U.S. Department of Education Washington, D.C. 20202-5335 • ' APPLICATION FOR GRANTS UNDER THE NATIONAL PROFESSIONAL DEVELOPMENT PROGRAM CFDA # 84.36SZ PR/Award # T36SZ170126 Gramts.gov Trackiug#: GRANT12392005 0MB No. , Expiratiou Date: PR/Award # T36SZl70!26 **Table of Contents** Form Page 1. Application for Federal Assistance SF-424 e3 Attachment - 1 (1238-Project EMPOWER - Areas Affected) e6 Attachment - 2 (1239-Project EMPOWER - Districts) e7 2. Standard Budget Sheet (ED 524) e8 3. Assurances Non-Construction Programs (SF 4248) e10 4. Disclosure Of Lobbying Activities (SF-LLL) e12 5. ED GEPA427 Form e13 Attachment - 1 (1240-Project EMPOWER - GEPA Statement) e14 6. Grants.gov Lobbying Form e16 7. Dept of Education Supplemental Information for SF-424 e17 8. ED Abstract Narrative Form e18 Attachment - 1 (1237-Project EMPOWER - Abstract) e19 9. Project Narrative Form e20 Attachment - 1 (1235-Project EMPOWER - Narrative) e21 10. Other Narrative Form e57 Attachment - 1 (1234-Project EMPOWER - Letters and Personnel) e58 11. Budget Narrative Form e75 Attachment - 1 (1236-Project EMPOWER - Budget Narrative) e76 This application was generated using the PDF functionality. The PDF functionality automatically numbers the pages in this application. Some pages/sections of this application may contain 2 sets of page numbers, one set created by the applicant and the other set created bye-Application's PDF functionality. Page numbers created by the e-Application PDF functionality will be preceded by the letter e (for example, e t . e2, e3, etc.). Page e2 0MB Number: 4040-0004 Expiration Date: 10/31/2019 Application for Federal Assistance SF-424 • 1. Type of Submission: • 2. Type of Application: • If Revision, select appropriate letter(s): 0 Preapplication ~New I I ~ Application D Continuation • Other (Specify): 0 Changed/Corrected Application D Revision I I • 3. Date Received: 4. Applicant Identifier: 104/24/2017 I I I 5a. Federal Entity Identifier: 5b. Federal Award Identifier: I I INA I State Use Only: 6. Date Received by State: I I 17. State Application Identifier: I I 8. APPLICANT INFORMATION: • a. Legal Name: IGrand Vi ew University I • b. Employer/Taxpayer Identification Number (EIN/TIN): • c. Organizational DUNS: 142-0681049 I 10834 937260000 I d. Address: • Street1: 11200 Grandview Avenue I Street2: I I • City: loes Moines I County/Parish: I I • State: I IA : Iowa I Province: I I • Country: USA : UNITED I STATES I * Zip / Postal Code: 150316-1599 I e. Organizational Unit: Department Name: Division Name: !Academic Affairs I !Graduate and Adult Programs I f. Name and contact information of person to be contacted on matters involving this application: Prefix: IMs . I • First Name: lcindy I Middle Name: I I • Last Name: lschaffer I Suffix: I I Title: loirec tor of Corporate and Foundation Relation I Organizational Affiliation: I I • Telephone Number: isis-263-2910 I Fax Number: I I • Email: lcschaffer@grandview . edu I PR/Award# T365Z170126 Page e3 Tracking Number: GRANT12392005 Funding Opportunity Number:ED-GRANTS-022117-001 Received Date:Apr 24, 20 I 7 11:40:09 AM EDT Application for Federal Assistance SF-424 * 9. Type of Applicant 1: Select Applicant Type: 0 : Private Institution of Higher Education I Type of Applicant 2: Select Applicant Type: I Type of Applicant 3: Select Applicant Type: I * Other (specify): I * 10. Name of Federal Agency: !Department o f Educati on I 11 . Catalog of Federal Domestic Assistance Number: 184 . 365 I CFDA Title: English Language Acquisition State Grants * 12. Funding Opportunity Number: IED - GRANTS - 022117- 001 I * Title: Office o f English Language Acquisition (OELA) : National Prof essional Development (NPD) Program CFDA Number 8 4 . 365Z 13. Competition Identification Number: I84- 365Z2017- 2 I Title: NATIONAL PROFESSIONAL DEVELOPMENT PROGRAM 14. Areas Affected by Project (Cities, Counties, States, etc.): Add Attachment Delete Attachment View Attachment 1238- Project EMPOWER - Ar eas Affec ted. pdf I I 11 1 1 I * 15. Descriptive Title of Applicant's Project: IPrnjec, EMPQWe, I Attach supporting documents as specified in agency instructions. Add Attachments Delete Attachments 11 View Attachments I II I PR/Award# T365Z170126 Page e4 Tracking Number:GRANT12392005 Funding Opportunity Number:ED-GRANTS-022117-001 Received Date:Apr 24, 20 I 7 11:40:09 AM EDT Application for Federal Assistance SF-424 16. Congressional Districts Of: • a. Applicant II A-003 I • b. Program/Project IIA- 003 I Attach an additional list of Program/Project Congressional Districts if needed. Add Attachment Delete Attachment View Attachment 11239- Projec t EMPOWER - Dist rict s . pdf I I 11 1 1 I 17. Proposed Project: • a. Start Date: !os101;201 7 I • b. End Date: 107/31 /20221 18. Estimated Funding ($): • a. Federal I 550, ooo . ooi • b. Applicant I o.ool * c. State o.ooi • d. Local o.ooi • e. Other o.ooi • f. Program Income o. ool 'g.TOTAL 550, ooo . ooi * 19. Is Application Subject to Review By State Under Executive Order 12372 Process? D a. This application was made available to the State under the Executive Order 12372 Process for review on I I- D b. Program is subject to E.O. 12372 but has not been selected by the State for review. IZl c. Program is not covered by E.O. 12372. • 20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes," provide explanation in attachment.) o ves iZI No If "Yes", provide explanation and attach Add Attachment Delete Attachment 1 1 View Attachment I I I 11 I 21 . *By signing this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances•* and agree to comply with any resulting terms if I acc,ept an award. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001) iZI *' I AGREE •• The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency specific instructions. Authorized Representative: Prefix: IMs. I * First Name: lc i ndy I Middle Name: I I • Last Name: lschaffer I Suffix: I I * Title: !Direc t o r o f Cor por a t e and Founda tion Rela tion I • Telephone Number: ls is-263- 2910 I Fax Number: I I • Email: lcschaffer@grandview. e d u I • Signature of Authorized Representative: !Cindy Schatter I • Date Signed: 104/24/2017 I PR/Award # T365Z170126 Page e5 Tracking Number: GRANT12392005 Funding Opportunity Number:ED-GRANTS-022117-001 Received Date:Apr 24, 20 I 7 11:40:09 AM EDT Areas Affected by the Project (Cities, Counties, States) Grand View University - Project EMPOWER Applicant: Des Moines, IA (Polk County) Project: Marshalltown, IA (Marshall County) Postville, IA (Allamakee and Clayton Counties) Columbus Junction, IA (Louisa County) West Liberty, IA (Muscatine County) Des Moines, IA (Polk County) Iowa City, IA (Johnson County) PR/Award# T365Z170126 Page e6 Additional Congressional Districts Grand View University - Project EMPOWER Applicant: IA-003 Project: IA-001 IA-002 IA-003 PR/Award# T365Z170126 Page e7 U.S. DEPARTMENT OF EDUCATION 0MB Number: 1894-0008 BUDGET INFORMATION Expiration Date: 06/30/2017 NON-CONSTRUCTION PROGRAMS Name of Institution/Organization Applicants requesting funding for only one year should complete the column under "Project Year 1." Applicants requesting funding for multi-year grants should complete all View University !Grand I applicable columns. Please read all instructions before completing form. SECTION A - BUDGET SUMMARY U.S. DEPARTMENT OF EDUCATION FUNDS Budget Project Year 1 Project Year 2 Project Year 3 Project Year 4 Project Year 5 Total Categories (a) (b) (c) (d) (e) (f) 1. Personnel 87 , 300 . 001 I 68 , 817 . 001 70 , 036 . oo l 71 , 288 . oo l 72, 569 . ool 370, 010 . oo l 2. Fringe Benefits 23 , 427 . ool 18, 251. 001 1s , 593 . oo j 18, 943 .001 19 , 302 . 001 98, 516 . oo l 3. Travel 4, 500 . ool 2, ooo . ool 2, 000 .001 2, ooo . oo l 2, ooo . ool 12, 500 . oo l 4. Equipment o. ool o. ooj o. oo l o. oo l o. ool o. oo l 5. Supplies 1, 750 . 001 200 . ooj 200 . oo j I 200 . oo l 200 . ool 2, 550 . oo l 6. Contractual o . ool o. ool o. oo l o. oo l o. ool o. oo l 7. Construction o. ool o. ooj o. oo j o. oo l o. ool o. oo l 8. Other 230 , ooo . ool 204 , ooo . ooj 204 , ooo . oo l 204 , ooo . oo l 204, ooo . ool 1, 046, ooo . oo l 9. Total Direct Costs 346 , 977 . 001 293, 268 . ooj 294 , 829 . 001 296, 431 . oo l 298, 011 . ool 1, 529, 576 .001 (lines 1-8) 10. Indirect Costs• 27 , 758 . 001 23, 461. ooj 23, 586 .oo j 23, 71 4. oo l 23 , 846 . 001 122 , 365 .001 11. Training Stipends 175 ,2 65 . ool 233 , 21 1. ool 231, 585 . oo j 229, 855 . oo l 228, osJ . ool 1, 098 , 059 . oo l 12. Total Costs 550 , ooo . ool 550 , ooo . ool 550 , ooo . oo j sso, ooo . oo l 550, ooo . ool 2 , 7so, ooo .oo l /lines 9-11) *Indirect Cost Information (To Be Completed by Your Business Office): If you are requesting reimbursement for indirect costs on line 10, please answer the following questions: (1 ) Do you have an Indirect Cost Rate Ag reement approved by the Federal government? 0 Yes ~No (2) If yes, please provide the following information: Period Covered by the Indirect Cost Rate Agreement: From: I I To: I I (mm/dd/yyyy) Approving Federal agency: 0 ED D Other (please specify): I I The Indirect Cost Rate is I IO/o.