ࡱ> ] 8bjbj ߒee(0[(((((43)3)3)h)_,3)6z/hk1(1112T/3K3$f*۾(52255۾((11H@@@5(1(1@5@@xK݀1@$8{} and bullets). When uploading documents to EWEG be sure to properly label each document with the title of the form, not the appendix number. Use the checklist (see Included ( Column) to ensure that all required components have been completed. Required (()FormEWEG TAB/SUBTABRequired (()(EWEGAdmin (Contacts, Allocation, Assurance, Board Resolution and DUNS-SAM)((EWEGNarrative (Abstract, Need, Description, Goals/Objectives/Indicators, Activity Plan, Organizational Commitment & Capacity) ((EWEGBudget(*The following documents are to be scanned and uploaded in the EWEG Application, as PDF files, prior to submission. With the exception of the Agency Annual Report, Weekly schedule and Child Care License, all forms are included as Appendices in the NGO document. (NGODocumentation of 501-c3 Applicant Eligibility (Appendix 1)(Documentation of Existing Program Sites (Appendix 1a)(NGODocumentation of School Eligibility, Schoolwide and Low-income form (Appendix 2)((NGOVerification of School Collaboration (Appendix 3)((NGOProgram Statement of Assurances (Appendix 4)((NGODocumentation of Required Collaboration (Appendix 5)((Agency Annual Report as requested in section 1.2 (Scan/Upload)((Child Care License for each program site (Scan/Upload)((Weekly schedule of activities for each program site (Scan/Upload)((New Jersey Charities Registration Number or 10-digit incorporation number as requested in section 1.2 (Scan/Upload)((Entity Overview page from the  HYPERLINK "http://www.sam.gov/" \o "http://www.sam.gov/" www.sam.gov website. (This is the page that shows your agencys name, address with 4-digit extension zip code, DUNS number, and SAM expiration date, which must be a date that comes after the start date of the grant program.)( Applicant Agency: _____________________________ Appendix 1 DOCUMENTATION OF 501(c)(3) ELIGIBILITY Applicants must complete this form to document their agencys eligibility to apply for these funds. This grant opportunity is open to all national or statewide, public or private 501(c)(3) youth-serving organizations, but limited to those organizations that have implemented an afterschool model, that has been evaluated and demonstrated positive results and is currently operating at least six sites throughout all regions in NJ (statewide) or at least three states, including three sites in New Jersey (national). Applicant Agency Name: _____________________________________________________ Address: _________________________________________________________ Phone: (___) _____________ Fax: (___) ________________________ County: _________________________________________________________ I certify that the applicant agency listed above meets the following eligibility requirements:  FORMCHECKBOX  Has established residency in New Jersey, as identified by their New Jersey Charities Registration Number or 10-digit incorporation identification number obtained from the New Jersey Division of Taxation (note: there is no single, all-purpose number for nonprofits);  FORMCHECKBOX  Currently, provides afterschool and summer programs to participants that are any of ages five through 18;  FORMCHECKBOX  Demonstrates statewide capacity to provide OST activities, including the submission of a recent copy of the annual report that was presented to their Board of Directors or governing authority to further support their eligibility; and  FORMCHECKBOX  A minimum of 45% or more of the total number of local program site(s) participants must come from low-income families.  FORMCHECKBOX  As proof of an organizations 501(c)(3) status, the IRS issues letters stating their status. Applicant must upload a copy of their 501(c)(3) letter as part of the application. ______________________________________________ Print Name of Applicant Agency Chief Executive Officer _________________________________________________ ______________ Signature of Applicant Agency Chief Executive Officer Date Applicant Agency: _____________________________ Appendix 1a Documentation of EXISTING Program Site(s) (Please duplicate if necessary for additional sites.) Name of Program Site: _____________________________________________________ Current Total Number of Participants_________________________________________ Address: _________________________________________________________ Phone: (___) _____________ Fax: (___) ________________________ Serving School District: _______________________________________________________ County: _________________________________________________________ Name of Program Site: _____________________________________________________ Current Total Number of Participants_________________________________________ Address: _________________________________________________________ Phone: (___) _____________ Fax: (___) ________________________ Serving School District: ______________________________________________________ County: ________________________________________________________ Name of Program Site: _____________________________________________________ Current Total Number of Participants__________________________________________ Address: _________________________________________________________ Phone: (___) _____________ Fax: (___) ________________________ Serving School District: _________________________________________________________ County: _________________________________________________________ Applicant Agency: _____________________________ Appendix 2 DOCUMENTATION OF School Eligibility, Schoolwide and Low-income form Please copy and complete for each school the applicant proposes to serve. Applicants who propose to serve students who: (1) attend schools implementing comprehensive or targeted support and improvement activities; or (2) attend schools eligible for schoolwide programs; (3) students attending other schools determined by the LEA to be in need of intervention and support or (4) attend schools with a high percentage of students from low-income families. Schools that serve a high percentage of low-income families will be defined as those schools that have a minimum of 30% of its student population defined as low-income. Low-income families are defined as those families whose children are eligible for free lunch and/or free milk as defined in the Application for State School Aid (ASSA). Applicant Agency Name: _____________________________________________________  FORMCHECKBOX  Check this box if this school will be the site where activities will take place Name of School: _________________________________________________________ Address: _________________________________________________________ Phone: (___) _____________ Fax: (___) ________________________ District: _________________________________________________________ County: _________________________________________________________ I certify that the school listed above meets one of the following eligibility requirement (please check one box)  FORMCHECKBOX  (1) Currently listed as a comprehensive or targeted support and improvement school; or  FORMCHECKBOX  (2) Currently eligible for schoolwide programs under section Title I, Section 1114; or  FORMCHECKBOX  (3) Identified by an LEA to be in need of intervention and support based on state or district data. If a grantee selects this option, the grantee must submit a rationale for its selection process, which must include state or district data.; or  FORMCHECKBOX  (4) A minimum of 30% of the school buildings student population is free-eligible for lunch and/or milk, as documented in the most recent Application for State School Aid (ASSA) count of enrolled students. 1. Total Number of Students Enrolled: _____ 2. Total Number of Students Eligible for Free Lunch: ____ 3. Total Number of Students Eligible for Free Milk: _____ 4. Low Income Percentage (adding #2 & #3 and dividing by #1): _________% Name of Chief School Administrator (Print): ____________________________________ Signature Chief School Administrator: ________________________________ Date: ________________ Applicant Agency: _____________________________ Appendix 3 VERIFICATION OF SCHOOL COLLABORATION (Please duplicate for each school to be served.) This document is to be signed and included with the application as evidence of collaboration with each school approved to be served. Applicant Agency Name: ______________________________________________________________ Name of School to be Served: ___________________________________________________________ Name of School District: __________________________________ It is my understanding that the above-named applicant will serve the students who attend my school with comprehensive out-of-school time services. A representative of the above named school will work with this program to ensure coordination and collaboration of services to these students and their families. ______________________________________ ______________________________ Print Name of Chief School Administrator District _____________________________________ _______________________ Signature of Chief School Administrator Date _______________________________________________ Print Name of Applicant Agency Chief Executive Officer _______________________________________________ _______________________ Signature of Applicant Agency Chief Executive Officer Date Applicant Agency: _____________________________ Appendix 4 PROGRAM STATEMENT OF ASSURANCES The ____________________________________________________ (applicant agency name) hereby assures that: The applicant will ensure the local program activities are conducted in a safe and easily accessible facility. The applicant will ensure the local program provides safe transportation of students to and from the program. The applicant will ensure the local program targets a minimum of 100 additional students. The applicant will ensure that the local program provides afterschool or summer programs to participants that are any of ages five through 18; The applicant will ensure the local program funds under the program will be used for authorized programs and activities. The applicant will ensure the local program will conduct outreach activities to identify qualified children with disabilities who meet the eligibility criteria for participation in the centers programs. The applicant will ensure the local program will provide accommodations, modifications, supplementary aids, and services for eligible children with disabilities and their families that ensure their equal participation in, and benefit from, the programs/services/activities offered to nondisabled children and their families. The applicant will ensure the local program will maintain documentation that 45% or more of the total number of participants currently receiving services from the New Jersey programs, and those proposed to be served by these state funds, are from low-income families. Documentation of low income status may include: free or reduced lunch qualification letter, agency registration form that indicates income status or certification from the school. The applicant will ensure the local program will maintain an average daily attendance of 70% for the participating youth. The applicant will ensure the local program will measure student academic attitude and behavior. _______________________________________________ Print Name of Chief School Administrator or CEO _______________________________________________ _______________ Signature of Chief School Administrator or CEO Date Applicant Agency: _____________________________ Appendix 5 DOCUMENTATION OF REQUIRED COLLABORATION (Please duplicate for each collaborating agency) This document is to be signed and submitted with the grant application as evidence of the collaboration between the applicant and the agency with whom the applicant has or will coordinate in the planning and execution of services outlined in the grant application. Name of Collaborating Agency/Organization: ______________________________________ Contact Person Name and Title: ___________________________________________________ Address: _____________________________________________________________________ County: _________________Telephone #: ___________________ Fax #: _______________ Email Address: ________________________________________________ Type of agency/organization (Please check the appropriate agency type): ___ Charter School ___ Institution of Higher Education ___ City Government ___ County Government___ Local Educational Agency ___ Business/ Corporation ___ Community-based Organization ___ Faith-based Organization  It is my understanding that the applicant listed above plans to submit a New Jersey Afterschool/Summer program application, available through the New Jersey Ƶ (Ƶ) to provide afterschool and/or summer programming services to eligible students and their families. Recognizing the need for such services, I am committed to ensuring that my agency acts in full support of the proposed program through the provision of activities, services, and/or resources as a result of the collaborative effort between my agency and the aforementioned applicant agency. In addition, my agency will provide data or other information to the applicant for the purposes of documentation of services and the state evaluation of the program. Please check off the services that the collaborating agency will provide: ___ Provide programming/activity-related services ___ Provide paid staffing ___ Provide volunteer staffing ___ Provide in-kind donations ___ Provide goods/materials ___ Provide transportation ___ Provide technical assistance___ Provide services (referral, mental health counseling,social services) ___ Fundraising ___ Adult Education ___ Parent Education ___ Provide evaluation services ___ Other (please specify) _________________ ___________________________________________________ Print Name of Collaborating Agency/Organization CEO or CSA ___________________________________________________ ______________________ Signature of Collaborating Agency/Organization CEO or CSA Date Applicant Agency: ______________________________________ Appendix 6 Budget Requirements Instructions and Reminders To reduce the number of pre-award revisions, please follow instructions below: In EWEG under the Salary tabs and in the Title of Position box, be sure to list the other benefits by type and percentage amount for positions that have other benefits such that the total of the individual other benefit percentage amounts equal the percentage amount shown in the Other Benefits box. Be sure to explain what the amounts in the How Many and Cost per Unit boxes represent for the Supply, Equipment, and Other tabs budget entries. If the amounts in those boxes represent a calculation, describe that calculation in the Description box. Be sure the Description boxes also describe the cost of the item, the need for the item, and the items relation to the grant program. Mileage reimbursement budget entries must describe the relation to the grant of the traveler(s) and the grant-related purpose(s) of the travel, as well as a brief explanation of how the number of miles was calculated. Mileage must be a separate budget entry. When requesting conference travel costs such as airfare, lodging, and meals, create separate entries for each conference. Be sure to identify the relation of the grant to each traveler. (There should be a corresponding conference registration entry.) Insert this statement: gsa.gov rates will be used at the time of travel for all conference travel costs. Be sure to itemize the cost per person as follows: meals = cost per day times the number of days, round-trip coach air or rail fare = per person times the number of grant staff, and lodging = per room per night basis times the number of rooms times the number nights. Note that car rental at a conference is generally not allowed. Applicant Agency: _____________________________ Appendix 7 NEW JERSEY AFTERSCHOOL SUMMER PROGRAM Electronic Web-Enabled Grants System (EWEG) Tips The following are tips for working in the EWEG system. Please take note as these will ease submission of your application. Do not use the Back button. This will cause a system error. It is always recommended that long narrative sections be typed in either Word or Note Pad, and copied and pasted into EWEG. Doing this, will prevent you losing the text that you worked hard to create, should something go wrong when you save the page. When copying and pasting from Word or Note Pad, be sure to check for special characters. Most notably, quotation marks, apostrophes, bullets and hyphens are the biggest culprits. Avoid using all of the other special characters (!@#$%^&*()~/<>{} and bullets). Do not try to use fancy formatting. It will only give you problems. Just be sure that the content is there in a concise and clear manner. The EWEG system is not compatible with the way Microsoft Word formats quotation marks, apostrophes, bullets and hyphens. Use the following procedure to resolve this problem. Remove the quotation marks, apostrophes, bullets and hyphens in the text that you want to copy and paste. Paste the text into EWEG. Working in EWEG, BEFORE YOU TRY TO SAVE THE PAGE, put the bullets, hyphens, apostrophes and quotation marks back in. You will notice that the apostrophes and quotation marks will now look different indicating that the problematic formatting has been removed. You should be able to save the page without getting an error message. When you click on a Tab to open a page, do not click on it more than once. Some of our pages take a while to open. If you click on the tab more than once, you will get a system error. Certain systems are just not compatible with EWEG. Most notably: MAC, hand-held devices, Notebooks, Safari, Google Chrome and Firefox. If you have these systems, please try to locate a different PC to use to enter your data. Also note that Internet Explorer versions higher than 7.0 should access the EWEG site in Compatibility Mode or you may have unexpected errors and will not be able to view all application pages.      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