Louisiana Community and Technical College System
WorkReady U
265 South Foster Drive
Baton Rouge, LA 70806
Sean P. Martin
Executive Director
Federal and State Funding
Grant Renewal Application
FISCAL YEAR 2016-2017
This WorkReady U Renewal Application provides guidelines and documents
to apply for Adult Education, Family Literacy, EL-Civics and/or Leadership
(Regional Resource Centers) funds.
Complete one set of program forms regardless of the number of budget
applications.
Due Date:
Monday, May 23, 2016
5:00 p.m.
Federal Funds authorized under Title II Adult Education and Family Literacy of the Workforce Innovation and
Opportunity Act (WIOA) of 2014 and the Catalog of Federal Domestic Assistance (CFDA) 84.002; 84.191; 84.255 and
97.010.
State Funds authorized under Louisiana Revised Statutes, Title 17:1871 and 17:3217.1.
General Information
Project Period
Federal Funds: Adult Education, Family Literacy, Leadership and EL-Civics Grants: July 1, 2016 – September 30, 2017
State Funds: July 1, 2016 – June 30, 2017
Submission Instructions
 Completed renewal applications are due by Monday, May 23, 2016 at 5:00 PM.
 Incomplete applications will not be considered. Applications that are missing required signatures/initials are
considered incomplete.
 Applications must be arranged in the order outlined in the Index of the application.
 Applicants must submit three (3) complete copies of the application. Please submit two (2) paper copies with original
signatures and one (1) electronic copy.
 Send electronic submissions to workreadyu@lctcs.edu.
 Mailed/Hand-Delivered copies should be sent to:
Louisiana Community and Technical College System
WorkReady U
265 South Foster Drive
Baton Rouge, LA 70806
 Any questions regarding the application may be submitted via email to workreadyu@lctcs.edu. Questions and
responses will be posted on the LCTCS, WorkReady U website.
Applicable Laws and Regulations
The Louisiana State Plan provides for activities authorized under Title II Adult Education and Family Literacy of the
Workforce Innovation and Opportunity Act of 2014.
All recipients of funding shall comply with Louisiana Revised Statues, Title 17:1871 and 17:3217.1, and the Adult
Education and Family Literacy Act (AEFLA), P.L. 105-2220. Additional federal statutes governing local funding include
the General Education Provisions Act (GEPA) and the Education Department General Administrative Regulations
(EDGAR).
Local providers are responsible for issuing announcements concerning the allocation of federal funds to support the adult
education program. When issuing press releases describing programs funded in whole or in part with federal money, all
recipients shall clearly state:
1. The percentage of the total cost of the program that will be financed with federal funds; and
2. The dollar amount of federal funds for the program.
LCTCS reserves the right to reject any or all applications for failure to submit an application in accordance with
the instructions in this renewal application packet or by the specified deadline. Receipt of applications by LCTCS
confers no rights upon the applicant nor obligates LCTCS in any manner.
State requirements are denoted with an asterisk (*).
1
Application Index
Form #1
Form #2
Form #3
Form #4
Form #5
Form #6
Form #7
Form #8
Form #9
Form #10
Form #11
Abstract: Instructions
Page 3
Form
Page 4
Local Activities
Page 5
Family Literacy and EL-Civics Provider Information
Page 6
Program Service
Page 7
Transition to Postsecondary Education & Occupational Training
Page 8
Partnerships/Coordination of Services
Page 9
Professional Development Plan
Page 10
Program Income Form
Page 11
Certification(s) and Assurance(s)
Page 12
Certifications
Certifications Regarding Lobbying
Statement of Loan Guarantees and Loan Insurance
Standard Form (SF)-LLL Form –Disclosure of Lobbying Activities (if applicable)
Assurances
Non-Public Statement of Assurance
Authorized Signature
Page 14
Board Resolution (if applicable)
Page 15
Budget Information
Page 16
Appendix I (List of LA Workforce Development Regions/Parishes
Page 17
2
Instructions for Application Form #1 – Abstract
Provide a very concise program abstract. Limit your response to the space provided.
Instructions:
Item 1 and 2 are self-explanatory.
Item 3:
Requested Funds
 Enter the amount of each budget request. Please use the amount your program was awarded in FY1516. However, the total amount of funding in FY16-17 will be contingent upon the availability of State
General funds, Federal Funds made available under AEFLA, Section 211 (b) (1), demonstrated
program effectiveness, program service and compliance with all requirements imposed by Federal
and State laws, as well as any supplemental regulations and requirements imposed by the Louisiana
Community and Technical College System guidelines and the WorkReady U Recipient Grant
Management Handbook.
 Indicate if funds will be used to provide services at a correctional facility in FY 16-17
Item 4:
Enter the Federally Negotiated Indirect Cost Rate for your district.
Item 5:
Service Area Information
 Indicate your LA Workforce Development Region(s)
 Indicate the LCTCS College(s) located in your Region.
Item 6:
Target Population
 Enter the Total Negotiated Target Population (FY15-16).
 Enter the Target Population Served (7/1/15 to 4/30/16).
Item 7:
Program Income Disclosure. If the program income will be collected—
 Indicate the amount students will be charged; and
 Complete the Program Income Form on page 11
Item 8:
Provide your nine-digit DUNS number assigned by Dun & Bradstreet, Inc.
Signature of Authorized Representative
3
Application Form #1
Abstract
1. Applicant Organization
2. Applicant Contact Person
Name
Name of WRU Supervisor:
Email Address:
Telephone Number:
Physical Address (Main Place of Performance):
WRU Website Information
City/State/Zip Code:
Name of Contact Person:
Title:
Email:
Telephone Number:
Fax Number:
3.
Requested Funds:
Federal Adult Education and/or Family Literacy (§231): $
Federal EL-Civics (§243): $
Federal Leadership (Regional Resource Centers): (§223) $
State: $
4.
Federally Negotiated Indirect Cost Rate:
In FY 16-17, will funds be used to provide
services at a correctional facility?
Yes
No
%
Service Area Information:
Check your LA Workforce Development Region(s): Refer to Appendix I for list of regions/parishes.
□ Area #1
5.
□ Area #2
□ Area #3
□ Area #4
□ Area #5
□ Area #6
□ Area #7
□ Area #8
Check all applicable LCTCS College(s) located in your area(s):
□ Baton Rouge Community College (BRCC)
□ Bossier Parish Community College (BPCC)
□ Central LA Technical Community College (CLTCC)
□ Delgado Community College
□ L.E. Fletcher Community College
□ Louisiana Delta Community College
□ Northshore Technical Community College
□ Northwest LA Technical College
□ Nunez Community College
□ River Parishes Community College (RPCC)
□ South Central LA Technical College (SCLTC)
□ South LA Community College (SLCC)
□ Sowela Technical Community College
6.
Negotiated Target Population (FY15-16)?
7.
Program Income Disclosure
Do you plan to collect program income from adult education students during FY16-17?
8.
If yes, how much will be charged? $________
If yes, the Program Income Form on page 11 must be completed.
What is your nine-digit Data Universal Numbering System (DUNS) Number?
# Served FY 15-16 (7/1/15 to 4/30/16)?
Yes
No
The signature below indicates that the applicant has read and is in compliance with all of the GENERAL and SPECIFIC
requirements contained within the Federal and/or State certifications and assurances.
TYPE/PRINT NAME AND TITLE OF AUTHORIZED REPRESENTATIVE
SIGNATURE
DATE
Application Form #2
Local Adult Education and Literacy Activities
Local Activities shall include academic instruction and educational services to eligible individuals1 that will increase the
individual’s ability to: (1) read, write and speak English and perform mathematics or other activities necessary for the
attainment of a secondary school diploma or its recognized equivalent; (2) transition to postsecondary education and
training; and (3) obtain employment through the following Workforce Innovation and Opportunity Act (WIOA), Title II,
Section 203 mandated programs, activities and services.
I. Place an X in the box to the left of each activity/service that your program currently provides and will continue
to offer in FY 16-17.
Adult Basic Education and Literacy Activities
Activities that improve an individual’s ability to read, write, and speak in English, compute, and solve problems, at
levels of proficiency necessary to function on the job, in the family, and in society. Providers must demonstrate the
ability to provide services that will include Integrated Education and Training that provides adult education and
literacy activities concurrently and contextually with workforce preparation activities and workforce training for a
specific occupation or occupational cluster for the purpose of educational and career advancement.
Workplace Adult Education and Literacy Activities
Activities, programs or services designed to help an individual acquire a combination of basic academic skills, critical
thinking skills, digital literacy skills, and self-management skills, including competencies in utilizing resources, using
information, working with others, understanding systems and obtaining skills necessary for successful transition into
and completions of postsecondary education or training, or employment.
English language and acquisition activities
Activities include programs of instruction designed to help eligible individuals who are English language learners
achieve competence in reading, writing, speaking, and comprehension of the English language that leads to attainment
of a secondary school diploma or its recognized equivalent; and transition to postsecondary education and training; or
employment. Activities may include instruction in life skills, citizenship, and employability skills. Employability skills
may include a range of instructional services such as education and training in job readiness.
Workforce preparation activities
Activities designed to help an individual acquire a combination of basic academic skills, critical thinking skills, digital
literacy skills, and self-management skills, including competencies in utilizing resources, using information, working
with others, understanding systems, and obtaining skills necessary for successful transition into and completion of
postsecondary education or training, or employment.
Integrated education and training activities (IET)
Activities that provide adult education and literacy activities concurrently and contextually with workforce preparation
activities and workforce training for a specific occupation or occupational cluster for the purpose of educational and
career advancement.
II. Based upon your response above, describe the plan to implement and/or partner to ensure that all WIOA
mandated services are provided to students within your region.
(Limit response to two pages. If additional response space is needed, include an attachment and label the sheet Attachment #2A)
1
Eligible Individual: an individual who has attained 16 years of age; who is not enrolled or required to be enrolled in secondary
school under State law; and who – is basic skills deficient; does not have a secondary school diploma or its recognized equivalent, and
has not achieved an equivalent level of education; or is an English language learner.
5
Application Form #3
Family Literacy and EL-Civics Providers
Only currently funded Family Literacy and EL-Civics programs complete this form
(Limit response to one page. If additional response space is needed, include an attachment and label the sheet Attachment #3A)
Family Literacy Program
I. Describe new activities planned for FY 16-17 that create a range of integrated adult basic education and literacy
services that support family literacy and expand partnerships with existing early childhood education programs.
English Language/Civics (EL/Civics) Program
Under WIOA English literacy and civics education requires programs to provide services that integrate education and
training activities that: 1) prepare adults who are English language learners for, and place such adults in, unsubsidized
employment in in-demand industries and occupations that lead to economic self-sufficiency; and (2) integrates with the
local workforce development system and its functions to carry out the activities of the program.
I. Describe progress made to ensure that integrated education and training activities are incorporated into English
Language/Civics programming.
6
Application Form #4
Program Service*
(If additional response space is needed, include an attachment and label the sheet Attachment #4A)
Provide a copy of the program’s projected FY16-17 schedule by site. The schedule(s) should include:
1) Site name, physical address and telephone number;
2) Instructional/Class Information;
a) start and end dates (i.e., August 1 – December 23, 2015; January 5 – May 31, 2016)
b) day(s) of the week class is offered (i.e., Monday-Friday; Tuesday/Thursday)
c) time(s) class is offered (i.e., 8:00am – noon; 1:00pm – 4:00pm; 5:00pm – 7:00pm)
d) class type (ESL, ABE, etc)
e) total number of days that classroom instruction is provided within the start/end dates
3) Orientation and intake dates; and
4) Any other significant events.
Note: A final schedule should be submitted via email to WRU by September 1, 2016, workreadyu@lctcs.edu.
*Program Service will be considered in FY16-17 program funding. Programs shall offer flexible, year-round
instructional services with a minimum of 220 instructional days within the fiscal year.
7
Application Form #5
Transition to Postsecondary Education/Occupational Training
(Limit response to two pages. If additional response space is needed, include an attachment and label the sheet Attachment #5A)
I. Measures and Evaluation of the Transition Program and Services.
a. Identify and describe the goals of your program’s transition activities and the transitional services provided to
WRU students.
b. List the tools and/or reports used to evaluate the effectiveness of your transition program.
c. In the chart below, provide the number of students transitioned and/or concurrently enrolled in postsecondary
institutions from your WorkReady U program during FY 15-16 (YTD).
College(s)
# of students to transition
# of students concurrently enrolled
(WRU + postsecondary)
8
Application Form #6
Partnerships/Coordination of Services
(Limit response to two pages. If additional response space is needed, include an attachment and label the sheet
Attachment #6A)
Workforce Innovation and Opportunity Act of 2014 located at http://www.doleta.gov/wioa, Title II Section 231 and
Section 232 the local application shall include a description of any cooperative arrangements the applicant has with other
agencies, institutions, or organizations for the delivery of adult education and literacy activities. The eligible agency
(LCTCS, WorkReady U) shall consider whether the activities coordinate with other available resources in the community,
such as by establishing strong links with elementary schools and secondary schools, postsecondary educational institution,
one-stop centers, job training programs, and social service agencies.
With attention to the priorities (i.e. partnerships, collaboration) within WIOA, provide a detailed response to the
following questions:
1. Has the program implemented a career pathways program? If so, please describe. Describe the program’s future plans
to expand or develop a career pathways program. What activities will the program undertake to ensure
contextualized instruction occurs to promote college and career readiness?
2. Including the WIOA core partners, provide a list of existing and intended partnerships with other providers, in support
of adult education participants. Please include the service(s) to be provided by/with each partner to ensure that
students receive necessary support services, as they prepare to enter the workforce and/or postsecondary education.
3. Describe how the various departments/components within your organization will assist to provide coordinated support
services for the program (e.g. Special Populations, Student Services).
Note: For the partnerships described above, MOUs, letters of agreement and collaborative agreements must be
maintained locally and be made available for review.
9
Application Form #7
Professional Development Plan
(If additional response space is needed, include an attachment and label the sheet Attachment #7A)
WRU and the Regional Resource Centers (RRCs) are dedicated to providing quality professional development
opportunities that disseminate information and resources focusing on WIOA alignment and the WRU 2020 vision.
I. Describe your program’s progress with implementing –
(Limit response to one page. If additional response space is needed, include an attachment and label the sheet Attachment #7A)
 adult education college and career readiness standards (CCRS), and
 developing/expanding career pathway opportunities for students.
II. Evaluate the program’s greatest PD needs:
Check all that apply.
Administrators
Fiscal matters
Staff observations
Managed enrollment
Orientation process
Tests & testing
procedures
Building in WIOA
requirements
Recruitment/Retention
Data for program
improvement
Community Education
Program offerings and
schedules
Starting an ESL Program
Instructors
Subject-specific training
(list areas/topics of interest
next to subject):
Reading
Writing
Math
Science/SS
ESL
Transitions
Data for classroom
improvement
CCRS
Critical thinking
Classroom management
Student Support
Tests & Testing
Procedures
Orientation, Intake &
Follow-up
Integrated Education &
Training
Partnerships with
colleges and the workforce
Data
Reporting tools
Quarterly reviews
EOY cleanup
Beginning of year set up
Other(s):
10
Application Form #8
Program Income Form
Program income is defined as “gross income earned by the non-Federal entity that is directly generated by a
[grant] supported activity or earned as a result of the Federal [grant] award during the period of performance[.]”
2 C.F.R. § 200.80. Program income is governed by the terms of the agreement between the state and local
subgrantee. Program income must be accounted for in program records and used only for costs allowable under
the AEFLA. Program income may only be used to provide local adult education and literacy services. This
may include the payment of salaries and purchase of materials.
In accordance with EDGAR at 2 C.F.R. § 200.307 and 34 C.F.R. § 76.534, tuition monies and/or fees collected
by WRU grant recipients must be used for classes, coordination, supervision, and general administration of fulland part-time adult basic education programs, including responsibilities associated with the management of the
finances of these programs.
Program Income Disclosure consists of two parts: (1) How Program Income will be collected; and (2) Program Income
Waiver Process.
1) How Program Income Will Be Collected
Use the form below to list the service(s), class(es), or items for which income will be collected. Examples of
service(s), class(es), and/or items includes AE classes, EL Civics classes, Family Literacy classes, Registration,
Textbooks, IDs, etc.
List the service(s), class(es) or items for which you propose to collect income.
$
Service/Item/Class
Amount to be charged
$
Service/Item/Class
Amount to be charged
$
Service/Item/Class
Amount to be charged
$
Service/Item/Class
Amount to be charged
2) Program Income Waiver Process - Rubric
Applicant must provide the rubric, as Attachment 8A, used to determine hardship cases for students who are
unable to pay the imposed fee.
Program income must be used for the purposes and under the conditions of the WRU subgrant. Applicants must
keep all copies of documentation/receipts for payment as well as records related to program income and/or expenditures.
Additional information is available in the WorkReady U Recipient Grant Management Handbook.,
http://www.lctcs.edu/workready-u/policies-and-procedures/20132014aegrantapp.
11
Application Form #9
CERTIFICATION(S)/ASSURANCES
CERTIFICATIONS
1. The application is submitted by the agency that is eligible to submit the plan.
Yes
No
2. The applicant has been informed of the requirements imposed by Federal laws, regulations, and the provisions of
contracts or grant agreements as well as any supplemental requirements imposed by the Louisiana Community and
Technical College System, (LCTCS), including adopting the WorkReady U model.
Yes
No
3. The applicant has provided the TOTAL AMOUNT ($________ insert amount here) of prior year expenditures of Federal
Funds according to regulations issued by Office of Management and Budget Circular from all sources (described as funds
received as direct or pass-through funds).
Yes
No
3. The applicant assures that it will permit the Louisiana Community and Technical College System, the Legislative
Auditors and all other required personnel to have access to the records and financial statements as necessary.
Yes
No
4. The applicant assures that it has been advised that a non-Federal entity that expends $750,000 or more during the nonFederal entity’s fiscal year in Federal awards must have a single or program-specific audit conducted for that year in
accordance with the provisions of 2CFR 200.521(a).
Yes
No
4. The applicant agrees to use program funds only to supplement and not supplant funds from non-Federal sources, and to
extent practical, increase the level of funds that would, in the absence of the Federal funds, be made available from nonFederal sources.
Yes
No
5. The applicant agrees to maintain all books, records and other documents for at least (5) federal fiscal years after the
final payment or as described in EDGAR at 2 C.F.R. §200.335 or whichever is longest.
Yes
No
6. The applicant has been informed of the WorkReady U Recipient - Grant Management Handbook, which contains
WorkReady U guidelines for fiscal compliance.
Yes
No
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CERTIFICATIONS REGARDING LOBBYING
Certification for Contracts, Grants, Loans, and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned to any person for
influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee
of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the
making of any Federal grants, the making of any Federal loan, the entering into of any cooperative agreement, and the
extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative
agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress,
or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement,
the undersigned shall complete and submit Standard Form-LLL, “Disclosure of Lobbying Activities,” in accordance with
its instructions.
12
(3) The undersigned shall require that the language of this certification be included in the award documents for all
subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements)
and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon
which reliance was placed when this transaction was made or entered into. Submission of this certification is a
prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who
fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than
$100,000 for each such failure.
STATEMENT OF LOAN GUARANTEES AND LOAN INSURANCE
The undersigned states, to the best of his or her knowledge and belief, that:
If any funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee
of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in
connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit
Standard Form-LLL, “Disclosure of Lobbying Activities,” in accordance with its instructions. Submission of this
certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code.
Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not
more than $100,000 for each such failure.
Standard Form (SF)-LLL Form – Disclosure of Lobbying Activities (only if applicable)
(https://www2.ed.gov/fund/grant/apply/appforms/sflll.doc). If applicable, please print,
workreadyu@lctcs.edu.
sign
and
email
to
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ASSURANCES
1. The agency will expend funds appropriated to carry out title II of the Workforce Innovation and Opportunity Act
(WIOA) only in a manner consistent with fiscal requirements under section 241 (a) of WIOA and the WorkReady U
Recipient - Grant Management Handbook.
Yes
No
2. The eligible agency will not use any funds made available under title II of WIOA for the purpose of supporting or
providing programs, services, or activities for individuals who are not “eligible individuals” within the meaning of section
203(4) of WIOA, unless it is providing programs, services or activities related to family literacy activities, as defined in
section 203(9) of WIOA.
Yes
No
3. The Integrated English Literacy and Civics Education program under section 243 (a) of WIOA will be delivered in
combination with integrated education and training activities.
Yes
No
4. The Integrated English Literacy and Civics Education program under section 243(a) of WIOA will be designed to (1)
prepare adults who are English language learners for, and place such adult in, unsubsidized employment in in-demand
industries and occupations that lead to economic self-sufficiency and (2) integrate with the local workforce development
system and its functions to carry out the activities of the program.
Yes
No
5. Using funds made available under title II of WIOA to carry out a program for criminal offenders within a correctional
institution, the eligible agency will give priority to serving individuals who are likely to leave the correctional institution
with five years of participation in the program.
Yes
No
*6. No more than 6% of the Federal and/or State award may be dedicated to programs at correctional institutions to
provide services or activities as defined in section 225 of WIOA.
Yes
No
*7. It is hereby agreed that the Louisiana Community and Technical College System, Office of the Legislative Auditor,
and/or the Office of the Governor, the Division of Administration and any other agencies representing the state or federal
government shall have the option of auditing all accounts or records of the grantee which relate to this award. All copies
of required audits must be forwarded to the Louisiana Community and Technical College System.
Yes
No
13
*8. If the appropriation for this award is reduced by the Louisiana Legislature, the veto or Executive Order of the
Governor, or by any means provided in the appropriations act which prevents the total appropriation for the year from
exceeding revenues for that year, or for any other lawful purpose, and the effect of such reduction is to provide
insufficient monies for the continuation of this award, the award shall either be reduced or terminated.
Yes
No
*10. I understand that all funds will be expended by the end of the project period identified in the Grant Award
Notification and in accordance with the Louisiana Community and Technical College System guidelines and the
WorkReady U Recipient Grant Management Handbook. All expenditures shall be in compliance with the approved
application and budget.
Yes
No
11. The information contain in this proposal is true and correct to the best of my knowledge and belief.
No
Yes
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*NON-PUBLIC STATEMENT OF ASSURANCE
(Appropriation Bill, Act 14 of 2003 Legislative Session, Section 18B)
Grant recipient must present a comprehensive budget to the Legislative Auditor and the Louisiana Community and
Technical College System showing all anticipated uses of the appropriation, an estimate of the duration of the project, and
a plan showing specific goals and objectives for the use of such funds, including measures of performance. In addition
and prior to making such expenditure, the grant recipient must agree in writing to provide written reports to the Louisiana
Community and Technical College System at least every six months concerning the use of the funds and the specific goals
and objectives for the use of the funds. In the event the Louisiana Community and Technical College System determines
that the grant recipient failed to use the funds set forth in its budget within the estimated duration of the project or failed to
reasonably achieve its specific goals and objectives for the use of the funds, the Louisiana Community and Technical
College System shall demand that any unexpended funds be returned to the state treasury unless approval to retain the
funds is obtained from the Division of Administration and the Joint Legislative Committee on the Budget.
Each recipient shall be audited in accordance with R.S. 24:513. Act 290 of the 2011 Legislative Session amends the
audit law [R.S. 24:513 H. (2) (a)] to include the following provision: Each auditee shall designate an individual who
shall be responsible for filing annual financial reports with the legislative auditor and shall notify the legislative
auditor of the name and address of the person so designated. If the amount of funds received by grant recipient is
below the amount for which an audit is required under R.S. 24:513, the Louisiana Community and Technical College
System shall monitor and evaluate the use of the funds to ensure effective achievement of the goals and objectives.
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AUTHORIZED SIGNATURE
The undersigned has reviewed the Certifications, Certification Regarding Lobbying, Statement of Loan Guarantees and
Loan Insurance, Assurances, Non-Public Statement of Assurance and certifies that the applicant has been informed of
all requirement imposed by Federal and State laws, regulations and the provision of contracts or grant agreements as well
as any supplemental requirements imposed by the Louisiana Community and Technical College System.
Applicant’s Organization:
Full Name of Authorized Representative:
Title of Authorized Representative:
___________________________________________________________________________________
Authorized Representative Signature
Date
*State requirement
14
Application Form #10
BOARD RESOLUTION
(If applicable, please complete and sign)
(Name of Corporation)
Resolved, on motion of
,
seconded by
,
(Name of Board Member)
(Name of Board Member)
that the Board of Directors designated
,
(Name of Appointee)
, to initiate, negotiate, and sign for grants between the Louisiana Community and
(Title)
Technical College System and the
.
(Name of Corporation)
President
Date
I hereby certify that the above resolution and foregoing are a true and correct extract
from the minutes of a
meeting of the Board of Directors held on
(Regular or Special)
at which there was a quorum present and voting.
(Date)
ATTEST:
Secretary
DATE:
15
Application Form #11
Budget Information
BUDGET FORMS/WORKBOOK
Please complete a budget summary and detail form for each funding source for the amount that your program was
awarded in FY 15-16. However, the total amount of funding in FY16-17 will be contingent upon the availability of State
General funds, Federal Funds made available under AEFLA, Section 211 (b) (1), demonstrated program effectiveness,
program service and compliance with all requirements imposed by Federal and State laws, as well as any supplemental
regulations and requirements imposed by the Louisiana Community and Technical College System guidelines and the
WorkReady U Recipient - Grant Management Handbook.
1.
2.
3.
4.
Federal Adult Education;
Federal Adult Education/Family Literacy;
Federal EL-Civics; and/or
State.
The Budget Summary and Detail forms are available at http://www.lctcs.edu/workready-u/policies-andprocedures/20132014aegrantapp.
*Program Service will be considered in FY16-17 program funding. Programs shall offer flexible, year-round instructional services
with a minimum of 220 instructional days within the fiscal year.
16
Appendix I
Louisiana Workforce Development Regions/Parishes
WORKFORCE REGIONS
Region 1
Region 2
Region 3
Region 4
Region 5
Region 6
Region 7
Region 8
Jefferson
Orleans
Plaquemines
Ascension
East Baton Rouge
East Feliciana
Iberville
Livingston
Pointe Coupee
Assumption
Lafourche
Acadia
Evangeline
Iberia
Lafayette
St. Landry
Allen
Beauregard
Calcasieu
Avoyelles
Catahoula
Concordia
Grant
Bienville
Bossier
Caddo
Claiborne
DeSoto
Caldwell
East Carroll
Franklin
Jackson
Ouachita
Madison
PARISHES
St. Bernard
St. Charles
St. Tammany
St. Helena
Tangipahoa
Washington
West Baton Rouge
West Feliciana
Terrebonne
St. Martin
St. Mary
Vermilion
Cameron
Jefferson Davis
Vernon
LaSalle
Rapides
Winn
Lincoln
Natchitoches
Red River
Sabine
Webster
Morehouse
Richland
Tensas
Union
West Carroll
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