Standard Forms

OMB Number: 4040-0004

Expiration Date: 11/30/2025

Application for Federal Assistance SF-424
* 1. Type of Submission:				* 2. Type of Application:			* If Revision, select appropriate letter(s):
Preapplication Application Changed/Corrected Application				New Continuation * Other (Specify): Revision
* 3. Date Received: 4. Applicant Identifier:
5a. Federal Entity Identifier:								5b. Federal Award Identifier:
State Use Only:
6. Date Received by State:						7. State Application Identifier:
8. APPLICANT INFORMATION:
* a. Legal Name:
* b. Employer/Taxpayer Identification Number (EIN/TIN):								* c. Organizational DUNS:
d. Address:
Street1: Street2: City: County/Parish: State: Province: Country: USA: UNITED STATES Zip / Postal Code:
e. Organizational Unit:
Department Name:								Division Name:
f. Name and contact information of person to be contacted on matters involving this application:
Prefix: Middle Name: * Last Name: Suffix:					* First Name:
Title:
Organizational Affiliation:
* Telephone Number: Fax Number:
* Email:

Application for Federal Assistance SF-424
* 9. Type of Applicant 1: Select Applicant Type: Type of Applicant 2: Select Applicant Type: Type of Applicant 3: Select Applicant Type: * Other (specify):
* 10. Name of Federal Agency:
11. Catalog of Federal Domestic Assistance Number: CFDA Title:
* 12. Funding Opportunity Number: * Title:
13. Competition Identification Number: Title:
14. Areas Affected by Project (Cities, Counties, States, etc.):	Add Attachment	Delete Attachment	View Attachment
* 15. Descriptive Title of Applicant's Project:
Attach supporting documents as specified in agency instructions. Add Attachments Delete Attachments View Attachments

Application for Federal Assistance SF-424

16. Congressional Districts Of:

• a. Applicant

• b. Program/Project

Attach an additional list of Program/Project Congressional Districts if needed.

Add Attachment Delete Attachment View Attachment

16. Proposed Project:

• a. Start Date: * b. End Date:

16. Estimated Funding ($):

• 

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  a. Federal

• b. Applicant

• c. State

• d. Local

• e. Other

• f. Program Income

• g. TOTAL

• 19. Is Application Subject to Review By State Under Executive Order 12372 Process?

1. This application was made available to the State under the Executive Order 12372 Process for review on ^.

2. Program is subject to E.O. 12372 but has not been selected by the State for review.

3. Program is not covered by E.O. 12372.

• 20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes," provide explanation in attachment.)

Yes No

If "Yes", provide explanation and attach

Add Attachment Delete Attachment View Attachment

21. *By signing this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances** and agree to comply with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001)

** I AGREE

** The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency specific instructions.

Authorized Representative:

Prefix: * First Name:

Middle Name:

• Last Name: Suffix:

• Title:

• Telephone Number:

• Email:

Fax Number:

• Signature of Authorized Representative: * Date Signed:

U.S. Department of Education Supplemental Information for the SF-424 Application for Federal Assistance

OMB Number: 1894-0007

Expiration Date: 04/30/2026

1. Project Director and Applicable Entity Identification Numbers:

Prefix: * First Name: Middle Name: * Last Name:

Suffix:

• Project Director Level of Effort (percentage of time devoted to grant):

Address:

USA: UNITED STATES

* Street1: Street2:

* City: County:

* State:

* Zip Code:

* Country:

• Phone Number (give area code) Fax Number (give area code)

• Email Address:

Alternate Email Address:

OPE ID(s) (if applicable)

NCES School ID(s) (if applicable)

NCES LEA/School District ID(s) (if applicable)

2. New Potential Grantee or Novice Applicant:

N/A. This item is not applicable because the program competition’s notice inviting applications (NIA) does not include a definition of either “New Potential Grantee” or “Novice Applicant.” This item is not applicable when the program competition’s NIA does not include either definition.

For NIA’s that include a definition of “New Potential Grantee” or “Novice Applicant,” complete the following:

a. Are you either a new potential grantee or novice applicant as defined in the program competition’s NIA?

3. Human Subjects Research:

1. Are any research activities involving human subjects planned at any time during the proposed Project Period? Yes No

2. Are ALL the research activities proposed designated to be exempt from the regulations?

Yes

Provide Exemption(s) #(s):

1 2 3 4 5 6 7 8

No Provide Federal Wide Assurance #(s), if available:

3. If applicable, please attach your "Exempt Research" or "Nonexempt Research" narrative to this form as indicated in the definitions page in the attached instructions.

4. Infrastructure Programs and Build America, Buy America Act Applicability:

If the competition Notice Inviting Applications (NIA) in section III. 4. “Other” states that the program under which this application is submitted is subject to the Build America, Buy America Act (Pub. L. 117-58) (BABAA) domestic sourcing requirements, complete the following:

This application does not include any infrastructure projects or activities and therefore IS NOT subject the BABAA domestic sourcing requirements.

This application IS subject to the BABAA domestic sourcing requirements, because the proposed grant project described in this application includes the following infrastructure projects or activities:

Construction

Remodeling

Broadband Infrastructure

If this application IS subject to the BABAA domestic sourcing requirements, please list the page numbers from within the application narrative where the proposed infrastructure project or activities are described:

DISCLOSURE OF LOBBYING ACTIVITIES

CERTIFICATION REGARDING LOBBYING (80-0013)

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 grant, 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.

(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 for Loan Guarantees and Loan Insurance

The undersigned states, to the best of his or her knowledge and belief, that:

* APPLICANT’S ORGANIZATION

* PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE

Prefix: * First Name: Middle Name:

* Last Name: Suffix:

* Title:

* SIGNATURE: * DATE:

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 commitment providing for the United States to insure or guarantee a loan, the undersigned shall complete and submit Standard Form-LLL, ''Disclosure of Lobbying Activities,'' in accordance with its instructions. Submission of this statement 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 statement shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

OMB Control Number 1894-0005

Expiration 2/28/2026

NOTICE TO ALL APPLICANTS:

EQUITY FOR STUDENTS, EDUCATORS, AND OTHER PROGRAM BENEFICIARIES

Section 427 of the General Education Provisions Act (GEPA) (20 U.S.C. 1228a) applies to applicants for grant awards under this program.

ALL APPLICANTS FOR NEW GRANT AWARDS MUST INCLUDE THE FOLLOWING INFORMATION IN THEIR APPLICATIONS TO ADDRESS THIS PROVISION IN ORDER TO RECEIVE FUNDING UNDER THIS PROGRAM.

Please respond to the following requests for information:

1. Describe how your entity’s existing mission, policies, or commitments ensure equitable access to, and equitable participation in, the proposed project or activity.

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

2. Based on your proposed project or activity, what barriers may impede equitable access and participation of students, educators, or other beneficiaries?

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

3. Based on the barriers identified, what steps will you take to address such barriers to equitable access and participation in the proposed project or activity? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

4. What is your timeline, including targeted milestones, for addressing these identified barriers?

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Notes:

1. Applicants are not required to have mission statements or policies that align with equity in order to submit an application.

2. Applicants may identify any barriers that may impede equitable access and participation in the proposed project or activity, including, but not limited to, barriers based on economic disadvantage, gender, race, ethnicity, color, national origin, disability, age, language, migrant status, rural status, homeless status or housing insecurity, pregnancy, parenting, or caregiving status, and sexual orientation.

3. Applicants may have already included some or all of this required information in the narrative sections of their applications or their State Plans.  In responding to this requirement, for each question, applicants may provide a cross-reference to the section(s) and page number(s) in their applications or State Plans that includes the information responsive to that question on this form or may restate that information on this form.

Paperwork Burden Statement

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 1894-0005. Public reporting burden for this collection of information is estimated to average 3 hours per response, including time for reviewing instructions, searching existing data sources, gathering, and maintaining the data needed, and completing and reviewing the collection of information. The obligation to respond to this collection is required to obtain or retain a benefit. If you have any comments concerning the accuracy of the time estimate or suggestions for improving this individual collection, send your comments to ICDocketMgr@ed.gov and reference OMB Control Number 1894-0005. All other comments or concerns regarding the status of your individual form may be addressed to either (a) the person listed in the FOR FURTHER INFORMATION CONTACT section in the competition Notice Inviting Applications, or (b) your assigned program officer.

U.S. Department of Education Evidence Form

OMB Number: 1894-0001

Expiration Date: 07/31/2025

1. Level of Evidence

Select the level of evidence of effectiveness for which you are applying. See the Notice Inviting Applications for the relevant definitions and requirements.

2. Citation and Relevance

Fill in the chart below with the appropriate information about the studies that support your application.

A. Research/Citation	B. Relevant Outcome(s)/Relevant Finding(s)	C. Project Component(s)/Overlap of Populations and/or Settings

Instructions for Evidence Form

1. Level of Evidence. Check the box next to the level of evidence for which you are applying. See the Notice Inviting Applications for the evidence definitions.

2. Citation and Relevance. Fill in the chart for each of the studies you are submitting to meet the evidence standards. If allowable under the program you are applying for, you may add additional rows to include more than four citations. (See below for an example citation.)

   1. Research/Citation. For Demonstrates a Rationale, provide the citation or link for the research or evaluation findings. For Promising, Moderate, and Strong Evidence, provide the full citation for each study or WWC publication you are using as evidence. If the study has been reviewed by the WWC, please include the rating it received, the WWC review standards version, and the URL link to the description of that finding in the WWC reviewed studies database. Include a copy of the study or a URL link to the study, if available. Note that, to provide promising, moderate, or strong evidence, you must cite either a specific recommendation from a WWC practice guide, a WWC intervention report, or a publicly available, original study of the effectiveness of a component of your proposed project on a student outcome or other relevant outcome.

   2. Relevant Outcome(s)/Relevant Finding(s). For Demonstrates a Rationale, describe how the research or evaluation findings suggest that the project component included in the logic model is likely to improve relevant outcomes. For Promising, Moderate and Strong Evidence, describe: 1) the project component included in the study (or WWC practice guide or intervention report) that is also a component of your proposed project, 2) the student outcome(s) or other relevant outcome(s) that are included in both the study (or WWC practice guide or intervention report) and in the logic model (theory of action) for your proposed project, and 3) the study (or WWC intervention report) finding(s) or WWC practice guide recommendations supporting a favorable relationship between a project component and a relevant outcome. Cite page and table numbers from the study (or WWC practice guide or intervention report), where applicable.

   3. Project Component(s)/Overlap of Population and/or Settings. For Demonstrates a Rationale, explain how the project component(s) is informed by the research or evaluation findings. For Promising, Moderate, and Strong Evidence, explain how the population and/or setting in your proposed project are similar to the populations and settings included in the relevant finding(s). Cite page numbers from the study or WWC publication, where applicable.

EXAMPLES: For Demonstration Purposes Only (the three examples are not assumed to be cited by the same applicant)

A. Research/Citation	B. Relevant Outcome(s)/Relevant Finding(s)	C. Project Component(s)/Overlap of Populations and/or Settings
Graham, S., Bruch, J., Fitzgerald, J., Friedrich, L., Furgeson, J., Greene, K., Kim, J., Lyskawa, J., Olson, C. B., & Smither Wulsin, C. (2016). Teaching secondary students to write effectively (NCEE 2017-4002). Washington, DC: National Center for Education Evaluation and Regional Assistance (NCEE), Institute of Education Sciences, U.S. Department of Education. Retrieved from the NCEE website: https://ies.ed.gov/ ncee/wwc/PracticeGuide/22. This report was prepared under Version 3.0 of the WWC Handbook (p. 72).	(Table 1, p. 4) Recommendation 1 ("Explicitly teach appropriate strategies using a Model – Practice – Reflect instructional cycle") is characterized as backed by "strong evidence." (Appendix D, Table D.2, pp. 70-72) Studies contributing to the "strong evidence" supporting the effectiveness of Recommendation 1 reported statistically significant and positive impacts of this practice on genre elements, organization, writing output, and overall writing quality.	(Appendix D, Table D.2, pp. 70-72) Studies contributing to the “strong evidence” supporting the effectiveness of Recommendation 1 were conducted on students in grades 6 through 12 in urban and suburban school districts in California and in the Mid-Atlantic region of the U.S. These study samples overlap with both the populations and settings proposed for the project.

A. Research/Citation	B. Relevant Outcome(s)/Relevant Finding(s)	C. Project Component(s)/Overlap of Populations and/or Settings
U.S. Department of Education, Institute of Education Sciences, What Works Clearinghouse. (2017, February). Transition to College intervention report: Dual Enrollment Programs. Retrieved from https://ies.ed.gov/ncee/wwc/Intervention/1043. This report was prepared under Version 3.0 of the WWC Handbook (p. 1).	(Table 1, p. 2) Dual enrollment programs were found to have positive effects on students' high school completion, general academic achievement in high school, college access and enrollment, credit accumulation in college, and degree attainment in college, and these findings were characterized by a "medium to large" extent of evidence.	(pp. 1, 19, 22) Studies contributing to the effectiveness rating of dual enrollment programs in the high school completion, general academic achievement in high school, college access and enrollment, credit accumulation in college, and degree attainment in college domains were conducted in high schools with minority students representing between 32 and 54 percent of the student population and first generation college students representing between 31 and 41 percent of the student population. These study samples overlap with both the populations and settings proposed for the project.
Bettinger, E.P., & Baker, R. (2011). The effects of student coaching in college: An evaluation of a randomized experiment in student mentoring. Stanford, CA: Stanford University School of Education. Available at https://ed.stanford.edu/sites/default/files/ bettinger_baker_030711.pdf Meets WWC Group Design Standards without Reservations under review standards 2.1 (http://ies.ed. gov/ncee/wwc/Study/72030).	The intervention in the study is a form of college mentoring called student coaching. Coaches helped with a number of issues, including prioritizing student activities and identifying barriers and ways to overcome them. Coaches were encouraged to contact their assignees by either phone, email, text messaging, or social networking sites (pp. 8-10). The proposed project for Alpha Beta Community College students will train professional staff and faculty coaches on the most effective way(s) to communicate with their mentees, suggest topics for mentors to talk to their mentees, and be aware of signals to prevent withdrawal or academic failure. The relevant outcomes in the study are student persistence and degree completion (Table 3, p. 27), which are also included in the logic model for the proposed project. This study found that students assigned to receive coaching and mentoring were significantly more likely than students in the comparison group to remain enrolled at their institutions (pp. 15-16, and Table 3, p. 27).	The full study sample consisted of "13,555 students across eight different higher education institutions, including two- and four-year schools and public, private not-for-profit, and proprietary colleges." (p. 10) The number of students examined for purposes of retention varied by outcome (Table 3, p. 27). The study sample overlaps with Alpha Beta Community College in terms of both postsecondary students and postsecondary settings.

Paperwork Burden Statement: 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 1894-0001. The time required to complete this information collection is estimated to vary from 1 to 4 hours per response, with an average of 1.5 hours per response, including the time to review instructions, search existing data sources, 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. 20202-4537. If you have comments or concerns regarding the status of your individual submission of this form, write directly to the Office of Innovation and Improvement, U.S. Department of Education, 400 Maryland Avenue, S.W., Washington, D.C. 20202