Program Application Guide - Public Institutions

U.S. DEPARTMENT OF EDUCATION

Washington, DC 20202

Fiscal Year 2014

Application Package to Request

Designation as an Eligible Institution

Under the Following Title III and Title V Programs:

• Strengthening Institutions Program (SIP)

• Alaska Native and Native Hawaiian-Serving Institutions (ANNH) Program

• Developing Hispanic-Serving Institutions (HSI) Program

• Hispanic Serving-Institutions (STEM and Articulation) Program

• Promoting Post-baccalaureate Opportunities for Hispanic Americans (PPOHA)

• Asian American and Native American Pacific Islander-Serving (AANAPISI) Program

• Predominantly Black Institutions (PBI) Program

• Waiver of the Non-Federal Cost-Share Requirement

CLOSING DATES:

[Insert Date] for Eligibility Designation

and

Non-Federal Cost-Share Waiver

CFDA Number: 84.031H

OMB Number: 1840-xxxx, ED FORM 1049

EXPIRES: [insert date]

TABLE OF CONTENTS

Dear Applicant Letter 1

Eligibility Highlights 4

Before You Get Started 5

Instructions for Completing the Application

Part I Identity of Applicant Institution 8

Part II Institutional Enrollment 10

Part III Institutional Statistics 11

Part IV Specific Institutional Eligibility 14

Requirements

Part V Certification 23

APPENDICES

Application For Designation As An Eligible Institution 25

(ED Form 1049)

Federal Register Closing Date Notice Inviting 28

Applications

Dear Applicant:

We are pleased to provide the application package for fiscal year (FY) 2014 Designation as an Eligible Institution under the following Title III and Title V programs of the Higher Education Act of 1965, as amended.

• STRENGTHENING INSTITUTIONS PROGRAM (SIP)

• ALASKA NATIVE AND NATIVE HAWAIIAN-SERVING INSTITUTIONS (ANNH) PROGRAM

• DEVELOPING HISPANIC-SERVING INSTITUTIONS (HSI) PROGRAM

• HISPANIC-SERVING INSTITUTIONS STEM and ARTICULATION PROGRAM

• PROMOTING POSTBACCALAUREATE OPPORTUNITIES FOR HISPANIC AMERICANS (PPOHA)

• ASIAN AMERICAN AND NATIVE AMERICAN PACIFIC ISLANDER-SERVING INSTITUTIONS (AANAPISI) PROGRAM

• PREDOMINANTLY BLACK INSTITUTIONS (PBI) PROGRAM

This application package includes the information and instructions that you need to apply for eligibility designation. Eligibility designation qualifies an institution of higher education (IHE) to apply for grants under the above Title III and Title V programs, provided the institution meets certain additional program specific eligibility requirements.

The purpose of these programs is to provide funds to eligible institutions of higher education to increase their self-sufficiency by improving their academic programs, institutional management, and fiscal stability.

In addition, this application package may be used by IHEs to apply for a waiver of certain non-Federal cost-share requirements under the following programs:

• FEDERAL WORK-STUDY (FWS) PROGRAM

• FEDERAL SUPPLEMENTAL EDUCATIONAL OPPORTUNITY GRANTS (FSEOG) PROGRAM

• TRIO STUDENT SUPPORT SERVICES (SSS) PROGRAM

• UNDERGRADUATE INTERNATIONAL STUDIES AND FOREIGN LANGUAGE (UISFL) PROGRAM

Read this package in its entirety before you begin to complete the application. It is essential that you provide sufficient responses to ALL applicable questions and that you enter the correct data throughout the application. .

• All institutions interested in applying for a new FY 2014 Title III or Title V grant and/or the non-Federal Cost-Share Waiver MUST apply for eligibility designation by [insert date].

• You must reapply for eligibility each year that you wish to apply for a new grant award. Even if Title III or Title V grants in subsequent fiscal years are made by funding down the slate from an FY 2014 competition, an institution would still need to be deemed eligible in that fiscal year in order to receive that award.

• IHEs currently receiving Title III or Title V funds do not need to apply for eligibility designation unless they intend to apply for a new grant. IHEs designated as Historically Black Colleges and Universities or Tribally Controlled Colleges and Universities are statutorily exempt from the non-Federal cost-share match requirement and do not need to apply for eligibility designation.

• FY 2014 applicants will report their required student head count figures based solely on their 2011 fall semester enrollment.

• To further assist you in determining the low-income levels of your students, we have included (in the Federal Register notice) the 2011 low-income figures, as determined by the U.S. Census Bureau. The term “low income individual” means an individual from a family whose taxable income for the preceding year did not exceed 150 percent of an amount equal to the poverty level established by the U.S. Census Bureau.

• To assist you with calculating your institution’s average educational and general (E&G) expenditures per Full Time Equivalent (FTE) student, the ED Form 1049 has been improved to calculate your institution’s E&G expenditures for you. See page 13 for specific instructions.

• If you are designated as an eligible institution, your waiver of the non-Federal cost-share requirement is effective for five consecutive years. You will need to request another waiver in [insert date].

• If you are a current Title III or Title V grant recipient, you are already entitled to the cost-share waiver.

For FY 2014, all applications must be submitted electronically as described in this application package. The deadline is [insert date].

Once you have submitted your eligibility application online, please print a copy of your submissions for your records.

If you need further assistance, please contact us at the telephone numbers or e-mail addresses cited in this application package.

Sincerely,

Leonard L. Haynes, III, Ph.D.

Senior Director

Institutional Service

ELIGIBILITY HIGHLIGHTS

• Please notify the eligibility staff if your institution’s legal name has changed. This MUST be done in writing prior to applying for eligibility designation. The eligibility staff’s contact information can be found on page 5.

• You must apply for eligibility in your institution’s legal name. Also, if you are planning to submit an application for new funds, both applications (i.e., the eligibility application and the application for funding) MUST be in the same name or your application for funding will be rejected.

• To apply for a waiver of the non-federal cost share requirement, you MUST apply for eligibility.

• The term “low income individual” means an individual from a family whose taxable income for the preceding year did not exceed 150 percent of an amount equal to the poverty level established by the U.S. Census Bureau.

• You have the option to select which program(s) you are applying to for Designation as an Eligible Institution.

• Once you submit your eligibility application, the system will determine your status. If deemed ineligible, the system will then provide you with the following prompt: “Do you want to apply for a waiver?” Click “YES” and then upload your waiver narrative.

It is the applicant’s responsibility to upload ALL supporting documentation at the time of submission.

• You are responsible for verifying and certifying the accuracy and completeness of the data you submit. We are unable to notify institutions of errors or missing data.

• You must click SUBMIT to officially upload your application. For your convenience, a SAVE button has been added to the submission page.

• Applicants can print their eligibility letters from the eligibility website at: http://opeweb.ed.gov/title3and5/. The eligibility homepage list the dates that letters can be printed.

• The Department will not mail letters to eligible applicants. Ineligible applicants may print their letters from the eligibility Web site.

• Applications must be submitted by 11:59 p.m. Washington, DC time on the closing dates with all supporting documentation.

BEFORE YOU GET STARTED

Read this entire application package, and collect the required data before you attempt to complete the application online. This application package may be obtained using the “eligibility” link, at the following Web site:

http://opeweb.ed.gov/title3and5/

For any questions regarding the Eligibility application, you may contact the individuals listed below:

Carnisia.Proctor@ed.gov or 202-502-7606

Robyn.Wood@ed.gov or 202-502-7434

Jeffrey.Hartman@ed.gov or 202-502-7607

You will need your institution's unique 8-digit identifier, referred to as the Office of Postsecondary Education Identification (OPE ID) number, in order to electronically retrieve and complete a valid eligibility application form. If your institution’s OPE ID number is not readily available, your business office or student financial aid office should have your OPE ID number.

Throughout this application package we refer to certain sections of program regulations. In the event that you wish to reference the regulations governing the Title III and Title V programs, you may do so at the following Web site:

http://www.ed.gov/legislation/FedRegister/finrule/2001-4/121599a.html

Only individual accredited institutions, including eligible branch campuses, may apply for designation as an eligible institution. The regulations at 34 CFR Part 606.2(a)(6) and 607.2(a)(4) outline the accreditation requirements. A higher education system, foundation or district may not apply on behalf of individual institutions.

Only submit data pertinent to your individual institution. Do not include data that is reported as part of a single filing by a higher education system or district no matter whether your institution normally maintains and submits data to the U. S. Department of Education as part of a single filing by a higher education system for all institutions within that system or by a district for all institutions within that district.

Designation As An Eligible Branch Campus

To be designated as an eligible branch campus, the branch campus must meet the needy student enrollment requirement, the educational and general (E&G) expenditures requirement, and the definition of a branch campus. The regulations at 34 CFR Part 606.7(b) and 34 CFR Part 607.7(e) define “branch campus” as a unit of a college or university that is geographically apart from the main campus and independent of that main campus. We consider a unit of a college or university to be independent of the main campus if the unit is permanent in nature; offers courses for credit and programs leading to an associate or bachelor’s degree; is autonomous to the extent that it has its own faculty and administrative or supervisory organization; and its own budgetary and hiring authority. If your institution is applying for eligibility as a branch campus, provide the eligibility data pertinent to the branch campus.

The Government Paperwork Elimination Act (GPEA) of 1998 (P. L. 105-277) and the Federal Financial Assistance Management Improvement Act of 1999 (P. L. 106-107) encourage us to undertake initiatives to improve our grant processes. Enhancing the ability of individuals and entities to conduct business with us electronically is a major part of our response to these Acts. Therefore, we are taking steps to adopt the internet as our chief means of conducting transactions in order to improve services to our customers and to simplify and expedite our business processes.

Note: Some of the procedures for transmitting applications in these instructions differ from those in the Education Department General Administrative Regulations (EDGAR) (34 CFR 75.102). Under the Administrative Procedure Act (5 U.S.C. 553), the Department generally offers interested parties the opportunity to comment on proposed regulations. However, these amendments make procedural changes only and do not establish new substantive policy. Therefore, under 5 U.S.C. 553(b)(A), the Secretary has determined that proposed rulemaking is not required.

All applications and waiver narratives, must be submitted electronically by

[insert date] .

We are requiring that all FY 2014 applications for eligibility designation be submitted electronically at:

http://opeweb.ed.gov/title3and5/

You may submit your application in paper format if you are unable to submit an application electronically because:

• You do not have access to the internet; or

• You do not have the capacity to upload the data online.

You must mail or fax a written statement to the Department, explaining which of the two grounds for an exception prevent you from using the internet to submit your application, no later than two weeks before the application deadline (14 calendar days or, if the fourteenth calendar day before the application deadline date falls on a Federal holiday, the next business day following the Federal holiday), If you mail your written statement to the Department, it must be postmarked no later than two weeks before the application deadline date. If you fax your written statement to the Department, we must receive the faxed statement no later than two weeks before the application deadline.

Address and mail or fax your statement to: Dr. Nancy Regan, U.S. Department of Education, 1990 K Street, N.W., Room 6032, Washington, DC 20006-8513. Fax: (202) 502-7861. Your paper application must be submitted in accordance with the mail or hand delivery instructions provided in the official notice published in the Federal Register.

IMPORTANT NOTE: Before submitting your application electronically, double check for accuracy and print a copy for yourself. When you press the submit button, the system will display a message confirming that you have successfully submitted your application. Save and print this confirmation as proof that you have submitted your application electronically. If you do not receive this confirmation, you should assume that we did not receive your application. Please contact Carnisia Proctor, Robyn Wood or Jeffrey Hartman (see page 5 for contact information).

You are responsible for verifying and certifying the accuracy and completeness of the data you submit. We are unable to notify institutions of errors or missing data.

Do not wait until the due date to submit your application:

• [Insert date] for Eligibility Designation and the non-Federal Cost-Share Waiver

INSTRUCTIONS FOR COMPLETING THE APPLICATION (ED Form 1049)

(ELECTRONIC SUBMISSION REQUIRED)

PART I – IDENTITY OF APPLICANT INSTITUTION

ITEM 1. INSTITUTION/CAMPUS OPE ID NUMBER

You will need your institution's unique 8-digit identifier, referred to as the Office of Postsecondary Education Identification (OPE ID) number, in order to electronically retrieve and complete a valid eligibility application form.

ITEM 2. NAME OF INSTITUTION/CAMPUS

Use your institution's complete name. If your institution is a branch campus, use the parent institution's name but follow it with the name of the branch campus (see definition of branch campus on page 5 of the application package). For example, if you are referring to Brockport Campus, you would cite, “State University of New York, Brockport Campus”.

Enter the name of the institution in the spaces provided.

If your institution's name has changed within the last two years, include the former name on the appropriate line provided in Part V of the eligibility application form.

ITEMS 3 THROUGH 6.

Self-explanatory.

ITEM 7. DATA UNIVERSAL NUMBERING SYSTEM (DUNS) NUMBER

Enter your institution’s DUNS number in the spaces provided.

DUNS Number: Dun and Bradstreet assign your institution's 9-digit DUNS number. Your business office will likely know your institution’s DUNS number. If not, you can obtain it at no charge by calling 1-800-333-0505 or by completing a DUNS Number Request Form. You may obtain the form at:

http://www.dnb.com

ITEM 8. TYPE OF INSTITUTION

Enter your institution's type: Identify the institution as either a 2-year or 4-year IHE.

If your institution recently changed its status from 2-year to 4-year, identify the institution as 4-year.

If the institution offers both undergraduate and graduate education, identify it as a 4-year institution.

ITEM 9. CONTROL OF INSTITUTION

Identify the institution as either a private nonprofit institution or a public institution.

PART II - INSTITUTIONAL ENROLLMENT

ITEM 1. TOTAL INSTITUTIONAL ENROLLMENT (Fall 2011 Head Count)

Determine the institution's 2011 fall semester head count of enrolled undergraduate and graduate students.

Do not include foreign students who are not eligible to participate in Title IV need-based financial assistance programs.

Enter this number in the space provided.

ITEM 2. TOTAL MINORITY ENROLLMENT (Fall 2011 Head Count)

Determine the institution's 2011 fall semester head count of enrolled minority undergraduate and graduate students.

Do not include foreign students who are not eligible to participate in Title IV need-based financial assistance programs.

The regulations at 34 CFR Part 606.7(b) and Part 607.7(e) define minority student as a student who is Hispanic/Latino of any race, Alaska Native or American Indian, Asian American, Black or African American, Native Hawaiian or Other Pacific Islander.

Enter this number in the space provided.

PART III - INSTITUTIONAL STATISTICS

ITEM 1. NEEDY STUDENT REQUIREMENT

Fill out Part III, Items 1A through 1D, using the following instructions.

ITEM 1.A. FALL 2011 HEAD COUNT ENROLLMENT OF UNDERGRADUATE AND GRADUATEDEGREE STUDENTS

Determine the institution's total 2011 fall semester head count of undergraduate and graduate students who were enrolled in a degree program. The regulations at 34 CFR Part 606.7(b) and at 34 CFR Part 607.7(e) define “degree student” as a student who enrolls at an institution for the purpose of obtaining a degree, certificate or other recognized educational credential offered by that institution. We consider the transcript that a student receives for the successful completion of a two-year transfer program to be an “other recognized educational credential.”

Do not include foreign students who are not eligible to participate in Title IV need-based assistance programs.

Determine the undergraduate student head count by including all undergraduate students who were enrolled in a program that resulted in the award of a bachelor’s degree. Include those enrolled in a two-year transfer program and those enrolled in a two-year educational program that resulted in the award of an associate degree. Include those enrolled in a vocational or technical program of at least two years in length that resulted in the award of a certificate that testifies that the student qualifies to work as a technician or at the semiprofessional level in technological fields.

Enter the total in the space provided under Part III, Item 1.A.

ITEM 1.B. FALL 2011 RECIPIENTS OF TITLE IV NEED-BASED FINANCIAL ASSISTANCE

Determine the institution's total 2011 fall semester unduplicated student head count of degree students who received any of the following Title IV need-based assistance: Federal Pell Grant, Federal College Work Study, Federal Perkins Loan or Federal Supplemental Educational Opportunity Grant. To compute the unduplicated student head count, count each student who received Title IV need-based assistance, regardless of the number of need-based programs in which the student participated. If a student participates in multiple need-based programs, that student is to be counted only once.

Enter the total in the space provided under item Part III, Item 1.B.

ITEM 1.C. FALL 2011 ENROLLMENT OF HALF TIME, UP TO AND INCLUDING FULL-TIME, UNDERGRADUATE STUDENTS

Determine the institution's total 2011 fall semester undergraduate head count of students who were enrolled at least half time in degree programs at your institution.

Do not include foreign students who are not eligible for Title IV need-based financial assistance.

Enter the total in the space provided under Part III, Item 1.C.

ITEM 1.D. FALL 2011 PELL GRANT RECIPIENTS ONLY

Determine your institution's total 2011 fall semester undergraduate head count of students who received Pell Grants for the 2011-2012 academic term. Include Pell Grant recipients who were enrolled in a program on at least a half-time basis.

Enter the total undergraduate head count of Pell Grant recipients in the space provided under Part III, Item 1.D.

ITEM 2. EDUCATIONAL AND GENERAL (E&G) EXPENDITURES REQUIREMENT

Use the following instructions to complete items 2.A through 2.D.

ITEM 2.A. UNDERGRADUATE FULL-TIME EQUIVALENT, FALL 2011 ENROLLMENT

Determine your institution's full-time equivalent (FTE) 2011 fall semester enrollment of undergraduate students. The regulations at 34 CFR Part 606.7(b) and 34 CFR Part 607.7(e) describe how to calculate your FTE enrollment and the instructions below paraphrase those regulations.

Based on the full-time load at your institution, count a full-time undergraduate student as one FTE.

Determine the FTE for part-time undergraduate students by entering the total number of credit hours of all part-time undergraduate students. The total will automatically be divided by 12. The result is the FTE for part-time undergraduate students.

The system will then add the total (full-time AND part-time) undergraduate students. The result is the total number of undergraduate FTE equivalent FY 2011 enrollment.

NOTE: This number should not exceed the total institutional enrollment entered under Part II, Item 1.

ITEM 2.B. GRADUATE FULL-TIME EQUIVALENT 2011 FALL ENROLLMENT

Determine the institution's FTE 2011 fall semester enrollment of graduate students, if any, including both full-time and part-time students, as explained here.

Based on the full-time load at your institution, count a full-time graduate student as one FTE.

Determine the FTE for part-time graduate students by entering the total number of credit hours of all part-time graduate students. That number will automatically be divided by 12. The result is the FTE for part-time graduate students.

Calculate the total graduate FTE by adding the FTE of full-time graduate students to the FTE of part-time graduate students, then multiply this total by a factor of 2.5. This final figure is the graduate FTE. The use of the 2.5 factor is required by the Department’s regulations at 34 CFR 606.4(a) (2) and 607.4(a) (2) to account for higher educational and general expenditures for graduate versus undergraduate students.

The system will then add the total (full-time plus part-time) graduate students. The result is the total number of graduate FTE equivalent FY 2011 enrollment.

ITEM 2.C. TOTAL EDUCATIONAL AND GENERAL EXPENDITURES

Determine the institution's E&G expenditures for 2011-2012. The regulations at 34 CFR Part 606.7(b) and 34 CFR Part 607.7(e) define E&G expenditures as the total amount expended by an IHE for: instruction, research, public service, academic support (including library expenditures), student services, institutional support, scholarships and fellowships, operation and maintenance expenditures for physical plant, and any mandatory transfers which the institution is required to pay by law. In determining the institution's E&G expenditures, total these costs. Do not include Federal student financial aid.

Enter the total 2011-2012 E&G expenditures in the space provided under Part III, Item 2.C.

ITEM 2.D. AVERAGE EDUCATIONAL AND GENERAL EXPENDITURES PER FTE STUDENT

The system will calculate the institution's average E&G expenditures per FTE for 2011-2012.

PART IV. SPECIFIC INSTITUTIONAL ELIGIBILITY REQUIREMENTS

ITEM 1. NEEDY STUDENT REQUIREMENTS

Use the following calculations to determine whether your institution meets the needy student requirement in at least one of two possible ways.

YOUR INSTITUTION MEETS THE NEEDY STUDENT REQUIREMENT IF:

A. At least 50% of its 2011 fall semester, unduplicated student head count of undergraduate degree students received financial assistance under one or more of the following programs: Federal Pell Grant, Federal College Work-Study, Federal Perkins Loan or Federal Supplemental Educational Opportunity Grant Programs (Part III, 1B).

Or

B. The percentage of its 2011 fall semester, undergraduate degree students who were enrolled on at least a half-time basis and received Federal Pell Grants exceeded the median percentage of undergraduate degree students who were enrolled on at least a half-time basis and received Federal Pell Grants at comparable institutions that offered similar instruction (Part III, 1D).

ITEM 1. A. AT LEAST 50% OR MORE OF FALL 2011 DEGREE STUDENTS WERE RECIPIENTS OF NEED-BASED FINANCIAL SUPPORT 

If your institution meets the needy student requirement because 50 percent or more of its 2011 fall semester enrolled degree students received the above-mentioned Title IV need-based financial assistance, select Part IV, Item 1.A. If the percentage turns out to be less than 50%, DO NOT select Part IV, Item 1.A.

EXAMPLE: Needy Student Calculation 

To determine whether your institution meets the statutory needy student requirement for 2011-2012, divide the number of 2011 fall semester, Title IV recipients (Part III, Item 1.B) by the 2011 fall semester enrollment of degree students (Part III, Item 1.A). The result (Part III, 1.B., divided by Part III, 1.A) is the percentage of needy students enrolled in the institution for the base year. If the result is 50 percent or more, your institution meets the statutory needy student requirement threshold. The regulations at 34 CFR Part 606.3(a)(1) and at 34 CFR Part 607.3(a)(1) describe the needy student requirement.

Example

2011 fall semester enrollment (Part III, 1.A) = 800 degree students

2011fall semester Title IV recipients (Part III, 1.B) = 600 students

Percentage of recipients of need-based financial support

= 75% (600 divided by 800)

The example institution meets the needy student requirement because 50 percent or more of its 2011 fall semester degree students received need-based financial support.

ITEM 1.B. THE PERCENTAGE OF FEDERAL PELL GRANT RECIPIENTS AT THE APPLICANT INSTITUTION EXCEEDED THE MEDIAN PERCENTAGE AT SIMILAR INSTITUTIONS. 

If your institution meets the statutory needy student requirement because the percentage of its 2011 fall semester enrolled students that received Pell Grants exceeded the median Federal Pell Grant percentage for its category of institutions (see below), check Part IV, Item 1.B. If your percentage does not exceed the median Federal Pell Grant percentage for your category of institutions, do not check Part IV, Item 1.B.

If the institution meets both Part IV, Items 1.A and 1.B, check the box next to Part IV, Item 1.A only.

EXAMPLE: Needy Student Calculation 

To determine if your institution meets the statutory needy student requirement for 2011, divide the number of 2011 fall semester Pell Grant recipients (Part III Item 1.D) by the 2011 fall semester enrollment of half-time up to and including full-time degree seeking students (Part III Item 1.C). The result (Part III, 1.D, divided by Part III, 1.C) is the percentage of Pell Grant recipients enrolled in the institution for the base year. If this result exceeds the "Median Federal Pell Grant Percentage" for your category of institutions, your institution meets the statutory needy student requirement threshold.

Example

2011 fall semester enrollment of half-time to full-time degree students

(Part III, 1.C) = 600

2011fall semester Pell Grant recipients (Part III, 1.D) = 250)

2011 Pell Grant percentage = 41.6% (250 divided by 600)

Here are the median Federal Pell Grant percentages or thresholds for base year 2011-2012:

For 2-year public institutions, the median = 37.6%

For 2-year non-profit private institutions, the median =44.1%

For 4-year public institutions, the median = 35.4%

For 4-year non-profit private institutions, the median = 35.5%

Since in our example, the institution’s Pell Grant percentage is greater than the median Pell Grant percentage for any category of institution, the example institution meets the needy student requirement.

ITEM 1.C. REQUESTING A WAIVER OF THE NEEDY STUDENT REQUIREMENT 

If the institution does not meet the statutory needy student requirement, under either the Title IV need-based financial assistance 50% threshold or the appropriate Pell Grant threshold, you may request a waiver of this requirement. Before doing so, review the seven possible waiver options below. These options correspond to the seven options listed in the regulations at 34 CFR Part 606.3(b) and 34 CFR Part 607.3(b).

Check Part IV, Item 1.C, denoting that you are requesting a waiver.

After you review the seven possible waiver options for the needy student requirement, select the option(s) that applies to your institution’s particular situation. You may apply for more than one option.

Prepare a separate narrative that provides the required evidence for the chosen waiver option(s) and demonstrates that the waiver(s) applies to your particular institution. Following the instructions detailed below, the narrative must contain compelling evidence. Mere statements of fact may not be enough to support your request. Provide supporting documentation (relevant studies, recent reports and/or data, etc.) to justify your request for a waiver. It is acceptable to upload photocopies of supporting documentation when addressing the waivers.

Needy Student Waiver Option #1, 34 CFR 606.3(b)(1) and 607.3(b)(1)

Provide evidence that the state provided more than 30 percent of your institution’s budget for the 2011-2012 base year.

AND

Provide evidence that your institution charged not more than $99.00 per student for tuition and fees for the 2011-2012 base year.

Please identify the resources provided by the state, citing specific dollar amounts. Also, show actual tuition and fees charged per student, and provide supporting documentation such as posted tuition and fees.

Needy Student Waiver Option #2, 34 CFR 606.3(b)(2) and 607.3(b)(2)

Provide evidence that at least 30 percent of the students served by your institution in the 2011-2012 base year were students from low-income families.

The regulations at 34 CFR Part 606.7(c) and 34 CFR 607.7(e) define a low income individual to be one from a family whose taxable income for the base year did not exceed 150% of an amount equal to the poverty level as determined by the U.S. Census Bureau. In the Federal Register Closing Date Notice, we stated the low-income figures for 2011.

Support your request by providing documentation (statistical and whole numbers baseline data) that verifies your claim that at least 30 percent of your enrolled students were from low-income families.

Needy Student Waiver Option #3, 34 CFR 606.3(b)(3) and 607.3(b)(3)

Provide evidence that your institution, in the base year, substantially increased the higher education opportunities for low-income students who were also educationally disadvantaged, or from groups underrepresented in postsecondary education, or were minority students. The program regulations at 34 CFR 606.7(b) and 607.7(e) define "educationally disadvantaged ", "minority student” and "underrepresented ".

Include ALL the following information:

l. A description of the student body characteristics, including the racial/ethnic composition and the number of low-income students, for the 2011-2012 base year.

2. The number of low-income students for the 2011-2012 base year that were also educationally disadvantaged, from groups underrepresented in postsecondary education, or minority students.

3. A description of the programs and services in place during the 2011-2012 base year that were specifically designed to increase the educational opportunities for the low income students who were also educationally disadvantaged, from groups underrepresented in higher education, or minority students.

4. A longitudinal progression detailing the number of these students served by the institution’s programs and services during the past five academic periods: 2007-2008, 2008-2009, 2009-2010, 2010-2011 and 2011-2012.

Needy Student Waiver Option #4, 34 CFR 606.3(b)(4) and 607.3(b)(4)

Provide evidence that your institution substantially increased the higher education opportunities in the 2011-2012 base year for individuals who resided in an area that is not included in a "metropolitan statistical area" (MSA) as defined by the Office of Management and Budget and who were unserved by other postsecondary institutions.

Include ALL the following information:

1. The geographical areas of residence for enrolled students in the 2011-2012 base year including:

-- The percentage of enrolled students from MSAs; and

-- The percentage of enrolled students from locations outside an MSA.

2. A map or scale drawing showing the geographically isolated or rural nature of your institution’s location. Include its geographic relationship to the nearest other institution(s) of higher education and nearest MSA; and the mileage between the institution and other institutions and the nearest MSA.

3. A description of the geographic barriers and climatic and other conditions that limit the options of individuals to attend other institutions.

4. A brief longitudinal progression detailing the number of enrolled students served by the applicant institution during the past five academic periods: 2007-2008, 2008-2009, 2009-2010, 2010-2011 and 2011-2012 who resided in areas outside the boundaries of an MSA.

Needy Student Waiver Option #5, 34 CFR 607.3(b)(5)

Provide evidence that your institution is located on or within 50 miles of an American Indian reservation or of a substantial population of American Indians, and that the institution will substantially increase higher education opportunities for American Indians. In addressing "higher education opportunities for American Indians;” include both student enrollment and retention.

Include ALL the following information:

1. A map or scale drawing showing your institution's location in relation to the American Indian reservation or population center. Include the mileage between the institution and the reservation or population center.

2. A description of the student body characteristics for the 2011-2012 base year and the two academic years following the base year (2012-2013 and 2013-2014). Include the racial/ethnic composition and specifically identify the number and percentage of American Indian students by full-time and part-time status.

3. Describe the programs and services in place during the 2011-2012 base year and the two academic years following the base year (2012-2013 and 2013-2014) that were specifically designed to increase the higher educational opportunities for American Indians.

4. Describe your institution's plans to develop and implement programs and services specifically designed to increase the higher educational opportunities for American Indians.

5. Describe the institution's enrollment goals for American Indian students for the next three academic years (2011-2012, 2012-2013 and 2013-2014). Detail the institution's plans to meet these goals.

Needy Student Waiver Option #7, 34 CFR 607.3(b)(7):

Provide evidence that your institution will substantially increase higher education opportunities for Hispanic/Latino of any race, Alaska Native or American Indian, Asian American, Black or African American, Native Hawaiian or Other Pacific Islander, White, Two or More. When addressing "higher education opportunities" include both student enrollment and retention.

Include ALL of the following information:

1. A description of the student body characteristics for the 2011-2012 base year and the two academic years following the base year (2012-2013 and 2013-2014). Include the racial/ethnic composition and specifically identify the number and the percentage for each racial/ethnic group listed above by full-time and part-time status.

2. Describe the programs and services in place during the 2011-2012 base year and the two academic years following the base year (2012-2013 and 2013-2014) that were specifically designed to increase the higher educational opportunities for one or more of the racial/ethnic groups listed above.

3. Describe the programs and services your institution is currently developing that are specifically designed to increase the higher educational opportunities for one or more of the racial/ethnic groups listed above. Include the projected date(s) for the implementation of these programs and services.

4. Describe your institution's enrollment goals for one or more of the racial/ethnic groups listed above for the next three academic years (2011-2012, 2012-2013 and 2013-2014). Explain in detail the institution's plans to meet these goals.

PART IV, ITEM 2. EDUCATIONAL & GENERAL EXPENDITURES REQUIREMENT

Your institution meets the E&G expenditures requirement if its average E&G expenditures per FTE student cited in Part III, Item 2.D, is less than the average E&G per FTE for the same category of institution. The average 2011-2012 E&G expenditures per FTE student for each category of institution is the following:

2- year public institution = $ per FTE student

2- year non-profit private = $ per FTE student

4- year public institution = $ per FTE student

4- year non-profit private = $ per FTE student

PART IV, ITEM 2.A 

Check Item 2.A only if your institution’s 2011-2012 average E&G expenditures per FTE are less than the average E&G expenditures per FTE student for its category of institution.

PART IV, ITEM 2.B 

Check Item 2.B if your institution exceeded the E&G expenditures threshold and you are requesting a waiver.

Write a justification for each waiver option you are requesting.

Instructions for Selecting Waiver Option(s) for the E&G Expenditures Requirement

Review all six waiver options below and select the option(s) that applies to your institution’s situation. You may request multiple options. You must submit a written justification with the eligibility application form for each option requested. The waiver option justification narrative must contain compelling evidence that the specific waiver condition exists. Mere statements of fact may not be enough to support your request. Provide supporting documentation (relevant studies, recent reports and/or data, etc.) to justify your request for a waiver. It is acceptable to upload photocopies of supporting documentation when addressing the waivers.

E&G Waiver Option #1, 34 CFR 606.4(d)(1) and 607.4(d)(1)

Low student enrollment in the Fall 2011 distorted your institution’s E&G expenditures per FTE undergraduate student and the institution’s eligible designation is otherwise consistent with the purposes of the Title III or Title V program. Please show your institutions enrollment was low relative to the enrollment before the base year and/or low relative to the enrollment after the base year.

Provide detailed evidence to support your claim that low student enrollment in 2011 distorted your E&G expenditures. Show that enrollments in the years prior to and after 2011 were greater, citing specific numbers. Please include comparisons with similar IHEs.

E&G Waiver Option #2, 34 CFR 606.4(d)(2) and 607.4(d)(2)

Location of the institution in an unusually high cost-of-living area distorted your institution’s E&G expenditures per FTE undergraduate student and the institution’s eligible designation is otherwise consistent with the purposes of the Title III or Title V program. Provide documentation from a governmental source to substantiate the high cost of living in the area.

Cite recent statistics from local, state and/or national levels. Please include comparisons with similar IHEs.

E&G Waiver Option #3, 34 CFR 606.4(d)(3) and 607.4(d)(3)

High energy costs distorted your institution’s E&G expenditures per FTE undergraduate student and the institution’s eligible designation is otherwise consistent with the purposes of the Title III or Title V program.

Provide documentation to substantiate the high energy costs. Please show comparisons with similar IHEs and include supporting documentation.

E&G Waiver Option #4, 34 CFR 606.4(d)(4) and 607.4(d)(4)

An increase in State funding, that was part of a desegregation plan for higher education, distorted your institution’s E&G expenditures per FTE undergraduate student and the institution’s eligible designation is otherwise consistent with the purposes of the Title III or Title V program.

Provide documentation to substantiate your request.

E&G Waiver Option #5, 34 CFR 606.4(d)(5) and 607.4(d)(5)

Operation of high cost professional schools such as medical and dental schools or technology and health science programs, distorted your institution’s E&G expenditures per FTE undergraduate student, and the institution’s eligible designation is otherwise consistent with the purposes of the Title III or Title V program.

Provide documentation to substantiate your request. Please include enrollment and cost comparisons with similar IHEs.

PART V. CERTIFICATION

A duly authorized representative of the institution must check the box in Part V to certify that to the best of his or her knowledge that all data in the application are true and correct and that the applicant institution will comply with the required assurances. By checking this box and submitting this application, the applicant institution also certifies that they meet the accrediting requirements and, if applicable, meet the definition of a branch campus.

APPENDICES

Application for Designation As An Eligible Institution

(ED Form 1049)

Federal Register Closing Date Notice Inviting Applications

UNITED STATES DEPARTMENT OF EDUCATION

WASHINGTON, D.C. 20006

APPLICATION FOR DESIGNATION AS AN ELIGIBLE INSTITUTION

FISCAL YEAR 2014

CFDA Number: 031H

To apply for grants under

Title III Programs (SIP), (ANNH), (AANAPISI),

Title V Programs (HSI-STEM and ARTICULATION), (PPOHA)

and the Predominately Black Institutions (PBI) Programs

Authority: 34 CFR Part 606 and 607 Programs

Important: You are required to provide the information requested

in order to obtain or retain a benefit.

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is 1840-0103. The time required to complete this information collection is estimated to average 7.00 hours (or minutes) per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Education, Washington, D.C. 20202-4561. If you have comments or concerns regarding the status of your individual submission for this form, write directly to: Institutional Services, U.S. Department of Education, 1990 K Street, N.W., 6^th Floor; Washington, DC 20006-8513

* This form must be completed electronically.

Part I. Identity of Applicant Institution

1. Institution/Campus OPE ID Number:

2. Name of Institution/Campus Requesting:

3. Address (Street # or P.O. Box and Street Name, City, State, Zip):

4. Contact Person’s Name: (Last Name, First Name, Middle Initial):

5. Contact Person’s Title, Phone Number, Extension:

6. E-mail Address:

7. Data Universal Numbering System (DUNS Number):

8. Type (mark one): ( ) 2-Year Institution ( ) 4-Year Institution

9. Control (mark one): ( ) Private Non-Profit Institution ( ) Public Institution

Part II. Institutional Enrollment

1. Total Institutional Enrollment (Fall 2011 Head Count):

2. Total Minority Enrollment (Fall 2011 Head Count):

Part III. Institutional Statistics

1. Needy Student Requirement

A. Fall 2011 Head Count Enrollment of Undergraduate and Graduate Degree Students:

B. Fall 2011 Recipients of Title IV Need-Based Financial Assistance:

(Include Only Pell Grant, Supplemental Educational Opportunity Grant, College Work Study, and Perkins Loan)

C. Fall 2011 Enrollment of Half-Time up to and including Full-Time Undergraduate Students:

D. Fall 2011 Pell Grant Recipients:

2. Educational & General Expenditures Requirement (E&G)

A. Undergraduate Full-Time Equivalent Fall 2011 Enrollment

a. Total Full-Time Undergraduate Students:

b. Total Number of Credit Hours for all Part-Time Undergraduate Students:

B. Graduate Full-Time Equivalent Fall 2011 Enrollment:

a. Total Full-Time Graduate Students:

b. Total Number of Credit Hours for all Part-Time Graduate Students:

C. Total 2011-2012 Educational & General Expenditures (E&G):

D. Average 2011-2012 E&G per FTE = C/(A+B):

Part IV. Specific Institutional Eligibility Requirements

1. Needy Student Requirement (mark A, B. or C)

( ) A. According to the result, after dividing item 1B by item 1A in Part III of this form, at least 50% of Degree Students are recipients of Need-Based Financial Support; or

( ) B. According to the result, after dividing item 1D by item 1C in Part III of this form, our enrollment exceeds the pertinent threshold for Substantial Percentage of Students Receiving Pell Grants for the 2011-2012 year.

( ) C. Requesting Waiver (Section 607.3(b) and Section 606.3(b) option(s):

Check an option, and attach the narrative justification to this form.

AND

2. Educational & General Expenditures Requirement (mark A or B)

( ) A. The E&G expenditures per FTE Student are less than the pertinent threshold for base year 2011-2012.

( ) B. Requesting Waiver (Section 607.4(c) and (d) and Section 606.4(c) and (d) option(s):

Check an option, and attach the narrative justification to this form.

Part V. Certification

(Although this Certification requirement is waived for applicants applying online,

the Department reserves the right to require a signed form on request.)

To the best of my knowledge and belief, all data in this application are true and correct. The governing body of the applicant has duly authorized this document and the applicant will comply with the required assurances. We meet the accrediting requirements and, if applicable, we meet the definition of a branch campus as defined in 34 CFR Part 606.7(b) and 34 CFR 607.7(e).

Authorized Representative's Typed Name and Title:

Date:

Authorized Representative's Signature:

Phone Number:

Fax Number:

Former Name of Applicant:

Institution/Campus (if applicable)”

Form Approved - OMB No. 1840-0103 Expiration Date 03/31/2014

ED Form 1049 (Revised 11/99), Replaces ED Form 1049, Revised 8/95 which is obsolete.

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