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EMERGENCY ASSISTANCE TO NON-PUBLIC SCHOOLS PROGRAM PART A: (Alabama Department of Education)

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1
EMERGENCY ASSISTANCE TO NON-PUBLIC SCHOOLS PROGRAM
PART A: Cover Sheet
Name of School:
Mailing Address (Street Number and Name, City, State, Zip Code):
Email Address of Authorized Representative of the School:
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 may subject me to criminal or civil penalties under applicable State and Federal laws.
Authorized Representative of the School (Typed Name):
Telephone:
Signature of Authorized Representative of the School:
Date:
Primary Contact
Please provide one point of contact who shall be responsible for submitting documentation to the
Department for the purposes of requesting reimbursements and payments and managing the fiscal oversight
of the program on behalf of the Applicant.
Name: _________________________________________________
Title: _________________________________________________
Email Address: _________________________________________________
Telephone Number: _________________________________________________
Please email completed applications to EANSapplications@alsde.edu by April 2, 2021. For questions
contact Angela Martin at amartin@alsde.edu or Andy Craig at acraig@alsde.edu.
2
PART B: Non-Public School Eligibility and Assurances
ELIGIBILITY
By checking each box below, I affirm that the following is true and correct regarding my school.
☐ The school requesting services or assistance is a non-profit school.
☐ The school requesting services or assistance is accredited, licensed, or otherwise approved to operate in
accordance with State law.
☐ The school requesting services or assistance existed and operated prior to March 13, 2020.
☐ 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.
☐ None of the services or assistance for which I am requesting support in Part D of this application have
already been supported by a loan under the PPP.
NOTE: The Alabama State Department of Education may require a non-public school applicant to submit
reasonable and appropriate documentation to substantiate one or more of the above eligibility assurances.
ASSURANCES
By checking each box below, I acknowledge the following:
☐ Control of funds for services and assistance provided to a non-public school under the EANS program
and title to materials, equipment and property purchased with such funds, must be in a public agency, and
a public agency must administer such funds, materials, equipment, and property. Therefore, the Alabama
State Department of Education or another public agency will assume ownership and title to all materials,
equipment and property purchased using EANS funds, including reimbursements. The non-public school
agree to the monitoring of services and assistance provided
☐ All services or assistance provided under the EANS program must be secular, neutral, and non-
ideological.
☐ Equipment and supplies purchased with EANS funds for students and teachers in a non-public school
may be used for the authorized purposes of the EANS program during the period of performance (through
September 30, 2023) or until the equipment and supplies are no longer needed for the purposes of the EANS
program. The non-public school agree to the monitoring of services and assistance provided.
3
PART C: Non-Public School Data
Section 312(d)(3)(C) requires an SEA to prioritize services or assistance to non-public schools that enroll
low-income students and are most impacted by COVID-19. Accordingly, the State requests that the
school provide the data described below. Such data must not include personally identifiable information
about students or their families.
1. Enrollment and Low-Income Data
A. Total student enrollment of the school in the 2019-2020 school year: __________________
B. Number or estimated number of students from low-income families enrolled in the school in
the 2019-2020 school year: _______________________
This number or estimated number is from the following data source(s): _________________
The SEA will accept the following:
• Free and reduced-priced lunch data
• Scholarship or financial assistance data
• E-rate data
• Other relevant data, such as data that the non-public school has provided to the State
for purposes of State or local programs
• Data imputing the number of students from low-income families based on the
American Community Survey (ACS) or the Small Area Income and Poverty
Estimates (SAIPE) program by the U.S. Census Bureau
• Proportionality data
• Other approved data source
C. Percentage or estimated percentage of total students in the school who are students from low-
income families (i.e., 1.B/1.A): ______ %
2. Paycheck Protection Program (PPP)
A. Did the school receive a loan guaranteed under the PPP before December 27, 2020?
☐ Yes.
☐ No.
B. If the answer to 2.A is yes, please respond to the following:
i. What was the total amount of the PPP loan? $______________
ii. 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.
4
3. Impact of COVID-19
Describe the impact of COVID-19 on your non-public school(s) including but 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.
4. Whether the Non-Public School Received Equitable Services Under the CARES Act
Did the school receive equitable services from an LEA under the CARES Act?
☐ Yes.
☐ No.
5
PART D: Non-Public School Services or Assistance Requested
A non-public school may apply to receive services or assistance from the SEA or its contractors to
address educational disruptions resulting from COVID-19 for:
• Supplies to sanitize, disinfect, and clean school facilities
• Personal Protective Equipment (PPE)
• Improving ventilation systems, including windows or portable air purification systems
• Training and professional development for staff on sanitization, the use of PPE, and minimizing
the spread of infectious diseases
• Physical barriers to facilitate social distancing
• Other materials, supplies or equipment recommended by the CDC for reopening and operation of
school facilities to effectively maintain health and safety
• Expanding capacity to administer coronavirus testing to effectively monitor and suppress the
virus
• Educational technology
• Redeveloping instructional plans for remote or hybrid learning or to address learning loss
• Leasing sites or spaces to ensure social distancing
• Reasonable transportation costs
• Initiating and maintaining education and support services or assistance for remote or hybrid
learning or to address learning loss
• Reimbursement for the expenses of any services or assistance described above that a non-public
school incurred on or after March 13, 2020, except for:
o Improvements to ventilation systems (including windows), except for portable air purification
systems, which may be reimbursed.
o Staff training and professional development on sanitization, the use of PPE, and minimizing
the spread of COVID-19.
o Developing instructional plans, including curriculum development, for remote or hybrid
learning or to address learning loss.
o Initiating and maintaining education and support services or assistance for remote or hybrid
learning or to address learning loss.
o Any expenses reimbursed through a loan guaranteed under the PPP (15 U.S.C. 636(a)) prior
to December 27, 2020.
For additional information on allowable services or assistance, please see the Frequently Asked
Questions posted online at https://oese.ed.gov/offices/education-stabilization-fund/emergency-
assistance-non-public-schools/
Table 1: Requests for Reimbursement of Previous Expenses: Additional rows are allowed
Service or Assistance
Description
Dollar amount
TOTAL
n/a
6
NOTE: The non-public school’s expenditures must be allowable expenses, that the non-public school has
sufficient documentation supporting such expenditures, and that the non-public school acknowledges that
the SEA or another public agency gains title to materials, equipment, and property for which it provides
reimbursement. Thus, the SEA may require any reasonable documentation, such as paid invoices or
receipts, related to items for which a non-public school is requesting reimbursement. The SEA may also
request this information, and that requested in Table 2 of this document, in narrative or list format.
Table 2: Requests for Future Services or Assistance (or Reimbursement of Future Expenses): Additional
rows are allowed
Service or Assistance
Description
Anticipated
approximate dollar
amount
TOTAL
n/a
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EMERGENCY ASSISTANCE TO NON-PUBLIC SCHOOLS PROGRAM PART A: (Alabama Department of Education)

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Completed 28 February 2022

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