1. Applicant Information
- Applicant Name
- [School / District Name]
- BEN (Billed Entity #)
- [XXXXXX]
- FCC Registration #
- [XXXXXXXXXX]
- NCES ID
- [NCES ID]
- E-Rate Contact
- [Name, Title, Email, Phone]
- Total Enrollment
- [Number]
- FRL Percentage
- [XX%]
- Locale
- [Urban / Rural]
- Discount Rate
- [XX%]
- Funding Year
- [FY XXXX]
2. Discount Rate Calculation
E-Rate discount rates are based on the percentage of students eligible for the National School Lunch Program (NSLP) and whether the school is located in an urban or rural area.
| FRL % | Urban Discount | Rural Discount |
|---|---|---|
| <1% | 20% | 25% |
| 1-19% | 40% | 50% |
| 20-34% | 50% | 60% |
| 35-49% | 60% | 70% |
| 50-74% | 70% | 80% |
| 75-100% | 80% | 90% |
Your discount rate: [XX%] (based on [XX%] FRL rate, [urban/rural] locale)
3. Service Category & Request
Category 2: Internal connections, managed internal broadband, and basic maintenance. Budget cap of $167/student over 5 years (pre-discount).
| Service / Equipment | Category | Vendor (SPIN) | Pre-Discount Cost | E-Rate Share | Applicant Share |
|---|---|---|---|---|---|
| [Service 1] | [1/2] | [Vendor (SPIN)] | [$] | [$] | [$] |
| [Service 2] | [1/2] | [Vendor (SPIN)] | [$] | [$] | [$] |
| Total | [$] | [$] | [$] | ||
Category 2 Budget Check: $167 × [enrollment] = [$XX,XXX] total 5-year budget. Amount used to date: [$XX,XXX]. Remaining: [$XX,XXX].
4. Cost-Effectiveness Analysis
Demonstrate that the selected vendor/solution represents the best value for the requested services.
| Criterion | Selected Vendor | Alternative 1 | Alternative 2 |
|---|---|---|---|
| Vendor Name | [Vendor A] | [Vendor B] | [Vendor C] |
| Annual Cost (Pre-Discount) | [$XX,XXX] | [$XX,XXX] | [$XX,XXX] |
| E-Rate Share | [$XX,XXX] | [$XX,XXX] | [$XX,XXX] |
| Applicant Share | [$X,XXX] | [$X,XXX] | [$X,XXX] |
| Contract Term | [X years] | [X years] | [X years] |
| Service Level | [1 Gbps] | [500 Mbps] | [1 Gbps] |
Explain why the selected vendor is the best value (price must be primary factor per FCC rules).
[e.g., "Vendor A was selected as the most cost-effective provider offering the required service level. While Vendor C offers equivalent 1 Gbps service, Vendor A's annual cost is $[X,XXX] less over the contract term. Vendor B was eliminated due to insufficient bandwidth for our 1:1 device program requirements. The selected solution provides $[X.XX] per-student per-year connectivity cost, which is [XX%] below the national E-Rate average of $[X.XX] for comparable school sizes."]
5. Competitive Bidding Documentation
| Step | Date | Documentation |
|---|---|---|
| Form 470 Posted | [Date] | Form 470 # [Number] |
| 28-Day Window Closed | [Date] | Minimum waiting period met |
| Bids Received | [Number] | Evaluation matrix on file |
| Vendor Selected | [Date] | Selected: [Vendor Name] |
| Contract Signed | [Date] | Contract term: [X years] |
Vendor Selection Criteria
[Describe the evaluation criteria used. Price must be the primary factor. Example: "Bids were evaluated on: (1) price of eligible services — 40%, (2) experience with K-12 — 25%, (3) prior experience with E-Rate — 20%, (4) references — 15%."]
6. Technology Plan Alignment
Describe how the requested services support the school's or district's technology plan and educational goals.
Current Infrastructure
[Describe existing network infrastructure, bandwidth, and any deficiencies. Example: "Current bandwidth of 100 Mbps serves 850 students and 65 staff. Peak usage regularly exceeds 90% capacity, resulting in degraded performance during online assessment windows."]
Requested Improvement
[Describe what will change. Example: "Upgrading to 1 Gbps fiber with managed Wi-Fi (802.11ax) access points in all instructional spaces will support 1:1 device programs, cloud-based curriculum, and simultaneous online testing."]
Educational Impact
[Connect to learning outcomes. Example: "Reliable, high-speed connectivity is a prerequisite for our adopted digital curriculum (e.g., Google Classroom + Khan Academy), state-mandated online assessments, and adaptive learning tools that personalize instruction for each student."]
7. Long-Term Technology Plan Alignment
Connect this E-Rate request to the school/district's multi-year technology roadmap.
| Year | Technology Initiative | E-Rate Component | Status |
|---|---|---|---|
| [Year 1] | [Upgrade WAN to fiber] | [Cat 1 — Internet Access] | [This request] |
| [Year 2] | [Replace aging Wi-Fi APs] | [Cat 2 — Internal Connections] | [Planned] |
| [Year 3] | [Managed Wi-Fi service] | [Cat 2 — Managed Internal] | [Planned] |
Explain how this request fits into a larger infrastructure strategy.
[e.g., "This E-Rate request is Phase 1 of a 3-year technology infrastructure plan approved by the school board on [date]. Year 1 establishes high-speed WAN connectivity as the foundation. Year 2 upgrades internal wireless access points (currently 802.11ac) to Wi-Fi 6E, and Year 3 adds managed Wi-Fi services. The phased approach aligns with our Category 2 budget availability and allows each phase to build on proven infrastructure."]
8. Budget Narrative
Explain the total cost of ownership and how the applicant share will be funded.
[e.g., "The total pre-discount cost of $[XX,XXX] represents a [XX%] E-Rate discount, resulting in an applicant share of $[X,XXX] annually. The applicant share will be funded from the district's technology operating budget (line item [XXX]). The per-student connectivity cost of $[X.XX]/year (pre-discount) is in line with the FCC's benchmark for adequate broadband in schools. The selected contract term of [X] years provides cost stability and avoids annual re-procurement overhead."]
9. E-Rate Filing Timeline
Annual E-Rate Application Cycle
- Form 470 + RFP — Post competitive bid request (July-November for following funding year)
- 28-Day Waiting Period — Receive and evaluate vendor bids
- Vendor Selection — Select provider, sign contract
- Form 471 — Submit funding request to USAC (filing window typically January-March)
- PIA Review — USAC Program Integrity Assurance review
- FCDL Issued — Funding Commitment Decision Letter (approval/denial)
- Service Delivery — Services delivered within the funding year (July 1 - June 30)
- Form 472 (BEAR) or Form 474 (SPI) — Invoice for reimbursement
10. CIPA Compliance
CIPA Policy Adopted: [Date]
Board Approval: [Date of school board resolution]
Content Filter: [Product name — e.g., GoGuardian, Securly, Lightspeed]
11. Technology Impact Logic Model
| Inputs | Activities | Outputs | Short-Term Outcomes | Long-Term Outcomes | ||||
|---|---|---|---|---|---|---|---|---|
| [E-Rate funds, vendor services, IT staff time] | → | [Network upgrade, AP installation, staff training, bandwidth monitoring] | → | [1 Gbps connectivity, XX APs deployed, 99.9% uptime SLA] | → | [Reliable 1:1 device access, uninterrupted online testing, cloud curriculum] | → | [Digital equity, improved assessment completion, technology-integrated instruction] |