Request for Application

REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: ESC Region No.: Project No./NOGA ID No.: SCHEDULE #1: General Information—Include in ApplicationProgram Authority: Public Law 107-110 McKinney-Vento Homeless Education Assistance Improvements Act of 2001Project Dates: Year One, 9/1/2015 through 8/31/2016 New ApplicationApplicant Organization Name:Applicant Organization Mailing Address:City: Zip:Name, Title, and Telephone Number of Local Education Official with Signatory Authority to Obligate this Applicant Name: Title: Telephone: The superintendent of the school district or his/her designee must sign applications submitted by public school districts. The executive director or his/her designee must sign applications submitted by regional education service centers. The chief operating officer of the school must sign applications submitted by eligible charter schools. The signature on this page obligates the applicant to the Certification and Incorporation agreement below. CERTIFICATION AND INCORPORATION I hereby certify that the information contained in this application is, to the best of my knowledge, correct and that the local education agency named above has authorized me as its representative to obligate this agency. I further certify that any ensuing program and activity will be conducted in accordance with all applicable Federal and State laws and regulations, application guidelines and instructions, the Provisions and Assurances, Debarment and Suspension, lobbying requirements, Special Provisions and Assurances, and the schedules attached as applicable. It is understood by the applicant that this application constitutes an offer and, if accepted by Region 10 Education Service Center or renegotiated to acceptance, will form a binding agreement. Signature of Authorized Official Date Signed:For Office Use Only. Application approved by: Date: Changes/notes made on this application have been confirmed with: By: email fax In person telephone1 RFA #ESCR-10 (SSA Application) H2015-17(1) County-District No.: ESC Region No.: Project No./NOGA ID No.: SCHEDULE #1.1:General Information—Type Of SSA—Include in ApplicationPlace an “X” by all that apply to this SSA: a. Fiscal agent provides services only to member LEAs (does not flow funds or provide payments of any kind to member LEAs). b. Fiscal agent flows funds or provides payments to member LEAs. c. Fiscal agent provides services to member LEAs and flows funds or provides payments to member LEAs.IMPORTANT INFORMATIONServices to Other LEAs/ESCs If an LEA/ESC provides services only to member districts, then the Fiscal Agent will list the cost of these services on the appropriate budget schedules under the Fiscal Agent Amount, but will not place any amount in any column referring to flow-through funds. For example, if Region 99 ESC provides tutors on campuses in three school districts, then Region 99 ESC is the fiscal agent for the SSA and will list those tutors on the appropriate budget schedule as either employees or contractors with Region 99 ESC. The three districts are member LEAs and will complete Schedule #8. There will be no costs listed in the flow-through column. Contracts with Other LEAs/ESCs If an LEA or ESC only contracts with other LEAs/ESCs to provide specific services, and budgets funds for these services on Schedule #6200, and does not flow funds to other LEAs and/or ESCs using schedules other than #6200, then this is not an SSA. The applicant should complete the Single-LEA application. If an LEA or ESC contracts with other LEAs/ESCs to provide services AND engages in other activities where funds flow through to other LEAs and/or ESCs, then the applicant should complete the SSA application but list only those member LEAs that receive flow-through funds. For example, if Region 66 ESC contracts with Corvette ISD and Thunderbird ISD to provide a tutoring program using Schedule #6200, and Region 66 ESC also flows funds to Rainbow ISD, Thunder ISD, and Sunny ISD, then the SSA would include only Region 66 ESC as the fiscal agent and Rainbow, Thunder, and Sunny ISDs as the member LEAs. Corvette and Thunderbird ISDs are considered vendors, not member LEAs.2RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: ESC Region No.: Project No./NOGA ID No.: SCHEDULE #2: Contact Information for SSA Fiscal Agent—Include in ApplicationSuperintendent, ESC Director, or CEO (Name and Title):Mailing Address:City: Zip:Office Phone: *Cell Phone: Fax: Email:TEXSHEP Contact (Name and Title):Mailing Address:City: Zip:Office Phone: *Cell Phone: Fax: Email:Homeless Liaison, if different from TEXSHEP Contact, (Name and Title):Mailing Address:City: Zip:Office Phone: *Cell Phone: Fax: Email:Business Office Contact (Name and Title):Mailing Address:City: Zip:Office Phone: *Cell Phone: Fax: Email:IMPORTANT NOTES: If the liaison(s) named above have not registered on the Texas Homeless Education Office’s (THEO) website, please do so by visiting the THEO website at http://www.utdanacenter.org/theo and following the instructions at the very bottom of the News section, which is located on the homepage.*The information on this page is for use by Region 10 or its designee only. Cell phone numbers will not be shared with third parties and will be used only in situations where absolutely necessary.3RFA #ESCR-10 (SSA Application) H2015-17(1) County-District No.: ESC Region No.: Project No./NOGA ID No.: SCHEDULE #2.1:Homeless Liaison Contact Information In Member LEAs [Include all LEAs listed on Schedule #8—Certification for Shared Services Arrangements] —Include in ApplicationMember District Name Homeless Liaison Name Email Work Phone 1 2 3 4 5 6 7 8 9 1 0 1 1 1 2 1 3 1 4 1 5 1 6 1 7 1 8 1 9 2 0 2 1 2 2 2 3 2 4 2 5 2 6 2 74RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year One2 8 2 9 3 0 3 1 3 2 3 3 3 4 3 5IMPORTANT NOTES: If the liaison(s) named above have not registered on the Texas Homeless Education Office’s (THEO) website, please do so by visiting the THEO website at http://www.utdanacenter.org/theo and following the instructions at the very bottom of the News section, which is located on the homepage.5RFA #ESCR-10 (SSA Application) H2015-17(1) 6RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: SCHEDULE #3: Index to Application Section 1: The schedules in this section must be completed and submitted with this application:Schedule Schedules with an “X” must be No. Schedule Name completed 1 General Information X 1.1 General Information—Type of SSA X 2 Contact Information for SSA Fiscal Agent X 2.1 Homeless Liaison Contact Information In Member LEAs X 3 Index to Application X 6A Descriptive Information X 6B.1 Needs Identification: Baseline and Projected Outcomes for Homeless X Students Enrollment, Served by TEXSHEP, and Attendance Rates 6B.2 Needs Identification: Baseline and Projected Outcomes for Homeless X Student Proficiency In State Assessments 6B.3 Needs Identification: Stakeholder Input X 6C Project Needs Identified X 6D Project Activities X 6E Collaboration/Coordination X 6F Title I Services for Children and Youth in Homeless Situations X 6G Project Evaluation X 6H Capacity to Implement and Manage the Project X 6I Project Summary X 7 Budget Summary X 7.1 Anticipated Annual Expenditures X 7.2 Flow-Through Funds (6493) Description Chart X 8 Certification for Shared Services Arrangements X 9 Equitable Access and Participation X 10 Policies and Procedures Implementation XSection 2: Only the schedules in this section that apply to the specific program design should be completed and submitted with this application. Place an “X” in the third column to indicate each schedule that will be completed and submitted with this application.Place an “X” to indicate each Schedule additional schedule being No. Schedule Name completed 7A Payroll Costs 6100 7B Professional and Contracted Services 6200 7B.1 Contractor Information 7C Supplies and Materials 6300 7D Other Operating Costs 6400 7E Capital Outlay 6600 7F Adaptation of Space 11 Disclosure of Lobbying Activities* *Required only if the applicant has lobbying activities to disclose. Do not submit if there are no lobbying activities to disclose.Section 3: Submit forms that are used to identify and/or enroll homeless students as Appendix A of this document. Do not submit them as a separate document.The Grant Requirements and provisions and assurances for this RFA are found in Schedules #12 and #13A-D. These schedules need not be submitted with the application; however, the authorized signatures on Schedules #1 and #8 certifies that the applicant and member LEAs have read all provisions and assurances that apply to this application and agree to adhere to those provisions and assurances as set forth in the respective schedules, which are posted on the THEO website at http://www.utdanacenter.org/theo.7RFA #ESCR-10 (SSA Application) H2015-17(1) 8RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: SCHEDULE #6A:Descriptive Information (Competition Schedule-Not To Be Amended)Page Limit: Do not exceed the four-page limit for this schedule. Within this schedule, the space may be allocated as deemed appropriate, but any text beyond the end of the fourth page will be deleted before the application is released to the readers.REQUIRED INFORMATION: For each member LEA, include forms that are used to identify and/or enroll homeless students and submit them as Appendix A along with the rest of the RFA. Do not submit as a separate document.1. Describe how member LEAs identify children and youth enrolling in their LEAs who are living in a homeless situation, including both students new to the LEA and those returning after summer break.RESPONSE TO ITEM 1:2. Describe how member LEAs identify children and youth who become homeless after they have already started attending school in a given year. RESPONSE TO ITEM 2:3. Describe efforts of member LEAs to locate homeless children in communities of member LEAs who are not currently enrolled or attending school.RESPONSE TO ITEM 3:4. a. Describe training that staff members in member LEAs receive regarding the identification and enrollment of students experiencing homelessness. RESPONSE TO ITEM 4a: b. Describe training that service providers in member LEAs receive regarding the identification and enrollment of students experiencing homelessness. RESPONSE TO ITEM 4b:9RFA #ESCR-10 (SSA Application) H2015-17(1) County-District No.: SCHEDULE #6A: Descriptive Information, Continued (Application Schedule Not To Be Amended)5. Describe how local homeless service providers and/or community organizations, if any, help the LEA to identify students experiencing homelessness in member LEAs.RESPONSE TO ITEM 5:6. Provide any other information that the applicant deems relevant regarding the identification and enrollment of children and youth experiencing homelessness in member LEAs.RESPONSE TO ITEM 6:7. Describe local conditions that contribute to homelessness in member LEAs.RESPONSE TO ITEM 7:10RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year One11RFA #ESCR-10 (SSA Application) H2015-17(1) County-District No.: SCHEDULE #6B.1: Needs Identification: Baseline and Projected Outcomes for Homeless Student Enrollment, Served by TEXSHEP, and Attendance Rates (Competition Schedule-Not To Be Amended)Enrollment and Served by TEXSHEP Projected Year One Estimated # Non- Homeless, At Risk Served by TEXSHEP Total # Projected Year 2015-2016 Total Enrolled One Estimated # Projected Year One (ONLY 5% of all students Students Homeless Homeless Estimated # served by TEXSHEP can Enrolled Students Enrolled 2015- Homeless Served by be Non-Homeless, At- Grades 2013-14 in 2013-14 2016 TEXSHEP 2015-2016 Risk) Age 0 - 2 Age 3-5 (not kindergarten) Kindergarten 1 2 3 4 5 6 7 8 9 10 11 12 TotalAttendance Rates District Attendance Rates Homeless Attendance Projected Year One Homeless Grades In 2013-2014 Rates in 2013-2014 Attendance Rates 2015-2016 1 2 3 4 5 6 7 8 9 10 11 12 Total12RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneEnrollment for Each Member LEA Total Students Total # Enrolled Enrolled in 2013- Homeless Students in List Each Member LEA 2014 2013-201413RFA #ESCR-10 (SSA Application) H2015-17(1) Attendance Rates for Each Member LEA Total District Total Homeless Attendance Rate Attendance Rate In List Each Member LEA in 2013-2014 2013-201414RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.:SCHEDULE #6B.2: Needs Identification: Baseline and Projected Outcomes for Homeless Student Proficiency In State Assessments (Competition Schedule-Not To Be Amended)Grades 3 – 8: Cumulative Totals for All Member LEAs % Homeless Who Met Projected Year One % All Students Who Met Standard in 2013- Estimated % Homeless to Grade: STAAR Subject Standard in 2013-2014 2014 Meet Standard in 2015-2016 3: Math 3: Reading 4: Math 4: Reading 4: Writing 5: Math 5: Reading 5: Science 6: Math 6: Reading 7: Math 7: Reading 7: Writing 8: Math 8: Reading 8: Science 8: Social StudiesGrades 9 – 12: Cumulative Totals for All Member LEAs 9-12 STAAR EOC % All Students Who Met % Homeless Who Met Projected Year One Estimated % Homeless Subject Standard in 2013-2014 Standard in 2013-2014 to Meet Standard in 2015-2016 Algebra I EOC English I EOC English II EOC Biology EOC US History EOC15RFA #ESCR-10 (SSA Application) H2015-17(1) Grade 3-8 STAAR: % Who Met Standard in 2013-2014 % Who Met Math % Who Met % Who Met % Who Met % Who Met Social Standard Reading Standard Writing Standard Science Standard Studies Standard List each member LEA All Homeless All Homeless All Homeless All Homeless All Homeless16RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneGrade 9–12 STAAR EOC: % Who Met Standard In 2013-2014 % Who Met % Who Met Algebra I % Who Met English II % Who Met % Who Met US Standard English I Standard Standard Biology Standard History Standard List each member LEA All Homeless All Homeless All Homeless All Homeless All Homeless17RFA #ESCR-10 (SSA Application) H2015-17(1) County-District No.:SCHEDULE #6B.3: Needs Identification: Stakeholder Input (Competition Schedule-Not To Be Amended)StakeholdersName of Type of Meeting Organization/ Mark Mark X if (group, one on Date Agency/ X if Community one, phone, email, Meeting Staff Name Staff Title Entity LEA Organization etc.) Held 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30Conversation Highlights1. What are some examples of data the applicant provided or presented to the stakeholders?2. What are some examples of data the stakeholders provided or presented to the applicant?3. What were the most significant findings to emerge from the discussion(s)? (Examples of findings applicants might include: educational and related barriers/challenges for students in homeless situations and the activities needed to address these barriers/challenges.)18RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year One19RFA #ESCR-10 (SSA Application) H2015-17(1) County-District No.: SCHEDULE #6C: Project Needs Identified Identify Up to Five Needs.Using data and information collected on Schedules #6B.1, #6B.2, and #6B.3, provide the information requested for up to FIVE needs. Do not exceed FIVE needs.Need 1 Identified:How Need 1 Supports Academic Success:Need 2 Identified:How Need 2 Supports Academic Success:Need 3 Identified:How Need 3 Supports Academic Success:Need 4 Identified:How Need 4 Supports Academic Success:Need 5 Identified:How Need 5 Supports Academic Success:20RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: SCHEDULE #6D: Project ActivitiesActivity Description Table.Activity Description (Briefly describe what the activity is, who will participate, approximately how often it will occur, and any other important information. Documentary evidence showing Include at least one parental Position responsible activity is ongoing or completed involvement activity on line 1 General Location (do not for collecting and (such as sign-in sheets for below Additional parent Estimated # to include names) Positions responsible for providing training, supplies distribution Activity activities may be added on participate in (Example: campuses, completing the activity (do documentary rosters, activity logs, contact Number subsequent lines. Be concise.) activity shelter, community site) not include names) evidence logs, referral logs, etc.) 1 Parent Involvement Activity description (required):2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2021RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year One22 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: SCHEDULE #6E: Collaboration/CoordinationSummary of All Collaborative AgreementsThere is no limit on collaborators.Collaborators within the Communities of Member LEAs Collaborators within the (List names of Related Member LEAs organizations, TEXSHEP (List names of departments, business, etc., and activity # offices, etc., and LEA ) name of community) Collaborative Activities Description numbers Ex: National Honor Society at Provides nutritious snacks once per week for 3, 4 Bowie HS, WOW ISD after-school tutoring program Ex: Interfaith Ministries, Provides new and gently used school uniforms 5 Tinseltown for homeless children; provides vouchers for shoes at local stores 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2023 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year One24 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: SCHEDULE #6F:Title I Services for Children and Youth in Homeless Situations Use of Title I Funds—Applicants must answer all questions.1. Title I Funding Information Failure to set aside funds from Title I, Part A, will eliminate the applicant from consideration for funding. EXCEPTION: LEAs in which all campuses are designated as Title I campuses, including schoolwide or targeted assistance, are exempt from this requirement; however, such LEAs may set aside funds to serve students in homeless situations and are encouraged to do so. Place an “X” in Column a, b, or c as appropriate. If an “X” is placed in either Column b or c, then a dollar amount must be placed in Column d.If applicable, from any Reservation of Title I, Part A Funds allocation of Title I Funds c. NOT f. a. b. EXEMPT Estimated EXEMPT EXEMPT from the dollar ($) from Title I, from set- Title I, Part d. amount of Part A, set- aside but A, set- Dollar ($) e. Title I to be aside and WILL set aside and amount of Percentage spent on MV NOT aside IS set aside of homeless mandated, setting funds from setting listed in liaison’s school-of- List all member aside Title I, Part aside Column b salary paid origin # LEAs funds A funds or c out of Title I transportation 1 $ $ $ % $ 2 $ $ $ % $ 3 $ $ $ % $ 4 $ $ $ % $ 5 $ $ $ % $ 6 $ $ $ % $ 7 $ $ $ % $ 8 $ $ $ % $ 9 $ $ $ % $ 1 $ $ $ % $ 0 1 $ $ $ % $ 125 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneQuestions 2-4 must not exceed three pages. Within this schedule, the space may be allocated as deemed appropriate, but any text beyond the three-page limit for questions 2-4 will be deleted before the application is released to the readers. Observe font and text guidelines.In order to avoid unnecessary duplication, instead of providing answers for each separate member LEA, provide summary answers for questions 2, 3, and 4 that take into account the information from each member LEA. However, the SSA fiscal agent must keep the information for each separate, member LEA on file and available upon request. 2. Title I and McKinney-Vento Collaboration. a. How will the Title I and the TEXSHEP programs collaborate effectively in member LEAs? b. What are the roles of each program in member LEAs? c. How will the Title I/TEXSHEP collaborations in member LEAs ensure that the actual needs of homeless students are met? d. How do homeless liaisons in member LEAs communicate with or participate in the Title I Campus Improvement Plan (CIP) process? e. How do Title I Campus Improvement Plans in member LEAs process address homelessness? 3. Use of Title I Funds. How will the use of Title I funds strengthen the proposed project and improve services to homeless students in member LEAs?4. Accessing Title I Funds. How will homeless liaisons or appropriate subgrant staff in member LEAs access Title I funds?26 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year One27 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: SCHEDULE #6G: Project EvaluationSCHEDULE #6G SPACE LIMITATION: This schedule must not exceed four complete RFA pagesDescribe how the applicant will evaluate the proposed project. An effective project evaluation will begin at the project start date and be ongoing throughout the project year. The project evaluation should be an ongoing assessment of the project’s progress toward its desired outcomes. A strong evaluation component assists project managers in determining the project’s strengths and those areas needing improvement.A robust, comprehensive evaluation design does the following: • It incorporates project activities, outcomes, collaborations, ongoing financial review, and other elements.• It describes how project successes and weaknesses will be identified and describes the process and positions responsible for making ongoing improvements to the project.• It includes a timeline for major evaluation activities.28 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year One29 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: SCHEDULE #6H: Capacity to Implement and Manage the Project SCHEDULE #6H SPACE LIMITATION: This schedule must not exceed five complete RFA pages. There is no specified length for the response to any individual item. Any text that exceeds the five-page limit will be removed prior to distribution to the readers. A. Past Challenges and Success1. Describe the challenges the applicant and member LEAs have experienced in educating children and youth experiencing homelessness and/or living in poverty situations. RESPONSE TO ITEM A1:2. Describe the successes the applicant and member LEAs have experienced in educating children and youth experiencing homelessness and/or living in poverty situations. RESPONSE TO ITEM A2:B. Personnel Responsible Provide the following information about the primary positions that will manage the subgrant and carry out activities described in this application. These positions should be the applicant’s staff and not staff employed by member LEAs. Applicants must provide information for at least one primary staff and may provide information for up to four primary staff. It is acceptable to delete any unused items so that more space will be available for text. 1. Name: Position: Experience managing programs for or working with children in poverty and/or homelessness:2. Name: Position: Experience managing programs for or working with children in poverty and/or homelessness:3. Name: Position: Experience managing programs for or working with children in poverty and/or homelessness:4. Name: Position: Experience managing programs for or working with children in poverty and/or homelessness:C. Management1. Describe the applicant’s past experience in managing discretionary grants—any discretionary grants whether or not they are related to homelessness and/or poverty. RESPONSE TO ITEM C1:30 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year One31 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: SCHEDULE #6H: Capacity to Implement and Manage the Project, Continued2. Describe the management of the project’s daily operations—what types of activities will occur on an ongoing, regular basis?RESPONSE TO ITEM C2:3. Describe how the applicant will manage the overall project to ensure that the projected outcomes are met or will be adjusted through the amendment process.RESPONSE TO ITEM C3.4. Describe how the project’s finances will be managed. a. How will the applicant monitor expenditures to ensure that the applicant and member LEAs expend subgrant funds in a timely manner?RESPONSE TO ITEM C4a: b. How will the applicant review its finances and those of member LEAs to ensure that there are no unspent funds to be turned back?RESPONSE TO ITEM C4b: c. How will the business office contact person and the TEXSHEP manager periodically review accounting records to ensure funds are expended as approved in the application and for allowable expenditures? The description should also address the following items:• initial budget set-up • quarterly and final expenditure reports • appropriate coding and placement of budgeted items on schedules • allowable budget expenses • proposed budget vs. actual expenditures • communication with member LEAs concerning fundingRESPONSE TO ITEM C4c:32 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year One33 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: SCHEDULE #6I: Project SummaryProvide a brief summary of the proposed three-year project. The summary should not exceed this page. 34 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year One35 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: SCHEDULE #7: Budget Summary Do Not Submit with AmendmentsProgram Authority: Public Law 107-110 McKinney-Vento Homeless Education Assistance Improvements Act of 2001.Fund Code/Shared Services Arrangement Code: 84.196Project Period: 09/01/2015 through 08/31/2016Flow Through to Total Class/ Fiscal Member Budgeted Schedule Object Agent LEAs Expend- Line No. Class/Object Description Number Code Amount (6493) itures01 Payroll Costs 7A 6100Professional and Contracted 02 Services 7B 620003 Supplies and Materials 7C 630004 Other Operating Costs 7D 6400Capital Outlay(Exclusive of 6619 05 and 6629) 7E 660006 Adaptation of Space 7F 662907 Total Direct Costs (Sum of lines 1-6)08 Indirect Costs (Rate: %) (1)09 Total Costs(1) Indirect costs may not exceed 8% or the restricted indirect cost rate approved by the Texas Education Agency, less required exclusions, whichever is less.NOTE: For assistance in computing the Indirect Costs for this grant, please see the Indirect Cost Calculation Worksheet on the THEO website at: http://www.utdanacenter.org/theo/downloads/texshep/TEA_IndirectCostRates_Handbook.pdf36 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year One37 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: SCHEDULE #7.1: Anticipated Annual ExpendituresThis table shows the anticipated expenditures over the course of the program year. Provide the anticipated expenditure for each quarter of the program year. The amounts for each quarter should add up to the total amount budgeted for the whole year.All of the total budgeted expenditure amounts on this table should match the amounts on Schedule #7: Budget Summary.Class/ Total Line Object 1st 2nd 3rd 4th Budgeted No. Class/Object Description Code Quarter Quarter Quarter Quarter Expenditures01 Payroll Costs 6100Professional and Contracted 02 Services 620003 Supplies and Materials 630004 Other Operating Costs 6400Capital Outlay(Exclusive of 6619 05 and 6629) 660006 Adaptation of Space 6629 07 Total Direct Costs (Sum of lines 1-6) 08 Indirect Costs 09 Total Costs38 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year One39 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: SCHEDULE #7.2: Flow-Through Funds (6493) Description Chart This schedule is to be completed only by applicants that have budgeted money for flow-through funds to member LEAs (6493).Provide the following information for each district receiving flow-through funds as part of a shared services arrangement: district name, county-district number, related objectives, and amount of flow–– through funds received. Please note that the total on this schedule should equal the amount listed on Line 09 in the column for Flow Through to Member LEAs (6493) on Schedule 7D––Budget Summary). Amount of flow-through funds received Related Activity/ies County- or District Schedule Subtotal LEA Name Number Numbers 6100 6200 6300 6400 6600 6629 For LEA Total amount of flow-through funds (should equal the amount listed in the column Flow Through to Member LEAs (6493) on Line 09 of Schedule 7—Budget Summary. $40 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year One41 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: SCHEDULE #7A: Payroll Costs 6100FTE FTE As Equivalent Equivalent Flow Description of Payroll Costs Applicable: charged to Charged to Through One Line Per Position1 Related this This to Total Activity or subgrant Subgrant Fiscal Member Budgeted Line Note: Fringe Benefits must be Schedule (Fiscal (Member Agent LEAs Expend- No. budgeted separately on Line 12 Number(s) Agent) LEAs) Amount (6493) itures01020304050607 SUBTOTAL (Lines 01-06) $ Substitutes for Public Explain 08 School Personnel purpose: (6112) $ Extra-Duty Explain 09 Pay/Beyond Normal purpose: Work Hours (6119/6121) $ Other Explain 10 purpose: $ 11 SUBTOTAL (Lines 08-10) $ Fringe Benefits paid from subgrant funds for all positions listed on this 12 schedule 2 $ 13 TOTAL COSTS (add lines 7 + 11 + 12) $ For federally-funded projects, charges to payroll must be documented according to the requirements in OMB Circular A-87. Refer to the THEO website for a summary of these requirements. From the USDE letter dated July 22, 2014: Title I, Part A, may be used to pay for all or a portion of the homeless liaison’s salary. Title I funds may also be used to transport homeless students to and from the school of origin. The homeless education liaison’s position and transportation costs must be budgeted in the NCLB Consolidated Application under Title I, Part A, if funding from Title I.1 For teachers, instructional aides, and tutors, provide the grade levels and subject areas. 2 If fringe benefits will be paid from other sources, name the source of funds that will cover fringe benefit costs:42 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: SCHEDULE #7B: Professional and Contracted Services 6200Flow Through Related to Total Activity or Fiscal Member Budgeted Line Schedule Agent LEAs Expend- No. Description of Expense Items Specify/Explain Number(s) Amount (6493) itures 01 Contracted Services provided by ESC (6230). Specify type(s) of services in next column. 02 Professional/Consulting Services Licensed or Registered with the State (6219). For each consultant/contractor provide a line on Schedule #7B.1: Contractor Information. 03 Other Professional/Consulting Services (629X). For each consultant/contractor provide a line on Schedule #7B.1: Contractor Information.04 Contracted maintenance and repair of equipment purchased with grant funds (624X). Specify type and purpose in next column. 05 Utilities (625X). Includes telephone, FAX charges, and telecommunication services, water, electricity, and gas for heating/cooling for grant activities conducted before school, after school, or during the summer. Specify type and purpose in next column. 06 Rental or lease of equipment or building space (6269). Specify type and purpose in next column. 07 Contracted Transportation for Excess Cost of School-of-Origin Transportation (6269) Explain purpose in next column 08 Contracted Transportation that is not related to School-of-Origin Transportation (6269 or 62XX) Explain purpose in next column 09 Tuition Services (6220). Explain purpose in next column. 10 Other Explain purpose in next column. 11 TOTAL COSTS (add lines 01 through 10) $All contracted services must be provided by persons not employed by the applicant. The applicant shall not use or pay any consultant if the services could have been rendered by applicant’s employees. “Honoraria” are not allowable expenditures. See instructions.Copyright/Ownership: The subgrantee must ensure that the TEA/Region 10 Education Service Center retains copyright and ownership of any and all materials/products conceived or developed under the grant by any and all contractors. Subgrantee must ensure that such copyright/ownership is clearly stated in any and all written agreements/contracts for services.43 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.:SCHEDULE #7B.1: Contractor Information (A supplement to lines 02 and 03 of Schedule #7B: Professional and Contracted Services 6200)For each consultant/contractor listed on lines 02 (6219) and 03 (629X) of Schedule #7B: Professional and Contracted Services 6200, include a brief description of the services to be provided. Add as many rows as necessary. Do not include information about any items on lines other than 02 and 03 of Schedule #7B.Flow Through to Total Fiscal Member Budgeted Name or Type of Agent LEAs Expend- Consultant/Contractor Description of Services Amount (6493) ituresTOTAL COSTS of lines 02 and 03 from Schedule #7B: Professional and Contracted Services 6200 $44 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year One45 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: SCHEDULE #7C: Supplies and Materials 6300Flow General Through Descriptions/ Related to Total Lists of Activity or Fiscal Member Budgeted Line Hardware/ Schedule Agent LEAs Expend- No. Description of Expense Items Equipment Number(s) Amount (6493) itures 01 General program supplies and materials (639X). Includes consumable teaching and office supplies; workbooks; audio-visual aids such as DVDs; computer software; and supplies for technology. Give general description in next column.02 Student School Supplies (639X). Give general description in next column.03 Textbooks and other reading materials (632X). Includes textbooks and magazines, periodicals, newspapers and reference books placed in the classroom or in an office. Also includes library books and media that are not capitalized and/or that have a useful life of one year or less. Subscriptions to periodicals/magazines must be in the name of the organization and not in the name of an individual. Give general description in next column.04 Testing materials (633X). Does not include scoring of tests. Give general description in next column.05 Emergency Clothing, Shoes, Hygiene Items (639X). Give general description in next column.06 Computer hardware (not capitalized) (6395). List the hardware requested and the estimated quantity for each type in the next column. Describe the use/purpose of the hardware in accomplishing the objectives of the project. An amendment is required if the use/purpose of the hardware changes, if the estimated quantity of an item increases by Quantity: more than 20 percent, or if a new item is requested. Item: Attach an additional page if necessary. Use/Purpose: 07 Other equipment (not capitalized) (6395). List equipment requested and the estimated quantity for each in the next column. Describe the use/purpose of the equipment in accomplishing the objectives of the project. An amendment is required if the use/purpose Quantity: of the equipment changes, if the estimated quantity increases by more than 20 percent, Item: or if a new item is requested. Attach an additional page if necessary. Use/Purpose:46 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year One08 Supplies/materials for maintenance and/or operations (631X) Give general description in next column. Includes gasoline/fuel for transportation, janitorial supplies, building maintenance supplies, and supplies for upkeep of equipment. 09 Other (63XX) Give general description in next column.10 TOTAL COSTS (add lines 01 through 09) $All costs include shipping and handling costs.47 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: SCHEDULE #7D: Other Operating Costs 6400Flow Through Related to Total Activity or Fiscal Member Budgeted Line Identify/Explain Schedule Agent LEAs Expend- No. Description of Expense Items Purpose Number(s) Amount (6493) itures 01 Travel Costs for Employees and Non- (Enter the Employees (6410). total Includes: amount a. In-State Travel requested b. Conference/Workshop/Seminar for travel. Registration Fees. Do not split out the Rates for travel may not exceed those costs established in the General Appropriations among sub- Act for Texas. items.)02 Out-of-State Travel Costs for Employees and Non-Employees (6419). 03 Membership Dues (6495) in Professional Organizations. However, membership dues to organizations that lobby are not allowable. Membership must be in the name of the subgrantee organization and not in the name of an individual. Identify memberships in next column. 04 Awards/Incentives for Participation and Miscellaneous Items (6499) (nominal in cost) Identify types of awards/incentives and miscellaneous items to be provided in next column. 05 Testing Fees (6499) Identify types of testing fees in the next column. 06 Insurance (6420). (personal insurance is not allowable) Explain purpose in next column. 07 Transportation that is not school-of- origin transportation (6494) Transportation that is not related to school- of-origin transportation. This category can include such supplemental transportation as field trips and transportation to and from before- and after-school tutoring. Explain purpose in next column. 08 Excess cost for School of Origin Transportation (6499) This cost must be calculated as a per mile cost that includes all expenses (e.g., driver, gas, maintenance, repairs). Consult your transportation director for assistance or contact your THEO consultant. 09 Excess cost for School of Origin Transportation that is NOT Provided by a Regular School Bus This category is used when transportation other than a school bus provides transportation to the school of origin. For example, bus passes, taxi fare, and parent reimbursement.48 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year One10 Food and Beverage Costs (not provided by the district food service program) (6499). Refer to instructions for allowable food costs. Explain purpose in next column. 11 Stipends to Non-employees (6413). Explain purpose in next column. 12 Other Explain purpose in next column.13 TOTAL COSTS (add lines 01 through 12) $49 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year One50 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: SCHEDULE #7E: Capital Outlay 6600 Flow Related Through to Total Activity or Fiscal Member Budgeted Line Description/ Schedule Unit Agent LEAs Expend- No. Description of Expense Items Purpose Number(s) Quantity Cost Amount (6493) itures 01 Library Books and Media (capitalized and controlled by library) (6669)02 Technology hardware, capitalized (66XX)03 Technology software, capitalized (66XX)04 Equipment, furniture, or vehicles (66XX)05 TOTAL COSTS (add lines 01 – 05) $All costs include shipping and handling.For open-enrollment charter schools: funds to be used for capital assets should be requested on this schedule. Refer to the Special Supplement to Financial Accounting and Reporting Nonprofit Charter School Chart of Accounts: A Module of the TEA Financial Accounting System Resource Guide for reporting expenditures for capital assets in PEIMS.51 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year One1.52 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: SCHEDULE #7F: Adaptation of Space Related Total Budgeted Activity or Fiscal Expenditures Description of Schedule Agent Flow Through to (not to exceed $5,000 Line No. Expense Items Numbers Amount Member LEAs (6493) total)01 Adaptation of $ Space for nonschool facilities Costs must be budgeted on the appropriate budget schedule in the appropriate line item. For example, any labor to adapt space must be performed by LEA employees or by employees of the nonschool facility (at no charge to the grant). If LEA employee labor is to be charged to the grant, the position performing the work must be listed on Schedule #7A: Payroll Costs 6100. Supplies and materials, such as paint and carpeting, must be budgeted on Schedule #7C: Supplies and Materials 6300. Equipment, such as study carrels, must be budgeted according to the LEA’s capitalization policy, either Schedule #7C: Supplies and Materials 6300, or Schedule #7Capital Outlay 6600. The total of the costs budgeted on the separate budget schedules added together must equal the total amount provided above.PROJECT JUSTIFICATION: A. Facility Types and Name(s): (1) 2) (3) B. Estimated date(s) of completion: (1) 2) (3) C. For each adaptation (1 through 3), provide a statement below explaining why this proposed adaptation of space is necessary and how it will benefit children and youth in homeless situations. Describe the major components of the adaptation project53 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: SCHEDULE #8: Certification for Shared Services Arrangements The actual signatures must be submitted separately, using the separate Certification for Shared Services signature page available on the THEO website. Instructions for completing and submitting the Certification for Shared Services signature page are on the instructions for this schedule. This schedule is to be submitted with each application and if a new member joins the Shared Services Arrangement.Program Authority: Public Law 107-110 McKinney-Vento Homeless Education Assistance Improvements Act of 2001.I, as one of the undersigned, certify that to the best of my knowledge, the information contained in this application is correct and complete, that the local education agency (LEA) that I represent has authorized me to file this application, and that such authorization action is recorded in the minutes of the agency's board meeting. The participating or intermediate education agency named below has been designated as the administrative and fiscal agent for this project and is authorized to receive and expend funds for the conduct of this project. The fiscal agent is accountable for all shared services arrangement activities and is therefore responsible for ensuring that all funds including payments to members of shared services arrangements are expended in accordance with applicable laws and regulations. All participating agencies have entered into a written shared services agreement which describes the responsibilities of the fiscal agent and SSA members, including the refund liability that may result from on- site monitoring or audits and the final disposition of equipment, facilities, and materials purchased for this project from funds specified below. It is understood that the fiscal agent is responsible for the refund for any exceptions taken as a result of on-site monitoring or audits; however, based upon the SHARED SERVICES AGREEMENT, which must be on file with the fiscal agent for review, the fiscal agent may have recourse to the member agencies where the discrepancy(ies) occurred. All funds are released when the tentative entitlement is released, i.e., any additional funds that result from the maximum entitlement or from reallocation will not require additional signatures. Each member identified below acknowledges accountability for the requirements contained in Schedules #12 and #13A-D as applicable. L Amount of Funds i County Typed Name and Title of Designated for n District Typed Legal Name Authorized Member Use e Number of Agency Representative Signature (If Applicable) # (A) (B) (C) (D) (E) 01 Designated Fiscal Agent: $02 Member LEAs: $030405060708091011121314151617181920 TOTAL AMOUNT $54 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: SCHEDULE #9: Equitable Access and Participation (Required for Programs funded by the U.S. Department of Education) (This schedule will be distributed as part of the initial NOGA. Afterwards, it will be kept on file and will be available only upon request. It can be amended at any time. However, it will not be distributed as part of the regular amendment or continuation packages unless an applicant specifically requests it in order to make changes.)1. Listed in the table in Item #4 are barriers that may prevent students, teachers, and other beneficiaries from having equitable access to and participation in McKinney-Vento projects and activities. After reading the barriers listed, determine which, if any, are applicable, in member LEAs. Place an X in box #1A or #2B to indicate which best describes the barriers in member LEAs of this SSA. Check only one box.1A. Barriers do not exist in any member LEA. If no homeless students in any member LEA experience any of the barriers listed below, justify why this subgrant is necessary; do not check or respond to anything else on this schedule (also use this section as described in 2B below):1B. Barriers do exist in one or more member LEAs that will be addressed. Go to item #2 below.2. If Box #1B above is checked, place an X in Box #2A or #2B below to indicate the extent to which member LEAs experience barriers. Check only one box.2A. All member LEAs share the same barriers as listed in #1B above and use the same strategies to address the barriers. For each barrier below that is checked, briefly describe the strategies the applicant will use to ensure that the affected group will have equitable access to and participation in the McKinney-Vento project. Not every group will be affected by a given barrier––provide descriptions of strategies only for the groups that are affected. Use additional pages as needed. 2B. Member LEAs have different barriers and will use different strategies to address the barriers. Submit a completed, separate Schedule #9 for each member LEA; be sure to include the name of the member LEA in the box in Item #3 on each schedule. Also include a Schedule #9 for each member LEA for which no barriers exist. For those with no barriers, use box #1A to provide an explanation as to why the LEA is a member of this SSA.3. If Box #2B above is checked, please provide the member-LEA name for this specific schedule:4. Barriers and Strategies to Address Them Strategy for Barriers Strategy for Students Teachers Strategy for Others a Gender-specific bias b. Gang-related activities c. Drug-related activities d. Visual impairments e. Hearing impairments f. Learning disabilities g. Lack of transportation to program activities h. Lack of knowledge regarding program benefits i. High mobility rates j. Absenteeism/truancy k. Lack of support from parents 55 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year One l. Inaccessible physical structures m. Shortage of qualified personnel n. Cultural, linguistic, or economic diversity o. Other physical disabilities/constraints p. Other:56 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: SCHEDULE #10: Policies and Procedures ImplementationMember District Name:A. For each item below, indicate whether or not the member LEA has documentation on file to verify compliance by checking either the “Yes” or “No” box. Submit a separate form for each member LEA.1 The applicant has policies and procedures to ensure that homeless children and youth are not stigmatized or Yes . segregated on the basis of their status as homeless (i.e., provide evidence that the district does not host or No support separate schools or classrooms within schools for homeless children and youth). [No Child Left Behind Act, Title X, Part C, §722(g)(1)(J)(i)] 2 The applicant has policies and procedures to ensure that the enrollment, attendance, and academic success Yes . challenges identified in Schedule 6B—Needs Identification Justification are addressed. [No Child Left Behind Act, No Title X, Part C, §722(g)(1)(I)] 3 The applicant has policies and procedures to ensure that homeless children and youth are enrolled in school Yes . immediately. [No Child Left Behind Act, Title X, Part C, §722(g)(3)(C)(i)] No4 The applicant has policies and procedures to ensure that homeless children and youth are enrolled in the school Yes . that is in their best interest (the school of origin or the school in the attendance zone where children or youth No reside) and are allowed to remain in that school until the end of the school year if they become permanently housed or through the duration of homelessness. [No Child Left Behind Act, Title X, Part C, §722(g)(3)(A)(i)(I)(II) and (ii)] 5 The applicant has policies and procedures to ensure that transportation is provided, at the request of the parent or Yes . guardian (or in the case of an unaccompanied youth, the liaison), to and from the school of origin. [No Child Left No Behind Act, Title X, Part C, §722(g)(3)(J)(iii)(I) and (II)] 6 The applicant has policies and procedures to resolve enrollment disputes. Yes . No In the space below, describe how parents/unaccompanied youth will be informed in writing about the decision made regarding enrollment in the school in which the student was attempting to enroll, regardless of whether the student will or will not be allowed to enroll in that particular school. [No Child Left Behind Act, Title X, Part C, §722(g)(3)(E)(i)-(iv)] Description:7 The applicant has policies and procedures to address other issues affecting homeless children and youth not Yes . addressed elsewhere in this RFA. NoIf “Yes,” use the space below to describe the issues such policies and procedures address. Description:B. Position(s) responsible for developing, implementing, and revising (if necessary) the policies and procedures required by the McKinney-Vento Act and listed above. Positions:57 RFA #ESCR-10 (SSA Application) H2015-17(1) REGION 10 EDUCATION SERVICE CENTER Texas Support for Homeless Education Program (TEXSHEP), 2015-2017: Year OneCounty-District No.: SCHEDULE #11: Disclosure of Lobbying ActivitiesThis schedule is required only if the applicant has lobbying activities to disclose. Do not submit if there are no lobbying activities to disclose.(This schedule will be distributed as part of the initial NOGA. Afterwards, it will be kept on file and available only upon request. It can be amended at any time. However, it will not be distributed as part of the regular amendment or continuation packages unless an applicant specifically requests it in order to make changes.) Member LEA Name:Complete this form to disclose lobbying activities for lobbying services procured (pursuant to 31 U.S.C. 1352). This disclosure form is required for any federal grant/contract received in excess of $100,000 and on any subgrant/subcontract made by the grantee/contractor. (Read the instructions for this schedule for further information.) Do not sign and submit this disclosure form unless lobbying activities are being disclosed. Federal Program Name______1. Type of Federal Action 2. Status of Federal Action: 3. Report Type: a. Contract a. Bid/Offer/Application a. Initial filing b. Grant b. Initial award b. Material change c. Post-award For Material Change Only: Year quarter date of last report 4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Region 10 Education Service Center Subawardee 400 East Spring Valley Road Tier, if known: P.O. Box 831300 Congressional District, if known: Richardson, Texas 75083-1300 Congressional District, if known: 32 6. Federal Department/Agency: 7. Federal Program Name/Description:CFDA Number, if applicable: 84.196 8. Federal Action Number, if known: 9. Award Amount, if known: $ 10. a. Name and Address of Lobbying Registrant 10. b. Individuals Performing Services (including address if different from (if individual, last name, first name, MI): No. 10a; last name, first name, MI):(attach Continuation Sheet(s), if necessary)[ITEMS 11-15 REMOVED]16. Information requested through this form is authorized by Title Signature 31 U.S.C. Section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when this transaction was made or Print Name entered into. This disclosure is required pursuant to 31 U.S.C 1352. This information will be reported to the Congress semi- Title annually and will be available for public inspection. Any person who fails to file the required disclosure shall be Telephone Date subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Federal Use Only: Standard Form LLL58 RFA #ESCR-10 (SSA Application) H2015-17(1)

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