Nita M. Lowey 21st Century Community Learning Centers
Request for Applications

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Application Information
Forms
Site Information
Financials
Proposal Narrative
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Basic Service Components

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Please review your application to ensure you have filled out the entire form.
The button to submit your application is available at the bottom of this page. 

Application Information

Director of Agency:

Is the Grant Contact/Project Director the same contact as the Director of Agency?

Grant Contact/Project Director: 

Data Collection and Evaluation Contact:

Fiscal Contact (your school or organization's Chief Financial Officer/Business Manager):

Yes
No

Are you a past grantee?

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On April 4, 2022, the U.S. Department of Education will join other Federal agencies and transition to utilizing new Unique Entity Identifiers (UEIs) for grant recipient and applicant organizations, rather than the previously utilized DUNS numbers. The UEI is administered through SAM.gov (System for Award Management).

Entities that do not have a registered DUNS in SAM.gov should ensure that they are registered well before the switch takes place. We recommend that organizations initiate the process with SAM.gov no later than March 1, 2022, as it may take some time for registration to be completed.

For detailed information about this change, please refer to the Fact Sheet found here: UEI Transition Fact Sheet.

Only past grantees are required to fill out this section. 

Please respond to the following questions.

ESSA 4203(14) describes how the State educational agency will evaluate the effectiveness of programs and activities carried out under this part. ESSA 4204.2 (E) a description of how the activities will meet the measures of effectiveness described in section 4205(b); ESSA 4205(1) IN GENERAL.—For a program or activity developed pursuant to this part to meet the measures of effectiveness, monitored by the State educational agency as described in section 4203(a)(14).

Section 4204.4(J) of the ESEA authorizes SEAs to renew sub-grants awarded to eligible entities under ESSA, “based on the eligible entity’s performance during the preceding subgrant period.” Based on the plain meaning of the language of this provision, SEAs have discretion to renew sub-grants that they award to eligible entities under ESSA, provided that the eligible entity’s performance under the preceding subgrant was satisfactory. Under section 312 of the Department of Education Appropriations Act, 2016, the provisions of ESSA apply to 21stCCLC program sub-grants awarded during the 2017-18 school year and later years. Therefore, SEAs may renew 21stCCLC program sub-grants awarded on or after July 1, 2017. Under the orderly transition authority of ESSA, ED authorizes SEAs to renew sub-grants awarded under the ESEA, as amended by NCLB prior to July 1, 2017. Limitation: Renew current sub-grants one time for one to five years, consistent with the terms of the original subgrant’s performance period. Example: If a grant has an original performance period of 5 years, that grant may be renewed up to an additional 5 years, not to exceed a total of 10 years.

Have you ever been in non-compliance (received a letter notice from Iowa Department of Education stating non-compliance) with 21CCLC rules and regulations in the past five years? 
Did you meet your attendance goals for the past two years? (21CCLC funded sites are required to meet their attendance goals at a rate of 70% in year one and 80% by year three)
Did you meet your academic goals for the past two years?
How many of your local evaluation goals did you meet over the past two years?
How much have office referrals been reduced over the past five years of your grant?
Have you provided children with the required snack?
Have you exceeded the snack requirement, by providing a full meal?
Are you charging program fees to families?
If you charge program fees, have you submitted an enrollment form to the SEA prior to the start of your program?
After 5 years, how many community partners for sustainability have been recruited?
Have you participated in required committee work in the last year? Attended:
Have you attended required Professional Development in the last year? Attended:

These questions provide data on the effectiveness of an existing program. Monitored as required by ESSA and the Iowa Grant Agreement Performance Monitoring section. 

Forms

Legal Status of Applicant* 

Please download the "Legal Status of Applicant" document, fill out the form, and upload the complete form using the button below. 


Supported formats: Word or PDF

Upload Completed Form

Collaborative Signatures *

Please download the "Collaborative Signatures" document, fill out the form, and upload the complete form using the button below. 
 

Supported formats: Word or PDF

Request for Competitive Priority*

It is the responsibility of the applicant to request and provide documentation of competitive priority in scoring of applications. In the downloadable form, please check the boxes for priority you are requesting and provide explanation of the documentation provided to substantiate your request. Examples of documentation are provided. 

 

Please download the "Request for Competitive Priority" document, fill out the form, and upload the complete form using the button below. 

Supported formats: Word or PDF

Upload Completed Form

Minority Impact Statement*

Please download the "Minority Impact Statement" document, fill out the form, and upload the complete form using the button below. Please complete as is required by Iowa code. 

Supported formats: Word or PDF

Upload Completed Form

Private School Consultation Meeting Log*

Please download the "Private School Consultation Meeting Log" document, fill out the form, and upload the complete form using the button below. This is required by federal statute.

Supported formats: Word or PDF

Upload Completed Form

Sustainability Planning Template and Previous Sustainability Form*

Sustainability Plan*

Please download the "Sustainability Plan Form" document, fill out the form, and upload the complete form using the button below.
All new grant applications must have a plan (this may be updated from your previous application).

Supported formats: Word or PDF

Upload Completed Form

Past Grantee Sustainability Form

Existing 21st Century Community Learning Center programs are required to document efforts of sustainability according to federal law. This template serves as an opportunity for existing 21st Century Community Learning Centers grantees to document what partners have committed to support through financial contributions, in-kind donations, volunteer time, and other goods and services. This document should provide evidence of a good-faith effort to sustain a portion of the grant. A lack of evidence of sustainability will be considered supplanting and will not be funded. 

Supported formats: Word or PDF. Only submit if you're a past grantee. 

Upload Completed Form

Community Partner Official Notice

Districts that are eligible for a community partner to apply in a high need urban area (with two high schools) MUST provide the Iowa Department of Education with official notice of who that partner will be and a description of the partnership and how it will benefit at-risk children in the community. 

Failure to provide this official notice will result in ONLY the district application being accepted for grant review. The Community Partner application will not be read but will have the option of re-applying the following year. 

Required for community-based organizations only. 

Supported formats: Word or PDF

Upload Completed Form

Assurances & Agreements Required of All Applicants*

Please download the "Assurances & Agreements" document, fill out the form, and upload the complete form using the button below. 

Supported formats: Word or PDF

Upload Completed Form
Upload Completed Form

MOU Template*

Please download the "MOU Template" document, fill out the form, and upload each completed form using the button below. Please upload at least 5 and up to 10 MOUs. If you have more than 10 MOUs, please cite the total number of MOUs in your narrative.

 

Supported formats: Word or PDF

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Site Information 

Target Schools*

School-Wide Information 
# of Youth to be Served

Grades Served by School 

Total Enrollment 

Free and Reduced Lunch Rate 

Grades Served by Program 

BS

AS

School Name
(can apply for up to 3 sites) 

SUM

TOTAL

Before School (BS) Site Operations*

Please mark each field NA if it does not apply to your site.
 

Monday 

Tuesday

Wednesday

Thursday

Friday

Saturday

Start Time 

End Time 

Hours 

After School (AS) Site Operations*
Please mark each field NA if it does not apply to your site.

Monday 

Tuesday

Wednesday

Thursday

Friday

Saturday

Start Time 

End Time 

Hours 

Summer (SUM) Site Operations*
Please mark each field NA if it does not apply to your site.

Monday 

Tuesday

Wednesday

Thursday

Friday

Saturday

Start Time 

End Time 

Hours 

Family Engagement* 

All 21CCLC programs are required to host a minimum of four family-centered events each year. A general rule of thumb is one per quarter. Examples of events include back-to-school celebrations, literacy nights, family game nights, recreational events, guest speakers, and so on.

Total Number of Family Events*
School Name
Estimated Total Number of Adult Family Members Served:*
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Financials

Funding Estimator 

The Funding Estimator is provided as an Excel document and is designed to be a tool to determine the amount of funding needed to implement a successful program. The funding estimator does not need to be uploaded. It is just a resource. This tool is designed to assist you in determining an appropriate budget request. Your partner contributions should be documented and deducted from your accounting for an accurate estimation of request.

Form D1: 21CCLC Application Funding Request Summary
 

21CCLC TOTAL FUNDING REQUEST*

(Before and/or After School and Summer Program Funds) 

FUNDING FOR EACH SITE INCLUDED IN THIS APPLICATION*

Make sure you that your funding request matches in all parts of your application. Include community partner, in-kind, and contributions.

NOTE: A program site may serve students from many schools. For example, a location that serves students from three (3) different schools would be considered one Program Site. 

Name of Program Site(s) 
Year 1 Funding Request 
Year 2 Funding Request 
Year 3 Funding Request 
Total Funding Request 
(3-year total) 
Number of Students Served per site per year 
Name of Program Site(s) 
Year 1 Funding Request 
Year 2 Funding Request 
Year 3 Funding Request 
Total Funding Request 
(3-year total) 
Number of Students Served per site per year 

Form D2

Please submit a single spreadsheet with all your D2 forms tabulated. You must complete a form for each site you will operate under your 21CCLC grant.

Upload Completed Form

Form D3

Please submit a single spreadsheet for your Form D3. This form is new this year and provides a summary of your 21st Century expenditures and partner contributions. You are only required to submit Year 1 of this form. The other tabs in the spreadsheet are provided for your information. 

 

2 CFR 200.331(b) requires states to conduct a risk assessment- Each Quarter your claim is reviewed for the amount (over or below quarterly average) and for restricted categories (like PD). We are adding a quarterly attendance check. Your D1 number is the number of students you proposed to serve and are receiving federal funds for. The Enrollment number is the actual number of students. The average daily attendance shows how many attend on a regular basis. 

The Grant Application requires you to serve 70% attendance of the D1 number by the end of year 1. The Grant Application requires you to serve 80% attendance of the D1 number by the end of year 3. 

If your recruiting methods are effective and you maintain a student leadership group and engage them with telling other students about the activities offered in afterschool, you should have no trouble meeting this goal. 

If your program provides engaging activities and you develop positive relationships with the students, you should have no trouble with increasing regular attendance (even with a hi