NCLB Consolidated Application – Title I, Part A 2014PS3101 2015
Part 2: Funding Requirements
Planned Reservations of Title I, Part A, Funds at the LEA Level
N/A
a.
Activities Conducted with Reserved Funds
Amount
Districtwide Parent Involvement Activities
Title I, Part A Services to Eligible Private School Students,
Not Including Administration
Preschool Programs
Administration of Title I, Part A, Programs (including
administration of Title I, Part A program for eligible private
school students and students at facilities for neglected and
delinquent)
Districtwide Professional Development Activities
Services to Homeless Students Attending Campuses Not
Served with Title I, Part A
b.
c.
d.
e.
f.
g.
Percentage
1% over
$500,000
Must set
aside some
funds for
non-Title I
Campuses
Services to Students Residing in Local Facilities for the
Neglected
Services to Student Residing in Local Facilities for the
Delinquent
Other (Specifiy)
Total Reserved Funds
h.
i.
Professional Development to the HQ Requirements for Teachers and the
Qualifications Requirements for Paraprofessionals Under Section 1119 (must be at
least 5% of current entitlement and must be reflected in Line e, unless:
_____ Reserve 5% Amount ______________
_____ Lesser amount is needed because other fund source is used
_____ N/A – 100% of teachers and Title I, Part A paraprofessionals already meet HQ
requirements
Part 3: Parental Involvement Consultation and Evaluation
a. Date When Parents Were Involved in the Evaluation of the Title I, Part A, Parent
Involvement Program
_________________
b. Date of the most Recent Consultation Meeting with Parents _________________
Part 4: Liaison for Homeless Students
Liaison’s Position______________________________________________
Campus Number ______________________________________________
1
NCLB Consolidated Application – Title I, Part A 2014PS3101 2015
Part 5: District Composite of Planned Title I, Part A, Activities
S – Schoolwide
T – Targeted Assistance
P – Private Non-Profit
H - Homeless
N – Neglected
D – Delinquent
S T P H N D
Supplemental, Research-Based Reading/ELA Instruction
Supplemental, Research-Based Writing Instruction
Supplemental, Research-Based Math Instruction
Supplemental, Research-Based Social Studies Instruction
Supplemental, Research-Based Science Instruction
Supplemental, Research-Based Foreign Language Instruction
Supplemental, Campus-Based Parental Involvement
Supplemental, Campus-Based Professional Development
Supplemental, Guidance & Counseling
Supplemental, Health/Dental/Eye Care
Transition Services/Vocational Career
Other (specify)
Other (specify)
Part 6: District Composite of Planned Title I, Part A, Service Delivery Method(s)
S T P H N D
Tutorials
Small-Group Instruction
Individualized Instruction
Computer-Aided Instruction
Extended Learning Opportunities
Other (specify)
Other (specify)
Page 3
2
NCLB Consolidated Application – Title I, Part A 2014PS3101 2015
SC5000 - Campus Selection Information: Use a consistent, auditable date for all
student counts.
1. District low-income percentage
_____%
Calculation: Total number of” low-income” students residing in the district ÷ Total
number of students in the district
*Charter schools only - use “enrollment” instead of residing for your calculations
2. Source of low-income data _____F/R Lunch ______ Direct Certification
_____Other (Please specify)
___________________________________________________________________
To complete campus information, use the chart on the next page. List every campus in
your district regardless of Title I status. Run additional sheets as needed. Instructions
for completing the chart are listed below.
A. List every campus in your LEA regardless of Title I status
B. List the total campus enrollment for every campus listed in Column A
C. List the low income percentage for each individual campus
D. List the Basis of Eligibility for each campus. Use the choices below:
 (N) None – no students enrolled at the campus
 (R) Residing – the total known number of students in each attendance
area who are eligible to attend the campus, including students enrolled at
private schools and facilities other than the public school campus
 (E) Enrollment – total number of students enrolled at the campus; only
charter schools may use enrollment figures
 (EFW) Ed-Flex Waiver – campuses using the waiver must provide date
the waiver was granted.
 (OYT) One Year Transition – a campus that is no longer Title I, Part A
eligible, but was served last year
 (SPY) Schoolwide from Previous Year – campus was schoolwide in the
past but is no longer at or above 40% may use the percentage from a
previous year. The “year” and “percentage” must be provided.
 (FP) Feeder Pattern – a campus may use the low income percentage
from its feeder campus(es)
3
NCLB Consolidated Application – Title I, Part A 2014PS3101 2015
E. List the Title I, Part A Campus Status. Use the choices below:
 (SW) Schoolwide
 (TA) Targeted Assistance Campus
 (NS-E) Campus is not served but is Title I Part A Eligible. In a single
attendance area or if the LEA has fewer than 1000 students, all campuses
are Title I eligible regardless of the low income percentage. In a multiple
attendance area, campuses are eligible if they have a low income
percentage of 35% or more or if the campus low income percentage is
above the district low income percentage.
 (NS-NE) Not Served, Not Title I Part A Eligible – see eligibility criteria
above
 (SK) Skipped – The LEA has elected not to serve a campus; however, the
campus is still Title I, Part A eligible. Title I, Part A Comparability
requirements apply.
 ****New 2014-2015 Direct Certification – The Campus is using the
percentage from the Community Eligibility Provision
F. List the estimated number of students who will receive services on the TA
campus(es).
*The number must be less than 40% of total campus enrollment.
G. List how you consolidate funds on your SW campus.
Answer only if you listed SW on “E.” *Disregard for TA campuses.
Use the choices below. Please note: Funds may be consolidated, but tracked to
individual fund sources.
 (TI) Title I, Part A Only – Campus does not combine funds with any other
Federal, state, or local funds.
 (FF) Federal Funds Only – Only Federal funds are combined
 (FSL) Federal, State, Local – Campus combine federal, state and local funds
to carry out programs on the SW campus
Submit to Region 10 by Friday May 30 to
Nerissa.Erickson@region10.org
Submit Google Doc at:
https://docs.google.com/forms/d/1ecrcvy4QoJ84vD12qF4XzZvEB
0wCHbtsrRDd2C3pgik/viewform
4