New Hampshire Department of Education by bH1nxDE0

VIEWS: 9 PAGES: 26

									                                        New Hampshire State Department of Education
                                                 Bureau of Special Education
                                                      101 Pleasant Street
                                            Concord, New Hampshire 03301-3860
                                          Tel: (603) 271-3741 Fax: (603) 271-1099

              INDIVIDUALS WITH DISABILITIES EDUCATION IMPROVEMENT ACT OF 2004
                                             (IDEA)
                                     (20 U.S.C. 1400 et seq.)


                      ANNUAL REQUEST FOR FEDERAL SPECIAL EDUCATION FUNDS
                                       Fiscal Year (FY) 2010
                               COVER PAGE - IDENTIFYING INFORMATION

         Project Title: _______________________________________________________________________________

         IDEA Part B Section 611 Start Date: ____________ IDEA Part B Section 611 End Date: ______________

         Preschool Section 619 Start Date: _______________ Preschool Section 619 End Date: ________________



          Agency Responsible for Programmatic and Fiscal Administration:


          Agency Name:______________________________________________________________________________
          Agency Address:____________________________________________________________________________
          ___________________________________________________________________________________________
          Project Manager: ______________________________________________ Phone:_______________________
          Title:______________________________________________________________________________________
          Fax: ________________________________ E-mail:_______________________________________________
          Contact Person(s) (if different):________________________________ Phone:_________________________
          Fax:_________________________________ E-mail:_______________________________________________




          If the Administrative Agency will contract with another agency for the management of this project, provide
          the following information regarding this management agency:


          Name of Agency:___________________________________________________________________________
          Address:__________________________________________________________________________________
          __________________________________________________________________________________________
          Administrator:_______________________________________________Phone:________________________
          Fax:__________________________________ E-mail:______________________________________________
          (See Page 2 of the Instruction packet)




New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                 1
                      ANNUAL REQUEST FOR FEDERAL SPECIAL EDUCATION FUNDS FY’10

                                                     PROJECT DESCRIPTION
(See Pages 2-7 of the Instruction packet)

Applicant Agency: _____________________________________________________ Fiscal Year: ________________


 PRIORITY TO BE ADDRESSED: Please fill in one priority area per page. If you need additional pages, please identify pages as
 2a, 2b, 2c etc. (located in Appendix C). (Please use the priorities on pages 3 and 4 of the instruction packet)




 ACTIVITIES:    (See pages 4 through 7 of the Instruction packet)
                                                                                 FUNCTION/      IDEA-B       PRESCHOOL
 PLEASE TAKE NOTE: When using Object Code Series 100, please use
                                                                                  OBJECT       AMOUNT         AMOUNT
 Appendix B to reference the position titles, incumbent/vacant, and dollar
 amounts that will coincide with the amount listed under Activities.




                                                                             Totals for each
                                                                             funding source

NOTE: Additional project description pages (2a-2k) are located in Appendix C if you need them.




New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                  2
                      ANNUAL REQUEST FOR FEDERAL SPECIAL EDUCATION FUNDS FY’10

   COORDINATED EARLY INTERVENING SERVICES (CEIS) FOR STUDENTS (K-12) WHO HAVE
                             NOT BEEN IDENTIFIED
                   AS NEEDING SPECIAL EDUCATION SERVICES
(See Pages 7-8 of Instruction packet)

Applicant Agency: ____________________________________________________ Fiscal Year: __________________

NOTE: Using IDEA Part B and/or IDEA Recovery Funds for CEIS may impact the district’s ability to reduce
Maintenance of Effort. Guidance from OSEP is expected.

 PRIORITY TO BE ADDRESSED: To develop and implement coordinated, early intervening services, which may include
 interagency financing structures, for students in kindergarten through grade 12 (with a particular emphasis on students in
 kindergarten through grade 3) who have NOT been identified as needing special education or related services but who need
 additional academic and behavioral support to succeed in a general education environment.


Each LEA that develops and maintains CEIS must report to the State on the number of children who received CEIS and
the number of those who subsequently received special education and related services under Part B of IDEA in the two-
year period after receiving CEIS. The NHDOE and LEAs must maintain these records for audit and monitoring purposes.
The NHDOE will notify you at a later date regarding reporting numbers and tracking information on students who receive
CEIS. (OSEP memo 08-09: http://www.ed.gov/policy/speced/guid/idea/ceis.html)

 ACTIVITIES:    (See pages 4 through 7 of the Instruction packet)
                                                                             FUNCTION/OBJECT    IDEA-B         PRESCHOOL
 PLEASE TAKE NOTE: When using Object Code Series 100, please use
                                                                                               AMOUNT           AMOUNT
 Appendix B to reference the position titles, incumbent/vacant, and dollar
 amounts that will coincide with the amount listed under Activities.




                                                                             Totals for each
                                                                             funding source




New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                        3
                 ANNUAL REQUEST FOR FEDERAL SPECIAL EDUCATION FUNDS FY’10

     CHILDREN WITH DISABILITIES ENROLLED BY THEIR PARENTS IN PRIVATE SCHOOLS
                                                (20 U.S.C. 1412 (a) (10))
                                                    PART I, II AND III
Part I: Private School Consultations (See pages 8 and 9 of the Instruction packet.)
 (a) If there are no private elementary and secondary schools within the jurisdiction of the LEA, check here and go to

Charter schools; page 6.                                      □
(b) List all private elementary and secondary schools, including religious schools, located within the jurisdiction of the LEA. In
    NH, private elementary and secondary schools, including religious schools, are schools approved through the NHDOE
    nonpublic approval process.
        http://www.ed.state.nh.us/education/doe/organization/curriculum/documents/AllNPS_FHExpByTownOpen.pdf




(c) Please submit an “Affirmation of Consultation” for each private school. A sample form of an “Affirmation of Consultation”
    is provided as Appendix A.

Part II: Funds to be Carried Forward from FY’ 09 (2008-2009) for Parentally Placed Children with Disabilities:
(See page 9 of the Instruction packet). If there are no dollars, please indicate by entering $0. If there are no eligible children,
please indicate by entering “0”

(a) FY’ 09 total # of children with disabilities enrolled by their parents in private schools within the jurisdiction of this LEA .
 The count must be conducted on any date between October 1 and December 1, inclusive, of each year. ______

(b) Per child proportional share for FY’ 09: $____________
(Calculation for (b) = (the total entitlement for FY’ 09 IDEA Part B Section 611divided by (# of children with         disabilities
enrolled by their parents in private schools plus # of eligible children with disabilities in public schools in the LEA).

(c) Total Amount of Funds Allocated for FY’ 09 (a) times (b) =     $ ________________________
(Note: This represents the proportional share of funds allocated for FY’ 09 and does not include the funds carried forward
from the previous year, as those funds must have been spent and are no longer available.)

(d) Amount FY’ 09 Proportional Share Funds Expended $ ________________________
       (Not including funds carried forward from FY’ 08)
(e) Amount of Funds Carried Forward to FY’10 (c) minus (d) $ ________________________

Part III: Proportional Share for FY’10 (2009-2010) (See page 9 of the Instruction packet) If there are no dollars, please
indicate by entering $0. If there are no eligible children, please indicate by entering “0”

(a) Total # children with disabilities enrolled by their parents in private schools within the jurisdiction of this LEA ____.
    The count must be conducted on any date between October 1 and December 1, inclusive, of each year.

(b) Per child Proportional Share: $ __________

    (Note: Calculation for (b) for FY 2010 = (the total entitlement for IDEA Part B Section 611 plus IDEA Recovery (Part B
    only) divided by (# of children with disabilities enrolled by their parents in private schools plus # of eligible children with
    disabilities in public schools in the LEA)

(c) Total Amount of Funds Allocated for FY’10 (a) times (b) $__________

I certify that the above information is complete and accurate for Parts I, II and III.

AUTHORIZED SIGNATURE: _______________________________________________________________________

DATE: _________________________________________________________________________________________
New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                            4
                      ANNUAL REQUEST FOR FEDERAL SPECIAL EDUCATION FUNDS FY’10


   CHILDREN WITH DISABILITIES ENROLLED BY THEIR PARENTS IN PRIVATE SCHOOLS –
                               ACTIVITY DESCRIPTION
(See Page 9 of the Instruction packet)

Applicant Agency: _____________________________________________________ Fiscal Year: ________________


 PRIORITY TO BE ADDRESSED:      Each LEA must spend the proportionate share of the LEA’s FY’ 2010 IDEA Part B
 entitlement funds to provide special education and related services (including direct services) to parentally placed
 private school children with disabilities. For FY ‘2010, the LEA must also include the district’s total allocation of
 IDEA Recovery Funds Part B (only) when determining the proportional share.

Complete Page 4 of the application to determine the funds carried forward and proportional share.

Funds carried forward from FY’09: $_______________                    Proportional Share for FY’10 $_________________

LEAs must determine the funding source(s) (IDEA Part B Section 611 and/or IDEA Recovery Funds (Part B only)) for
expending the proportionate share for children with disabilities enrolled by their parents in private schools. Please indicate
here the amount of funds to be requested through each funding source. The total of these funds must equal the funds carried
forward from FY’09 plus the proportional share for FY’10.

IDEA Part B Section 611 $_____________                                   IDEA Recovery Funds (Part B only) $_____________

The Activity Description provided below is for activities funded with IDEA Part B Section 611 only.          LEAs will provide a
description of any activities funded through the IDEA Recovery Part B in a separate application.

 ACTIVITIES:    (See pages 4 through 7 of the Instruction packet)
                                                                               FUNCTION/OBJECT           IDEA-B
 PLEASE TAKE NOTE: When using Object Code Series 100, please use
                                                                                                        AMOUNT
 Appendix B to reference the position titles, incumbent/vacant, and dollar
 amounts that will coincide with the amount listed under Activities.




                                                                              Total funding

                                                                              (Funds carried forward
                                                                              plus proportional
                                                                              share)




New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                      5
                      ANNUAL REQUEST FOR FEDERAL SPECIAL EDUCATION FUNDS FY’10

                              IDEA Part B SECTION 611 ASSURANCES – SECTION I

                                                        Charter Schools
                                                         (20 USC 1411(e))

(See Page 10 of the Instruction packet)

The LEA must provide information to demonstrate with respect to charter schools that are public schools of the
LEA, the LEA will:

(a) Serve children with disabilities attending those schools in the same manner as it serves children with disabilities in
    its other schools; and

(b) Provide funds under Part B of the Act to those schools in the same manner and at the same time as it provides
    those funds to its other schools.

                                                               OR




                  (c) If there are no charter schools that are public schools of the LEA in the
                      jurisdiction of the LEA, please put a check ( ) in the box below.




                                              MAINTENANCE OF EFFORT
(See page 10 of the Instruction Packet)

Maintenance of Effort (Non-Supplanting): This information is to be provided prior to the Form 2 being issued.


(a)                                                 FY 2009 Actual Expended                    FY 2010 Budgeted Funds
                                                    Funds or Average Per Capita                or Average Per Capita
                  LEA Name                          for Special Education                        for Special Education

                                                    $                                          $

                                                    $                                          $

                                                    $                                          $

                                                    $                                          $

                           The above computations for funds are based on a combination of state and local funds.

 (b) If Budgeted figure for FY 2010 is less than the amount of the combination of state and local funds actually expended
     for FY 2009 for Special Education, please justify according to the exception to maintenance of effort listed on Page 10
     of the Instruction Packet.



New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                         6
                      ANNUAL REQUEST FOR FEDERAL SPECIAL EDUCATION FUNDS FY’10

                                             CONSOLIDATED AGREEMENT

(See Page 10 of the Instruction packet)

This agreement must be completed when the application includes federal Section 611/Section 619 entitlement funds from
more than one LEA.

For Fiscal Year 2010, the LEAs listed below have agreed to the following:


1.                                           will serve as the ADMINISTRATIVE AGENCY for the consolidated application
  for the following federal funds: Check each source of funds for which there is a SEPARATE Form 1 included with this
  application.

                              IDEA Part-B SECTION 611                             PRESCHOOL SECTION 619


 2.                                               will serve as the PROJECT MANAGER for the consolidated application for the
      federal funds indicated in item #1 above.


3. For Section 611/Section 619 entitlement grants, the services and other items specified in the consolidated application
  will be delivered to each participating district in a manner consistent with the amount of funds allocated to this project by
  each district.


4. VERIFICATION of the delivery of the services described in this consolidated application will be reported to the State
   Department of Education as required in an End of the Year Report of Federal Funds Expended and to each of the
   participating districts at the conclusion of the project. Future allocation of federal funds for any of the participating LEAs
   is dependent upon all required programmatic and fiscal reports being satisfactorily completed and filed.


                                                   Date of
                                                   School        Amount           Original Signature of             Date of
                                                   Board       Allocated By      Superintendent or Other           Signature
                        LEA                       Approval         LEA            Authorized Personnel




New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                              7
                      ANNUAL REQUEST FOR FEDERAL SPECIAL EDUCATION FUNDS FY’10

                                                        IDEA Part B
                                                       ASSURANCES


(See Page 11 of the Instruction packet)

National Instructional Materials Accessibility Center (NIMAC)

1. The school district will coordinate with the National Instructional Materials Access Center (NIMAC). The LEA will, as
   part of any print instructional materials adoption process, procurement contract, or other practice or instrument used
   for purchase of print instructional materials entering into a written contract with the publisher of the print instructional
   materials to:

    (a) Require the publisher to prepare and, on or before delivery of the print instructional materials, provide to the
        National Instructional Materials Center, electronic files containing the contents of the print instructional materials
        using the NIMAS standard; or

    (b) Purchase instructional materials from the publisher that are produced in, or may be rendered in, specialized
        formats.

         ________ Yes, the district is participating in NIMAS/NIMAC.
         ________ No, the school district has chosen not to coordinate with the NIMAC, but assures that it will provide
                  instructional materials to blind persons or other persons with print disabilities in a timely manner.



I, the undersigned authorized official, do hereby certify that the Statement of Assurance provided herein for the
Special Education Grant Application for FY 2010 shall be fully implemented.




Signature of Superintendent/
Authorized Personnel                                _______________________________________________________


Name (please type)                                   ______________________________________________________


School District                                       ______________________________________________________


Date                                                 ______________________________________________________




New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                            8
                      ANNUAL REQUEST FOR FEDERAL SPECIAL EDUCATION FUNDS FY’10

                              IDEA Part B SECTION 611 ASSURANCES – SECTION II

(See Pages 11, 12 and 13 of the Instruction packet)


 Federal Assurance                                              Document Location
 Do not submit actual document ~                Document Name                              Page Numbers
                                                                (e.g. SAU Office, School
 cite location only                                                     Building)


 Free Appropriate Public Education
 (FAPE)

 Child Find



 Confidentiality



 IEPs



 Procedural Safeguards



 Participation in LRE



 Participation in State & District Wide
 Assessment



 Parent Participation with Special
 Education Process


 Full Educational Opportunity Goal



 Compliance with McKinney- Vento
 Homeless Assistance Act (42
 U.S.C.1143) (300.149 (a) (3))




New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                    9
                      ANNUAL REQUEST FOR FEDERAL SPECIAL EDUCATION FUNDS FY’10

                               IDEA Part B SECTION 611 ASSURANCES – Section III


(See Page 13 of the Instruction packet)


For purposes of implementing the Individuals with Disabilities Education Act (IDEA), formerly the Education of the
Handicapped Act (EHA), the LEAs listed on the page 4, make the following assurances as required by 34 CFR §76.301 and
20 U.S.C. 1232(e), a section of the General Education Provisions Act (GEPA) and IDEA Part B Section 611:

(1)     that the local educational agency will administer the program covered by the application in accordance with all
        applicable statutes, regulations, program plans, and applications;

(2)     that the control of funds provided to the local educational agency under this program and title to property acquired
        with those funds, will be in a public agency and that a public agency will administer those funds and property;

(3)     that the local educational agency will use fiscal control and fund accounting procedures that will ensure proper
        disbursement of, and accounting for, federal funds paid to that agency under this program;

(4)      that the local educational agency will make reports to the State agency or board as may reasonably be necessary to
        enable the State agency or board and the Secretary to perform their duties and that the local educational agency
        will maintain such records, including the records required under Section 443 of this Act, and provide access to
        those records, as the State agency or board or the Secretary deem necessary to perform their duties;

(5)     that the local educational agency will provide reasonable opportunities for the participation by teachers, parents,
        and other interested agencies, organizations, and individuals in the planning for and operation of this program;

(6)     that any application, evaluation, periodic program plan or report relating to this program will be made readily
        available to parents and other members of the general public;

(7)      that in the case of any project involving construction:

         (a)      the project is not inconsistent with overall State plans for the construction of school facilities, and

         (b)      in developing plans for construction, due consideration will be given to excellence of architecture and
                  design and to compliance with standards prescribed by the Secretary under Section 794 of Title 29 in
                  order to ensure that facilities constructed with the use of federal funds are accessible and usable by
                  individuals with disabilities;

(8)     that the local educational agency has adopted effective procedures for acquiring and disseminating to teachers
        and administrators participating in this program significant information from educational research, demonstrations,
        and similar projects, and for adopting, where appropriate, promising educational practices developed through
        such projects;

(9)      that none of the funds expended under this program will be used to acquire equipment (including computer software)
         in any instance in which such acquisition results in a direct financial benefit to any organization representing the
         interests of the purchasing entity or its employees or any affiliate of such an organization;

(10)    that the “Certification Regarding Drug-Free Workplace Requirements” and “Certification Regarding Debarment,
        Suspension, Ineligibility and Voluntary Exclusion” assurances will be submitted to the Office of the Commissioner
        prior to the receipt of federal funds for FY 2009;

(11)     that the local education agency cooperate in the secretary’s efforts under Section 1308 of ESEA to ensure the linkage
         of records pertaining to migrating children with a disability for the purpose of electronically exchanging, among the
         States, health and educational information regarding such children;




New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                         10
                      ANNUAL REQUEST FOR FEDERAL SPECIAL EDUCATION FUNDS FY’10



(12)     that the local education agency, to the extent consistent with the number and location of children with disabilities in
         the State who are enrolled by their parents in private elementary schools and secondary schools in the school district
         served by a local educational agency (LEA), provision is made for the participation of those children in the program
         assisted or carried out under IDEA by providing for such children special education and related services in
         accordance with Section 612(a)(10)(A);

(13)     that the local education agency, in calculating the proportionate amount of federal funds, after timely and meaningful
         consultation with representatives of private schools, shall conduct a thorough and complete child find process to
         determine the number of parentally placed children with disabilities attending private schools located in the LEA.
         Section 612(a)(10)(A)(i)(IV);

(14)     that the local education agency agrees that the amount of money provided under IDEA Part B will be expended only
         to pay the excess cost of providing special education and related services to children with disabilities and are used to
         supplement and not supplant state, local or other federal funds; and,

(15)     that all of the policies, procedures, documents and descriptions of activities, which are referred to in Section I & II
         of this Annual Request for Federal Special Education Funds are currently operational within each LEA listed on
         page 13.




New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                             11
                      ANNUAL REQUEST FOR FEDERAL SPECIAL EDUCATION FUNDS FY’10

                           IDEA-B SECTION 611 ASSURANCES – SECTIONS I, II & III


                                            Certification of Superintendent

(See Pages 11 through 15 of the Instruction packet)


        All policies, procedures, documents and descriptions of activities, which are referred to in Sections I, II and III of
        this Annual Request for Federal Special Education Funds are currently operational within each LEA listed below:



                                LEA                                Original Signature of Superintendent or                Date
                                                                         Other Authorized Personnel




New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                           12
                                                          Appendix A
                                                Affirmation of Consultation
           Representatives of Local School District, Parents of Parentally Placed Children and Private School


I.       Local School District ___________________________________________________________________
         Private School        ___________________________________________________________________
         Date of Consultation ___________________________________________________________________


                                          For July 1, 2009 through June 30, 2010

II.    This notice affirms that the representatives of the above named school district have engaged in a timely and
       meaningful consultation with representatives of the above-named private school and parents of parentally placed
       students.

III.   Issues discussed in the consultation include:

       1. Child Find – How parentally placed private school children will participate equitably.
       2. Child Find – How parents, teachers, and private school officials will be informed of the district’s year-round child
          find activities.
       3. Meaningful Participation – How the consultation process will operate throughout the school year to ensure that
          parentally placed private school children have the opportunity to meaningfully participate in special education and
          related services.
       4. Proportional Share – What the proportional share of federal IDEA Part B and IDEA Part B Recovery funds is for
          private school students placed by their parents. How this amount is calculated by the school district.
       5. Special Education Services –
               A. How special education and related services will be provided for these students.
               B. Where special education and related services will be provided for these students.
               C. Who will provide the special education and related services for these students?
               D. What types of services will be provided: Direct services, Contract services, Alternative service delivery
                   mechanisms.
               E. How services will be apportioned if the funds are insufficient to serve all parentally placed children.
               F. How the decisions in A – E will be made.

IV.      If the school district and private school officials disagree on the provision of services or types of services, the school
         district will provide the private school official a written explanation of the reasons why the school district chose not to
         provide the services in dispute. If this disagreement has occurred, the school district’s explanation is attached to
         this document.

V.      The following representatives have been involved in this consultation:

         Parents of parentally placed private school children within the district        Yes _____ No_____

         Private Schools located within the district                                     Yes _____ No _____

VI. My signature below affirms that I have participated in a timely and meaningful consultation process.


Name (Print) ___________________________________                       Title     _____________________________________
                                                                                (Private School Official)

Signature______________________________________                        Date     _____________________________________




New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                           13
*****************************************************************************************************************************************
For a list of approved non-public (private) schools:
http://www.ed.state.nh.us/education/doe/organization/curriculum/nonpublicpage.htm



If the representatives of private schools do not provide the district a signed affirmation form within a reasonable period of
time, the district will provide the NHDOE documentation that the consultation process occurred. This documentation will
include the date, place, time, and individuals in attendance at the consultation and the topics discussed, including but not
limited to 1 – 5 and A – E above.

If a private school official does not believe a timely and meaningful consultation process occurred or that the school district
did not give due consideration to the views of the private school official, that official may file a complaint with the New
Hampshire Department of Education. The complaint must be in writing and provide the basis of the noncompliance with
20 U.S.C. 1412(a) (10). The Department will render a decision to the parties within 60 days of the receipt of the written,
signed complaint. If the private school official is dissatisfied with the New Hampshire DOE’s decision the official may
submit a complaint to the United States Department of Education.




New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                                  14
                                                   Appendix B
                          Object Code 100 List of District Personnel (not contracted)
PLEASE TAKE NOTE: The dollar amount must equal what is listed on the page 2s and Form 1.

  Function/Object
                                        Position Title               Incumbent/Vacant      Dollar Amount
      Code




                                                                    Total Amount

New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                     15
                                                              Appendix C
                      ANNUAL REQUEST FOR FEDERAL SPECIAL EDUCATION FUNDS FY’10

                                                     PROJECT DESCRIPTION
(See Page 2-3 of the Instruction packet)

Applicant Agency: _____________________________________________________ Fiscal Year: ________________


 PRIORITY TO BE ADDRESSED: Please fill in one priority area per page. If you need additional pages, please identify pages as
 2a, 2b, 2c etc. (located in Appendix C). (Please use the priorities on pages 3 and 4 of the instruction packet)




 ACTIVITIES:    (See pages 5 through 7 of the Instruction packet)
                                                                                 FUNCTION/      IDEA-B       PRESCHOOL
 PLEASE TAKE NOTE: When using Object Code Series 100, please use
                                                                                  OBJECT       AMOUNT         AMOUNT
 Appendix B to reference the position titles, incumbent/vacant, and dollar
 amounts that will coincide with the amount listed under Activities.




                                                                             Totals for each
                                                                             funding source


2a




                      ANNUAL REQUEST FOR FEDERAL SPECIAL EDUCATION FUNDS FY’10
New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                  16
                                                     PROJECT DESCRIPTION
(See Page 2-3 of the Instruction packet)

Applicant Agency: _____________________________________________________ Fiscal Year: ________________


 PRIORITY TO BE ADDRESSED: Please fill in one priority area per page. If you need additional pages, please identify pages as
 2a, 2b, 2c etc. (located in Appendix C). (Please use the priorities on pages 3 and 4 of the instruction packet)




 ACTIVITIES:    (See pages 5 through 7 of the Instruction packet)
                                                                                 FUNCTION/      IDEA-B       PRESCHOOL
 PLEASE TAKE NOTE: When using Object Code Series 100, please use
                                                                                  OBJECT       AMOUNT         AMOUNT
 Appendix B to reference the position titles, incumbent/vacant, and dollar
 amounts that will coincide with the amount listed under Activities.




                                                                             Totals for each
                                                                             funding source


2b




                      ANNUAL REQUEST FOR FEDERAL SPECIAL EDUCATION FUNDS FY’10
New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                  17
                                                     PROJECT DESCRIPTION
(See Page 2-3 of the Instruction packet)

Applicant Agency: _____________________________________________________ Fiscal Year: ________________


 PRIORITY TO BE ADDRESSED: Please fill in one priority area per page. If you need additional pages, please identify pages as
 2a, 2b, 2c etc. (located in Appendix C). (Please use the priorities on pages 3 and 4 of the instruction packet)




 ACTIVITIES:    (See pages 5 through 7 of the Instruction packet)
                                                                                 FUNCTION/      IDEA-B       PRESCHOOL
 PLEASE TAKE NOTE: When using Object Code Series 100, please use
                                                                                  OBJECT       AMOUNT         AMOUNT
 Appendix B to reference the position titles, incumbent/vacant, and dollar
 amounts that will coincide with the amount listed under Activities.




                                                                             Totals for each
                                                                             funding source


2c




New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                  18
                      ANNUAL REQUEST FOR FEDERAL SPECIAL EDUCATION FUNDS FY’10

                                                     PROJECT DESCRIPTION
(See Page 2-3 of the Instruction packet)

Applicant Agency: _____________________________________________________ Fiscal Year: ________________


 PRIORITY TO BE ADDRESSED: Please fill in one priority area per page. If you need additional pages, please identify pages as
 2a, 2b, 2c etc. (located in Appendix C). (Please use the priorities on pages 3 and 4 of the instruction packet)




 ACTIVITIES:    (See pages 5 through 7 of the Instruction packet)
                                                                                 FUNCTION/      IDEA-B       PRESCHOOL
 PLEASE TAKE NOTE: When using Object Code Series 100, please use
                                                                                  OBJECT       AMOUNT         AMOUNT
 Appendix B to reference the position titles, incumbent/vacant, and dollar
 amounts that will coincide with the amount listed under Activities.




                                                                             Totals for each
                                                                             funding source


2d




New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                  19
                      ANNUAL REQUEST FOR FEDERAL SPECIAL EDUCATION FUNDS FY’10

                                                     PROJECT DESCRIPTION
(See Page 2-3 of the Instruction packet)

Applicant Agency: _____________________________________________________ Fiscal Year: ________________


 PRIORITY TO BE ADDRESSED: Please fill in one priority area per page. If you need additional pages, please identify pages as
 2a, 2b, 2c etc. (located in Appendix C). (Please use the priorities on pages 3 and 4 of the instruction packet)




 ACTIVITIES:    (See pages 5 through 7 of the Instruction packet)
                                                                                 FUNCTION/      IDEA-B       PRESCHOOL
 PLEASE TAKE NOTE: When using Object Code Series 100, please use
                                                                                  OBJECT       AMOUNT         AMOUNT
 Appendix B to reference the position titles, incumbent/vacant, and dollar
 amounts that will coincide with the amount listed under Activities.




                                                                             Totals for each
                                                                             funding source


2e




New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                  20
                      ANNUAL REQUEST FOR FEDERAL SPECIAL EDUCATION FUNDS FY’10

                                                     PROJECT DESCRIPTION
(See Page 2-3 of the Instruction packet)

Applicant Agency: _____________________________________________________ Fiscal Year: ________________


 PRIORITY TO BE ADDRESSED: Please fill in one priority area per page. If you need additional pages, please identify pages as
 2a, 2b, 2c etc. (located in Appendix C). (Please use the priorities on pages 3 and 4 of the instruction packet)




 ACTIVITIES:    (See pages 5 through 7 of the Instruction packet)
                                                                                 FUNCTION/      IDEA-B       PRESCHOOL
 PLEASE TAKE NOTE: When using Object Code Series 100, please use
                                                                                  OBJECT       AMOUNT         AMOUNT
 Appendix B to reference the position titles, incumbent/vacant, and dollar
 amounts that will coincide with the amount listed under Activities.




                                                                             Totals for each
                                                                             funding source


2f




New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                  21
                      ANNUAL REQUEST FOR FEDERAL SPECIAL EDUCATION FUNDS FY’10

                                                     PROJECT DESCRIPTION
(See Page 2-3 of the Instruction packet)

Applicant Agency: _____________________________________________________ Fiscal Year: ________________


 PRIORITY TO BE ADDRESSED: Please fill in one priority area per page. If you need additional pages, please identify pages as
 2a, 2b, 2c etc. (located in Appendix C). (Please use the priorities on pages 3 and 4 of the instruction packet)




 ACTIVITIES:    (See pages 5 through 7 of the Instruction packet)
                                                                                 FUNCTION/      IDEA-B       PRESCHOOL
 PLEASE TAKE NOTE: When using Object Code Series 100, please use
                                                                                  OBJECT       AMOUNT         AMOUNT
 Appendix B to reference the position titles, incumbent/vacant, and dollar
 amounts that will coincide with the amount listed under Activities.




                                                                             Totals for each
                                                                             funding source


2g




New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                  22
                      ANNUAL REQUEST FOR FEDERAL SPECIAL EDUCATION FUNDS FY’10

                                                     PROJECT DESCRIPTION
(See Page 2-3 of the Instruction packet)

Applicant Agency: _____________________________________________________ Fiscal Year: ________________


 PRIORITY TO BE ADDRESSED: Please fill in one priority area per page. If you need additional pages, please identify pages as
 2a, 2b, 2c etc. (located in Appendix C). (Please use the priorities on pages 3 and 4 of the instruction packet)




 ACTIVITIES:    (See pages 5 through 7 of the Instruction packet)
                                                                                 FUNCTION/      IDEA-B       PRESCHOOL
 PLEASE TAKE NOTE: When using Object Code Series 100, please use
                                                                                  OBJECT       AMOUNT         AMOUNT
 Appendix B to reference the position titles, incumbent/vacant, and dollar
 amounts that will coincide with the amount listed under Activities.




                                                                             Totals for each
                                                                             funding source


2h




New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                  23
                      ANNUAL REQUEST FOR FEDERAL SPECIAL EDUCATION FUNDS FY’10

                                                     PROJECT DESCRIPTION
(See Page 2-3 of the Instruction packet)

Applicant Agency: _____________________________________________________ Fiscal Year: ________________


 PRIORITY TO BE ADDRESSED: Please fill in one priority area per page. If you need additional pages, please identify pages as
 2a, 2b, 2c etc. (located in Appendix C). (Please use the priorities on pages 3 and 4 of the instruction packet)




 ACTIVITIES:    (See pages 5 through 7 of the Instruction packet)
                                                                                 FUNCTION/      IDEA-B       PRESCHOOL
 PLEASE TAKE NOTE: When using Object Code Series 100, please use
                                                                                  OBJECT       AMOUNT         AMOUNT
 Appendix B to reference the position titles, incumbent/vacant, and dollar
 amounts that will coincide with the amount listed under Activities.




                                                                             Totals for each
                                                                             funding source


2i




New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                  24
                      ANNUAL REQUEST FOR FEDERAL SPECIAL EDUCATION FUNDS FY’10

                                                     PROJECT DESCRIPTION
(See Page 2-3 of the Instruction packet)

Applicant Agency: _____________________________________________________ Fiscal Year: ________________


 PRIORITY TO BE ADDRESSED: Please fill in one priority area per page. If you need additional pages, please identify pages as
 2a, 2b, 2c etc. (located in Appendix C). (Please use the priorities on pages 3 and 4 of the instruction packet)




 ACTIVITIES:    (See pages 5 through 7 of the Instruction packet)
                                                                                 FUNCTION/      IDEA-B       PRESCHOOL
 PLEASE TAKE NOTE: When using Object Code Series 100, please use
                                                                                  OBJECT       AMOUNT         AMOUNT
 Appendix B to reference the position titles, incumbent/vacant, and dollar
 amounts that will coincide with the amount listed under Activities.




                                                                             Totals for each
                                                                             funding source


2j




New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                  25
                      ANNUAL REQUEST FOR FEDERAL SPECIAL EDUCATION FUNDS FY’10

                                                     PROJECT DESCRIPTION
(See Page 2-3 of the Instruction packet)

Applicant Agency: _____________________________________________________ Fiscal Year: ________________


 PRIORITY TO BE ADDRESSED: Please fill in one priority area per page. If you need additional pages, please identify pages as
 2a, 2b, 2c etc. (located in Appendix C). (Please use the priorities on pages 3 and 4 of the instruction packet)




 ACTIVITIES:    (See pages 5 through 7 of the Instruction packet)
                                                                                 FUNCTION/      IDEA-B       PRESCHOOL
 PLEASE TAKE NOTE: When using Object Code Series 100, please use
                                                                                  OBJECT       AMOUNT         AMOUNT
 Appendix B to reference the position titles, incumbent/vacant, and dollar
 amounts that will coincide with the amount listed under Activities.




                                                                             Totals for each
                                                                             funding source


2k




New Hampshire Department of Education
Bureau of Special Education
Revised April 28, 2009                                                                                                  26

								
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