Region 10 Title I, Part A

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Part 2: Funding Requirements

District Name *

Contact Name *

Planned Reservations of Title I, Part A, Funds at the LEA Level

Activities Conducted with Reserved Funds

Indicate amounts in the boxes below. If N/A put $0.00

A) Districtwide Parent Involvement Activities (1%) *

B) Title I, Part A Services to Eligible Private School Students, Not Including Administration *

Indicate amount in the box.

C) Preschool Programs *

D) 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) *

E) Districtwide Professional Development Activities *

F) LEA identified for School Improvement must reserve a minimum of 10% for professional development *

G) School Improvement Activities under P.L. 107-110, Section 1116 or 1117, Excluding the Amount Reserved in Line F *

H) Services to Homeless Students Attending Campuses Not Served with Title I, Part A *

I) Services to Students Residing in Local Facilities for the Neglected *

J) Services to Student Residing in Local Facilities for the Delinquent *

K) Other

Please specify.

Total Reserved Funds *

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% (Indicate Amount by 'Other' Below)

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

Other:

Required

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 *

Part 5: District Composite of Planned Title I, Part A, Activities

LEA must select at least one activity in this section for each campus receiving Title I, Part A funds.

Supplemental, Research-Based Reading/ELA Instruction

S – Schoolwide

T – Targeted Assistance

P – Private Non-Profit

H - Homeless

N – Neglected

D – Delinquent

Supplemental, Research-Based Writing Instruction

S – Schoolwide

T – Targeted Assistance

P – Private Non-Profit

H - Homeless

N – Neglected

D – Delinquent

Supplemental, Research-Based Math Instruction

S – Schoolwide

T – Targeted Assistance

P – Private Non-Profit

H - Homeless

N – Neglected

D – Delinquent

Supplemental, Research-Based Social Studies Instruction

S – Schoolwide

T – Targeted Assistance

P – Private Non-Profit

H - Homeless

N – Neglected

D – Delinquent

Supplemental, Research-Based Science Instruction

S – Schoolwide

T – Targeted Assistance

P – Private Non-Profit

H - Homeless

N – Neglected

D – Delinquent

Supplemental, Research-Based Foreign Language Instruction

S – Schoolwide

T – Targeted Assistance

P – Private Non-Profit

H - Homeless

N – Neglected

D – Delinquent

Supplemental, Campus-Based Parental Involvement

S – Schoolwide

T – Targeted Assistance

P – Private Non-Profit

H - Homeless

N – Neglected

D – Delinquent

Supplemental, Campus-Based Professional Development

S – Schoolwide

T – Targeted Assistance

P – Private Non-Profit

H - Homeless

N – Neglected

D – Delinquent

Supplemental, Guidance & Counseling

S – Schoolwide

T – Targeted Assistance

P – Private Non-Profit

H - Homeless

N – Neglected

D – Delinquent

Supplemental, Health/Dental/Eye Care

S – Schoolwide

T – Targeted Assistance

P – Private Non-Profit

H - Homeless

N – Neglected

D – Delinquent

Other (1)

Please specify below.

S – Schoolwide

T – Targeted Assistance

P – Private Non-Profit

H - Homeless

N – Neglected

D – Delinquent

Other:

Other (2)

Please specify below.

S – Schoolwide

T – Targeted Assistance

P – Private Non-Profit

H - Homeless

N – Neglected

D – Delinquent

Other:

Part 6: District Composite of Planned Title I, Part A, Service Delivery Method(s)

LEA must select at least one activity in this section for each campus receiving Title I, Part A funds.

Tutorials

S – Schoolwide

T – Targeted Assistance

P – Private Non-Profit

H - Homeless

N – Neglected

D – Delinquent

Small-Group Instruction

S – Schoolwide

T – Targeted Assistance

P – Private Non-Profit

H - Homeless

N – Neglected

D – Delinquent

Individualized Instruction

S – Schoolwide

T – Targeted Assistance

P – Private Non-Profit

H - Homeless

N – Neglected

D – Delinquent

Computer-Aided Instruction

S – Schoolwide

T – Targeted Assistance

P – Private Non-Profit

H - Homeless

N – Neglected

D – Delinquent

Extended Learning Opportunities

S – Schoolwide

T – Targeted Assistance

P – Private Non-Profit

H - Homeless

N – Neglected

D – Delinquent

Other (1)

Please specify below.

S – Schoolwide

T – Targeted Assistance

P – Private Non-Profit

H - Homeless

N – Neglected

D – Delinquent

Other:

Other (2)

Please specify below.

S – Schoolwide

T – Targeted Assistance

P – Private Non-Profit

H - Homeless

N – Neglected

D – Delinquent

SC5000 - Campus Selection Information

Use a consistent, auditable date for all student counts.

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.

Source of low-income data *

F/R Lunch

Other:

Required

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