Application for Funding: Emergency Assistance to Non-Public Schools

School or System Name*

COUNTY DISTRICT NUMBER (Agency ID)

SCHOOL NAME*

SCHOOL MAILING ADDRESS

COUNTRY*

ADDRESS 1*

ADDRESS 2

CITY*

State*

ZIP CODE*

AUTHORIZED REPRESENTATIVE OF THE SCHOOL*

First Last

PHONE NUMBER*

EMAIL*

ACKNOWLEDGMENT

ACKNOWLEDGMENT*

I acknowledge and certify that I have read and understand the authorizations, limitations and requirements of participation in the EANS program as set forth in the Coronavirus Response and Relief Supplemental Appropriations Act (CRRSA) and as established by the Nebraska Department of Education (NDE). Further, if participating in the EANS program, I acknowledge and agree to comply with the requirements and conditions of participating in the EANS program.

Further, I acknowledge and agree that timely and meaningful information regarding the EANS program has been provided and I, on behalf of the nonpublic school identified above, if participating in the EANS program, will continue to engage and cooperate a timely and meaningful way regarding the program.

I certify and represent that I am authorized to submit this Application and Agreement as a representative of the nonpublic school identified herein. Further, I certify to the best of my knowledge and belief, all of the information in this application is true and correct. I further understand that knowingly making a false statement or misrepresentation on this application, as well as noncompliance with the terms and conditions of the EANS program, may subject me to penalties under applicable State and Federal laws, whether administrative, civil or criminal and may disqualify the nonpublic institution from participation in the EANS program.

Yes, I certify.

Program Participation

Participate in Program*

Yes - we wish to participate
No - we do not wish to participate

Assurances

By checking each box below, I affirm that the following is true and correct regarding my school:

Eligibility*

The school requesting services or assistance is a non-public school, serving K-12 students, established prior to March 13, 2020, and accredited or approved to operate in accordance with Nebraska Department of Education Rules 10 or 14, respectively.

Enrollment and Low-Income Data*

I acknowledge that the NDE collects from our school the number and percentage of students from low income families enrolled each school year including the numbers for the 2019-2020 school year.

NOTE: The NDE has discretion to identify the data source(s) it will accept when calculating the number of students enrolled in a non-public school in school year 2019-2020 who are from low-income families and threshold for a family to have a low income. To ensure the definition of ‘low-income’ is the same for all non-public schools, the Nebraska Department of Education has selected 2019-2020 Non-public membership and the number of students eligible for free or reduced priced meal data through department data collection systems (Consolidated Data Collections (CDC) and Nutrition Services Direct Certification and Verification Reporting) as the most reliable school-audited and least burdensome data source for non-public schools and families.

PPP*

The school requesting services or assistance did not and will not apply for and receive a loan under the Small Business Administration’s Paycheck Protection Program (PPP) (15 U.S.C. 636(a)(37)) that is made on or after December 27, 2020.

NOTE: If a non-public school applies for a PPP loan on or after December 27, 2020, but does not receive funds under the PPP, the school may apply for services or assistance under the EANS program, as long as the non-public school meets the requirements and deadlines of this application. If a non-public school applied for or received a PPP loan prior to December 27, 2020, it remains eligible for the EANS program. Similarly, if a non-public school applies for but does not receive services or assistance through EANS, nothing in the Education Stabilization Fund would preclude that non-public school from applying for and receiving a PPP loan on or after December 27, 2020.

Program*

The school requesting services or assistance hereby certifies that they have read, understand, and will comply with the program assurances listed below.

1. The applicant may request to receive services or assistance to address educational disruption resulting from COVID-19 only after the Nebraska Department of Education has released final EANS allocations for services or assistance and a scope of work and budget for services (requests for reimbursement of previous expenses and future services or assistance (or reimbursement of future expenses)) has been approved by the Nebraska Department of Education or designated fiscal agent under such program.
2. The applicant will cooperate in carrying out any evaluation of the program conducted by or for the Nebraska Department of Education or other Federal officials.
3. The applicant will use such fiscal control and fund accounting procedures to ensure proper documentation or, and accounting for, federal funds paid to the applicant under such program.
4. The applicant will submit such reports to the Nebraska Department of Education or designated fiscal agent as may be requested.
5. The applicant will maintain such fiscal records, provide such fiscal information, and afford such access to the records as the Nebraska Department of Education or designated fiscal agent may reasonably require to carry out the administration of such program.

Paycheck Protection Program (PPP)

DID THE SCHOOL RECEIVE A LOAN GUARANTEED UNDER THE PPP BEFORE DECEMBER 27, 2020?*

Yes
No

WHAT WAS THE TOTAL AMOUNT OF THE PPP LOAN?*

DO YOU ASSURE THAT ANY FUNDS RECEIVED UNDER THE EANS PROGRAM WILL BE SERVICES OR ASSISTANCE NOT ALREADY FUNDED BY THE PPP LOAN?*

Yes
No

Impact of COVID-19

PLEASE DESCRIBE IMPACT OF COVID-19 ON THE NON-PUBLIC SCHOOL.*

Factors may include, but are not limited to: (1) loss of tuition revenue; (2) decrease in enrollment; (3) lack of capacity to provide remote learning due to insufficient technological support, and (4) data documenting the extent of learning loss attributable to the educational disruptions caused by COVID-19:

DID THE SCHOOL RECEIVE EQUITABLE SERVICES FROM AN LEA UNDER THE CARES ACT ESSER I FUND?*

Yes
No

Application for Funding: Emergency Assistance to Non-Public Schools

The applications for EANS are closed. Thank you.