 YesLJ No~ $199800

YesO NoO $

YesD NoO $

Yes LJ No LJ $

YesD NoO $

Yes LJ No 0 $

YesLJ NoO $

YesO NoO $

YesO NoO $

A Total Nonpublic School Enrollment 1508 B Total LEA Enrollment t11401I

C Total Enrollment (A+ B) ~2909J D Total Allocation Minus Administrative Costs ~163ol

E Per Pupil Allocation (PPA) M (Step D divided by Step C)

Nonpublic Information Page (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

Non-Public School Name Holy Family School Non-Public School Number BOSO____________________

Mailing Address 217 West Daisy Lane New Albany IN 47150

Contact Person (and Title Jerry Ernstberger Contact Phone Number 812-944-6090 _______---------------------- ----------Contact Email Address jernstbergerholyfa mi lyeaglescom

Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

~ Email communication [gt Will not participate

[gt Telephone conversation ~ Will participate in Title IV A programming activities

~ Face-to-face meeting

EE Other_~=

rJ v P2f(c lu 10417 Signature of NonpublicSchool Official Date

Gerald A Enstsberger Printed Name of Nonpublic School Official

14

Nonpublic Information Page (To be completed by the offlclal representative from each nonpublic school following timely and meaningful consultation)

Non-PubUcSchool Name CAltISf-- AuJuw _ iOt_A Non-Public School Number ThyS-

MalllnaAddress IOOo Ac~ Ju Vd-iivAllergt1 1 Z 7 fO Contact Person (and Title)JgtN Lo-(n fJGVllS V-bull c ~ Contact Phone Number 512 middot 1t~ two Contact Emall Address dlo C~c--ls11s

Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic offldals Outcome

~mail communication Wlll not participate~ middot middot Telephone conversation Will participate In Title IV A programming activitiesI ~

~ gg

Face-to-face meeting Other__

Signature of Nonpublic ScttoorOffida

~J Printed Name of Nonpublic School Offlclal

Non-Public Information Page continued) (To be completed by the official representative from each nonpubnc school followlnamp tlmely and meaningful consultation)

Focus Area A

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Focus~a-~Desaibe proposed activities

~tvU~il1

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Focus Area A

$ z12s-Focus Are B

$Joogt

Focus Area C s7-u

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_ I Tb - P17r _ I~ ~ Descr~theprogramobjectlvesandlntendedoutcomes

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- middot middott middot middot middot -ofcbull~-1o lgtlclCut t)wrH -5rvoeJ-r s r-1o ~t_ffr_____~c) Cf-e1~ _i nUS ~ (s41 middot

~iA((f J-(5 bullIf appllcable describe any partnetshlps with an Institution of higher education business nonprofit organization community-based organization or 0

other public or private entity -

-~-

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Nonpublic Information Page (To be completed by the official representative from each nonpublic school following tlmely and meaningful consultation)

Non-Public School Name (l~L-bto-J1jWLL~5o-fLJ-4ldc-l fWpublic School Number J3 Q bJ Q

Malling Address -=-=__-wuiu~1--JgtLamp41-LJ----------

Contact Person (and Title)__~4ltlJ-J--I-Z-ll---uopound-1=owe4-L--1-_L1a~ ct_ Contact Phone Number lttr_~ 1 7lt7p Contact Email Address tY benV1e1t 0 ( h h VJ a middot 0 rJ

I Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

riTI

nY Will not participate Will participate in Title IV A programming activities

C-J1-17Date

Email communication Telephone conversation

15

Non-Public Information Page (continued) (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

If applicable describe any partnerships with an Institution of higher education business nonprofit organization community-based organization or other public or private entity

9-2-f--1-r Date

0 ConKtEmall Address

t Cl) s s ctS ()

U)

ctStjQ15-inaJcoucsmt 05 E

Plefle Indicate howtlmely and mnnlnlful conversation occumd between the LEA and nonpublic officials

t Email communication Telephone conversation Face-to-face meeting Other__

gta c

Outcome C Cl)

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ctS ()

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bull bull bull bull 1 bull - 778 P~dhJC ik -laquolaquo-fIC Focus Arne~==r tampbull~ J middottJGA~ ~~ $ t

Describe the Title IV Afunded acti1Wes and prmiddotomlmmlng used to supportwe~ed-u __catlonfour-a_U_stu_d_ents soda--a_nd_e_m_o_tio_na_lsu-pp_orts_~---

and orte~ologyint~ [Sec4106] cJAt ~ bull -bull eAc-c1 _ U -1-u ~ obbullbullr~~ ~

If applicable describe any partnerships with an institution of higher education business nonprofit organization community-based organization or other public or rte entity

JI Q) C C ca ()

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gtshy0 tJ Q) C C ca ()

en

Part 9 Title IV Part A Budget

Instructions Please be sure to complete both the Budget Overview and the Title IV Part A Budget (linked below) Both sections will be needed prior to application review

Budget Overview

Budget Request Schoo1Year2017-2018

Title IV A Activities

fa1~IArtWgtiiiitr~ 10(ije~ti~~~l112middotmiddotbull

$8500000

Nonpublic Equitable Share $9311

Administration

(Optional maximum 2 of total original allocation) $

Indirect Cost Optional)

$1630

TOTAL FUNDING REQUEST $9594100

Title IV Part A Detailed Budget

Please complete the Title IV Part A budget as an excel spreadsheet linked below and submit with your application All expenses listed in the table

above should be included in the budget and described in the narrative below the budget

Title IV Part A Budget Spreadsheet

I lt lt lt igt i l gt bull 2 gt i bullmiddotmiddot ltTitleIV Pflrt A Oiiiinal Budizet bull bullbullbullbullbullbullbullbullbullbullbullbullbullbullbull bull

bull

110 120 211-290 211-290 311-319 440 510-593 611-689 710-748 910

Expenditure Salaiv Benefits Professional Other Purchase GeneralAcrountNumber Rentals

Services Supplies Property Transfer Line Totals

Accowlt Cert Noncert Cert Non Cert Services

IIOOO Instruction $

Support 21000 Services - 5714100 $30000 $ 717000 $ 9431100

Student Improvement of

22100 lnsuuction

$(Professional Dcvclonmcnt)

22900 Otl1er Support

$Serviccs-Admin

25191 Refund of sRevenue

26000 Operationamp $Maintenance

27000 Tran~rtation $

Community 33000 Service s

Qntgtrations

60100 Transfers

$ finterfund Column

$ $ $ $ 5714100 $ $ 3000000 $ $ 717000 $ $ 9431100Totals

Subtotal $9431100 Indirect Cost Rate Subtract the amount above $25000 (per individual contracted service) from your total budget SSS000

Total after deducting Property $7170 Total Available for Indirect Costs

Amount of Indirect Cost to be used $1630 Grand Total Including lndirett Cost

Budget Narrative

DIRECTIONS Provide a narrative below on how funding is allocated Include the line number on which the funds are budgeted the itemized amountsfltems and which application category the expenditure is budgeted foe Example Other Purchase Services 22100 $1500 Guided Math Train the Trainer Conference registration and travel July 12-14 2018 Chicago IL (Focus Area A)

Supplies PropertyTechnology 2100 $2125 Math Dibel software (Focus Aera A) 2100 $3000 IXL Math resource 6-8 (Focus Area B) 2100 $720 Ready A to Z software (Focus Area C) 2100 $463 IXL EILA Leaming Progression (Focus Area A) 2100 $298 purchase of an iPad (Focus Area C)

Pronertv Eouinment Other Purchase Services (travel communication

22100 $30000 reimbursement of AP JB exams (Focus Area A) 22 IOO $55000 contracted services with Five Star Technologies (Focus Area C) 2100 $1300 Mission Control training (Focus Area A) 2100 $393 STEAM course training (Focus area A) 2100 $448 Proactive Discipline Training (Focus Area B)

Professional Services (contracted services)

Title IV Part A Staffin2

Staff Name Staff Position CertNon~ FfE Stipend YIN Split Additional Funding Source Position Description

Certified Funded YIN

Page 10: Superintendent of Public Instruction DEPARTMENT OF … · 2020. 2. 18. · Sections 4105(a)(2), 4105(a)(3), and 4106(b) indicate that a State educational agency shall not award a

Nonpublic School List and Budget

Nonpublic School

Number Nonpublic School Name

Nonpublic School

Enrollment (Use same date as LEA enrollment

to determine this count)

Participating (YesNo)

Equitable Participation Amount (Use Step Ebelow)

Boys Christian Academy 789 Yes [8] No 0 $599600

8060 Our Lady Perpetural Help 297

Yes [8] No 0 $225700

8067 St Marys of the Knobs 159 Yes~ NoO $120800

BOSO Holy Family 263 YesLJ No~ $199800

YesO NoO $

YesD NoO $

Yes LJ No LJ $

YesD NoO $

Yes LJ No 0 $

YesLJ NoO $

YesO NoO $

YesO NoO $

A Total Nonpublic School Enrollment 1508 B Total LEA Enrollment t11401I

C Total Enrollment (A+ B) ~2909J D Total Allocation Minus Administrative Costs ~163ol

E Per Pupil Allocation (PPA) M (Step D divided by Step C)

Nonpublic Information Page (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

Non-Public School Name Holy Family School Non-Public School Number BOSO____________________

Mailing Address 217 West Daisy Lane New Albany IN 47150

Contact Person (and Title Jerry Ernstberger Contact Phone Number 812-944-6090 _______---------------------- ----------Contact Email Address jernstbergerholyfa mi lyeaglescom

Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

~ Email communication [gt Will not participate

[gt Telephone conversation ~ Will participate in Title IV A programming activities

~ Face-to-face meeting

EE Other_~=

rJ v P2f(c lu 10417 Signature of NonpublicSchool Official Date

Gerald A Enstsberger Printed Name of Nonpublic School Official

14

Nonpublic Information Page (To be completed by the offlclal representative from each nonpublic school following timely and meaningful consultation)

Non-PubUcSchool Name CAltISf-- AuJuw _ iOt_A Non-Public School Number ThyS-

MalllnaAddress IOOo Ac~ Ju Vd-iivAllergt1 1 Z 7 fO Contact Person (and Title)JgtN Lo-(n fJGVllS V-bull c ~ Contact Phone Number 512 middot 1t~ two Contact Emall Address dlo C~c--ls11s

Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic offldals Outcome

~mail communication Wlll not participate~ middot middot Telephone conversation Will participate In Title IV A programming activitiesI ~

~ gg

Face-to-face meeting Other__

Signature of Nonpublic ScttoorOffida

~J Printed Name of Nonpublic School Offlclal

Non-Public Information Page continued) (To be completed by the official representative from each nonpubnc school followlnamp tlmely and meaningful consultation)

Focus Area A

Clielt lla~a ~rmiddot--micro M- bull s is amp JC-1

Focus~a-~Desaibe proposed activities

~tvU~il1

- Iii$NCf F9sArealt ~a~ ll-111 _ Add additional activities os needed

Focus Area A

$ z12s-Focus Are B

$Joogt

Focus Area C s7-u

Desulbe the Title IV A-funded activities ind programming used to s~port well-rounded education for all students social and emotlonal supports and or technology Integration [sec 4106 ~$lt 711Ef Yr~~ cJ So t eJolc -rP I e)-rht 3-e)~ egt CIJ1~ lSbull-cent$ (r s~ lltJ Mtiraquo Qc-J kegto cr--s DesaibetheratlonaletledtotheNeedsAsse$$mentStakeholderlnputandor Jlltta A 1 _ bullbull u 517-a jampn-- I-lJE H-ae l)as~J 1fe NII-U 17gt rU-~ -nl 5C11$ gttNn ct- f_-r 0 ~ tvrreA_ -141 ~ tgt-4~ls Altgt I tAP-0 J-l11_ e-J__r tr1f~v 1-P~ bull -egt 5

_ I Tb - P17r _ I~ ~ Descr~theprogramobjectlvesandlntendedoutcomes

1S bull

lt

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middot~ -

middot-gtr~ middot i_middot

middot gt~tmiddot - middotJmiddot _ middot _middot_ 1 J --middot--~

f~ r-eampS -r-b~-- ~-middot bull 1 J~- ~ middotcr-c~ ~I~ J r-e middot middot middot middot

- middot middott middot middot middot -ofcbull~-1o lgtlclCut t)wrH -5rvoeJ-r s r-1o ~t_ffr_____~c) Cf-e1~ _i nUS ~ (s41 middot

~iA((f J-(5 bullIf appllcable describe any partnetshlps with an Institution of higher education business nonprofit organization community-based organization or 0

other public or private entity -

-~-

~bullbull t112s17 middot~ ate

-~_ __ middot=middot ~

bull ~

--~middotbull

middot

~

14

Nonpublic Information Page (To be completed by the official representative from each nonpublic school following tlmely and meaningful consultation)

Non-Public School Name (l~L-bto-J1jWLL~5o-fLJ-4ldc-l fWpublic School Number J3 Q bJ Q

Malling Address -=-=__-wuiu~1--JgtLamp41-LJ----------

Contact Person (and Title)__~4ltlJ-J--I-Z-ll---uopound-1=owe4-L--1-_L1a~ ct_ Contact Phone Number lttr_~ 1 7lt7p Contact Email Address tY benV1e1t 0 ( h h VJ a middot 0 rJ

I Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

riTI

nY Will not participate Will participate in Title IV A programming activities

C-J1-17Date

Email communication Telephone conversation

15

Non-Public Information Page (continued) (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

If applicable describe any partnerships with an Institution of higher education business nonprofit organization community-based organization or other public or private entity

9-2-f--1-r Date

0 ConKtEmall Address

t Cl) s s ctS ()

U)

ctStjQ15-inaJcoucsmt 05 E

Plefle Indicate howtlmely and mnnlnlful conversation occumd between the LEA and nonpublic officials

t Email communication Telephone conversation Face-to-face meeting Other__

gta c

Outcome C Cl)

~ Will not participate s21 Will participate In Title IV Aprogramming activities s

ctS ()

9 2-7 U)

oite

_~ tGmiddot0 I ~

bull

IUt4 M Ju~IAAlltl4 A-c -out Agtlt~ Pc-- Ac M ~ uJ~ 11e~tiJltI ii~ dbulllttcl _ _ ~l5P + 3~

ZXL SLA _ hfM ~

p ~ r 1Jtf FocusAreaA bullbull ~cusampeA bull ~ C)L- -151-A bull~~ ftZl(D fbulltt1_~A x1L ~ Ari + ftsii6tal ~ Focusampu1 ~ cbull~ p~ult 0bulllteu i-~i s unB

bull bull bull bull 1 bull - 778 P~dhJC ik -laquolaquo-fIC Focus Arne~==r tampbull~ J middottJGA~ ~~ $ t

Describe the Title IV Afunded acti1Wes and prmiddotomlmmlng used to supportwe~ed-u __catlonfour-a_U_stu_d_ents soda--a_nd_e_m_o_tio_na_lsu-pp_orts_~---

and orte~ologyint~ [Sec4106] cJAt ~ bull -bull eAc-c1 _ U -1-u ~ obbullbullr~~ ~

If applicable describe any partnerships with an institution of higher education business nonprofit organization community-based organization or other public or rte entity

JI Q) C C ca ()

Cl)

E ca ()

gtshy0 tJ Q) C C ca ()

en

Part 9 Title IV Part A Budget

Instructions Please be sure to complete both the Budget Overview and the Title IV Part A Budget (linked below) Both sections will be needed prior to application review

Budget Overview

Budget Request Schoo1Year2017-2018

Title IV A Activities

fa1~IArtWgtiiiitr~ 10(ije~ti~~~l112middotmiddotbull

$8500000

Nonpublic Equitable Share $9311

Administration

(Optional maximum 2 of total original allocation) $

Indirect Cost Optional)

$1630

TOTAL FUNDING REQUEST $9594100

Title IV Part A Detailed Budget

Please complete the Title IV Part A budget as an excel spreadsheet linked below and submit with your application All expenses listed in the table

above should be included in the budget and described in the narrative below the budget

Title IV Part A Budget Spreadsheet

I lt lt lt igt i l gt bull 2 gt i bullmiddotmiddot ltTitleIV Pflrt A Oiiiinal Budizet bull bullbullbullbullbullbullbullbullbullbullbullbullbullbullbull bull

bull

110 120 211-290 211-290 311-319 440 510-593 611-689 710-748 910

Expenditure Salaiv Benefits Professional Other Purchase GeneralAcrountNumber Rentals

Services Supplies Property Transfer Line Totals

Accowlt Cert Noncert Cert Non Cert Services

IIOOO Instruction $

Support 21000 Services - 5714100 $30000 $ 717000 $ 9431100

Student Improvement of

22100 lnsuuction

$(Professional Dcvclonmcnt)

22900 Otl1er Support

$Serviccs-Admin

25191 Refund of sRevenue

26000 Operationamp $Maintenance

27000 Tran~rtation $

Community 33000 Service s

Qntgtrations

60100 Transfers

$ finterfund Column

$ $ $ $ 5714100 $ $ 3000000 $ $ 717000 $ $ 9431100Totals

Subtotal $9431100 Indirect Cost Rate Subtract the amount above $25000 (per individual contracted service) from your total budget SSS000

Total after deducting Property $7170 Total Available for Indirect Costs

Amount of Indirect Cost to be used $1630 Grand Total Including lndirett Cost

Budget Narrative

DIRECTIONS Provide a narrative below on how funding is allocated Include the line number on which the funds are budgeted the itemized amountsfltems and which application category the expenditure is budgeted foe Example Other Purchase Services 22100 $1500 Guided Math Train the Trainer Conference registration and travel July 12-14 2018 Chicago IL (Focus Area A)

Supplies PropertyTechnology 2100 $2125 Math Dibel software (Focus Aera A) 2100 $3000 IXL Math resource 6-8 (Focus Area B) 2100 $720 Ready A to Z software (Focus Area C) 2100 $463 IXL EILA Leaming Progression (Focus Area A) 2100 $298 purchase of an iPad (Focus Area C)

Pronertv Eouinment Other Purchase Services (travel communication

22100 $30000 reimbursement of AP JB exams (Focus Area A) 22 IOO $55000 contracted services with Five Star Technologies (Focus Area C) 2100 $1300 Mission Control training (Focus Area A) 2100 $393 STEAM course training (Focus area A) 2100 $448 Proactive Discipline Training (Focus Area B)

Professional Services (contracted services)

Title IV Part A Staffin2

Staff Name Staff Position CertNon~ FfE Stipend YIN Split Additional Funding Source Position Description

Certified Funded YIN

Page 11: Superintendent of Public Instruction DEPARTMENT OF … · 2020. 2. 18. · Sections 4105(a)(2), 4105(a)(3), and 4106(b) indicate that a State educational agency shall not award a

Nonpublic Information Page (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

Non-Public School Name Holy Family School Non-Public School Number BOSO____________________

Mailing Address 217 West Daisy Lane New Albany IN 47150

Contact Person (and Title Jerry Ernstberger Contact Phone Number 812-944-6090 _______---------------------- ----------Contact Email Address jernstbergerholyfa mi lyeaglescom

Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

~ Email communication [gt Will not participate

[gt Telephone conversation ~ Will participate in Title IV A programming activities

~ Face-to-face meeting

EE Other_~=

rJ v P2f(c lu 10417 Signature of NonpublicSchool Official Date

Gerald A Enstsberger Printed Name of Nonpublic School Official

14

Nonpublic Information Page (To be completed by the offlclal representative from each nonpublic school following timely and meaningful consultation)

Non-PubUcSchool Name CAltISf-- AuJuw _ iOt_A Non-Public School Number ThyS-

MalllnaAddress IOOo Ac~ Ju Vd-iivAllergt1 1 Z 7 fO Contact Person (and Title)JgtN Lo-(n fJGVllS V-bull c ~ Contact Phone Number 512 middot 1t~ two Contact Emall Address dlo C~c--ls11s

Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic offldals Outcome

~mail communication Wlll not participate~ middot middot Telephone conversation Will participate In Title IV A programming activitiesI ~

~ gg

Face-to-face meeting Other__

Signature of Nonpublic ScttoorOffida

~J Printed Name of Nonpublic School Offlclal

Non-Public Information Page continued) (To be completed by the official representative from each nonpubnc school followlnamp tlmely and meaningful consultation)

Focus Area A

Clielt lla~a ~rmiddot--micro M- bull s is amp JC-1

Focus~a-~Desaibe proposed activities

~tvU~il1

- Iii$NCf F9sArealt ~a~ ll-111 _ Add additional activities os needed

Focus Area A

$ z12s-Focus Are B

$Joogt

Focus Area C s7-u

Desulbe the Title IV A-funded activities ind programming used to s~port well-rounded education for all students social and emotlonal supports and or technology Integration [sec 4106 ~$lt 711Ef Yr~~ cJ So t eJolc -rP I e)-rht 3-e)~ egt CIJ1~ lSbull-cent$ (r s~ lltJ Mtiraquo Qc-J kegto cr--s DesaibetheratlonaletledtotheNeedsAsse$$mentStakeholderlnputandor Jlltta A 1 _ bullbull u 517-a jampn-- I-lJE H-ae l)as~J 1fe NII-U 17gt rU-~ -nl 5C11$ gttNn ct- f_-r 0 ~ tvrreA_ -141 ~ tgt-4~ls Altgt I tAP-0 J-l11_ e-J__r tr1f~v 1-P~ bull -egt 5

_ I Tb - P17r _ I~ ~ Descr~theprogramobjectlvesandlntendedoutcomes

1S bull

lt

middot-middotmiddot - -

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middot-gtr~ middot i_middot

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f~ r-eampS -r-b~-- ~-middot bull 1 J~- ~ middotcr-c~ ~I~ J r-e middot middot middot middot

- middot middott middot middot middot -ofcbull~-1o lgtlclCut t)wrH -5rvoeJ-r s r-1o ~t_ffr_____~c) Cf-e1~ _i nUS ~ (s41 middot

~iA((f J-(5 bullIf appllcable describe any partnetshlps with an Institution of higher education business nonprofit organization community-based organization or 0

other public or private entity -

-~-

~bullbull t112s17 middot~ ate

-~_ __ middot=middot ~

bull ~

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14

Nonpublic Information Page (To be completed by the official representative from each nonpublic school following tlmely and meaningful consultation)

Non-Public School Name (l~L-bto-J1jWLL~5o-fLJ-4ldc-l fWpublic School Number J3 Q bJ Q

Malling Address -=-=__-wuiu~1--JgtLamp41-LJ----------

Contact Person (and Title)__~4ltlJ-J--I-Z-ll---uopound-1=owe4-L--1-_L1a~ ct_ Contact Phone Number lttr_~ 1 7lt7p Contact Email Address tY benV1e1t 0 ( h h VJ a middot 0 rJ

I Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

riTI

nY Will not participate Will participate in Title IV A programming activities

C-J1-17Date

Email communication Telephone conversation

15

Non-Public Information Page (continued) (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

If applicable describe any partnerships with an Institution of higher education business nonprofit organization community-based organization or other public or private entity

9-2-f--1-r Date

0 ConKtEmall Address

t Cl) s s ctS ()

U)

ctStjQ15-inaJcoucsmt 05 E

Plefle Indicate howtlmely and mnnlnlful conversation occumd between the LEA and nonpublic officials

t Email communication Telephone conversation Face-to-face meeting Other__

gta c

Outcome C Cl)

~ Will not participate s21 Will participate In Title IV Aprogramming activities s

ctS ()

9 2-7 U)

oite

_~ tGmiddot0 I ~

bull

IUt4 M Ju~IAAlltl4 A-c -out Agtlt~ Pc-- Ac M ~ uJ~ 11e~tiJltI ii~ dbulllttcl _ _ ~l5P + 3~

ZXL SLA _ hfM ~

p ~ r 1Jtf FocusAreaA bullbull ~cusampeA bull ~ C)L- -151-A bull~~ ftZl(D fbulltt1_~A x1L ~ Ari + ftsii6tal ~ Focusampu1 ~ cbull~ p~ult 0bulllteu i-~i s unB

bull bull bull bull 1 bull - 778 P~dhJC ik -laquolaquo-fIC Focus Arne~==r tampbull~ J middottJGA~ ~~ $ t

Describe the Title IV Afunded acti1Wes and prmiddotomlmmlng used to supportwe~ed-u __catlonfour-a_U_stu_d_ents soda--a_nd_e_m_o_tio_na_lsu-pp_orts_~---

and orte~ologyint~ [Sec4106] cJAt ~ bull -bull eAc-c1 _ U -1-u ~ obbullbullr~~ ~

If applicable describe any partnerships with an institution of higher education business nonprofit organization community-based organization or other public or rte entity

JI Q) C C ca ()

Cl)

E ca ()

gtshy0 tJ Q) C C ca ()

en

Part 9 Title IV Part A Budget

Instructions Please be sure to complete both the Budget Overview and the Title IV Part A Budget (linked below) Both sections will be needed prior to application review

Budget Overview

Budget Request Schoo1Year2017-2018

Title IV A Activities

fa1~IArtWgtiiiitr~ 10(ije~ti~~~l112middotmiddotbull

$8500000

Nonpublic Equitable Share $9311

Administration

(Optional maximum 2 of total original allocation) $

Indirect Cost Optional)

$1630

TOTAL FUNDING REQUEST $9594100

Title IV Part A Detailed Budget

Please complete the Title IV Part A budget as an excel spreadsheet linked below and submit with your application All expenses listed in the table

above should be included in the budget and described in the narrative below the budget

Title IV Part A Budget Spreadsheet

I lt lt lt igt i l gt bull 2 gt i bullmiddotmiddot ltTitleIV Pflrt A Oiiiinal Budizet bull bullbullbullbullbullbullbullbullbullbullbullbullbullbullbull bull

bull

110 120 211-290 211-290 311-319 440 510-593 611-689 710-748 910

Expenditure Salaiv Benefits Professional Other Purchase GeneralAcrountNumber Rentals

Services Supplies Property Transfer Line Totals

Accowlt Cert Noncert Cert Non Cert Services

IIOOO Instruction $

Support 21000 Services - 5714100 $30000 $ 717000 $ 9431100

Student Improvement of

22100 lnsuuction

$(Professional Dcvclonmcnt)

22900 Otl1er Support

$Serviccs-Admin

25191 Refund of sRevenue

26000 Operationamp $Maintenance

27000 Tran~rtation $

Community 33000 Service s

Qntgtrations

60100 Transfers

$ finterfund Column

$ $ $ $ 5714100 $ $ 3000000 $ $ 717000 $ $ 9431100Totals

Subtotal $9431100 Indirect Cost Rate Subtract the amount above $25000 (per individual contracted service) from your total budget SSS000

Total after deducting Property $7170 Total Available for Indirect Costs

Amount of Indirect Cost to be used $1630 Grand Total Including lndirett Cost

Budget Narrative

DIRECTIONS Provide a narrative below on how funding is allocated Include the line number on which the funds are budgeted the itemized amountsfltems and which application category the expenditure is budgeted foe Example Other Purchase Services 22100 $1500 Guided Math Train the Trainer Conference registration and travel July 12-14 2018 Chicago IL (Focus Area A)

Supplies PropertyTechnology 2100 $2125 Math Dibel software (Focus Aera A) 2100 $3000 IXL Math resource 6-8 (Focus Area B) 2100 $720 Ready A to Z software (Focus Area C) 2100 $463 IXL EILA Leaming Progression (Focus Area A) 2100 $298 purchase of an iPad (Focus Area C)

Pronertv Eouinment Other Purchase Services (travel communication

22100 $30000 reimbursement of AP JB exams (Focus Area A) 22 IOO $55000 contracted services with Five Star Technologies (Focus Area C) 2100 $1300 Mission Control training (Focus Area A) 2100 $393 STEAM course training (Focus area A) 2100 $448 Proactive Discipline Training (Focus Area B)

Professional Services (contracted services)

Title IV Part A Staffin2

Staff Name Staff Position CertNon~ FfE Stipend YIN Split Additional Funding Source Position Description

Certified Funded YIN

Page 12: Superintendent of Public Instruction DEPARTMENT OF … · 2020. 2. 18. · Sections 4105(a)(2), 4105(a)(3), and 4106(b) indicate that a State educational agency shall not award a

14

Nonpublic Information Page (To be completed by the offlclal representative from each nonpublic school following timely and meaningful consultation)

Non-PubUcSchool Name CAltISf-- AuJuw _ iOt_A Non-Public School Number ThyS-

MalllnaAddress IOOo Ac~ Ju Vd-iivAllergt1 1 Z 7 fO Contact Person (and Title)JgtN Lo-(n fJGVllS V-bull c ~ Contact Phone Number 512 middot 1t~ two Contact Emall Address dlo C~c--ls11s

Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic offldals Outcome

~mail communication Wlll not participate~ middot middot Telephone conversation Will participate In Title IV A programming activitiesI ~

~ gg

Face-to-face meeting Other__

Signature of Nonpublic ScttoorOffida

~J Printed Name of Nonpublic School Offlclal

Non-Public Information Page continued) (To be completed by the official representative from each nonpubnc school followlnamp tlmely and meaningful consultation)

Focus Area A

Clielt lla~a ~rmiddot--micro M- bull s is amp JC-1

Focus~a-~Desaibe proposed activities

~tvU~il1

- Iii$NCf F9sArealt ~a~ ll-111 _ Add additional activities os needed

Focus Area A

$ z12s-Focus Are B

$Joogt

Focus Area C s7-u

Desulbe the Title IV A-funded activities ind programming used to s~port well-rounded education for all students social and emotlonal supports and or technology Integration [sec 4106 ~$lt 711Ef Yr~~ cJ So t eJolc -rP I e)-rht 3-e)~ egt CIJ1~ lSbull-cent$ (r s~ lltJ Mtiraquo Qc-J kegto cr--s DesaibetheratlonaletledtotheNeedsAsse$$mentStakeholderlnputandor Jlltta A 1 _ bullbull u 517-a jampn-- I-lJE H-ae l)as~J 1fe NII-U 17gt rU-~ -nl 5C11$ gttNn ct- f_-r 0 ~ tvrreA_ -141 ~ tgt-4~ls Altgt I tAP-0 J-l11_ e-J__r tr1f~v 1-P~ bull -egt 5

_ I Tb - P17r _ I~ ~ Descr~theprogramobjectlvesandlntendedoutcomes

1S bull

lt

middot-middotmiddot - -

middot~ -

middot-gtr~ middot i_middot

middot gt~tmiddot - middotJmiddot _ middot _middot_ 1 J --middot--~

f~ r-eampS -r-b~-- ~-middot bull 1 J~- ~ middotcr-c~ ~I~ J r-e middot middot middot middot

- middot middott middot middot middot -ofcbull~-1o lgtlclCut t)wrH -5rvoeJ-r s r-1o ~t_ffr_____~c) Cf-e1~ _i nUS ~ (s41 middot

~iA((f J-(5 bullIf appllcable describe any partnetshlps with an Institution of higher education business nonprofit organization community-based organization or 0

other public or private entity -

-~-

~bullbull t112s17 middot~ ate

-~_ __ middot=middot ~

bull ~

--~middotbull

middot

~

14

Nonpublic Information Page (To be completed by the official representative from each nonpublic school following tlmely and meaningful consultation)

Non-Public School Name (l~L-bto-J1jWLL~5o-fLJ-4ldc-l fWpublic School Number J3 Q bJ Q

Malling Address -=-=__-wuiu~1--JgtLamp41-LJ----------

Contact Person (and Title)__~4ltlJ-J--I-Z-ll---uopound-1=owe4-L--1-_L1a~ ct_ Contact Phone Number lttr_~ 1 7lt7p Contact Email Address tY benV1e1t 0 ( h h VJ a middot 0 rJ

I Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

riTI

nY Will not participate Will participate in Title IV A programming activities

C-J1-17Date

Email communication Telephone conversation

15

Non-Public Information Page (continued) (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

If applicable describe any partnerships with an Institution of higher education business nonprofit organization community-based organization or other public or private entity

9-2-f--1-r Date

0 ConKtEmall Address

t Cl) s s ctS ()

U)

ctStjQ15-inaJcoucsmt 05 E

Plefle Indicate howtlmely and mnnlnlful conversation occumd between the LEA and nonpublic officials

t Email communication Telephone conversation Face-to-face meeting Other__

gta c

Outcome C Cl)

~ Will not participate s21 Will participate In Title IV Aprogramming activities s

ctS ()

9 2-7 U)

oite

_~ tGmiddot0 I ~

bull

IUt4 M Ju~IAAlltl4 A-c -out Agtlt~ Pc-- Ac M ~ uJ~ 11e~tiJltI ii~ dbulllttcl _ _ ~l5P + 3~

ZXL SLA _ hfM ~

p ~ r 1Jtf FocusAreaA bullbull ~cusampeA bull ~ C)L- -151-A bull~~ ftZl(D fbulltt1_~A x1L ~ Ari + ftsii6tal ~ Focusampu1 ~ cbull~ p~ult 0bulllteu i-~i s unB

bull bull bull bull 1 bull - 778 P~dhJC ik -laquolaquo-fIC Focus Arne~==r tampbull~ J middottJGA~ ~~ $ t

Describe the Title IV Afunded acti1Wes and prmiddotomlmmlng used to supportwe~ed-u __catlonfour-a_U_stu_d_ents soda--a_nd_e_m_o_tio_na_lsu-pp_orts_~---

and orte~ologyint~ [Sec4106] cJAt ~ bull -bull eAc-c1 _ U -1-u ~ obbullbullr~~ ~

If applicable describe any partnerships with an institution of higher education business nonprofit organization community-based organization or other public or rte entity

JI Q) C C ca ()

Cl)

E ca ()

gtshy0 tJ Q) C C ca ()

en

Part 9 Title IV Part A Budget

Instructions Please be sure to complete both the Budget Overview and the Title IV Part A Budget (linked below) Both sections will be needed prior to application review

Budget Overview

Budget Request Schoo1Year2017-2018

Title IV A Activities

fa1~IArtWgtiiiitr~ 10(ije~ti~~~l112middotmiddotbull

$8500000

Nonpublic Equitable Share $9311

Administration

(Optional maximum 2 of total original allocation) $

Indirect Cost Optional)

$1630

TOTAL FUNDING REQUEST $9594100

Title IV Part A Detailed Budget

Please complete the Title IV Part A budget as an excel spreadsheet linked below and submit with your application All expenses listed in the table

above should be included in the budget and described in the narrative below the budget

Title IV Part A Budget Spreadsheet

I lt lt lt igt i l gt bull 2 gt i bullmiddotmiddot ltTitleIV Pflrt A Oiiiinal Budizet bull bullbullbullbullbullbullbullbullbullbullbullbullbullbullbull bull

bull

110 120 211-290 211-290 311-319 440 510-593 611-689 710-748 910

Expenditure Salaiv Benefits Professional Other Purchase GeneralAcrountNumber Rentals

Services Supplies Property Transfer Line Totals

Accowlt Cert Noncert Cert Non Cert Services

IIOOO Instruction $

Support 21000 Services - 5714100 $30000 $ 717000 $ 9431100

Student Improvement of

22100 lnsuuction

$(Professional Dcvclonmcnt)

22900 Otl1er Support

$Serviccs-Admin

25191 Refund of sRevenue

26000 Operationamp $Maintenance

27000 Tran~rtation $

Community 33000 Service s

Qntgtrations

60100 Transfers

$ finterfund Column

$ $ $ $ 5714100 $ $ 3000000 $ $ 717000 $ $ 9431100Totals

Subtotal $9431100 Indirect Cost Rate Subtract the amount above $25000 (per individual contracted service) from your total budget SSS000

Total after deducting Property $7170 Total Available for Indirect Costs

Amount of Indirect Cost to be used $1630 Grand Total Including lndirett Cost

Budget Narrative

DIRECTIONS Provide a narrative below on how funding is allocated Include the line number on which the funds are budgeted the itemized amountsfltems and which application category the expenditure is budgeted foe Example Other Purchase Services 22100 $1500 Guided Math Train the Trainer Conference registration and travel July 12-14 2018 Chicago IL (Focus Area A)

Supplies PropertyTechnology 2100 $2125 Math Dibel software (Focus Aera A) 2100 $3000 IXL Math resource 6-8 (Focus Area B) 2100 $720 Ready A to Z software (Focus Area C) 2100 $463 IXL EILA Leaming Progression (Focus Area A) 2100 $298 purchase of an iPad (Focus Area C)

Pronertv Eouinment Other Purchase Services (travel communication

22100 $30000 reimbursement of AP JB exams (Focus Area A) 22 IOO $55000 contracted services with Five Star Technologies (Focus Area C) 2100 $1300 Mission Control training (Focus Area A) 2100 $393 STEAM course training (Focus area A) 2100 $448 Proactive Discipline Training (Focus Area B)

Professional Services (contracted services)

Title IV Part A Staffin2

Staff Name Staff Position CertNon~ FfE Stipend YIN Split Additional Funding Source Position Description

Certified Funded YIN

Page 13: Superintendent of Public Instruction DEPARTMENT OF … · 2020. 2. 18. · Sections 4105(a)(2), 4105(a)(3), and 4106(b) indicate that a State educational agency shall not award a

Non-Public Information Page continued) (To be completed by the official representative from each nonpubnc school followlnamp tlmely and meaningful consultation)

Focus Area A

Clielt lla~a ~rmiddot--micro M- bull s is amp JC-1

Focus~a-~Desaibe proposed activities

~tvU~il1

- Iii$NCf F9sArealt ~a~ ll-111 _ Add additional activities os needed

Focus Area A

$ z12s-Focus Are B

$Joogt

Focus Area C s7-u

Desulbe the Title IV A-funded activities ind programming used to s~port well-rounded education for all students social and emotlonal supports and or technology Integration [sec 4106 ~$lt 711Ef Yr~~ cJ So t eJolc -rP I e)-rht 3-e)~ egt CIJ1~ lSbull-cent$ (r s~ lltJ Mtiraquo Qc-J kegto cr--s DesaibetheratlonaletledtotheNeedsAsse$$mentStakeholderlnputandor Jlltta A 1 _ bullbull u 517-a jampn-- I-lJE H-ae l)as~J 1fe NII-U 17gt rU-~ -nl 5C11$ gttNn ct- f_-r 0 ~ tvrreA_ -141 ~ tgt-4~ls Altgt I tAP-0 J-l11_ e-J__r tr1f~v 1-P~ bull -egt 5

_ I Tb - P17r _ I~ ~ Descr~theprogramobjectlvesandlntendedoutcomes

1S bull

lt

middot-middotmiddot - -

middot~ -

middot-gtr~ middot i_middot

middot gt~tmiddot - middotJmiddot _ middot _middot_ 1 J --middot--~

f~ r-eampS -r-b~-- ~-middot bull 1 J~- ~ middotcr-c~ ~I~ J r-e middot middot middot middot

- middot middott middot middot middot -ofcbull~-1o lgtlclCut t)wrH -5rvoeJ-r s r-1o ~t_ffr_____~c) Cf-e1~ _i nUS ~ (s41 middot

~iA((f J-(5 bullIf appllcable describe any partnetshlps with an Institution of higher education business nonprofit organization community-based organization or 0

other public or private entity -

-~-

~bullbull t112s17 middot~ ate

-~_ __ middot=middot ~

bull ~

--~middotbull

middot

~

14

Nonpublic Information Page (To be completed by the official representative from each nonpublic school following tlmely and meaningful consultation)

Non-Public School Name (l~L-bto-J1jWLL~5o-fLJ-4ldc-l fWpublic School Number J3 Q bJ Q

Malling Address -=-=__-wuiu~1--JgtLamp41-LJ----------

Contact Person (and Title)__~4ltlJ-J--I-Z-ll---uopound-1=owe4-L--1-_L1a~ ct_ Contact Phone Number lttr_~ 1 7lt7p Contact Email Address tY benV1e1t 0 ( h h VJ a middot 0 rJ

I Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

riTI

nY Will not participate Will participate in Title IV A programming activities

C-J1-17Date

Email communication Telephone conversation

15

Non-Public Information Page (continued) (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

If applicable describe any partnerships with an Institution of higher education business nonprofit organization community-based organization or other public or private entity

9-2-f--1-r Date

0 ConKtEmall Address

t Cl) s s ctS ()

U)

ctStjQ15-inaJcoucsmt 05 E

Plefle Indicate howtlmely and mnnlnlful conversation occumd between the LEA and nonpublic officials

t Email communication Telephone conversation Face-to-face meeting Other__

gta c

Outcome C Cl)

~ Will not participate s21 Will participate In Title IV Aprogramming activities s

ctS ()

9 2-7 U)

oite

_~ tGmiddot0 I ~

bull

IUt4 M Ju~IAAlltl4 A-c -out Agtlt~ Pc-- Ac M ~ uJ~ 11e~tiJltI ii~ dbulllttcl _ _ ~l5P + 3~

ZXL SLA _ hfM ~

p ~ r 1Jtf FocusAreaA bullbull ~cusampeA bull ~ C)L- -151-A bull~~ ftZl(D fbulltt1_~A x1L ~ Ari + ftsii6tal ~ Focusampu1 ~ cbull~ p~ult 0bulllteu i-~i s unB

bull bull bull bull 1 bull - 778 P~dhJC ik -laquolaquo-fIC Focus Arne~==r tampbull~ J middottJGA~ ~~ $ t

Describe the Title IV Afunded acti1Wes and prmiddotomlmmlng used to supportwe~ed-u __catlonfour-a_U_stu_d_ents soda--a_nd_e_m_o_tio_na_lsu-pp_orts_~---

and orte~ologyint~ [Sec4106] cJAt ~ bull -bull eAc-c1 _ U -1-u ~ obbullbullr~~ ~

If applicable describe any partnerships with an institution of higher education business nonprofit organization community-based organization or other public or rte entity

JI Q) C C ca ()

Cl)

E ca ()

gtshy0 tJ Q) C C ca ()

en

Part 9 Title IV Part A Budget

Instructions Please be sure to complete both the Budget Overview and the Title IV Part A Budget (linked below) Both sections will be needed prior to application review

Budget Overview

Budget Request Schoo1Year2017-2018

Title IV A Activities

fa1~IArtWgtiiiitr~ 10(ije~ti~~~l112middotmiddotbull

$8500000

Nonpublic Equitable Share $9311

Administration

(Optional maximum 2 of total original allocation) $

Indirect Cost Optional)

$1630

TOTAL FUNDING REQUEST $9594100

Title IV Part A Detailed Budget

Please complete the Title IV Part A budget as an excel spreadsheet linked below and submit with your application All expenses listed in the table

above should be included in the budget and described in the narrative below the budget

Title IV Part A Budget Spreadsheet

I lt lt lt igt i l gt bull 2 gt i bullmiddotmiddot ltTitleIV Pflrt A Oiiiinal Budizet bull bullbullbullbullbullbullbullbullbullbullbullbullbullbullbull bull

bull

110 120 211-290 211-290 311-319 440 510-593 611-689 710-748 910

Expenditure Salaiv Benefits Professional Other Purchase GeneralAcrountNumber Rentals

Services Supplies Property Transfer Line Totals

Accowlt Cert Noncert Cert Non Cert Services

IIOOO Instruction $

Support 21000 Services - 5714100 $30000 $ 717000 $ 9431100

Student Improvement of

22100 lnsuuction

$(Professional Dcvclonmcnt)

22900 Otl1er Support

$Serviccs-Admin

25191 Refund of sRevenue

26000 Operationamp $Maintenance

27000 Tran~rtation $

Community 33000 Service s

Qntgtrations

60100 Transfers

$ finterfund Column

$ $ $ $ 5714100 $ $ 3000000 $ $ 717000 $ $ 9431100Totals

Subtotal $9431100 Indirect Cost Rate Subtract the amount above $25000 (per individual contracted service) from your total budget SSS000

Total after deducting Property $7170 Total Available for Indirect Costs

Amount of Indirect Cost to be used $1630 Grand Total Including lndirett Cost

Budget Narrative

DIRECTIONS Provide a narrative below on how funding is allocated Include the line number on which the funds are budgeted the itemized amountsfltems and which application category the expenditure is budgeted foe Example Other Purchase Services 22100 $1500 Guided Math Train the Trainer Conference registration and travel July 12-14 2018 Chicago IL (Focus Area A)

Supplies PropertyTechnology 2100 $2125 Math Dibel software (Focus Aera A) 2100 $3000 IXL Math resource 6-8 (Focus Area B) 2100 $720 Ready A to Z software (Focus Area C) 2100 $463 IXL EILA Leaming Progression (Focus Area A) 2100 $298 purchase of an iPad (Focus Area C)

Pronertv Eouinment Other Purchase Services (travel communication

22100 $30000 reimbursement of AP JB exams (Focus Area A) 22 IOO $55000 contracted services with Five Star Technologies (Focus Area C) 2100 $1300 Mission Control training (Focus Area A) 2100 $393 STEAM course training (Focus area A) 2100 $448 Proactive Discipline Training (Focus Area B)

Professional Services (contracted services)

Title IV Part A Staffin2

Staff Name Staff Position CertNon~ FfE Stipend YIN Split Additional Funding Source Position Description

Certified Funded YIN

Page 14: Superintendent of Public Instruction DEPARTMENT OF … · 2020. 2. 18. · Sections 4105(a)(2), 4105(a)(3), and 4106(b) indicate that a State educational agency shall not award a

14

Nonpublic Information Page (To be completed by the official representative from each nonpublic school following tlmely and meaningful consultation)

Non-Public School Name (l~L-bto-J1jWLL~5o-fLJ-4ldc-l fWpublic School Number J3 Q bJ Q

Malling Address -=-=__-wuiu~1--JgtLamp41-LJ----------

Contact Person (and Title)__~4ltlJ-J--I-Z-ll---uopound-1=owe4-L--1-_L1a~ ct_ Contact Phone Number lttr_~ 1 7lt7p Contact Email Address tY benV1e1t 0 ( h h VJ a middot 0 rJ

I Please indicate how timely and meaningful conversation occurred between the LEA and nonpublic officials Outcome

riTI

nY Will not participate Will participate in Title IV A programming activities

C-J1-17Date

Email communication Telephone conversation

15

Non-Public Information Page (continued) (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

If applicable describe any partnerships with an Institution of higher education business nonprofit organization community-based organization or other public or private entity

9-2-f--1-r Date

0 ConKtEmall Address

t Cl) s s ctS ()

U)

ctStjQ15-inaJcoucsmt 05 E

Plefle Indicate howtlmely and mnnlnlful conversation occumd between the LEA and nonpublic officials

t Email communication Telephone conversation Face-to-face meeting Other__

gta c

Outcome C Cl)

~ Will not participate s21 Will participate In Title IV Aprogramming activities s

ctS ()

9 2-7 U)

oite

_~ tGmiddot0 I ~

bull

IUt4 M Ju~IAAlltl4 A-c -out Agtlt~ Pc-- Ac M ~ uJ~ 11e~tiJltI ii~ dbulllttcl _ _ ~l5P + 3~

ZXL SLA _ hfM ~

p ~ r 1Jtf FocusAreaA bullbull ~cusampeA bull ~ C)L- -151-A bull~~ ftZl(D fbulltt1_~A x1L ~ Ari + ftsii6tal ~ Focusampu1 ~ cbull~ p~ult 0bulllteu i-~i s unB

bull bull bull bull 1 bull - 778 P~dhJC ik -laquolaquo-fIC Focus Arne~==r tampbull~ J middottJGA~ ~~ $ t

Describe the Title IV Afunded acti1Wes and prmiddotomlmmlng used to supportwe~ed-u __catlonfour-a_U_stu_d_ents soda--a_nd_e_m_o_tio_na_lsu-pp_orts_~---

and orte~ologyint~ [Sec4106] cJAt ~ bull -bull eAc-c1 _ U -1-u ~ obbullbullr~~ ~

If applicable describe any partnerships with an institution of higher education business nonprofit organization community-based organization or other public or rte entity

JI Q) C C ca ()

Cl)

E ca ()

gtshy0 tJ Q) C C ca ()

en

Part 9 Title IV Part A Budget

Instructions Please be sure to complete both the Budget Overview and the Title IV Part A Budget (linked below) Both sections will be needed prior to application review

Budget Overview

Budget Request Schoo1Year2017-2018

Title IV A Activities

fa1~IArtWgtiiiitr~ 10(ije~ti~~~l112middotmiddotbull

$8500000

Nonpublic Equitable Share $9311

Administration

(Optional maximum 2 of total original allocation) $

Indirect Cost Optional)

$1630

TOTAL FUNDING REQUEST $9594100

Title IV Part A Detailed Budget

Please complete the Title IV Part A budget as an excel spreadsheet linked below and submit with your application All expenses listed in the table

above should be included in the budget and described in the narrative below the budget

Title IV Part A Budget Spreadsheet

I lt lt lt igt i l gt bull 2 gt i bullmiddotmiddot ltTitleIV Pflrt A Oiiiinal Budizet bull bullbullbullbullbullbullbullbullbullbullbullbullbullbullbull bull

bull

110 120 211-290 211-290 311-319 440 510-593 611-689 710-748 910

Expenditure Salaiv Benefits Professional Other Purchase GeneralAcrountNumber Rentals

Services Supplies Property Transfer Line Totals

Accowlt Cert Noncert Cert Non Cert Services

IIOOO Instruction $

Support 21000 Services - 5714100 $30000 $ 717000 $ 9431100

Student Improvement of

22100 lnsuuction

$(Professional Dcvclonmcnt)

22900 Otl1er Support

$Serviccs-Admin

25191 Refund of sRevenue

26000 Operationamp $Maintenance

27000 Tran~rtation $

Community 33000 Service s

Qntgtrations

60100 Transfers

$ finterfund Column

$ $ $ $ 5714100 $ $ 3000000 $ $ 717000 $ $ 9431100Totals

Subtotal $9431100 Indirect Cost Rate Subtract the amount above $25000 (per individual contracted service) from your total budget SSS000

Total after deducting Property $7170 Total Available for Indirect Costs

Amount of Indirect Cost to be used $1630 Grand Total Including lndirett Cost

Budget Narrative

DIRECTIONS Provide a narrative below on how funding is allocated Include the line number on which the funds are budgeted the itemized amountsfltems and which application category the expenditure is budgeted foe Example Other Purchase Services 22100 $1500 Guided Math Train the Trainer Conference registration and travel July 12-14 2018 Chicago IL (Focus Area A)

Supplies PropertyTechnology 2100 $2125 Math Dibel software (Focus Aera A) 2100 $3000 IXL Math resource 6-8 (Focus Area B) 2100 $720 Ready A to Z software (Focus Area C) 2100 $463 IXL EILA Leaming Progression (Focus Area A) 2100 $298 purchase of an iPad (Focus Area C)

Pronertv Eouinment Other Purchase Services (travel communication

22100 $30000 reimbursement of AP JB exams (Focus Area A) 22 IOO $55000 contracted services with Five Star Technologies (Focus Area C) 2100 $1300 Mission Control training (Focus Area A) 2100 $393 STEAM course training (Focus area A) 2100 $448 Proactive Discipline Training (Focus Area B)

Professional Services (contracted services)

Title IV Part A Staffin2

Staff Name Staff Position CertNon~ FfE Stipend YIN Split Additional Funding Source Position Description

Certified Funded YIN

Page 15: Superintendent of Public Instruction DEPARTMENT OF … · 2020. 2. 18. · Sections 4105(a)(2), 4105(a)(3), and 4106(b) indicate that a State educational agency shall not award a

15

Non-Public Information Page (continued) (To be completed by the official representative from each nonpublic school following timely and meaningful consultation)

If applicable describe any partnerships with an Institution of higher education business nonprofit organization community-based organization or other public or private entity

9-2-f--1-r Date

0 ConKtEmall Address

t Cl) s s ctS ()

U)

ctStjQ15-inaJcoucsmt 05 E

Plefle Indicate howtlmely and mnnlnlful conversation occumd between the LEA and nonpublic officials

t Email communication Telephone conversation Face-to-face meeting Other__

gta c

Outcome C Cl)

~ Will not participate s21 Will participate In Title IV Aprogramming activities s

ctS ()

9 2-7 U)

oite

_~ tGmiddot0 I ~

bull

IUt4 M Ju~IAAlltl4 A-c -out Agtlt~ Pc-- Ac M ~ uJ~ 11e~tiJltI ii~ dbulllttcl _ _ ~l5P + 3~

ZXL SLA _ hfM ~

p ~ r 1Jtf FocusAreaA bullbull ~cusampeA bull ~ C)L- -151-A bull~~ ftZl(D fbulltt1_~A x1L ~ Ari + ftsii6tal ~ Focusampu1 ~ cbull~ p~ult 0bulllteu i-~i s unB

bull bull bull bull 1 bull - 778 P~dhJC ik -laquolaquo-fIC Focus Arne~==r tampbull~ J middottJGA~ ~~ $ t

Describe the Title IV Afunded acti1Wes and prmiddotomlmmlng used to supportwe~ed-u __catlonfour-a_U_stu_d_ents soda--a_nd_e_m_o_tio_na_lsu-pp_orts_~---

and orte~ologyint~ [Sec4106] cJAt ~ bull -bull eAc-c1 _ U -1-u ~ obbullbullr~~ ~

If applicable describe any partnerships with an institution of higher education business nonprofit organization community-based organization or other public or rte entity

JI Q) C C ca ()

Cl)

E ca ()

gtshy0 tJ Q) C C ca ()

en

Part 9 Title IV Part A Budget

Instructions Please be sure to complete both the Budget Overview and the Title IV Part A Budget (linked below) Both sections will be needed prior to application review

Budget Overview

Budget Request Schoo1Year2017-2018

Title IV A Activities

fa1~IArtWgtiiiitr~ 10(ije~ti~~~l112middotmiddotbull

$8500000

Nonpublic Equitable Share $9311

Administration

(Optional maximum 2 of total original allocation) $

Indirect Cost Optional)

$1630

TOTAL FUNDING REQUEST $9594100

Title IV Part A Detailed Budget

Please complete the Title IV Part A budget as an excel spreadsheet linked below and submit with your application All expenses listed in the table

above should be included in the budget and described in the narrative below the budget

Title IV Part A Budget Spreadsheet

I lt lt lt igt i l gt bull 2 gt i bullmiddotmiddot ltTitleIV Pflrt A Oiiiinal Budizet bull bullbullbullbullbullbullbullbullbullbullbullbullbullbullbull bull

bull

110 120 211-290 211-290 311-319 440 510-593 611-689 710-748 910

Expenditure Salaiv Benefits Professional Other Purchase GeneralAcrountNumber Rentals

Services Supplies Property Transfer Line Totals

Accowlt Cert Noncert Cert Non Cert Services

IIOOO Instruction $

Support 21000 Services - 5714100 $30000 $ 717000 $ 9431100

Student Improvement of

22100 lnsuuction

$(Professional Dcvclonmcnt)

22900 Otl1er Support

$Serviccs-Admin

25191 Refund of sRevenue

26000 Operationamp $Maintenance

27000 Tran~rtation $

Community 33000 Service s

Qntgtrations

60100 Transfers

$ finterfund Column

$ $ $ $ 5714100 $ $ 3000000 $ $ 717000 $ $ 9431100Totals

Subtotal $9431100 Indirect Cost Rate Subtract the amount above $25000 (per individual contracted service) from your total budget SSS000

Total after deducting Property $7170 Total Available for Indirect Costs

Amount of Indirect Cost to be used $1630 Grand Total Including lndirett Cost

Budget Narrative

DIRECTIONS Provide a narrative below on how funding is allocated Include the line number on which the funds are budgeted the itemized amountsfltems and which application category the expenditure is budgeted foe Example Other Purchase Services 22100 $1500 Guided Math Train the Trainer Conference registration and travel July 12-14 2018 Chicago IL (Focus Area A)

Supplies PropertyTechnology 2100 $2125 Math Dibel software (Focus Aera A) 2100 $3000 IXL Math resource 6-8 (Focus Area B) 2100 $720 Ready A to Z software (Focus Area C) 2100 $463 IXL EILA Leaming Progression (Focus Area A) 2100 $298 purchase of an iPad (Focus Area C)

Pronertv Eouinment Other Purchase Services (travel communication

22100 $30000 reimbursement of AP JB exams (Focus Area A) 22 IOO $55000 contracted services with Five Star Technologies (Focus Area C) 2100 $1300 Mission Control training (Focus Area A) 2100 $393 STEAM course training (Focus area A) 2100 $448 Proactive Discipline Training (Focus Area B)

Professional Services (contracted services)

Title IV Part A Staffin2

Staff Name Staff Position CertNon~ FfE Stipend YIN Split Additional Funding Source Position Description

Certified Funded YIN

Page 16: Superintendent of Public Instruction DEPARTMENT OF … · 2020. 2. 18. · Sections 4105(a)(2), 4105(a)(3), and 4106(b) indicate that a State educational agency shall not award a

0 ConKtEmall Address

t Cl) s s ctS ()

U)

ctStjQ15-inaJcoucsmt 05 E

Plefle Indicate howtlmely and mnnlnlful conversation occumd between the LEA and nonpublic officials

t Email communication Telephone conversation Face-to-face meeting Other__

gta c

Outcome C Cl)

~ Will not participate s21 Will participate In Title IV Aprogramming activities s

ctS ()

9 2-7 U)

oite

_~ tGmiddot0 I ~

bull

IUt4 M Ju~IAAlltl4 A-c -out Agtlt~ Pc-- Ac M ~ uJ~ 11e~tiJltI ii~ dbulllttcl _ _ ~l5P + 3~

ZXL SLA _ hfM ~

p ~ r 1Jtf FocusAreaA bullbull ~cusampeA bull ~ C)L- -151-A bull~~ ftZl(D fbulltt1_~A x1L ~ Ari + ftsii6tal ~ Focusampu1 ~ cbull~ p~ult 0bulllteu i-~i s unB

bull bull bull bull 1 bull - 778 P~dhJC ik -laquolaquo-fIC Focus Arne~==r tampbull~ J middottJGA~ ~~ $ t

Describe the Title IV Afunded acti1Wes and prmiddotomlmmlng used to supportwe~ed-u __catlonfour-a_U_stu_d_ents soda--a_nd_e_m_o_tio_na_lsu-pp_orts_~---

and orte~ologyint~ [Sec4106] cJAt ~ bull -bull eAc-c1 _ U -1-u ~ obbullbullr~~ ~

If applicable describe any partnerships with an institution of higher education business nonprofit organization community-based organization or other public or rte entity

JI Q) C C ca ()

Cl)

E ca ()

gtshy0 tJ Q) C C ca ()

en

Part 9 Title IV Part A Budget

Instructions Please be sure to complete both the Budget Overview and the Title IV Part A Budget (linked below) Both sections will be needed prior to application review

Budget Overview

Budget Request Schoo1Year2017-2018

Title IV A Activities

fa1~IArtWgtiiiitr~ 10(ije~ti~~~l112middotmiddotbull

$8500000

Nonpublic Equitable Share $9311

Administration

(Optional maximum 2 of total original allocation) $

Indirect Cost Optional)

$1630

TOTAL FUNDING REQUEST $9594100

Title IV Part A Detailed Budget

Please complete the Title IV Part A budget as an excel spreadsheet linked below and submit with your application All expenses listed in the table

above should be included in the budget and described in the narrative below the budget

Title IV Part A Budget Spreadsheet

I lt lt lt igt i l gt bull 2 gt i bullmiddotmiddot ltTitleIV Pflrt A Oiiiinal Budizet bull bullbullbullbullbullbullbullbullbullbullbullbullbullbullbull bull

bull

110 120 211-290 211-290 311-319 440 510-593 611-689 710-748 910

Expenditure Salaiv Benefits Professional Other Purchase GeneralAcrountNumber Rentals

Services Supplies Property Transfer Line Totals

Accowlt Cert Noncert Cert Non Cert Services

IIOOO Instruction $

Support 21000 Services - 5714100 $30000 $ 717000 $ 9431100

Student Improvement of

22100 lnsuuction

$(Professional Dcvclonmcnt)

22900 Otl1er Support

$Serviccs-Admin

25191 Refund of sRevenue

26000 Operationamp $Maintenance

27000 Tran~rtation $

Community 33000 Service s

Qntgtrations

60100 Transfers

$ finterfund Column

$ $ $ $ 5714100 $ $ 3000000 $ $ 717000 $ $ 9431100Totals

Subtotal $9431100 Indirect Cost Rate Subtract the amount above $25000 (per individual contracted service) from your total budget SSS000

Total after deducting Property $7170 Total Available for Indirect Costs

Amount of Indirect Cost to be used $1630 Grand Total Including lndirett Cost

Budget Narrative

DIRECTIONS Provide a narrative below on how funding is allocated Include the line number on which the funds are budgeted the itemized amountsfltems and which application category the expenditure is budgeted foe Example Other Purchase Services 22100 $1500 Guided Math Train the Trainer Conference registration and travel July 12-14 2018 Chicago IL (Focus Area A)

Supplies PropertyTechnology 2100 $2125 Math Dibel software (Focus Aera A) 2100 $3000 IXL Math resource 6-8 (Focus Area B) 2100 $720 Ready A to Z software (Focus Area C) 2100 $463 IXL EILA Leaming Progression (Focus Area A) 2100 $298 purchase of an iPad (Focus Area C)

Pronertv Eouinment Other Purchase Services (travel communication

22100 $30000 reimbursement of AP JB exams (Focus Area A) 22 IOO $55000 contracted services with Five Star Technologies (Focus Area C) 2100 $1300 Mission Control training (Focus Area A) 2100 $393 STEAM course training (Focus area A) 2100 $448 Proactive Discipline Training (Focus Area B)

Professional Services (contracted services)

Title IV Part A Staffin2

Staff Name Staff Position CertNon~ FfE Stipend YIN Split Additional Funding Source Position Description

Certified Funded YIN

Page 17: Superintendent of Public Instruction DEPARTMENT OF … · 2020. 2. 18. · Sections 4105(a)(2), 4105(a)(3), and 4106(b) indicate that a State educational agency shall not award a

IUt4 M Ju~IAAlltl4 A-c -out Agtlt~ Pc-- Ac M ~ uJ~ 11e~tiJltI ii~ dbulllttcl _ _ ~l5P + 3~

ZXL SLA _ hfM ~

p ~ r 1Jtf FocusAreaA bullbull ~cusampeA bull ~ C)L- -151-A bull~~ ftZl(D fbulltt1_~A x1L ~ Ari + ftsii6tal ~ Focusampu1 ~ cbull~ p~ult 0bulllteu i-~i s unB

bull bull bull bull 1 bull - 778 P~dhJC ik -laquolaquo-fIC Focus Arne~==r tampbull~ J middottJGA~ ~~ $ t

Describe the Title IV Afunded acti1Wes and prmiddotomlmmlng used to supportwe~ed-u __catlonfour-a_U_stu_d_ents soda--a_nd_e_m_o_tio_na_lsu-pp_orts_~---

and orte~ologyint~ [Sec4106] cJAt ~ bull -bull eAc-c1 _ U -1-u ~ obbullbullr~~ ~

If applicable describe any partnerships with an institution of higher education business nonprofit organization community-based organization or other public or rte entity

JI Q) C C ca ()

Cl)

E ca ()

gtshy0 tJ Q) C C ca ()

en

Part 9 Title IV Part A Budget

Instructions Please be sure to complete both the Budget Overview and the Title IV Part A Budget (linked below) Both sections will be needed prior to application review

Budget Overview

Budget Request Schoo1Year2017-2018

Title IV A Activities

fa1~IArtWgtiiiitr~ 10(ije~ti~~~l112middotmiddotbull

$8500000

Nonpublic Equitable Share $9311

Administration

(Optional maximum 2 of total original allocation) $

Indirect Cost Optional)

$1630

TOTAL FUNDING REQUEST $9594100

Title IV Part A Detailed Budget

Please complete the Title IV Part A budget as an excel spreadsheet linked below and submit with your application All expenses listed in the table

above should be included in the budget and described in the narrative below the budget

Title IV Part A Budget Spreadsheet

I lt lt lt igt i l gt bull 2 gt i bullmiddotmiddot ltTitleIV Pflrt A Oiiiinal Budizet bull bullbullbullbullbullbullbullbullbullbullbullbullbullbullbull bull

bull

110 120 211-290 211-290 311-319 440 510-593 611-689 710-748 910

Expenditure Salaiv Benefits Professional Other Purchase GeneralAcrountNumber Rentals

Services Supplies Property Transfer Line Totals

Accowlt Cert Noncert Cert Non Cert Services

IIOOO Instruction $

Support 21000 Services - 5714100 $30000 $ 717000 $ 9431100

Student Improvement of

22100 lnsuuction

$(Professional Dcvclonmcnt)

22900 Otl1er Support

$Serviccs-Admin

25191 Refund of sRevenue

26000 Operationamp $Maintenance

27000 Tran~rtation $

Community 33000 Service s

Qntgtrations

60100 Transfers

$ finterfund Column

$ $ $ $ 5714100 $ $ 3000000 $ $ 717000 $ $ 9431100Totals

Subtotal $9431100 Indirect Cost Rate Subtract the amount above $25000 (per individual contracted service) from your total budget SSS000

Total after deducting Property $7170 Total Available for Indirect Costs

Amount of Indirect Cost to be used $1630 Grand Total Including lndirett Cost

Budget Narrative

DIRECTIONS Provide a narrative below on how funding is allocated Include the line number on which the funds are budgeted the itemized amountsfltems and which application category the expenditure is budgeted foe Example Other Purchase Services 22100 $1500 Guided Math Train the Trainer Conference registration and travel July 12-14 2018 Chicago IL (Focus Area A)

Supplies PropertyTechnology 2100 $2125 Math Dibel software (Focus Aera A) 2100 $3000 IXL Math resource 6-8 (Focus Area B) 2100 $720 Ready A to Z software (Focus Area C) 2100 $463 IXL EILA Leaming Progression (Focus Area A) 2100 $298 purchase of an iPad (Focus Area C)

Pronertv Eouinment Other Purchase Services (travel communication

22100 $30000 reimbursement of AP JB exams (Focus Area A) 22 IOO $55000 contracted services with Five Star Technologies (Focus Area C) 2100 $1300 Mission Control training (Focus Area A) 2100 $393 STEAM course training (Focus area A) 2100 $448 Proactive Discipline Training (Focus Area B)

Professional Services (contracted services)

Title IV Part A Staffin2

Staff Name Staff Position CertNon~ FfE Stipend YIN Split Additional Funding Source Position Description

Certified Funded YIN

Page 18: Superintendent of Public Instruction DEPARTMENT OF … · 2020. 2. 18. · Sections 4105(a)(2), 4105(a)(3), and 4106(b) indicate that a State educational agency shall not award a

Part 9 Title IV Part A Budget

Instructions Please be sure to complete both the Budget Overview and the Title IV Part A Budget (linked below) Both sections will be needed prior to application review

Budget Overview

Budget Request Schoo1Year2017-2018

Title IV A Activities

fa1~IArtWgtiiiitr~ 10(ije~ti~~~l112middotmiddotbull

$8500000

Nonpublic Equitable Share $9311

Administration

(Optional maximum 2 of total original allocation) $

Indirect Cost Optional)

$1630

TOTAL FUNDING REQUEST $9594100

Title IV Part A Detailed Budget

Please complete the Title IV Part A budget as an excel spreadsheet linked below and submit with your application All expenses listed in the table

above should be included in the budget and described in the narrative below the budget

Title IV Part A Budget Spreadsheet

I lt lt lt igt i l gt bull 2 gt i bullmiddotmiddot ltTitleIV Pflrt A Oiiiinal Budizet bull bullbullbullbullbullbullbullbullbullbullbullbullbullbullbull bull

bull

110 120 211-290 211-290 311-319 440 510-593 611-689 710-748 910

Expenditure Salaiv Benefits Professional Other Purchase GeneralAcrountNumber Rentals

Services Supplies Property Transfer Line Totals

Accowlt Cert Noncert Cert Non Cert Services

IIOOO Instruction $

Support 21000 Services - 5714100 $30000 $ 717000 $ 9431100

Student Improvement of

22100 lnsuuction

$(Professional Dcvclonmcnt)

22900 Otl1er Support

$Serviccs-Admin

25191 Refund of sRevenue

26000 Operationamp $Maintenance

27000 Tran~rtation $

Community 33000 Service s

Qntgtrations

60100 Transfers

$ finterfund Column

$ $ $ $ 5714100 $ $ 3000000 $ $ 717000 $ $ 9431100Totals

Subtotal $9431100 Indirect Cost Rate Subtract the amount above $25000 (per individual contracted service) from your total budget SSS000

Total after deducting Property $7170 Total Available for Indirect Costs

Amount of Indirect Cost to be used $1630 Grand Total Including lndirett Cost

Budget Narrative

DIRECTIONS Provide a narrative below on how funding is allocated Include the line number on which the funds are budgeted the itemized amountsfltems and which application category the expenditure is budgeted foe Example Other Purchase Services 22100 $1500 Guided Math Train the Trainer Conference registration and travel July 12-14 2018 Chicago IL (Focus Area A)

Supplies PropertyTechnology 2100 $2125 Math Dibel software (Focus Aera A) 2100 $3000 IXL Math resource 6-8 (Focus Area B) 2100 $720 Ready A to Z software (Focus Area C) 2100 $463 IXL EILA Leaming Progression (Focus Area A) 2100 $298 purchase of an iPad (Focus Area C)

Pronertv Eouinment Other Purchase Services (travel communication

22100 $30000 reimbursement of AP JB exams (Focus Area A) 22 IOO $55000 contracted services with Five Star Technologies (Focus Area C) 2100 $1300 Mission Control training (Focus Area A) 2100 $393 STEAM course training (Focus area A) 2100 $448 Proactive Discipline Training (Focus Area B)

Professional Services (contracted services)

Title IV Part A Staffin2

Staff Name Staff Position CertNon~ FfE Stipend YIN Split Additional Funding Source Position Description

Certified Funded YIN

Page 19: Superintendent of Public Instruction DEPARTMENT OF … · 2020. 2. 18. · Sections 4105(a)(2), 4105(a)(3), and 4106(b) indicate that a State educational agency shall not award a

I lt lt lt igt i l gt bull 2 gt i bullmiddotmiddot ltTitleIV Pflrt A Oiiiinal Budizet bull bullbullbullbullbullbullbullbullbullbullbullbullbullbullbull bull

bull

110 120 211-290 211-290 311-319 440 510-593 611-689 710-748 910

Expenditure Salaiv Benefits Professional Other Purchase GeneralAcrountNumber Rentals

Services Supplies Property Transfer Line Totals

Accowlt Cert Noncert Cert Non Cert Services

IIOOO Instruction $

Support 21000 Services - 5714100 $30000 $ 717000 $ 9431100

Student Improvement of

22100 lnsuuction

$(Professional Dcvclonmcnt)

22900 Otl1er Support

$Serviccs-Admin

25191 Refund of sRevenue

26000 Operationamp $Maintenance

27000 Tran~rtation $

Community 33000 Service s

Qntgtrations

60100 Transfers

$ finterfund Column

$ $ $ $ 5714100 $ $ 3000000 $ $ 717000 $ $ 9431100Totals

Subtotal $9431100 Indirect Cost Rate Subtract the amount above $25000 (per individual contracted service) from your total budget SSS000

Total after deducting Property $7170 Total Available for Indirect Costs

Amount of Indirect Cost to be used $1630 Grand Total Including lndirett Cost

Budget Narrative

DIRECTIONS Provide a narrative below on how funding is allocated Include the line number on which the funds are budgeted the itemized amountsfltems and which application category the expenditure is budgeted foe Example Other Purchase Services 22100 $1500 Guided Math Train the Trainer Conference registration and travel July 12-14 2018 Chicago IL (Focus Area A)

Supplies PropertyTechnology 2100 $2125 Math Dibel software (Focus Aera A) 2100 $3000 IXL Math resource 6-8 (Focus Area B) 2100 $720 Ready A to Z software (Focus Area C) 2100 $463 IXL EILA Leaming Progression (Focus Area A) 2100 $298 purchase of an iPad (Focus Area C)

Pronertv Eouinment Other Purchase Services (travel communication

22100 $30000 reimbursement of AP JB exams (Focus Area A) 22 IOO $55000 contracted services with Five Star Technologies (Focus Area C) 2100 $1300 Mission Control training (Focus Area A) 2100 $393 STEAM course training (Focus area A) 2100 $448 Proactive Discipline Training (Focus Area B)

Professional Services (contracted services)

Title IV Part A Staffin2

Staff Name Staff Position CertNon~ FfE Stipend YIN Split Additional Funding Source Position Description

Certified Funded YIN