ࡱ>       bjbjWW ==f%%'''s(s(s(X)4+s(|35(555 ==dG>4&*9'.N;N =.N.N%%55 J$VVV.N%<5'5V.NVVA#'|5pqs(PZn<wJRSfٿv'O1{>mCVFIe{>{>{>Tf{>{>{>.N.N.N.N{>{>{>{>{>{>{>{>{> $: Notice of Grant Opportunity 21st Century Community Learning Centers Program Training and Technical Assistance Continuation Application 16-EK35-H05 September 1, 2015 August 31, 2016 David C. Hespe Commissioner Susan Martz Assistant Commissioner Division of Student Services and Career Readiness Nancy Curry Director Office of Student Support Services Division of Student Services and Career Readiness June 2015 Application Due Date: July 23, 2014 CFDA #84.287C NEW JERSEY DEPARTMENT OF EDUCATION P.O. Box 500 Trenton, NJ 08625-0500  HYPERLINK "http://www.state.nj.us/education" http://www.state.nj.us/education STATE BOARD OF EDUCATION MARK W. BIEDRON . Hunterdon President JOSEPH FISICARO. Burlington Vice President ARCELIO APONTE.............................................................................. Middlesex RONALD K. BUTCHER .. Gloucester CLAIRE CHAMBERLAIN .. Somerset JACK FORNARO..... Warren EDITHE FULTON . Ocean ERNEST P. LEPORE .... Hudson ANDREW J. MULVIHILL Sussex J. PETER SIMON . Morris DOROTHY S. STRICKLAND .. Essex Dave C. Hespe, Commissioner Secretary, State Board of Education It is a policy of the New Jersey State Board of Education and the State Department of Education that no person, on the basis of race, color, creed, national origin, age, sex, handicap or marital status, shall be subjected to discrimination in employment or be excluded from or denied benefits of any activity, program or service for which the department has responsibility. The department will comply with all state and federal laws and regulations concerning nondiscrimination. TABLE OF CONTENTS When responding to this Notice of Grant Opportunity (NGO), applicants may also access the "Discretionary Grant Application (DGA)" for additional information governing the grant program. All forms are attached to this NGO. See HYPERLINK "http://www.nj.gov/njded/grants/discretionary/apps/"www.nj.gov/njded/grants/ or call the Application Control Center (ACC) at 609-633-6974. SECTION 1: GRANT PROGRAM INFORMATION PAGE 1.1 Description of the Grant Program 1 1.2 Eligibility to Apply 2 1.3 Federal Compliance Requirements (DUNS, SAM) 2 1.4 Statutory/Regulatory Source and Funding 3 1.5 Dissemination of This Notice 3 1.6 Technical Assistance 3 1.7 Application Submission 3 1.8 Program and Fiscal Reporting Requirements 4 1.9 Assessment of Statewide Program Results 5 1.10 Reimbursement Requests 5 1.11 Audit Reports 5 SECTION 2: PROJECT GUIDELINES Project Design Considerations 6 Project Requirements 6 Budget Design Considerations 11 Budget Requirements 12 SECTION 3: COMPLETING THE APPLICATION 3.1 General Instructions for Applying 15 3.2 Review of Application 15 3.3 Application Component Checklist 15 ATTACHMENTS: Application forms SECTION I: GRANT PROGRAM INFORMATION DESCRIPTION OF THE GRANT PROGRAM The New Jersey Department of Education (NJDOE), Office of Student Support Services (OSSS), seeks to offer this continuation notice of grant opportunity to provide statewide training and technical assistance to improve the quality of programming and build the capacity of staff in 43 21st Century Community Learning Centers (21st CCLC) existing grantees and up to 10 additional new grantees for the 2015-2016 grant period. Through this NGO, NJDOE expects to expand the resources and expertise available to 21st CCLC grantees and allow for more efficient use of resources by collaborating and coordinating the resources of other state agencies, community based organizations, foundations and/or corporations. It is the intention of this NGO to enhance 21st CCLC program quality and staff capacity through professional development for both school day and afterschool staff. Therefore, the grantee must develop a training and technical assistance plan that responds to the following goals: Develop and conduct capacity building training and professional development opportunities for the 21st CCLC programs and other out-of-school time programs to increase the quality programs within the state of New Jersey (Goal 1); Support 21st CCLC programs in enhancing and improving student academic performance by promoting research-based programs and practices and program sustainability (Goal 2); Facilitate networking opportunities for out-of-school time program providers throughout New Jersey (Goal 3); and Provide targeted technical assistance to 21st CCLC programs in the use of valid and reliable data for continuous improvement (Goal 4). New Jerseys Vision for 21st CCLC Programs The vision for New Jerseys 21st CCLC program is to develop high quality out-of-school time programs through community learning centers that provide services not just to the child but to the entire family. The provision of services through 21st CCLC programs throughout the state will: Increase students career and college readiness by offering high-quality remediation activities in core academic areas such as language arts and mathematics and enrichment activities including arts and culture, youth development experiences, and physical activity; Increase positive student behavior by infusing social, emotional, and character development into the program; Engage adult family members of participating students through participation in an array of parental involvement activities; and Establish and maintain partnerships and collaborative relationships to ensure participants access to all available resources through coordinated efforts and to sustain programs. Grant Program Period The award will be issued on an annual basis with the NJDOE reviewing program performance through reports, monitoring, adequate and efficient use of federal funds, and a continuation application to determine continued program funding. The year four award period is September 1, 2015 through August 31, 2016. The subsequent and final project period is: Year 5: September 1, 2016 August 31, 2017 NOTE: The award will be issued on an annual basis contingent on continued program eligibility, program performance and availability of federal funds. ELIGIBILITY TO APPLY Eligibility to apply for this Training and Technical Assistance Continuation grant is limited to the currently funded agency from the year one grant, the New Jersey School-Age Care Coalition (NJSACC). 1.3 FEDERAL COMPLIANCE REQUIREMENTS (DUNS, SAM) In accordance with the Federal Fiscal Accountability Transparency Act (FFATA), all grant recipients must have a valid DUNS number and must also be registered with the System for Award Management (SAM), the successor to the Central Contractor Registration (CCR) database. DUNS numbers are issued by Dun and Bradstreet and are available for free to all entities required to register under FFATA. To obtain a DUNS number, go to  HYPERLINK "http://fedgov.dnb.com/webform/" http://fedgov.dnb.com/webform/ To register with the SAM database, go to  HYPERLINK "http://www.sam.gov" www.sam.gov Applicants are required to submit their DUNS number and expiration date of their SAM registration as part of the application and must certify that they will ensure that their SAM registration will remain active for the entire grant period. FFATA Executive Compensation Disclosure Criteria In the preceding fiscal year, if an applicant: Received at least $25 million in annual gross revenues from federal awards; and, If at least eighty (80) percent of the applicants annual gross revenues came from federal awards; the applicant is required to disclose the name and total compensation of the five (5) most highly compensated officers of the applicant as part of the grant application. This information is to be submitted with the application. The term federal award includes federal contracts, sub-contracts, grants, and sub-grants. No award will be made to an applicant not in compliance with FFATA. STATUTORY/REGULATORY SOURCE AND FUNDING The grantees project must be designed and implemented in conformance with all applicable state and federal regulations. The 21st CCLC Training and Technical Assistance NGO is 100% federally-funded under Title IV, Part B of the NCLB Act of 2001, CFDA # 84.287C. The continuation project year of this multi-year grant program will begin September 1, 2015 and end August 31, 2016 based upon the availability of Title IV, Part B funds. The NJDOE will provide $160,000 to the existing recipient, New Jersey School-Age Care Coalition. These funds must supplement and not supplant other federal, state or local funds. Failure to demonstrate the aforesaid will result in the reduction of the requested award amount. The grantee is expected to complete the goals and objectives laid out in the approved grant application, complete implementation activities established in its grant agreement, and make satisfactory progress toward the completion of its approved action plan. Failure to do so may result in the withdrawal by the NJDOE of the grantees eligibility for the continuation of grant funding. The NJDOE will remove ineligible, inappropriate or undocumented costs from funding consideration. The grantee is reminded that the federal funding language and New Jersey 21st CCLC logo must be prominently displayed on all printed and electronic program materials. Additionally, the grantee must ensure that the program is listed on the agencys website to assist in marketability and recognition of the program. DISSEMINATION OF THIS NOTICE The OSSS will make this notice available to the current award recipient. The award recipient may access additional copies of the NGO at the NJDOEs website:  HYPERLINK "http://www.state.nj.us/njded/grants/discretionary/" http://www.state.nj.us/njded/grants/discretionary/. 1.6 TECHNICAL ASSISTANCE A technical assistance workshop will not be held. 1.7 APPLICATION SUBMISSION The NJDOE administers discretionary grant programs in strict conformance with procedures designed to ensure accountability and integrity in the use of public funds and, therefore, will not accept late applications. The responsibility for a timely submission resides with the applicant. The applicant must submit an original and four (4) copies of the completed application and all applicable forms, to the Application Control Center (ACC) no later than 4:00 P.M. on Thursday, July 23, 2015. Without exception, the ACC will not accept, and the Office of Grants Management cannot evaluate for funding consideration, an application received after this deadline. The applicant will lose the opportunity to be considered eligible for an award if the application is received after the due date. The original and four (4) copies of the application must be mailed or hand-delivered to the ACC. Postmarks are not acceptable evidence of timely submission. Receipt by the due date and time is required. The applicant is encouraged to obtain a dated receipt from the ACC or to sign in upon delivery to verify NJDOE receipt. The complete application includes all elements listed in Section 3.3, Application Component Checklist of this notice. Applications submitted via facsimile will not be accepted under any circumstances. To ensure timely delivery, the applicant is encouraged to: Hand-deliver the application to 100 River View Plaza, Trenton, New Jersey, which is located next to the Mercer County Waterfront Park on Route 29, between the hours of 8:30 A.M. and 4:00 P.M., Monday through Friday (excluding state holidays) and obtain a dated receipt; or Send the application by Certified Mail or Return Receipt; or Arrange for delivery by an overnight courier service to ensure timely delivery. The mailing and courier service addresses are listed in the chart below: Mailing AddressCourier Service AddressApplication Control Center New Jersey Department of Education 100 River View Plaza P.O. Box 500 Trenton, NJ 08625-0500Application Control Center New Jersey Department of Education 100 River View Plaza Trenton, NJ 08625 1.8 PROGRAM AND FISCAL REPORTING REQUIREMENTS Grant recipients are required to submit quarterly program and fiscal progress reports. For additional information regarding post-award reporting requirements, please review the Grant Recipients Manual for Discretionary Grants, Part Seven, which is available online at  HYPERLINK "http://www.nj.gov/njded/grants/discretionary/management/manual.shtml" http://www.nj.gov/njded/grants/discretionary/management/manual.shtml. All reports will be submitted through the online EWEG system. Program and fiscal reports for this program will be due through EWEG as follows: Program/Fiscal Report Quarterly Reporting Period Due Date_____ 1st Quarter September 1, 2015 December 31, 2015 January 31, 2016 Interim September 1, 2015 March 31, 2016 April 30, 2016 3rd Quarter September 1, 2015 June 30, 2016 July 31, 2016 Final September 1, 2015 August 31, 2016 October 31, 2016 Applicants will be required to submit the above reports through the online EWEG system at  HYPERLINK "http://homeroom.state.nj.us" http://homeroom.state.nj.us on the dates specified above. Accompanying the program report, the grantee is required to submit a narrative summary of activities conducted during the reporting period. This summary may be submitted as an upload within EWEG. A minimum of 5% of the total award amount will be withheld until all final reports have been submitted, reviewed and approved by the NJDOE. ASSESSMENT OF STATEWIDE PROGRAM RESULTS The NJDOE will utilize all available data to assess the effectiveness of the award recipient. Data may include, but is not limited to, participant evaluations, follow-up surveys, quarterly reports and deliverables outlined in this training and technical assistance NGO. The evaluation of the training and technical assistance project will be based on the extent to which the grantee: Fulfills the requirements detailed in this NGO, including deliverables, timelines and quarterly reporting; Provides trainings that are appropriate and effective using the results of the participant evaluation forms, follow-up surveys, and other appropriate methods of data collection; and Attains the goals, objectives and indicators described in Section 2.2. 1.10 Reimbursement Requests Payment of grant funds is made through a reimbursement system. Reimbursement requests for any grant funds the local project has expended are made through the EWEG system. Reimbursement requests may begin once the application has been marked Final Approved in the EWEG system, and the grantee has accepted the award by clicking on the Accept Award button on the Application Select page and completing the Grant Acceptance Certificate information. Payments cannot be processed until the award has been accepted in EWEG. Only one (1) reimbursement request may be submitted per month. In order to receive a reimbursement at the beginning of the following month, applicants, if awarded, must submit a monthly request no later than the 15th of the month. The requests may include funds that will be expended through the last calendar day of the month in which reimbursement is requested. If the grantees request is approved by the NJDOE program officer, the grantee should receive payment approximately between the 8th10th of the following month. A tutorial on reimbursement requests may be found at  HYPERLINK "http://www.nj.gov/education/grants/rrt.htm" http://www.nj.gov/education/grants/rrt.htm. The last day to submit a reimbursement request for this program is August 15, 2016. NOTE: The NJDOE will not approve a reimbursement request(s), if a program has any outstanding report(s). 1.11 AUDIT REPORTS This grant program is subject to the single audit policy outlined in NJ OMB Circular 15-08-OMB. Grantees subject to these requirements must submit their single audit report within nine (9) months of the end of the State fiscal year, which is June 30th. Therefore, the due date for the audit report is March 31, 2016. SECTION 2: PROJECT GUIDELINES The intent of this section is to provide the grantee with the framework within which it will plan, design, and develop its proposed project to meet the purpose of this grant program. When developing the application, the grantee may refer to the information found in the Discretionary Grant Application (DGA) available at  HYPERLINK "http://www.nj.gov/education/grants/discretionary/apps" http://www.nj.gov/education/grants/discretionary/apps. This NGO contains all of the required forms for this grant program. PROJECT DESIGN CONSIDERATIONS The grantee must develop the training and technical assistance plan that supports the 21st CCLC grantees to fulfill program requirements and also builds the capacity of the program staff which in turn will enhance the quality of the program. NJDOE expects to address program quality, sustainability and networking through training and technical assistance activities. All activities must support the participation of the 43 21st CCLC existing grantees. Additionally, NJDOE anticipates awarding up to 10 additional 21st CCLC grantees during the 2015-2016 project period that will also receive technical assistance and training. PROJECT REQUIREMENTS The grantee may use the funds to provide a broad array of training and technical assistance, approved by the NJDOE, to 21st CCLC programs and other eligible entities. Through this 21st CCLC Training and Technical Assistance project, the NJDOE intends to provide training and technical assistance that both assists the 21st CCLC grantees in implementing high quality programs and building the capacity of the program staff. The grantee agrees to: Promote the development, continuity and expansion of quality 21st CCLC grantees through on-site quality technical assistance visits; Utilize nationally recognized quality standards for afterschool in developing trainings, workshops and conferences. Conduct annual assessments of current 21st CCLC grantees to determine future training and technical assistance needs, that could include but are not limited to: sustainability efforts, out-of-school time needs and gaps across the state, program successes/ challenges; Develop all training content in collaboration with the NJDOE based on the analysis of 21st CCLC State-level evaluation and other data to identify program needs; Utilize presenters with documented expertise in the subject matter of the training or workshop they will provide; Culminate all trainings by assisting attendees in developing a plan to use the information obtained to improve the quality of their programs; Advertise all trainings, workshops and conferences a minimum of two months before the actual date of the session; Secure meeting locations; Maintain the capacity for on-line registration; Conduct planning meetings with the NJDOE staff at least 12 weeks prior to the training dates; Informally follow-up with grantees via email following each training; and Address the extent to which each training/technical assistance session achieved the goals and objectives established for the session to inform future planning and strategies. To maintain consistency with the regulations set forth by the United States Department of Education (USDE), the NJDOE has established minimum program requirements that must be addressed by the grantee. The following requirements are broken into the following sections: Project Description; Goals, Objectives and Indicators; and the Project Activity Plan. Project Description The grantee must provide a detailed description of the year four proposed project, including how the project will be implemented, managed and staffed. The grantee must address the following goals and objectives within the Project Description section: Develop and conduct capacity building training and professional development opportunities for the 21st CCLC programs and other out-of-school time programs to increase the quality programs within the state of New Jersey (Goal 1). Quality afterschool programs provide a unique environment where children and youth can develop a range of skills needed to support full involvement in their communities. Researchers have found that effective programs combine academic, enrichment, cultural and recreational activities to guide learning and engage youth. The vision of the New Jersey 21st CCLC program is to develop and support long-term, sustainable programs and practices that enhance or improve students academic performance. The grantee will be responsible to: Provide workshops focused on promoting quality improvement and specifically in the following areas: 21st Century Afterschool Science Project (21st CASP), Career Awareness and Exploration, Visual and Performing Arts, Science, Technology, Engineering and Mathematics and Civic Engagement. Provide leadership and mentorship training to 21st CCLC project directors and other out-of-school time (OST) veterans who desire to serve as mentors to newer 21st CCLC and OST programs. The grantees response must identify the frequency, method and anticipated outcome of the trainings and technical assistance. Support 21st CCLC programs in enhancing and improving student academic performance by promoting research-based programs, practices and program sustainability (Goal 2). As the national perspective of afterschool focuses on quality, it is imperative that the NJDOE provides training and technical assistance that directly impacts program quality through assisting the 21st CCLC grantees in achieving program requirements and builds the capacity of the program staff. The grantee must use presenters with documented expertise in the subject matter of the training or workshop they will provide. The NJDOE will assist in providing training materials in tandem with the grantee and in securing training venues and presenters. The grantee will be responsible to: Plan and provide a new grantee orientation for the new cohort of 21st CCLC competitive grantee awards in collaboration with the NJDOE. Plan and facilitate a total of four Project Director Meetings to be scheduled once per quarter throughout the year. Specific dates will be mutually agreed upon within 30 days of the award. Topics for each meeting will be determined in conjunction with the NJDOE and based on improving program quality, grantee feedback, needs identified in the statewide evaluation reports and grantee needs identified by NJDOE and training and technical assistance project staff. Training must also be provided for the three Cohort 7a grantees in their final grant year, regarding program sustainability. Each meeting will include time for differentiated training/technical assistance dependent on the topics being covered and identified need of the programs. Each meeting will include time for networking among the program staff as well as presentations from 21st CCLC grantees to share information on effective practices and activities. Each meeting will begin with a review of follow-up assignments and conclude with homework assignments for the next meeting. Develop supportive materials to assist grantees in implementing the specific requirements in the New Jersey Quality Standards for Afterschool. Conduct on-site technical assistance visits to promote quality and continuous improvement. The grantee will provide technical assistance and guidance during these visits and maintain appropriate documentation of information provided. The grantee and the NJDOE will pre-determine 21st CCLC programs to be visited based on established criteria (e.g. needs identified during site visits, evaluation information, identified promising practices and monitoring). The grantees response must identify the frequency, method and anticipated outcome of the trainings and technical assistance. Integration Strategies To ensure the implementation of quality enrichment programming within 21st CCLC programs and assist the NJDOE in realizing its vision, the grantee must address how it plans to integrate the following strategies in the overall training and technical assistance plan to: Increase participation of the 21st CCLC grantee staff by offering technical assistance in the various formats. Reinforce the use of the You 4 Youth professional development portal, developed by the USDE specifically for 21st CCLC programs nationwide. Encourage the use of inquiry based activities that guide youth in finding the answers themselves and modeling for staff how they can engage students to ask new questions along the way. Identify ways to increase academic impact in summer programs that will reduce the potential of summer learning loss. Identify methods to align with the school day (both public and non-public) to enhance participants academic and social progress and skills development. Encourage joint professional development with school day and afterschool staff. C. Facilitate networking opportunities for out-of-school time program providers throughout New Jersey (Goal 3). Partnering and collaborating is a vital part of 21st CCLC programs. The grantee will continue to develop networking opportunities with OST providers to enhance the resources available to 21st CCLC programs. The grantee will be responsible to: Coordinate, in consultation with the NJDOE, a 21st CCLC statewide afterschool conference, entitled Soaring Beyond Expectations: An Afterschool Showcase that will highlight selected 21st CCLC programs. Selected programs will provide workshops on sustainable practices that have demonstrated positive outcomes for students, family, school and/or community. The specific date will be mutually agreed upon within 30 days of the award. Tentative timelines include: a planning meeting during the 2nd week of October. Conference proposal invitations must be released to 21st CCLC grantees by end of November 2015; due back in January and acceptances sent out in February. Attendance will be limited to 120 attendees, excluding presenters and NJDOE personnel. Conference participants will be provided with documentation of professional development hours. Assist grantees in fulfilling their requirement to implement at least one NJ Celebrates Afterschool event annually. The grantees response must identify the follow-up, frequency, method and anticipated outcome of the trainings and technical assistance. D. To provide targeted technical assistance to 21st CCLC programs in the use of valid and reliable data for continuous improvement (Goal 4). The grantee must address its plan for supporting the 21st CCLC grantees in employing valid and reliable evaluative practices. The grantee must work with the NJDOE and the statewide evaluator to coordinate and develop training that will enhance the knowledge of 21st CCLC grantees in the use of data for effective evaluation practice to improve overall program quality. The grantee will be required to: Develop and deliver a grantee specific training on the importance of evaluation, the use of action-research and how to use data for continuous program improvement. Work with the state evaluator to develop half-day trainings that support the Evaluation Template Reporting System (ETRS), created by the American Institutes for Research (AIR) specifically for New Jerseys 21st CCLC programs. The grantees response must identify the frequency, method and anticipated outcome of the trainings and technical assistance. Management Plan The grantee must provide its intended management plan. The grantee has some flexibility in establishing their staffing patterns; however, the NJDOE will review and approve the management plan, including staffing, based on what is necessary and reasonable to implement the project and adhere to program requirements. The grantee is required to identify a project director who will serve as the agencys primary point of contact with the NJDOE program officer responsible for the grant program. This person must be employed by the grantee and is responsible for managing the administrative functions of this program. The grantees response must include a management plan that indicates all agency staff that will be working on this project, with specific time allocated to this project. Goals, Objectives, Indicators and Evaluation The NJDOE has mandated the following goals for this training and technical assistance project; however, the grantee is required to develop corresponding objectives and performance indicators. The goals, objectives and indicators must be created to support the activities described Project Description. Goal 1: To increase the quality of out-of-school time programs within the state of New Jersey. Goal 2: To support 21st CCLC programs in enhancing and improving student academic performance. Goal 3: To provide networking opportunities for out-of-school time program providers throughout New Jersey. Goal 4: To provide targeted technical assistance to 21st CCLC programs in the use of valid and reliable data for continuous improvement. Both the objectives and indicators, developed by the grantee, must be specific and measurable. The grantee's objectives provide details on how much of what will be accomplished by when. For example, one of several objectives for a community initiative to promote care and caring for older adults might be: "By 2016 (by when), to increase by 20% (how much) those elders reporting that they are in daily contact with someone who cares about them (of what)." The indicators are quantifiable performance measurements used to define success factors and measure progress toward the achievement of program goals and objectives. Each indicator must specify a time frame when that objective will be achieved; identify the clients and needs served; specify what will be achieved; and identify the expected level of performance. It may be helpful for the grantee to utilize the SMART format when developing the objectives and indicators. Specific target a specific area for improvement. Measurable quantify or at least suggest an indicator of progress. Achievable specify goals that are reachable. Realistic state what results can realistically be achieved, given available resources. Time-related specify when the result(s) can be achieved. The grantees response must include each goal with at least one or more objectives for each goal and one or more indicators for each of the identified objectives. Evaluation The grantee must describe how it will evaluate progress towards attaining the goals, objectives and indicators. The grantee must determine the effectiveness of the trainings and technical assistance provided on a quarterly basis. Additionally, the grantee must describe the types and sources of the data to be used to evaluate the effectiveness. The results of the evaluation must be used to refine, improve and strengthen the training and technical assistance plan throughout the year. The grantees response must include a description of the baseline data and outcome data, as appropriate. Project Activity Plan The grantee must describe the proposed activities for year 4. The Project Activity Plan must directly support the budget, as it will serve as the basis for the proposed expenditures. Activities described must be specific and measurable and directly relate to at least one goal and objective. For example, the following is an unacceptable activity: Meetings with community partners, community entities, collaborators. A more acceptable activity would be: The project director will meet with community entities, partners, and collaborators on a quarterly basis to discuss the sustainability plan. The grantees response must include a complete project activity form that indicates activities occurring in each of the four quarters. 2.3 BUDGET DESIGN CONSIDERATIONS The organization designated as the applicant in the original application must remain the applicant agency and must be accountable for all fiscal and program oversight for the duration of this five year award. In an effort to provide adequate funding for quality programming while promoting prudent operations and expenditures, the NJDOE will review budget line items to determine percentage of administrative costs and ensure that they, like all costs, are reasonable and necessary. Guidance on constructing a grant budget may be found in the Discretionary Grant Application (DGA) document, which can be accessed at  HYPERLINK "http://www.state.nj.us/education/grants/discretionary" www.state.nj.us/education/grants/discretionary. The grantee may not charge fees for services provided through this grant. This prohibition does not apply to charges for materials or other costs that are not included in the approved budget and that are necessary to recoup only actual costs to deliver required and approved activities. Any such charges or fees must have prior approval of the NJDOE. Income collected from fees cannot be carried over into any subsequent years. If approval is granted, the grantee will be required to submit a program income report with the quarterly and final fiscal reports. For additional information regarding the program income report, please see part seven of the Grant Recipients Manual for Discretionary Grants. This manual is available online at  HYPERLINK "http://www.nj.gov/njded/grants/discretionary/management/" www.nj.gov/njded/grants/discretionary/management/. Please consider the following when preparing the budget forms: Be sure to explain what the amounts in the Unit Cost and Quantity boxes represent for the supply, equipment and other budget entries. If the amounts in those boxes represent a calculation, describe that calculation in the description box. Be sure the description boxes also describe what the cost, the need for it, and its relation to the grant program. Mileage must be a separate budget entry. Mileage reimbursement budget entries must identify the employee title for each traveler(s) and describe the grant-related purpose(s) of the travel, as well as provide a brief explanation of how the number of miles was calculated. When requesting conference travel cost such as airfare, lodging, and meals, create separate entries for each conference. Be sure to identify the employee title of each traveler. There should be a corresponding conference registration entry. GSA.gov rates will be used at the time of the travel for all conference travel costs. Note that car transportation at a conference is generally not allowed. For airport shuttles, show the cost for up to four shuttles per person (home base to airport, to hotel, hotel to airport, back to home base). The grantees budget must be well-considered, necessary for the implementation of the project, remain within the funding parameters contained in this NGO, and demonstrate prudent use of resources. The grantee must provide a direct link for each cost to the goals, objectives and activities in the Project Activity Plan that specifies programmatic support for the proposed cost. In addition, the applicant must provide documentation and sufficient detail to support each proposed cost. BUDGET REQUIREMENTS In constructing the budget, please note that all costs must be reasonable and necessary to implement program activities. Additionally, the budget entries must demonstrate clear and specific links to the project activity plan. The applicant must complete budget detail forms, provide sufficient explanation of budgeted costs, including the calculation detail (cost-basis). In an effort to provide adequate funding for quality direct services while promoting prudent operations and expenditures, the NJDOE has limited administrative costs to 20% of the total budget. The administrative costs include the following: administrative salaries, fringe benefits, indirect costs, office supplies and office equipment. The NJDOE reserves the right to reduce these costs should it be determined that the administrative costs are excessive. The grantee must adhere to the NJDOE required provisions of A-5/Chapter Law 53. The provisions of A-5/Chapter Law 53 contain additional requirements concerning prior approvals, as well as expenditures related to travel. It is strongly recommended that the grantee work with their business administrator when constructing the budget. The NJDOE applies the A-5 restrictions uniformly to all grantees. Unless otherwise specified, the following restrictions apply to all grant programs: No reimbursement for in-state overnight travel (meals and/or lodging) No reimbursement for meals on in-state travel Mileage reimbursement may not exceed $.31 per mile The grantee must ensure that it meets all of the requirements listed below: Eligible Costs Grant funds may be used by the award recipient for the following costs that directly support the activities described in the application: Salaries and benefits for project staff; Purchase of project materials and supplies for grant-funded project activities; Identification, selection, and orientation of grant-funded staff; Other grant related expenses (e.g., printing, telephones, postage, travel, rent) that are necessary to perform grant administrative functions; and Indirect costs represent the expenses of doing business that are not readily identified with a particular grant function or activity, but are necessary for the general operation of the organization and the conduct of activities it performs. Indirect costs may be requested in the budget from applicants that either 1) have a current federally negotiated indirect cost rate agreement; or 2) have never received a federally negotiated indirect cost rate agreement. The actual indirect cost rate that may be used in budgeting is a de minimis rate, which is subject to the requirements of the grant program. If indirect costs are requested, care must be taken to ensure that costs that would be considered an indirect cost are not included in the budgeted as a direct cost. Please refer to 2 CFR Part 200.414 for additional information ( HYPERLINK "http://www.ecfr.gov" www.ecfr.gov). For grantees with a current federally negotiated indirect cost rate agreement, they must scan and upload a copy of their indirect cost rate agreement. As this program is subject to a supplement, not supplant requirement, applicants with an approved restricted indirect cost rate must use that rate; applicants with rate agreements that do not include a restricted indirect cost rate are limited to 8% MTDC. For grantees that have never received a federally negotiated indirect cost rate agreement, they must scan and upload a signed statement as part of the application. This statement must attest to the fact that the organization has never received a federally negotiated indirect cost rate agreement, and that the applicant is requesting the use of a de minimis indirect cost rate. This statement must be signed by the chief executive officer or designee of the organization. The de minimis rate is 8% MTDC, as this program is subject to a supplement, not supplant requirement. NOTE: Out-of-state travel not documented in the approved grant application requires prior approval from the grantees program officer. Ineligible Costs Funds provided under this grant may not be used for the following costs: Vehicle purchases; Food or light refreshments for any meetings and scheduled trainings; Supplanting local, state, or federal funds already designated for grant-related activities; Construction or capital improvements; Religious practices or programs, such as religious instruction, worship, or prayer; Costs that are not directly related to the implementation of grant activities; Membership to associations or organizations; In-state overnight lodging and/or meals; Meals on in-state travel; and Mileage reimbursement in excess of $.31 per mile. NOTE: Ineligible costs as well as costs not supported by the activity plan will be removed from consideration. SECTION 3: COMPLETING THE APPLICATION 3.1 GENERAL INSTRUCTIONS FOR APPLYING To apply for a grant under this NGO, the applicant must prepare and submit a complete application. The grantee must submit the Year 4 of 5 continuation application in paper form. The application will be a response to the states vision as articulated in Section 1: Grant Program Information of this NGO. It will be planned, designed and developed in accordance with the program framework articulated in Section 2: Project Guidelines of this NGO. The application package must also be constructed with the forms found only in this NGO. In preparing responses, the grantee must adhere to the following guidelines: Narrative format using complete sentences; Times New Roman, 12-point font; Single line-spacing; Single-sided pages; Sequentially-numbered pages, including forms, starting from page one, the Title Page; and Use of one budget detail form per budget code. 3.2 REVIEW OF APPLICATIONS NJDOE staff will review the continuation grant application on the basis of quality and comprehensiveness, including consistency with the comprehensive project plan selected and approved in the application under the initiating multiyear NGO. The application will also be reviewed for completeness, accuracy and appropriateness of response to each of the items identified in Section 2. Additionally, the final award will be based on the award recipients program and fiscal performance through quarterly reports, adequate and efficient use of federal funds and other areas deemed appropriate by the NJDOE. Please be advised that in accordance with the Open Public Records Act P.L. 2001, c. 404, all applications for discretionary grant funds received September 1, 2003 or later, as well as the evaluation results associated with these applications, and other information regarding the competitive grants process, will become matters of public record upon the completion of the evaluation process, and will be available to members of the public upon request. 3.3 APPLICATION COMPONENT CHECKLIST The following components are required (see Required (() column) to be included as part of your application. Failure to include a required component may result in your application being removed from consideration for funding. Use the checklist (see Included (() column) to ensure that all required components have been completed. Required (()LocationFormIncluded (() (NGOApplication Title Page(NGODocumentation of Federal Compliance (DUNS/SAM), including a copy of the Entity Overview page from the applicants  HYPERLINK "http://www.sam.gov" www.sam.gov registration. (NGOBoard Resolution to Apply (NGOStatement of Assurances (NGOProject Abstract (NGOProject Description (NGOGoals, Objectives, Indicators and Evaluation (NGOProject Activity Plan NGOBudget Form A: Full-Time and Part-Time Salaries NGOBudget Form B: Personal Services Employee Benefits NGOBudget Form C: Purchased Professional and Technical Services NGOBudget Form D: Supplies and Materials NGOBudget Form E: Equipment NGO Budget Form F: Other Costs NGO Subgrant Budget Summary(NGO Application for Funds Budget SummaryNGO Matching Funds Summary and Expenditure ReportCopy of applicants federally negotiated indirect cost rate OR a signed statement requesting the use of a de minimis indirect cost rate subject to the conditions set forth in the NGO. * Budget forms are required when applicable costs are requested. ATTACHMENTS BOARD RESOLUTION TO APPLY  FY NGO# WKL The _________________________________ Board* hereby certifies that permission has been granted to apply for the discretionary grant program entitled: for the purposes described in the application, in the amount of, $___________.00, starting on _______________, and ending on _______________. The filing of this application was authorized at the Board meeting held on, _____________________________, 20__ _______________________________ Secretary of the Board* __________________________, 20__ *For applicants that do not have a Board of Education, Board of Directors, or other similar governing body, the applicant should identify the body or individual who is legally authorized to approve the agencys application for grant funds. General Assurances The certifications listed below shall be treated as a material representation of fact by the applicant upon which the New Jersey Department of Education (NJDOE) will place reliance in making a grant award. The NJDOE is hereby assured by the applicant of the following: Legal authority Has the legal authority to apply for funds made available under the requirements for this grant program application, and has the institutional, managerial, and financial capacity (including funds sufficient to pay the federal/state/local share of project costs, as appropriate) to ensure proper planning, management, and completion of the project described in this grant application. Access to records Gives the New Jersey Department of Education (NJDOE) or its authorized representatives, access to and the right to examine all records, books, or discounts related to the award; and will establish a proper accounting system in accordance with Generally Accepted Accounting Principles (GAAP) and 200.300 et. seq. of the Uniform Grant Guidance (UGG). Conflict of Interest Shall establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest or personal gain in accordance with 200.112 of the Uniform Grant Guidance (UGG). Non-discrimination Shall comply with all federal and state statutes and regulations relating to nondiscrimination. These include, but are not limited to the following: Title VI of the Civil Rights Act of 1964 (P.L. 88-352; 34 CFR Part 100), which prohibits discrimination on the basis of race, color, or national origin; Title IX of the Education Amendments of 1972, as amended (20 U.S.C. 1681-1683, and 1685-1686; 34 CFR Part 106), which prohibits discrimination on the basis of sex; Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 794; 34 CFR Part 104), which prohibits discrimination on the basis of disability; Section 503 of the Rehabilitation Act of 1973, as amended (41 CFR Parts 61-741.5(a), as applicable, which requires affirmative action in employment; The Age Discrimination Act of 1975, as amended (42 U.S.C. 6101 et. seq.; 45 CFR Part 90), which prohibits discrimination on the basis of age; The Americans with Disabilities Act of 1990, as amended (P. L. 101-336), which prohibits discrimination on the basis of disability; The Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; Revised 4/2015 General Assurances, page 2 Any other nondiscrimination provisions in the specific statute(s) under which the application for Federal assistance is being made; and The requirements of any other nondiscrimination statute(s), which may apply to the application. Hatch Act Shall comply, as applicable, with provisions of the Hatch Act (5 U.S.C 1501-1508 and 7324-7328), which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. Trafficking Victims Protection Act Shall comply with the requirements of 106(g) of the Trafficking Victims Act (TVPA) of 2000, as amended (22 U.S.C. 7104), which prohibits grant award recipients or a sub-recipient from: (1) Engaging in severe forms of trafficking in persons during the period of time that the award is in effect; (2) Procuring a commercial sex act during the period of time that the award is in effect; or (3) Using forced labor in the performance of the award or subawards under the award. Lobbying Shall comply, for all contracts in excess of $100,000, with the New Restrictions on Lobbying (34 CFR Part 82). This certification extends to all subawards at all tiers (including subgrants, contracts under grants and cooperative agreements, and subcontracts). Debarment and Suspension Shall certify that the applicant, as well as its principals (Board of Education, Superintendent, Business Administrator, or others in equivalent positions) and subcontractors, is not presently debarred, proposed for debarment, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction from receiving federal funds in accordance with Executive Orders 12549 and 12689 and 34 CFR Part 85 Drug Free Workplace Shall comply with the provisions of the Drug Free Workplace Act of 1988, as implemented at 34 CFR Part 84, Subpart A Purpose and Coverage and Subpart B Requirements for Recipients Other Than Individuals. Equal Employment Opportunity Shall comply with Executive Order 11246, Equal Employment Opportunity dated September 24, 1965, as amended by Executive Order 11375, dated October 13, 1967, and as supplemented by the regulations at 41 CFR Part 60. General Educational Provisions Act (GEPA) Shall comply with the provisions of the General Education Provisions Act (GEPA) (20 U.S.C. 1221). Revised 4/2015 General Assurances, page 3 Education Department General Administrative Regulations (EDGAR) Shall comply with the provisions of the Education Department General Administrative Regulations (EDGAR) Part 76, Part 81, Part 82 and Part 99. Stevens Amendment Shall ensure projects will be administered in conformity with The Stevens Amendment (P.L. 101-166, 511). Projects or programs funded in whole or in part with Federal grant funds must credit the Federal government for the Federal government's portion of the financial support. Federal Fiscal Accountability and Transparency Act (FFATA) Shall comply with the provisions of The Federal Fiscal Accountability and Transparency Act (FFATA) and has provided to the NJDOE a correct and valid Data Universal Numbering System (DUNS) number for the applicant organization, as well as any controlling parent organization. Shall establish and maintain a current and complete registration in the System for Award Management (SAM), located at:  HYPERLINK http://www.sam.gov http://www.sam.gov prior to the submission of this grant application, and shall maintain a current SAM registration throughout the period of the grant award. Administration Shall adopt and use proper methods of administering each program, including the enforcement of any obligations imposed by law on agencies, institutions, organizations, and other recipients responsible for carrying out each program and the correction of deficiencies in program operations that are identified through audits, monitoring, or evaluations. NJ Public School Contracts Law Shall comply with provisions of the Public School Contracts Law: N.J.S.A. 18A:18A-1, et. seq. and other relevant state laws and regulations, whenever the program supported with these funds involves the procurement of goods or services from vendors or consultants, written contracts between the LEA and such vendors or consultants, and the award for such contracts. Board Resolution Local Educational Agency (LEA) applicants shall obtain and maintain on file a certified board resolution or board minutes verifying the District Board of Educations authorization for submission of this application or of any amendments that entail either programmatic or fiscal changes to the final, NJDOE approved grant application. Non-LEA applicants shall obtain and maintain on file, from officials authorized to bind the applicant, documentation verifying the applicants authorization for submission of this application or of any amendments that entail programmatic or fiscal changes to the final NJDOE approved grant application. Revised 4/2015 General Assurances, page 4 Uniform Grant Guidance Shall comply with the provisions of the Uniform Grant Guidance, as applicable (2 CFR 200 et. seq.) including, but not limited to, the following: Key Personnel standards as outlined in 200.201 (b)(5) with regard to changes in the project director, other key personnel, or scope of effort, which require prior written approval of the NJDOE. Property standards as outlined in 200.310 through 200.316; with an emphasis on internal controls related to equipment in 200.313. Procurement standards as outlined in 200.318 through 200.326, as well as the provisions of the New Jersey Public Schools Contracts Law (N.J.S.A. 18A:18A-1, et. seq.) applicable to the grantee. Performance and Reporting standards as outlined in 200.327 through 200.329. Reports will be submitted in accordance with established procedures and timelines, and any addenda, to enable the NJDOE to meet its responsibilities under the program. Record Retention and Access standards as outlined in 200.333 through 200.337. Records which document the compliance with program requirements, relate to fiscal control, and/or the accounting of project funds, shall be maintained for three years after the submission of all required reports to the NJDOE. Remedies for Noncompliance as outlined in 200.338 including the imposition of additional conditions as outlined in 200.207. Closeout as outlined in 200.343. Cost Principles as outlined in Subpart E, 200.400 through 200.475. Audit requirements in accordance with Subpart F, 200.501 and New Jersey Treasury Circular 15-08-OMB. Student Records and Privacy Shall comply with the provisions of: 34 CFR Part 99, Family Educational Rights and Privacy Act; 45 CFR Parts 160, 162, and 164, Health Insurance Portability and Accountability Act of 1996 (HIPAA) [P.L. 104-191]. Safe and Drug Free Schools Shall comply with the provisions of: 42 CFR Part 2, Confidentiality of Drug and Alcohol Abuse Patient Records; 34 CFR Part 98, Protection of Pupil Rights Amendment; 20 U.S.C. 7151, Gun-Free Schools Act and N.J.S.A. 18A:37-7 through 12, Zero Tolerance for Guns Act; 20 U.S.C. 7171, Transfer of Student Disciplinary Records and N.J.S.A. 18A:36- 19a, Record requests for newly enrolled students; and General Assurances, page 5 P.L. 102-321, Section 1926, Synar Amendment and N.J.S.A. 26:3D-17, Smoking Prohibitions in Educational Institution. Shall maintain a policy requiring referral to the appropriate law enforcement agency any student who brings a firearm or weapon to a school served by the LEA, pursuant to 20 U.S.C. 7151(h) and N.J.A.C. 6A:16-5.5(d)4 and 5.6(d)4. Shall maintain a description of the circumstances surrounding all student removals imposed under the one-year removal requirement for firearms offenses, pursuant to 20 U.S.C. 7151, Gun-Free Schools Act, N.J.S.A. 18A:37-7 through 12, Zero Tolerance for Guns Act and N.J.A.C. 6A:16-5.5, Removal of students for firearms offenses, which includes, at a minimum, the name of the school concerned, the number of students removed from the school, and the type of firearms concerned, as reported on the Electronic Violence and Vandalism Reporting system, pursuant to N.J.A.C. 6A:16-5.3. Additionally, pursuant to N.J.A.C. 6A:16-5.5(b)1i, the chief school administrator will develop and maintain a written record of any case-by-case modifications of the one-year removal requirement made by the chief school administrator. ___________________________________ ___________________________________ Applicant Agency Signature: Chief School Administrator, Chief Executive Officer (or equivalent) ___________________________________ ___________________________________ Date Typed Name and Title Documentation of Federal Compliance (DUNS/SAM) form Note: this form must be completed and returned by the applicant prior to any award being made. Please print out and attach a copy of the applicants Entity Overview Page from their  HYPERLINK "http://www.sam.gov" www.sam.gov registration to this form. Part I Applicant Organization Organizational Name of Applicant __________________________________ Address (including zip + 4 code) __________________________________ Congressional District __________________________________ DUNS number __________________________________ Expiration Date of SAM.GOV registration __________________________________ Part II Primary Place of Performance under this award City __________________________________ Congressional District __________________________________ County __________________________________ Part III Parent Organization Is the applicant owned or controlled by another entity? __________ Yes _________ No. If yes, please provide the following: Parent organization name __________________________________ Parent organization DUNS number __________________________________ Documentation of Federal Compliance form, page 2 Part IV Executive Compensation Disclosure Criteria Please circle the appropriate response to the questions below: Question 1: In the preceding fiscal year, did the applicant receive at least $25 million in federal awards? (Yes/No) Question 2: In the preceding fiscal year, did the applicant receive at least eighty (80) percent of their gross annual revenues from federal awards? (Yes/No) If the applicant answered YES to both questions, in the space below, please provide the name and total compensation of the five (5) most highly compensated officers of the applicant organization. _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ I certify that this information is complete and correct. Furthermore, the applicant certifies that it has completed its registration on the federal System for Award Management website, found at  HYPERLINK "http://www.sam.gov" www.sam.gov and shall maintain a current registration throughout the grant period. _____________________________________________ Signature of Chief School Administrator or equivalent _____________________________________________ Name and Title Date: ________________ Page ____ of ____ PROJECT ABSTRACT Copy this page as needed Applicant (Lead) Agency: _____________________________________________________________ NGO Title: ____________________________________________ NGO #: __________________ Date: ________________ Page ____ of ____ PROJECT DESCRIPTION Copy this page as needed Applicant (Lead) Agency: _____________________________________________________________ NGO Title: ____________________________________________ NGO #: __________________ Date: ________________ Page ____ of ____ GOALS, OBJECTIVES AND INDICATORS Copy this page as needed Applicant (Lead) Agency: _____________________________________________________________ NGO Title: ____________________________________________ NGO #: __________________ Date: _______________________ Page ____of ____ PROJECT ACTIVITY PLAN Copy this page as needed. Applicant (Lead) Agency: __________________________________ NGO Title: __________________________________ NGO #: __________ GOAL#: ______ OBJECTIVE #____: __________________________________________________________________________________________ Implementation ActivityPerson(s) Responsible for Conducting Activity DocumentationReport Period (D) * #1 #2 #3 #4 #5 #6   * See the Notice of Grant Opportunity (NGO) for the number of reporting periods applicable to the grant program for which you are applying. Use only the number of columns necessary to comply with the requirements of the applicable NGO. BUDGET DETAIL FORM A Personal Services - Salaries Function & Object Codes 100-100 and 200-100 NGO TITLE:( Check box if this is a subgrantee form and identify subgrantee below.APPLICANT (LEAD) AGENCY:SUBGRANTEE: NOTES: Copy this form. Refer to Part III, Constructing a Grant Application Budget, of the Discretionary Grant Application for instructions. Complete all columns. Use multiple lines for a single entry if necessary.  PROJECT GOAL/ OBJECTIVE/ ACTIVITYFUNCTION & OBJECT CODE POSITION/NAMECOST CALCULATION For full-time positions: total annual salary x percent of time to the grant project = total For part-time positions: rate ($) per hour x number of hours per week x number of weeks per year = totalGRANT REQUEST AMOUNT BUDGET DETAIL FORM B Personal Services Employee Benefits Function & Object Code 200-200 NGO TITLE:( Check box if this is a subgrantee form and identify subgrantee below.APPLICANT (LEAD) AGENCY:SUBGRANTEE: NOTES: Copy this form. Refer to Part III, Constructing a Grant Application Budget, of the Discretionary Grant Application for instructions. Complete all columns. Use multiple lines for a single entry if necessary.  POSITION/NAMEGRANT REQUESTED SALARY AMOUNTFICA 7.65%TPAF ------------%PERS ------------%WRKRS COMP ------------ %UNEMPLY. ------------ %DISABIL. ---------- %HEALTH ----------%OTHER SPECIFY: _________ ----------%TOTAL % OF BENEFITSGRANT REQUEST AMOUNT (BENEFITS ONLY) BUDGET DETAIL FORM C Purchased Professional and Technical Services Function & Object Codes 100-300 and 200-300 NGO TITLE:( Check box if this is a subgrantee form and identify subgrantee below.APPLICANT (LEAD) AGENCY:SUBGRANTEE: NOTES: Copy this form. Refer to Part III, Constructing a Grant Application Budget, of the Discretionary Grant Application for instructions. Complete all columns. Use multiple lines for a single entry if necessary. PROJECT GOAL/ OBJECTIVE/ ACTIVITYFUNCTION & OBJECT CODEDESCRIPTION/PURPOSERATE: HOURLY, DAILY, FLAT FEETIME REQUIREDGRANT REQUEST AMOUNT BUDGET DETAIL FORM D Supplies and Materials Function & Object Codes 100-600 and 200-600 NGO TITLE:( Check box if this is a subgrantee form and identify subgrantee below.APPLICANT (LEAD) AGENCY:SUBGRANTEE: NOTES: Copy this form. Refer to Part III, Constructing a Grant Application Budget, of the Discretionary Grant Application for instructions. Complete all columns. Use multiple lines for a single entry if necessary. PROJECT GOAL/ OBJECTIVE/ ACTIVITYFUNCTION & OBJECT CODEITEM DESCRIPTIONUNIT COST (UC)QUANTITY (Q)GRANT REQUEST AMOUNT (GR) BUDGET DETAIL FORM E Equipment Function & Object Codes 400-731 and 400-732 NGO TITLE:( Check box if this is a subgrantee form and identify subgrantee below.APPLICANT (LEAD) AGENCY:SUBGRANTEE: NOTES: Copy this form. Refer to Part III, Constructing a Grant Application Budget, of the Discretionary Grant Application for instructions. Complete all columns. Use multiple lines for a single entry if necessary. PROJECT GOAL/ OBJECTIVE/ ACTIVITYFUNCTION & OBJECT CODEITEM DESCRIPTIONUNIT COST (UC)QUANTITY (Q)GRANT REQUEST AMOUNT (GR) BUDGET DETAIL FORM F Other Purchased Services, Other Objects, Purchased Property Services, Travel, Indirect Costs, Buildings Function & Object Codes 100-500, 100-800, 200-400, 200-500, 200-580, 200-800, 200-860, 400-720 NGO TITLE:( Check box if this is a subgrantee form and identify subgrantee below.APPLICANT (LEAD) AGENCY:SUBGRANTEE: NOTES: Copy this form. Refer to Part III, Constructing a Grant Application Budget, of the Discretionary Grant Application for instructions. Complete all columns. Use multiple lines for a single entry if necessary. PROJECT GOAL/ OBJECTIVE/ ACTIVITYFUNCTION & OBJECT CODEDESCRIPTION/COST CALCULATIONGRANT REQUEST AMOUNT NJ DEPARTMENT OF EDUCATION SUBGRANT BUDGET SUMMARY Applicant (Lead) Agency: _______________________________________________________________________ CO/Lead Agency Code: ___ ___ / ___ ___ ___ ___ NGO Title: _______________________________________________________________________________ NGO#: ___ ___ ___ ___ ___ ___ ___ ___ ___ BUDGET CATEGORYFUNCTION & OBJECT CODESubgrantee: _________________Subgrantee: _________________Subgrantee: _________________Subgrantee: _________________Subgrantee: _________________TOTAL Sum of all subgrant columnsADMIN. COST SUMMARYINSTRUCTIONPersonal Services - Salaries100-100Purchased Prof. & Tech Svcs.100-300Other Purchased Services100-500Supplies and Materials100-600Other Objects100-800SUBTOTAL - INSTRUCTIONSUPPORT SERVICESPersonal Services - Salaries200-100Personal Svcs. - Emp. Benefits200-200Purchased Prof. & Tech Svcs.200-300Subgrant Cost Summary200-320Purchased Property Svcs 200-400Other Purchased Services200-500Travel200-580Supplies and Materials200-600Other Objects200-800Indirect Costs200-860SUBTOTAL - SUPPORT SERVICESFACILITIES ACQUISITION & CONSTR. SVCSBuildings 400-720Instructional Equipment400-731Noninstructional Equipment400-732SUBTOTAL - FACILITIESTOTAL COSTTotal Amount of subgrantee MATCHING FUNDS COMMITTED TO THIS PROJECT*: *Complete only when there is a matching funds requirement in the NGO. NJ DEPARTMENT OF EDUCATION APPLICATION FOR FUNDS - BUDGET SUMMARY Applicant (Lead) Agency: CO/Lead Agency Code: __ __ / __ __ __ __ NGO Title: ___ NGO#: ___ ___ ___ ___ ___ ___ ___ ___ ___ BUDGET CATEGORY FUNCTION & OBJECT CODE GRANT FUNDS REQUESTED STATE FEDERAL OTHER FUNDS FUNDS FUNDS (Column 1) (Column 2) (Column 3) TOTAL Sum of columns 1-3 (Column 4) ADMIN. COST SUMMARY (Column 5)INSTRUCTIONPersonal Services - Salaries100-100Purchased Professional & Technical Services100-300Other Purchased Services100-500Supplies and Materials100-600Other Objects100-800SUBTOTAL - INSTRUCTIONSUPPORT SERVICESPersonal Services - Salaries200-100Personal Services Employee Benefits200-200Purchased Professional & Technical Services200-300 Subgrant Cost Summary200-320Purchased Property Services200-400Other Purchased Services200-500 Travel 200-580Supplies and Materials200-600Other Objects200-800 Indirect Costs200-860SUBTOTAL - SUPPORT SERVICESFACILITIES ACQUISITION & CONSTR. SVCSBuildings 400-720Instructional Equipment400-731Noninstructional Equipment400-732SUBTOTAL - FACILITIESTOTAL COST Total Amount of MATCHING FUNDS COMMITTED TO THIS PROJECT*: *Complete only when there is a matching funds requirement in the NGO. _________________________________________ ___________ final 10/00 Business Administrator/Chief Fiscal Officer Date MATCHING FUNDS SUMMARY & EXPENDITURE REPORT (Complete this form only when required by the NGO) NGO TITLE:( Check box if matching funds are provided by a subgrantee. Identify the subgrantee below.APPLICANT (LEAD) AGENCY:SUBGRANTEE: Complete this box for Matching Funds expenditure Reporting:Report #: ______ ( Check box if FINAL report Reporting Period: (from) _____________ (to) _______________ NOTES: Copy this form. Refer to the Constructing a Grant Application Budget in the Discretionary Grant Application for instructions.  PROJECT GOAL/ OBJECTIVE/ ACTIVITYCOST CATEGORY (e.g., salaries, supplies, equipment, etc.)MATCHING FUNDS BUDGETED (by cost category)MATCHING FUNDS EXPENDED (by category)TOTAL MATCHING FUNDS BUDGETED:*TOTAL MATCHING FUNDS EXPENDED: *Use a copy of this form for reporting matching expenditures when submitting interim and final expenditure reports. NEW JERSEY DEPARTMENT OF EDUCATION NOTICE OF GRANT OPPORTUNITY - TITLE PAGE SECTION I: 16 EK35 H05 FY NGO# WKL TITLE OF NGO: 21st Century Community Learning Centers Program-Training & Technical Assistance- Year 4 of 5 DIVISION: Student Services and Career Readiness OFFICE: Student Support Services SECTION II: COUNTY:  FORMCHECKBOX  FORMCHECKBOX  LEA/OTHER:  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  SCHOOL:  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  COUNTY NAME:_____________________________ APPLICANT AGENCY AGENCY ADDRESS CITY STATE ZIP ( ) ( ) AGENCY TELEPHONE NUMBER AGENCY FAX # SCHOOL NAME PREVIOUS FUNDING: Agency received funding from the NJ Department of Education within the last two years of submission of this application. YES  FORMCHECKBOX  NO  FORMCHECKBOX  PROJECT DIRECTOR (Please print or type name): _________________________________________________________________ TELEPHONE NUMBER: (____)____________________ FAX#: (____)__________________ E-MAIL_______________________________ BUSINESS MANAGER: ________________________________ PHONE#: (____)___________ E-MAIL_____________________________ DURATION OF PROJECT: FROM: 9/1/15 TO: 8/31/16 TOTAL AMOUNT OF FUNDS REQUESTED: $__________________________________________ APPLICATION CERTIFICATION: To the best of my knowledge and belief, the information contained in the application is true and correct. The document has been duly authorized by the governing body of this agency and we will comply with the attached assurances if funding is awarded. I further certify the following is enclosed: AGENCY TITLE PAGE SIGNED STATEMENT OF ASSURANCES BOARD RESOLUTION TO APPLY APPLICATION NARRATIVE* BUDGET SUMMARY AND BUDGET DETAIL FORMS* ORIGINAL AND FOUR COPIES OF THE COMPLETE APPLICATION PACKAGE ___________________________________________________ _________________________________________ ________________ SIGNATURE OF CHIEF SCHOOL ADMINISTRATOR TITLE DATE OR EQUIVALENT OFFICER ___________________________________________________ (Please print or type name) *FAILURE TO INCLUDE A REQUIRED APPLICATION COMPONENT CONSTITUTES A VIOLATION OF THE NGO AND WILL RESULT IN THE APPLICATION BEING ELIMINATED FROM CONSIDERATION (See NGO Section 3.3 for itemized list). SECTION III: SEND OR DELIVER APPLICATIONS TO: APPLICATIONS MUST BE RECEIVED BY: NEW JERSEY DEPARTMENT OF EDUCATION APPLICATION CONTROL CENTER 4:00 P.M., ON 7/23/15 RIVER VIEW EXECUTIVE PLAZA BLDG. 100, ROUTE 29 PO Box 500 TRENTON, NJ 08625-0500 NO FACSIMILE SUBMISSION WILL BE ACCEPTED. 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