Title I Schoolwide Waiver

Title I Schoolwide Waiver

Complete this form to request a waiver of the 40% school poverty threshold requirement for Title I, Part A Schoolwide eligibility. This waiver is required when the poverty rate of a Title I school that wishes to become a Schoolwide program is below 40% (ESSA 1008(1)(a)(1)(B)). A Schoolwide waiver form should be submitted at the beginning of each ESEA Consolidated Application cycle. Any Schoolwide school with a poverty rate below 40% in June 2026 will need to submit an updated request.

For more information about Schoolwide programs, including a rubric for the Comprehensive Schoolwide Plan, please visit CDE’s Title I, Part A Schoolwide Programs website or contact your ESEA Regional Contact.

Please note, the SmartSheet form must be completed in one sitting (the online form will not save your work if you exit the form without submitting).

Date Form Completed*

Name of Authorized Representative Completing Form*

Email of Authorized Representative Completing Form*

District Code and Name*

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Year the Waiver will be Applied*

School Code and Name*

Please enter the school code and name. If there is more than one school that requires a Title I, Part A Schoolwide Waiver, complete a separate form for each school.

Part 1: Waiver Rationale

Need and Rationale*

Why would a Schoolwide program, as opposed to a Targeted Assistance program, best serve the needs of students who are failing, or at risk of failing, to meet challenging State academic standards? Include reasons why the need(s) cannot be met without a Schoolwide program (ESSA section 1114(a)(1)(B) and (b)(6)).

Teacher Certification*

Verify that all core content teachers meet applicable State certification and licensure requirements (ESSA 9214(a)(2)), including Special Education Teachers. Extensions cannot be provided for this requirement.

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Assurances*

In accordance with ESSA requirements, the LEA has developed a written comprehensive schoolwide plan:

annually, unless the LEA determines, in consultation with the school, that less time is needed to develop and implement the schoolwide program (ESSA 1008(1)(b)(1)),
with input from stakeholders (ESSA 1008(1)(b)(2)),
that remains in effect as long as the school participates in schoolwide programming, except for regular monitoring and revisions based on student need (ESSA 1008(1)(b)(3)),
that is provided to the public in a format and language that parents can understand (ESSA 1008(1)(b)(4)),
that is developed in coordination with other Federal, State, and local services, resources, and programs, as appropriate (ESSA 1008(1)(b)(5)),
that is based on the comprehensive needs assessment for the school taking into account the academic achievement of students in relation to the challenging State academic standards, particularly the needs of students who are failing, or at risk of failing to meet, State academic standards (ESSA 1008(1)(b)(6)),
that includes a description of the strategies that the school will implement to address school needs, provide opportunities for all students to meet challenging State academic standards, and use methods and instructional strategies that strengthen the academic program in the school (ESSA 1008(1)(b)(7)).
that includes evaluation methods; and
that will be retained on file and made available to CDE if requested for monitoring.

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Part 2: Signatures

Signatures*

Please upload signatures of three SAC members (a teacher, a parent/guardian, a chairperson), the school principal and the superintendent. Certify that the required Schoolwide planning process has been completed prior to the submission of this waiver application. In addition, the undersigned clearly understand and agree that if the evaluation criteria is not met, the waiver will be terminated, and the school will be ineligible to reapply for this waiver under the State’s current Ed-Flex authority.

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Date of Approval*

Date of approval by Board of Education

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