1. School / LEA Information
- School Name
- [School Name]
- NCES ID
- [NCES ID]
- District / LEA
- [District Name]
- Address
- [Street, City, State ZIP]
- Principal
- [Principal Name]
- Title I Coordinator
- [Coordinator Name & Email]
- School Level
- [Elementary / Middle / High]
- Total Enrollment
- [Number]
- FRL Percentage
- [XX%]
- Title I Status
- [Schoolwide / Targeted Assistance]
- Title I Allocation
- [$XX,XXX]
2. Item / Service Description
Describe the item(s) or service(s) to be purchased with Title I funds. Include product name, vendor, quantity, and unit cost.
| Item | Vendor | Qty | Unit Cost | Total |
|---|---|---|---|---|
| [Item 1] | [Vendor] | [#] | [$] | [$] |
| [Item 2] | [Vendor] | [#] | [$] | [$] |
| [Item 3] | [Vendor] | [#] | [$] | [$] |
| Total Requested | [$] | |||
3. Needs Assessment
Describe the specific challenge or gap this purchase addresses. Use quantitative data from assessments, surveys, or federal data sources.
Write 3-5 sentences describing your school's need. Include specific data points. Example:
[e.g., "In the 2024-25 school year, only 28% of 3rd-grade students at [School Name] scored proficient or above on the state mathematics assessment, compared to the state average of 41%. The school's FRL rate of [XX%] correlates with limited access to hands-on instructional materials. Current classroom inventories show an average of 1 manipulative kit per 3 classrooms, significantly below the district's recommended 1:1 classroom-to-kit ratio. Teacher surveys indicate 87% of teachers report insufficient materials for CRA (Concrete-Representational-Abstract) instruction."]
4. Educational Purpose & Alignment
Explain how this purchase directly supports student academic achievement and aligns with the school's Title I plan.
Alignment to State Standards
[Identify the specific state academic standards this purchase addresses. Example: "Aligns with CCSS.Math.Content.3.OA — Operations and Algebraic Thinking, supporting concrete-representational-abstract (CRA) instructional methodology."]
Connection to School Improvement Plan
[Describe how this purchase connects to a specific goal, strategy, or action step in the school's Title I Schoolwide Plan or Targeted Assistance Plan. Reference the plan section number if possible.]
Target Student Population
[Identify the students who will benefit. Include grade levels, number of students, and any specific subgroups (economically disadvantaged, EL, SWD). For Schoolwide: all students. For Targeted Assistance: identified students meeting selection criteria.]
5. Title I Funding Alignment
Eligible Use Category
- Instructional materials and supplemental resources (Sec. 1114(b)(7)(A)(iii))
- Strategies to increase learning time including before/after school and summer programs
- Professional development to improve instruction quality (Sec. 1114(b)(7)(A)(iii)(IV))
- Technology and digital learning tools supporting academic programs
Supplements Not Supplants
6. ESSA Evidence Tier
Under ESSA, programs funded with Title I dollars should demonstrate evidence of effectiveness. Identify which ESSA evidence tier applies to this intervention.
| Tier | Standard | Requirement |
|---|---|---|
| Tier 1 — Strong | At least 1 well-designed experimental study | Statistically significant positive effects |
| Tier 2 — Moderate | At least 1 well-designed quasi-experimental study | Statistically significant positive effects |
| Tier 3 — Promising | At least 1 correlational study with statistical controls | Positive effects with controls for selection bias |
| Tier 4 — Demonstrates Rationale | Well-defined logic model based on research | Ongoing effort to examine effects |
Evidence Citation for This Intervention
Cite the specific research supporting this intervention. Include study name, source (e.g., What Works Clearinghouse), and ESSA tier.
[e.g., "The What Works Clearinghouse meta-analysis on manipulative-based mathematics instruction (2023) found moderate evidence (ESSA Tier 2) of positive effects on student achievement in elementary grades. IES Practice Guide: 'Assisting Students Struggling with Mathematics' recommends systematic use of concrete representations (Recommendation 3, Strong evidence)."]
7. SMART Goals & Measurable Objectives
Define goals using the SMART framework: Specific, Measurable, Achievable, Relevant, Time-bound.
Write 2-3 SMART goals. Each should specify what, how much, for whom, and by when.
[Goal 1: "By May 2027, the percentage of 3rd-grade students scoring proficient or above on the state math assessment will increase from 28% to 40%, as measured by annual state assessment results."]
[Goal 2: "By December 2026, 90% of K-5 classroom teachers will implement manipulative-based instruction in at least 3 math lessons per week, as measured by classroom observation logs."]
[Goal 3: "By May 2027, student engagement in mathematics as measured by the annual student survey will increase by 15% from the Fall 2026 baseline."]
8. Per-Pupil Cost Analysis
Demonstrate the cost reasonableness of this purchase on a per-pupil, per-year basis.
| Metric | Value |
|---|---|
| Total Purchase Cost | [$X,XXX] |
| Students Served Per Class | [25] |
| Classes / Sections Served | [X] |
| Expected Useful Life (Years) | [5] |
| Per-Pupil Per-Year Cost | [Total / (Students × Classes × Years)] |
Example: $8,500 / (25 × 4 × 5) = $17.00 per pupil per year
9. Budget Narrative
Provide a prose justification explaining why each line item is necessary, how costs were determined, and why the expenditure is reasonable.
Write 1-2 paragraphs connecting each budget item to the educational goals. Explain cost reasonableness.
[e.g., "The proposed purchase of [X] manipulative kits at [$X,XXX] each is based on competitive vendor pricing obtained through [process]. The per-pupil cost of $[X.XX] per year over the kit's 5-year useful life is well within the range of comparable instructional materials ($15-$30 per pupil per year per IES benchmarks). Each kit serves [X] students across [X] class sections, providing comprehensive coverage of the [subject] curriculum. The cost includes all required components as specified in the [curriculum/standards] framework, eliminating the need for supplementary purchases."]
10. Implementation Plan
| Phase | Timeline | Action | Responsible |
|---|---|---|---|
| Procurement | [Month] | Purchase order submitted, delivery scheduled | [Name] |
| Training | [Month] | Teacher PD on implementation and integration | [Name] |
| Deployment | [Month] | Materials distributed, classroom use begins | [Name] |
| Monitoring | [Quarterly] | Usage tracking, formative assessment review | [Name] |
| Evaluation | [End of Year] | Outcome analysis, report to Title I committee | [Name] |
11. Evaluation Plan
Describe how the effectiveness of this investment will be measured, by whom, and on what schedule.
| Component | Details |
|---|---|
| Evaluation Methodology | [e.g., Pre-post comparison using state assessment data + classroom observation protocol] |
| Baseline Data | [Current proficiency rate, engagement score, usage metrics as of [date]] |
| Target Outcomes | [Specific targets from SMART goals above] |
| Assessment Instruments | [State assessment, curriculum-based measures, observation rubric, student survey] |
| Data Collection Schedule | [Baseline: Sep 2026 | Mid-year: Jan 2027 | End-of-year: May 2027] |
| Responsible Staff | [Title I Coordinator, grade-level team leads, building principal] |
| Reporting Cadence | [Quarterly progress reports to Title I committee; annual report to LEA] |
12. Logic Model
Visual framework connecting inputs to long-term outcomes.
| Inputs | Activities | Outputs | Short-Term Outcomes | Long-Term Outcomes | ||||
|---|---|---|---|---|---|---|---|---|
| [Title I funds, manipulative kits, PD hours, teacher time] | → | [Teacher training, daily math instruction with manipulatives, student practice] | → | [# teachers trained, # students served, # lessons using kits per week] | → | [Increased student engagement, improved formative assessment scores, teacher confidence with CRA] | → | [Increased state math proficiency, narrowed achievement gap, sustained instructional practice] |
13. Sustainability Plan
Explain how the program will continue after the initial funding period ends.
Describe the durability of materials, ongoing costs (if any), and how instructional capacity will be maintained.
[e.g., "The manipulative kits have a minimum 5-year useful life with no consumable components requiring annual replacement. Professional development during Year 1 creates lasting instructional capacity — trained teachers will mentor incoming staff through the district's existing induction program. The school's Title I Schoolwide Plan will be updated to include manipulative-based instruction as a core strategy, ensuring continuation regardless of specific funding source. Should additional kits be needed due to enrollment growth, the per-unit cost of $[X,XXX] can be absorbed within the school's annual Title I allocation."]
14. Stakeholder Consultation
Document the stakeholder engagement conducted for this purchase decision:
| Stakeholder Group | Date(s) | Method | Key Input |
|---|---|---|---|
| [Parents / PTO] | [Date] | [Meeting / Survey] | [Input received] |
| [Teachers] | [Date] | [PLC / Survey] | [Input received] |
| [Community / Board] | [Date] | [Meeting] | [Input received] |