Name of Grant Program:
Massachusetts 21st Century Community Learning Centers
– Supporting Additional Learning Time (ELT and OST)
Fund Code: 647-B1
PART III-a – REQUIRED PROGRAM INFORMATION – FY16
District Summary
Descriptions and Key Components of
Grant-Allowable Models for Adding Time through Fund Code 647-B1
Please see the Funding Opportunity-Request for Proposals (FO-RFP) for additional information including:
minimum eligibility requirements, maximum funding request amounts and priorities for the use of grant funds.
Model 1 (ELT)
Model 2 (OST)
Districts/communities with:
 >50% Low-Income, and
 > 10,000 students
Two schools/sites
Maximum number of school(s)/site(s)*
for which an applicant may apply:
No maximum
(Using 2014 low-income
and enrollment status.)
All other districts/communities:
One school/site
*All schools/sites must meet the criteria outlined in the Eligibility section of the FO-RFP.
Model 1: Expanded Learning Time (ELT)
For all students: Applicants will establish a school schedule that increases the total number of hours required for
all students by a minimum of 180 hours above the amount offered in either FY14 or FY15, and reflects a total of a
minimum of 1,330 hours.

Grant funds must be used primarily to support the implementation of new or enhanced academic
enrichment and/or intervention opportunities.

Other costs associated with adding time should be carefully considered and applicants must describe a
plan for covering these costs.

All students are required to participate in ELT; however, it is not expected that the grant funds cover
activities that benefit all children.
Model 2: Out-of-School Time (OST)
For targeted students: Applicants choosing this option will offer a total of a minimum of 448 hours of
comprehensive OST programming during the school-year and summer for a targeted group of students.

Comprehensive OST programming typically consists of time for: informal/social time, homework/academic
support, club or activity time (offering inquiry-based, service-learning and other project-based learning
opportunities), social-emotional programming, etc.

Enrolled students are not expected to attend all 448 hours, however it is expected that students will
attend the OST programming an average of a minimum of 80 hours for high school (grades 9-12), 90 for
middle school (grades 6-8) and 100 hours per school year for elementary schools (K-5).
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Name of Grant Program:
I.
Massachusetts 21st Century Community Learning Centers
– Supporting Additional Learning Time (ELT and OST)
Fund Code: 647-B1
DISTRICT COVER SHEET
IMPORTANT NOTE: If the lead applicant is not a district, it must work with the applicable district(s) to complete
this application.
Applicant
(District/Agency):
District/Agency Contact
Name:
Phone:
Proposed
School(s)/Site(s)
Include below all
schools/sites proposed in
this application. Insert
rows as needed.
Email:
Model for Adding Time
Please place an ‘x’ in the appropriate
box for each school/site proposed.
Model 1 (ELT)
Competitive Priority:
(Please put an ‘x’ in the
box if applicable)
School
Year
Model 2 (OST)
Total Request
District Enrollment:
Amount Requested
Summer
Total
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Please indicate the district’s*
low-income % in 2014:
(http://profiles.doe.mass.edu/).
[Model 2 (OST) Applicants Only] Districts/lead
applicants that have not received 21st CCLC funding within
at least the past three years (FY13-FY15).
*If the lead applicant is not the school district, please use the low-income % of the district in which the majority of
students served in the program are enrolled.
Instructions for completing this document:
 Please address each of the applicable questions on the following pages within the indicated page limits.
 Questions are labeled as follows to indicate which applicants should respond, according to the model
chosen for the respective site:
o [ALL] – Schools/sites applying for Model 1 (ELT) AND Model 2 (OST) should respond.
o [Model 1 (ELT) ONLY] – Only schools applying for Model 1 (ELT) should respond.
o [Model 2 (OST) ONLY] – Only schools applying for Model 2 (OST) should respond.





Responses should be provided within this document leaving the questions above each response.
Please do not delete questions that are not applicable – this will re-number questions and may lead to
confusion in responding to questions that reference earlier questions.
Please do not change the font size or margins.
All questions are shaded in gray and responses should be written in the white space below each
question.
Narrative and/or bulleted responses are acceptable.
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Name of Grant Program:
II.
Massachusetts 21st Century Community Learning Centers
– Supporting Additional Learning Time (ELT and OST)
Fund Code: 647-B1
DISTRICT SUMMARY
District Process and Rationale for Adding Time (3 pages maximum):
1. [ALL] Identify the elements of the district’s existing improvement, turnaround and/or other strategic plans that
will be addressed by adding time. Note: The response to this question should provide a general overview for
the district. School-specific needs/priorities will be described in the School/Site Implementation Plan(s).
2. [ALL] Describe lessons learned (both positive and negative) from past experiences running ELT and/or OST
programs (regardless of funding source), how those lessons have been applied to this application, and what
will be different about this program compared to the previous one(s).
2a. [Model 2 (OST) ONLY - if the proposed school(s)/site(s) received 21st CCLC OST funding during any of
the following years: FY11-FY14]). Did the school(s)/site(s) continue to operate an OST program(s) even if at a
reduced level?
Yes?
No?
If yes, briefly describe the current program.
If no, explain why not.
District Support and Sustainability (5 pages maximum, including the chart on the following page):
3. [ALL] Describe how the district/lead applicant and proposed school(s)/site(s) will collaborate to support
implementation of additional time, including in making budgetary decisions. Note: All applicants must
designate a full- or part-time coordinator whose primary role is to oversee grant implementation.
4. [ALL] Describe the qualifications/credentials the program will seek for the required coordinator position. If the
district currently has a person that will serve in such a role, describe that person’s qualifications/credentials.
5. [ALL] Describe the membership and roles of the required district-level community council and how it is/will be
representative of the school district boundaries, community, and populations to be served. (See Addendum A
- Grant Assurances for recommendations on council membership.)
What is the current status of the community council?
Newly formed?
Part of an existing council?
6.
Will be formed if funded?
[ALL] Describe how district-level partners with shared priorities will support the success and affordability of
additional time. (For example, partners who are working with multiple schools/sites and are contributing
resources (staff, funding, etc.) to the program.)
7. [ALL] Describe plans to support any costs associated with implementing additional time that will not be
covered through this grant. Include information about planned or anticipated coordination with and/or support
from other federal, state or local programs and grants (e.g. Title I, Title III, Wraparound Services, Gateway
Cities, etc). [Model 1 (ELT) applicants, if applicable] Include plans for negotiating collective bargaining
agreements to maximize financial support for ELT.
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Name of Grant Program:
Massachusetts 21st Century Community Learning Centers
– Supporting Additional Learning Time (ELT and OST)
Fund Code: 647-B1
8. [ALL] Complete the chart below to include anticipated TOTAL costs associated with adding time at the proposed school(s)/site(s), indicating
secured or anticipated funding sources that will be used to support these costs. The “Total Anticipated Costs” should reflect all costs
anticipated to implement the proposed ELT or OST programming, including the grant-request.
Funding Category
TOTAL Anticipated
FY16 Costs
(associated with
adding time at the
schools/sites
proposed in this
application)
District Level
TOTAL Anticipated
FY16 Costs
(associated with
adding time)
at Site 1: (list site
name below)
TOTAL Anticipated
FY16 Costs
(associated with
adding time)
at Site 2: (list site
name below)
TOTAL Anticipated
FY16 Costs
(associated with
adding time)
at Site 3: (list site
name below)
TOTAL Anticipated
FY16 Costs
(associated with
adding time)
at Site 4: (list site
name below))
List the sources of additional
secured or anticipated non 21st
CCLC funds/resources that will
support these costs at ALL sites
proposed (federal, state, local,
private, etc.)
Staffing (including, but not limited to,
instructional staff, planning time,
substitutes, etc.)
Professional Development
Partners/Vendors
Materials/Supplies
Transportation
Other: (please describe below)
Total Anticipated FY16 Costs
*If more than four sites are included in this application, please copy this entire chart and use the “Site” columns only to include information for
those sites. The Total Anticipated Costs column above should be completed ONCE in the original table.
Note: Level 2-5 districts are permitted to use their Title I, Part A reservation funds [formerly supplemental educational services (SES) and public
school choice set-aside funding] to support district/student needs as assessed in relation to the Conditions for School Effectiveness. This means
that a district can choose to direct part or all of its Title I, Part A allocation (which could also include Title II, Part A funds flexed into Title I, Part A)
to support additional time in one or more schools, if the district determines that will best meet the needs of the district's lowest performing students.
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