Fiscal Operations Report and Application to Participate (FISAP)

Transcription

1 ED Form OMB no Expires 6/3/212 Paperwork Burden Statement According to the Paperwork Reduction Act of 7995, no persons are required to respond to a collection ofinformation unless such collection displays a valid OMB control number. Public reporting burden for this collection ofinformation is estimated to average 9.67 hours per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The obligation to respond to this collection is mandatory to obtain or retain benefit in accordance with the following regulatory and statutory citations: Federal Perkins Loan (34 CFR ), Federal Work-Study (34 CFR ), and Federal Supplemental Educational Opportunity Grant (34 CFR ), (2 u.s.c. 794). Send comments regarding the burden estimate or any other aspect ofthis collection ofinformation, including suggestions for reducing this burden, to the u.s. Department ofeducation, 4 Maryland Ave., SW, Washington, DC or lcdocketmgr@edgovand reference the OMB Control Number Note: Please do not return the completed Fiscal Operations andapplication to Participate (FISAP) to this address. Fiscal Operations Report and Application to Participate (FISAP) Report: Award Year July 1, 21 through June 3, 211; Application: Award Year July 1, 212 through June 3, 213 Part I. Identifying Information, Certification and Warning Section A. Identifying Information 1 (a) Name and address of school Nicholls State University 96 East First Street Thibodaux LA (b) Mailing address (if different from 1(a)) 2. OPEID Number Type of school (select one) ~3.1 public _ 3.2 private/non-profit _ 3.3 proprietary (Select one if proprietary) _ (a) art _ (b) business _ (c) cosmetology _ (d) trade and technical _ (e) other 4. Length/type of longest program (select one) _ 4.1 less than 1 year _ year but less than 2 years _ years but less than 3 years _ years but less than 4 years _ years (no higher than a baccalaureate degree) ~ years or more _ 4.7 post-baccalaureate only 5. Additional locations Schools with separately eligible additional locations that will be funded under this application must list these locations and their addresses and OPEID Numbers on the screen. You may not file a separate application for any separately eligible school listed herein. 6. Financial Aid Administrator Name ~C=~=i~e=A~.T~n= c~h=e==~~~==~ addresscasie.triche@nicholls.edu We have entered a list of separately eligible additional locations included in this application. yes x no Telephone No. (985) Fax No. (985) Name and address of private financial aid consultant firm, if any Name Address 2 City State Zip COpy FISAP Version: Submitted Version Page A-1

2 ED Form OMB no Expires 6/3/212 Section B. Certification and Warning Name of School Nicholls State University OPEID Number 25 State _L_A Applicants must review the requirements for certification regarding lobbying included in the regulations cited below before completing this form. Applicants must sign this form to comply with the certification requirements under 34 CFR Part 82, "New Restrictions on Lobbying." This certification is a material representation of fact upon which the Department of Education relies when it makes a grant or enters into a cooperative agreement. As required by Section 1352, Title 31 of the U.S. Code, and implemented at 34 CFR Part 82, for persons entering into a Federal contract, grant or cooperative agreement over $1,, as defined at 34 CFR Part 82, Sections and 82.11, the applicant certifies that: (a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the making of any Federal grant, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal grant or cooperative agreement; (b) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal grant or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions; and (c) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subgrants and contracts under grants and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above certification. I further certify that the information contained in this electronic FISAP is in compliance with governing legislation and regulations and is true and accurate. I understand that all information associated with this FISAP is subject to audit and program review by representatives of the Secretary of Education. WARNING: If you purposely give false or misleading information, you may be fined up to $2,, sent to prison, or both. 8. Chief Executive Officer (includes President, Chancellor, and Director) Signature Date Signed _9_/2_3_/2_1_1 Name Stephen T. Hulbert Telephone No. (985) Title President Fax No. (985) address Stephen.Hulbert@NICHOLLS.EDU Mail signed form to: FISAP Administrator 311 Fairview Park Drive Suite 95 Falls Church, VA 2242 FISAP Version: Submitted Version Page A-2

3 ED Form OMB no Expires 6/3/212 Application to Participate, Part II Name of School Nicholls State University OPEID Number 25 State -=L=-A-=------_ Part II. Application to Participate for Award Year July 1,212 through June 3, 213 Section A. Request for Funds for the Award Year 1. Federal Perkins Loan Level of Expenditures $ 2 2. Federal Perkins Loan Federal Capital Contribution $ -"- 3. FSEOG federal funds $ FWS federal funds $ 31 Section B. Federal Perkins Loan Program Liquidation Request (Applies only to certain schools; see instructions) 5. My school wishes to discontinue participation in the Federal Perkins Loan Program. yes..x...- no Section C. Waiver Request for the Underuse of Funds My school has returned more than 1 percent of its Federa.l Perkins Loan, FSEOG, or FWS allocation for the award year. 6. My school wishes to apply for a waiver of the penalty for the underuse of funds and will provide, on the Additional Information screen, a written explanation of the circumstances. _ yes L. no FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-3

4 Application to Participate, Part II (continued) Name of School Nicholls State University OPEID Number 25 State _L_A Part II. Application to Participate for Award Year July 1,212 through June 3,213 Section D. Information on Enrollment ED Form OMB no Expires 6/3/212 My school's calendar is ~ Traditional _ Non-Traditional Schools with a non-traditional calendar that had enrollment, fill in fields 9 through 2. Schools with a traditional calendar that had enrollment, Continuing Students New Starts fill in Field 7. (a) (b) Undergraduate Graduate/Professional 9. July 1, 21 (a) (b) 1. August 1 7. Total number of 11. September 1 students, October November 1 Schools with a traditional calendar that did not have December 1 enrollment, fill in Field January 1, 211 Undergraduate Graduate/Professional 16. February 1 8. Estimated number of (a) (b) 17. March 1 students, o o 18. April May 1 2. June 1, TOTAL Section E. Assessments and Expenditures Undergraduate Graduate/Professional (a) (b) 22. Total tuition and fees for the award year July 1, 21 to June 3,211 $ $ Total Title IV, Part A, Subpart I, Grants $ (a) Total Federal Pell Grant expenditures for the award year $ (b) Total ACG expenditures for the award year $ (c) Total National SMART Grant expenditures for the award year $ Total expended for state grants and scholarships made to undergraduates for the award year July 1, 21 to June 3, 211 $ 68_3 8_6 Section F. Information on Eligible Aid Applicants Enrolled in Your School for Award Year Dependent Undergraduate Independent Undergraduate Independent Without Baccalaureate/ With Baccalaureate/ Without Baccalaureate/ With Baccalaureate/ Graduate/ 1st Prof. Degree 1st Prof. Degree 1st Prof. Degree 1st Prof. Degree Professional (a) (b) (c) (d) (e) 25. Students with an "Automatic" Zero EFC Taxable and Untaxed Income Taxable and Untaxed Income 26. $ - $2,999 5 $ - $ $3, - $5,999 8 $1, - $1, $6, - $8,999 9 $2, - $2, $9, - $11, $3, - $3, $12, - $14, $4, - $4, $15, - $17,999 2 $5, - $5, $18, - $23, $6, - $7, $24, - $29, $8, - $9, $3, - $35, $1, - $11, $36, - $41, $12, - $13, $42, - $47, $14, - $15, $48, - $53, $16, - $17, $54, - $59, $18, - $19, $6, and over $2, and over TOTAL TOTAL FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-4

5 Fiscal Operations Report, Part III Name of School Nicholls State University OPEID Number 25 State _L_A Part III. Federal Perkins Loan Program for Award Year July 1,21 through June 3, 211 Section A. Fiscal Report (Cumulative) as of June 3, 211 ED Form OMB no Expires 6/3/212 Field Item Amount Number of Borrowers Debit Balances Credit Balances (a) (b) (c) (d) 1.1. Cash on hand and in depository as of 6/3/211 $ Cash on hand and in depository as of 1/31/211 $ 2. Funds receivable from federal government $ 3. Funds receivable from school $ 4. Funds advanced to students 1488 $ Loan principal collected 1429 $ Loan principal assigned to and accepted by the United States 54 $ Loan ~rinci~al canceled for the following categories: 7. teaching/military service (applies to loans made prior to 7/1/1972) 35 $ certain subject matter teaching service (math, SCience, foreign languages, bilingual education) $ 9. all other authorized pre-k or K-12 teaching service 14 $ military service (applies to loans made 7/1/1972 and after) $ 11. volunteer service $ 12. law enforcement and corrections officer service 1 $ child/family/early intervention service $ 14. nurse/medical technician service 2 $ pre-k or child care program staff member service $ 16. service as an attorney in a public defender organization $ 17. fire fighter service 1 $ Tribal College or University faculty service $ 19. librarian service $ 2. speech-language pathology service $ 21. death/disability 13 $ 22. disability based on VA determination $ bankruptcy 9 $ surviving spouses of public service victims of 9-11 terrorist attacks $ 25. loans discharged due to closed schools $ 26. Loan principal adjustments - other 1 $ Federal Capital Contributions $ Repayments of fund capital to federal government $ Short-term loans to the Fund $ ICC deposited to the Fund $ Institutional Capital Contributions $ Repayment of short-term loans to the fund $ 3.2. Distribution of excesslliquidated fund capital $ Repayments of fund capital to school $ Interest income on loans $ Other income $ Reimbursements to the Fund of the amounts canceled on loans made 7/1/1972 and after $ Administrative cost allowance $ Collection costs $ Administrative cost allowance and collection costs (control) $ Cost of loan ~rinci~al and interest canceled for the following categories: 35. teaching/military service (applies to loans made prior to 7/1/1972) $ certain subject matter teaching service (math, science, foreign languages, bilingual education) $ 37. all other authorized pre-k or K-12 teaching service (applies to loans made 7/1/1972 and after) $ military service (applies to loans made 7/1/1972 and after) $ 39. volunteer service in the Peace Corps or under the Domestic Volunteer Service Act of 1973 $ FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT PageA-5

6 ED Form OMB no Expires 6/3/212 Fiscal Operations Report, Part III (continued) Name of School Nicholls State University OPEID Number 25 State _L_A Part III. Federal Perkins Loan Program for Award Year July 1,21 through June 3, 211 Section A. Fiscal Report (Cumulative) as of June 3, 211 Field Item Amount Number of Borrowers Debit Balances Credit Balances (a) (b) (c) (d) 4. law enforcement and corrections officer service $ 2QQ 41. child/family/early intervention service $ 42. nurse/medical technician service $ pre-k or child care program staff member service $ 44. service as an attorney in a public defender organization $ 45. fire fighter service $ Tribal College or University faculty service $ 47. librarian service $ 48. speech-language pathology service $ 49. death/disability $ VA disability determination $ 51. bankruptcy $ surviving spouses of public service victims of 9-11 terrorist attacks $ 53. Cost of loan principal and interest assigned to and accepted by the United States $ Cost of loan principal and interest canceled for loans discharged due to closed schools $ 55. Other costs or losses $ Balancing Adjustments (Debits) $ 57. Balancing Adjustments (Credits) $ '< Total debits and credits (Sum of fields 1.1 through 57) $ $ Section B. Fund Activity (Annual) During the Award Year (July 1,21 through June 3,211) Number of Borrowers (a) Amount (b) 1. Final adjusted Federal Capital Contribution (FCC) authorization 2. FWS funds transferred to the Fund 3. FCC transferred to: (a) FSEOG (b) FWS 4. Total federal funds available for the award year (fields (a) - 3(b» 5. The unexpended amount of final adjusted authorized FCC for award year that was NOT requested from G5 by June 3, 211. This amount will be reduced from your total award amount next spring (see instructions). 6. Institutional Capital Contribution (ICC) deposited into the Fund between July 1, 21 and June 3, Loans advanced to students from the Fund during the award year (minus award year refunds) 8. Administrative cost allowance claimed for the award year (see instructions) 9. Total principal and interest repaid by borrowers from all sources during the award year 1. Total principal repaid by borrowers from all sources during the award year for loans in default for more than 2 years but not more than 5 years 11. Total principal repaid by borrowers from all sources during the award year for loans in default for more than 5 years $ +$ -$ -$ $ Q $ $ $ $ 4 $ 1844 o $ o $ FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT PageA-6

7 ED Form OMB no Expires 6/3/212 Fiscal Operations Report, Part III (continued) Name of School Nicholls State University OPEID Number 25 State --=L'-"-A'----_ Part III. Federal Perkins Loan Program for Award Year July 1,21 through June 3,211 Section C. Cumulative Repayment Information as ofjune 3, 211 Status of Borrowers as of June Amount Number of Amount lent Principal Amount Borrowers Outstanding (a) (b) (c) (d) 1.1. Borrowers whose loans are fully retired 1429 $ loans that have been purchased $ 2. Borrowers whose loans were assigned to and officially accepted by the U.S. Department of Education as of June 3, 211 (Note: Field 2 equals the sum of Field 2.1 plus Field 2.2.) 54 $ 476 $ Assignments due to default or liquidation 53 $ 4585 $ Assignments due to total and permanent disability discharge $ 175 $ Total borrowers not in repayment status 3 $ Borrowers on schedule in repayment status $ In default less than 24 days (monthly installments) or less than 27 days (other installments) $ $ 5.2. In default 24 days or more (monthly installments) or 27 days or more (other installments), up to 2 years $ $ 5.3. In default more than 2 years but not more than 5 years $ $ 5.4. In default more than 5 years $ 275 $ 1346 Cohort Default Rate {Sections D and E} Schools with fewer than 3 borrowers who entered repayment in the award year should skip to Section E. Section D. Schools with 3 or More Borrowers Who Entered Repayment in the Award Year 1.1. Number of borrowers who entered repayment in o 1.2. Number of borrowers from Field 1.1 above with loans in default by June 3, 211 o 1.3. Cohort default rate «Field Field 1.1) x 1) o Section E. Schools with Fewer than 3 Borrowers Who Entered Repayment in the Award Year 2.1. Number of borrowers who entered repayment in: 2.2. Number of borrowers with loans in default by: (a) (7/1/27-6/3/28) o (a) June 3,29 (those in 2.1(a) only) o (b) (7/ ) (b) June 3, 21 (those in 2.1(b) only) (c) (7/1/29-6/3/21) (c) June 3, 211 (those in 2.1 (c) only) o 2.3. Total number of borrowers who entered repayment during the three years above (fields 2.1(a) + 2.1(b) + 2.1(c» Total number of borrowers with loans in default during the three years above (fields 2.2(a) + 2.2(b) + 2.2(c» 2.5. Cohort default rate «Field 2.4 1Field 2.3) x 1) 5. FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-7

8 ED Form OMB no Expires 6/3/212 Fiscal Operations Report, Part IV Name of School Nicholls State University OPEID Number 25 State LA --- Part IV. Federal Supplemental Educational Opportunity Grant (FSEOG) Program for Award Year July 1, 21 through June 3, 211 Section A. Federal Funds Authorized for FSEOG 1. Final adjusted FSEOG authorization $ ----'-'1--=-64_4..:.:...2 Section B. Federal Funds Available for FSEOG Expenditures 2. FWS funds transferred to and spent in FSEOG +$ 3. Federal Perkins Federal Capital Contribution funds transferred to and spent in FSEOG +$ 4. FSEOG funds transferred to and spent in FWS -$---_O~ FSEOG funds carried back and spent in $ 6. Additional FSEOG funds carried back and spent for 211 summer enrollment +$ --'" funds carried forward and spent in $ funds carried forward to be spent in $ funds carried back and spent in $ -''_ 1. Additional funds carried back and spent for 21 summer enrollment - $ -''_ 11. Total federal funds available for FSEOG (fields ) minus (fields ) $ ---=--: 1:...::..64-'--4=_2 Section C. Funds to FSEOG Recipients 12. Total funds to FSEOG recipients (fields ) $ ---"-1~1-"-3_' '73'_ 13. Nonfederal share of funds to FSEOG recipients (25 percent of Field 12) $ -'' (a) Cash outlay contributed $ ' (b) Other resources designated $ ' Section D. Federal Funds Spent for FSEOG Program 14. Federal share of funds to FSEOG recipients (75 percent of Field 12) $ -----=-1-=--1=-=3:...:...7.:: Administrative cost allowance claimed (see instructions) +$ _ -=5""'-"'-68"' 16. Federal funds spent for FSEOG (fields ) $ 1 64_4_1 Section E. Use of FSEOG Authorization 17. Expended FSEOG authorization (fields ) minus (fields ) $ ---"1=6"-'4:...:.4~1 18. Unexpended FSEOG authorization (Field 1 - Field 17) (cannot be negative) $ ----=--1 FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-8

9 Fiscal Operations Report, Part V Name of School Nicholls State University OPEID Number 25 State _L_A ED Form OMB no Expires 6/3/212 Part V. Federal Work-Study (FWS) Program for Award Year July 1, 21 through June 3, 211 Section A. Federal Funds Authorized for FWS 1. Final adjusted FWS authorization $ 1_84_3_3_ Section B. Federal Funds Available for FWS Expenditures 2. Federal Perkins Federal Capital Contribution funds transferred to and spent in FWS +$ 3. FSEOG funds transferred to and spent in FWS +$ 4. FWS funds transferred to and spent in: (a) FSEOG -$ (b) Federal Perkins Loan Program -$ FWS funds carried back and spent in $ 6. Additional FWS funds carried back and spent for 211 summer employment +$ funds carried forward and spent in $ funds carried forward to be spent in $ funds carried back and spent in $ 1. Additional funds carried back and spent for 21 summer employment -$ 11. Total federal funds available for FWS (fields ) minus (fields 4(a) + 4(b) ) $ Section C. Total Compensation for FWS 12. Total earned compensation for FWS Program $ (a) On-campus earned compensation $ (b) Off-campus earned compensation for public or private non-profit agencies, excluding amounts reported in Field 12(c) $ (c) Off-campus earned compensation for agencies that were unable to pay regular nonfederal share and had a federal share up to 9 percent $ (d) Off-campus earned compensation for private for-profit organizations $ 13. Total institutional share of earned compensation (see instructions) $ Section D. Funds Spent from Federal Share of FWS 14. Total federal share of FWS earned compensation $ (a) Federal share paid at a rate up to 75 percent $ (b) Federal share paid at a rate up to 1 percent for waivers of nonfederal share $ (c) Federal share paid at a rate up to 9 percent for agencies that were unable to pay regular nonfederal share $ (d) Federal share paid at a rate up to 5 percent for off-campus, private for-profit organizations $ 15. Administrative cost allowance claimed (see instructions) +$ Federal share of Job Location and Development (JLD) Program expenditures +$ o 17. Total federal funds spent for FWS (fields ) $ FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT PageA-9

10 Fiscal Operations Report, Part V (continued) Name of School Nicholls State University OPEID Number 25 State..::::L:..:...:A'------_ ED Form OMB no Expires 6/3/212 Part V. Federal Work-Study (FWS) Program for Award Year July 1, 21 through June 3, 211 Section E. Use of FWS Authorization 18. Expended FWS authorization (fields 4(a) + 4(b) ) minus (fields ) $ 1_8_43_3_ 19. Unexpended FWS authorization (Field 1 - Field 18) $ Section F. Information About the Job Location and Development (JLD) Program 2. Total expenditures for the JLD Program $ 21. Institutional expenditures for the JLD Program (see instructions) $ "- 22. Number of students for whom jobs were located or developed 23. Total earnings of the students in Field 22 above $ Section G. Information About FWS Students Employed in Community Service Activities 24. Number of students in community service employment Federal share of community service earned compensation $ 48_3_48_ 26. Nonfederal share of community service earned compensation $ Section H. Information About FWS Students Employed as Reading Tutors of Children or Employed in Family Literacy Activities 27. Number of FWS students employed as reading tutors of children or employed in family literacy activities Federal share of earned compensation for FWS students employed as reading tutors of children or employed in family literacy activities (a) Amount of the federal share in Field 28 spent on community service employment 29. Total earned compensation for FWS students employed as reading tutors of children or employed in family literacy activities $ 3"--,~52,,,-4,-- $ =:.3-=-:5:...=2--=-4 $ ---'3 52_4_ Section I. Information About FWS Students Employed as Mathematics Tutors of Children 3. Number of FWS students employed as mathematics tutors of children 31. Federal share of earned compensation for FWS students employed as mathematics tutors of children $ 32. Total earned compensation for FWS students employed as mathematics tutors of children $ Section J. Information About FWS Students in Civic Education and Participation Activities 33. Number of students in civic education and participation activities 34. Federal share spent for students in civic education and participation activities $ ;O~ 35. Total spent for students in civic education and participation activities $ :O~ Section K. Information About FWS Disaster-Affected Students 36. Number of disaster-affected students receiving FWS funds 37. Federal share of funds to disaster-affected students 38. Total funds to disaster-affected students $-----$ ' FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-1

11 ED Form OMS no Expires 6/3/212 Fiscal Operations Report, Part VI Name of School Nicholls State University OPEID Number 25 State LA Part VI. Program Summary for Award Year July 1, 21 through June 3, 211 Section A. Distribution of Program Recipients and Expenditures by Type of Student Taxable and Untaxed Income Category Student Type Federal Perkins Loan Recipients Funds (a) (b) FSEOG Recipients Funds (c) (d) FWS Recipients (e) Funds (f) Unduplicated Recipients (g) Undergraduate Dependent 1. $ - $ 5, $6, - $11, $12, - $23, $24, - $29, $3, - $41, $42, - $59, $6, and over Undergraduate Independent 8. $ - $ 1, $2, - $ 3, $4, - $ 7, $8, - $11, $12, - $15, $16, - $19, $2, and over Graduate/Professional does not apply does not apply TOTAL (fields 1-15) Totalless-than-full-time students (from fields 1-15) Total "Automatic" Zero EFC students (from fields 1-15) FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-11

12 ED Form OMB no Expires 6/3/212 Fiscal Operations Report, Part VI (continued) Name of School Nicholls State University OPEID Number 25 State _L_A Part VI. Program Summary for Award Year July 1, 21 through June 3, 211 Section B. Calculating the Administrative Cost Allowance Administrative Cost Allowance Worksheet (Worksheet must be retained for audit and program reviews) Step 1. Calculate the amount spent in on which the administrative cost allowance is based. 1. Total compensation in FWS (amount from Part V, Section C, Field 12) 2. Amount of Federal Perkins Loan funds advanced to students (amount from Part III, Section B, Field 7) 3. Total funds to FSEOG recipients (amount from Part IV, Section C, Field 12) 4. Total amount spent (fields ) $ 1"-,,6=64-,-,,3,-,,,--3 +$ -----"'- +$ ---"1-"-~13'--'-7-=::...3 $ 2----'6_78"""--'--'-6 Step 2. Calculate the administrative cost allowance. Schools whose total amount spent was $2,75, or less 5. Enter total amount spent (Field 4) 6. Multiply 7. Total administrative cost allowance-go to Step 3 $ x.5 $ 1339 Schools whose total amount spent was more than $2,75, but less than $5,5, 8. Enter total amount spent (Field 4) 9. Subtract 1. Expenditures over $2,75, (Field 8 - Field 9) 11. Multiply 12. Administrative cost allowance on expenditures over $2,75, (Field 1 x Field 11) 13. Add administrative cost allowance on expenditures of $2,75, ($2.75 million x.5) 14. Total administrative cost allowance (Field 12 + Field 13)-go to Step 3 $ -$ $ X.4 $ +$ $ Schools whose total amount spent was $5,5, or more 15. Enter total amount spent (Field 4) 16. Subtract 17. Expenditures of $5,5, or more (Field 15 - Field 16) 18. Multiply 19. Administrative cost allowance on expenditures of $5,5, or more (Field 17 x Field 18) 2. Add administrative cost allowance on expenditures less than $5,5, «$2.75 million x.5) + Field 12) 21. Total administrative cost allowance (Field 19 + Field 2)-go to Step 3 $ -$ $ x.3 $ +$ $ Step 3. Decide how much administrative cost allowance your school claimed. 22. How much administrative cost allowance did your school claim? (The amount may be the same or less than the amount calculated in Step 2.) $ -'-'13"-='3'-"-9-'<- 23. How much administrative cost allowance did your school claim in each program? (a) Federal Perkins Loan (must be the same as Part III, Section B, Field 8) (b) FSEOG (must be the same as Part IV, Section, Field 15) (c) FWS (must be the same as Part V, Section, Field 15) $ ~O $ -=--5:...:.6-=--8 $ ----'8"-"3'-"'2""-2 FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-12

13 ED Form OMB no Expires 6/3/212 Paperwork Burden Statement According to the Paperwork Reduction Act of 7995, no persons are required to respond to a collection ofinformation unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is The time required to complete this information collection is estimated to average 9.67 hours per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. Ifyou have any comments concerning the accuracy ofthe time estimate(s) or suggestions for improving this form, please write to: u.s. Department ofeducation, Federal Student Aid, Grants & Campus-Based Division, 83 First St. NE, Rm 62E2, Washington, D. C Ifyou have comments or concerns regarding the status ofyour individual submission ofthis form, write directly to: u.s. Department ofeducation, Federal Student Aid, Grants & Campus-Based Division, 83 First St. NE, Rm 62E2, Washington, D. C Fiscal Operations Report and Application to Participate (FISAP) Report: Award Year July 1, 29 through June 3,21; Application: Award Year July 1, 211 through June 3, 212 Part I. Identifying Information, Certification and Warning Section A. Identifying Information 1 (a) Name and address of school Nicholls State University 96 East First Street Thibodaux LA (b) Mailing address (if different from 1 (a)) 2. OPEID Number Type of school (select one) ~3.1 public _ 3.2 private/non-profit _ 3.3 proprietary (Select one if proprietary) _(a) art _ (b) business _ (c) cosmetology _ (d) trade and technical _ (e) other 4. Length/type of longest program (select one) _ 4.1 less than 1 year _ year but less than 2 years _ years but less than 3 years _ years but less than 4 years _ years (no higher than a baccalaureate degree) ~ years or more 4.7 post-baccalaureate only 5. Additional locations Schools with separately eligible additional locations that will be funded under this application must list these locations and their addresses and OPEID Numbers on the screen. You may not file a separate application for any separately eligible school listed herein. We have entered a list of separately eligible additional locations included in this application. yes x no 6. Financial Aid Administrator Name ~C~a~sl~ e=a~.~t_ri~ch=e====~==~~ addresscasie.triche@nicholls.edu Telephone No. (985) Fax No. (985) Name and address of private financial aid consultant firm, if any Name Address 1 Address 2. City State Zip FISAP Version: Submitted Version Page A-1

14 ED Form OMB no Expires 6/3/212 Section B. Certification and Warning OPEID Number 25 State _LA Applicants must review the requirements for certification regarding lobbying included in the regulations cited below before completing this form. Applicants must sign this form to comply with the certification requirements under 34 CFR Part 82, "New Restrictions on Lobbying." This certification is a material representation of fact upon which the Department of Education relies when it makes a grant or enters into a cooperative ag reement. As required by Section 1352, Title 31 of the U.S. Code, and implemented at 34 CFR Part 82, for persons entering into a Federal contract, grant or cooperative agreement over $1,, as defined at 34 CFR Part 82, Sections and 82.11, the applicant certifies that: (a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the making of any Federal grant, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal grant or cooperative agreement; (b) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal grant or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions (Available at the following link: and (c) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subgrants and contracts under grants and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above certification. I further certify that the information contained in this electronic FISAP is in compliance with governing legislation and regulations and is true and accurate. I understand that all information associated with this FISAP is subject to audit and program review by representatives of the Secretary of Education. WARNING: If you purposely give false or misleading information, you may be fined up to $2,, sent to prison, or both. 8. Chief Executive Officer (includes President, Chancellor, and Director) Signature Date sig ned 9/22/ Name Stephen T. Hulbert Telephone No. (985) Title President Fax No. (985) address Stephen.Hulbert@NICHOLLS.EDU Mail signed form to: FISAP Administrator 311 Fairview Park Drive Suite 95 Falls Church, VA 2242 FISAP Version: Submitted Version Page A-2

15 Application to Participate, Part II OPEID Number 25 State _L_A Part II. Application to Participate for Award Year July 1,211 through June 3, 212 Section A. Request for Funds for the Award Year 1. Federal Perkins Loan Level of Expenditures $ 2 ED Form OMB no Expires 6/3/ Federal Perkins Loan Federal Capital Contribution $ -'- 3. FSEOG federal funds $ FWS federal funds $ 31 Section B. Federal Perkins Loan Program Liquidation Request (Applies only to certain schools; see instructions) 5. My school wishes to discontinue participation in the Federal Perkins Loan Program. yes.ll no Section C. Waiver Request for the Underuse of Funds My school has returned more than 1 percent of its Federal Perkins Loan, FSEOG, or FWS allocation for the award year. 6. My school wishes to apply for a waiver of the penalty for the underuse of funds and will provide, on the Additional Information screen, a written explanation of the circumstances. _ yes x no FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-3

16 Application to Participate, Part II (continued) OPEID Number 25 State _L_A Part II. Application to Participate for Award Year July 1, 211 through June 3, 212 Section D. Information on Enrollment ED Form OMB no Expires 6/3/212 My school's calendar is ~ Traditional _ Non-Traditional Schools with a non-traditional calendar that had enrollment, fill in fields 9 through 2. Schools with a traditional calendar that had enrollment, Continuing Students New Starts fill in Field 7. (a) (b) Undergraduate Graduate/Professional 9. July 1, 29 (a) (b) 1. August 1 7. Total number of 11. September 1 students, October November 1 Schools with a traditional calendar that did not have December 1 enrollment, fill in Field January 1, 21 Undergraduate Graduate/Professional 16. February 1 8. Estimated number of (a) (b) 17. March 1 students, o o 18. April May 1 2. June 1, TOTAL Section E. Assessments and Expenditures Undergraduate Graduate/Professional (a) (b) 22. Total tuition and fees for the award year July 1, 29 to June 3, 21 $ $ Total Title IV, Part A, Subpart I, Grants $ 1 7_57_2_1 (a) Total Federal Pell Grant expenditures for the award year $ 97_3_77_5_2 (b) Total ACG expenditures for the award year $ 3_1_47_5_6 (c) Total National SMART Grant expenditures for the award year $ 2_32_1_3 24. Total expended for state grants and scholarships made to undergraduates for the award year July 1,29 to June 3,21 $ 61_7_25 2 Section F. Information on Eligible Aid Applicants Enrolled in Your School for Award Year Dependent Undergraduate Independent Undergraduate Independent Without Baccalaureate/ With Baccalaureate! Without Baccalaureate! With Baccalaureate! Graduate/ 1st Prof. Degree 1st Prof. Degree 1st Prof. Degree 1st Prof. Degree Professional (a) (b) (c) (d) (e) 25. Students with an "Automatic" Zero EFC Taxable and Untaxed Income Taxable and Untaxed Income 26. $ - $2,999 1 $ - $ $3, - $5,999 2 $1, - $1, $6, - $8,999 7 $2, - $2, $9, - $11, $3, - $3, $12, - $14, $4, - $4, $15, - $17, $5, - $5, $18, - $23,999 4 $6, - $7, $24, - $29, $8, - $9, $3, - $35, $1, - $11, $36, - $41, $12, - $13, $42, - $47, $14, - $15, $48, - $53, $16, - $17, $54, - $59, $18, - $19, $6, and over $2, and over TOTAL TOTAL FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-4

17 Fiscal Operations Report, Part III OPEID Number 25 State LA Part III. Federal Perkins Loan Program for Award Year July 1,29 through June 3, 21 Section A. Fiscal Report (Cumulative) as ofjune 3, 21 ED Form OMB no Expires 6/3/212 Field Item Amount Number of Borrowers Debit Balances Credit Balances (a) (b) (c) (d) Cash on hand and in depository as of 6/3/21 $ Cash on hand and in depository as of 1/31/21 $ Funds receivable from federal government $ 3. Funds receivable from school $ 4. Funds advanced to students 1488 $ Loan principal collected 1424 $ Loan principal assigned to and accepted by the United States 54 $ Loan ~rinci~al canceled for the following categories: 7. teaching/military service (applies to loans made prior to 7/1/1972) 35 $ certain subject matter teaching service (math, science, foreign languages, bilingual education) Q $ 9. all other authorized pre-k or K-12 teaching service 14 $ military service (applies to loans made 7/1/1972 and after) $ 11. volunteer service $ 12. law enforcement and corrections officer service 1 $ child/family/early intervention service $ 14. nurse/medical technician service 2 $ pre-k or child care program staff member service $ 16. service as an attorney in a public defender organization $ 17. fire fighter service $ 18. Tribal College or University faculty service $ 19. librarian service $ 2. speech-language pathology service $ 21. death/disability 13 $ disability based on VA determination $ 23. bankruptcy 9 $ surviving spouses of public service victims of 9-11 terrorist attacks $ 25. loans discharged due to closed schools $ 26. Loan principal adjustments - other 1 $ Federal Capital Contributions $ Repayments of fund capital to federal government $ Short-term loans to the Fund $ ICC deposited to the Fund $ Institutional Capital Contributions $ Repayment of short-term loans to the fund $ 3.2. Distribution of excesslliquidated fund capital $ Repayments of fund capital to school $ Interest income on loans $ Other income $ Reimbursements to the Fund of the amounts canceled on loans made 7/1/1972 and after $ Administrative cost allowance $ Collection costs $ Administrative cost allowance and collection costs (control) $ Cost of loan ~rinci~al and interest canceled for the following categories: 35. teaching/military service (applies to loans made prior to 7/1/1972) $ certain subject matter teaching service (math, science, foreign languages, bilingual education) $ 37. all other authorized pre-k or K-12 teaching service (applies to loans made 7/1/1972 and after) $ military service (applies to loans made 7/1/1972 and after) $ 39. volunteer service in the Peace Corps or under the Domestic Volunteer Service Act of 1973 $ FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-5

18 Fiscal Operations Report, Part III (continued) ED Form OMB no Expires 6/3/212 OPEID Number 25 State _L_A Part III. Federal Perkins Loan Program for Award Year July 1,29 through June 3, 21 Section A. Fiscal Report (Cumulative) as of June 3, 21 Field Item Amount Number of Borrowers Debit Balances Credit Balances (a) (b) (c) (d) 4. law enforcement and corrections officer service $ child/family/early intervention service $ 42. nurse/medical technician service $ pre-k or child care program staff member service $ 44. service as an attorney in a public defender organization $ 45. fire fighter service $ 46. Tribal College or University faculty service $ 47. librarian service $ 48. speech-language pathology service $ 49. death/disability $ VA disability determination $ 51. bankruptcy $ surviving spouses of public service victims of 9-11 terrorist attacks $ 53. Cost of loan principal and interest assigned to and accepted by the United States $ Cost of loan principal and interest canceled for loans discharged due to closed schools $ 55. Other costs or losses $ Balancing Adjustments (Debits) $ 57. Balancing Adjustments (Credits) $ 58. Total debits and credits (Sum of fields 1.1 through 57) $ $ Section B. Fund Activity (Annual) During the Award Year (July 1, 29 through June 3, 21) 1. Final adjusted Federal Capital Contribution (FCC) authorization 2. FWS funds transferred to the Fund 3. FCC transferred to: (a) FSEOG (b) FWS 4. Total federal funds available for the award year (fields (a) - 3(b» 5. The unexpended amount of final adjusted authorized FCC for award year that was NOT requested from G5 by June 3, 21. This amount will be reduced from your total award amount next spring (see instructions). 6. Institutional Capital Contribution (ICC) deposited into the Fund between July 1, 29 and June 3,21 7. Loans advanced to students from the Fund during the award year (minus award year refunds) 8. Administrative cost allowance claimed for the award year (see instructions) 9. Total principal and interest repaid by borrowers from all sources during the award year 1. Total principal repaid by borrowers from all sources during the award year for loans in default for more than 2 years but not more than 5 years 11. Total principal repaid by borrowers from all sources during the award year for loans in default for more than 5 years Number of Borrowers (a) $ +$ -$ -$ $ Amount (b) $ $ $ 2 $ 1 4 $ 127 o $ o $ FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-6

19 Fiscal Operations Report, Part III (continued) OPEID Number 25 State _L_A Part III. Federal Perkins Loan Program for Award Year July 1,29 through June 3, 21 Section C. Cumulative Repayment Information as ofjune 3, 21 Status of Borrowers as of June ED Form OMB no Expires 6/3/212 Amount Number of Amount Lent Principal Amount Borrowers Outstanding (a) (b) (c) (d) 1.1. Borrowers whose loans are fully retired 1426 $ Loans that have been purchased $ 2. Borrowers whose loans were assigned to and officially accepted by the U.S. Department of Education as of June 3, 21 (Note: Field 2 equals the sum of Field 2.1 plus Field 2.2.) 54 $ 476 $ Assignments due to default or liquidation 53 $ 4585 $ Assignments due to total and permanent disability discharge $ 175 $ Total borrowers not in repayment status 3 $ Borrowers on schedule in repayment status $ In default less than 24 days (monthly installments) or less than 27 days (other installments) $ 2 $ In default 24 days or more (monthly installments) or 27 days or more (other installments), up to 2 years 2 $ 35 $ In default more than 2 years but not more than 5 years $ 275 $ In default more than 5 years $ $ Cohort Default Rate {Sections D and E} Schools with fewer than 3 borrowers who entered repayment in the award year should skip to Section E. Section D. Schools with 3 or More Borrowers Who Entered Repayment in the Award Year 1.1. Number of borrowers who entered repayment in o 1.2. Number of borrowers from Field 1.1 above with loans in default by June 3, 21 o 1.3. Cohort default rate «Field 1.21 Field 1.1) x 1) o Section E. Schools with Fewer than 3 Borrowers Who Entered Repayment in the Award Year 2.1. Number of borrowers who entered repayment in: 2.2. Number of borrowers with loans in default by: (a) (7/1/26-6/3/27) (a) June 3, 28 (those in 2.1 (a) only) o (b) (7/1/27-6/3/28) o (b) June 3, 29 (those in 2.1 (b) only) o (c) (7/1/28-6/3/29) (c) June 3,21 (those in 2.1(c) only) 2.3. Total number of borrowers who entered repayment during the three years above (fields 2.1(a) + 2.1(b) + 2.1(c» Total number of borrowers with loans in default during the three years above (fields 2.2(a) + 2.2(b) + 2.2(c» 2.5. Cohort default rate «Field Field 2.3) x 1) 5. FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-7

20 ED Form OMS no Expires 6/3/212 Fiscal Operations Report, Part IV OPEID Number 25 State _L_A Part IV. Federal Supplemental Educational Opportunity Grant (FSEOG) Program for Award Year July 1, 29 through June 3, 21 Section A. Federal Funds Authorized for FSEOG 1. Final adjusted FSEOG authorization $ 1_3_27_3_ Section B. Federal Funds Available for FSEOG Expenditures 2. FWS funds transferred to and spent in FSEOG +$ -= Federal Perkins Federal Capital Contribution funds transferred to and spent in FSEOG +$ 4. FSEOG funds transferred to and spent in FWS -$ -= FSEOG funds carried back and spent in $ 6. Additional FSEOG funds carried back and spent for 21 summer enrollment +$ ---= funds carried forward and spent in $ O_= funds carried forward to be spent in $ funds carried back and spent in $ "_ 11. Total federal funds available for FSEOG (fields ) minus (fields ) Section C. Funds to FSEOG Recipients $ ---'1=3-"'--27'--"'3-" Total funds to FSEOG recipients (fields ) $ ---'1:.=2-=-64=1..:: Nonfederal share of funds to FSEOG recipients (25 percent of Field 12) $..::... (a) Cash outlay contributed (b) Other resources designated Section D. Federal Funds Spent for FSEOG Program $ 1. Additional funds carried back and spent for 29 summer enrollment - $ -' $ -' 14. Federal share of funds to FSEOG recipients (75 percent of Field 12) $ 1_2_64_1_ 15. Administrative cost allowance claimed (see instructions) +$ 63_2_ 16. Federal funds spent for FSEOG (fields ) $ 1_32_7_3_ Section E. Use of FSEOG Authorization 17. Expended FSEOG authorization (fields ) minus (fields ) $ ----'1;...:: '27...:...3-= Unexpended FSEOG authorization (Field 1 - Field 17) (cannot be negative) $ -=--- FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-8

21 Fiscal Operations Report, Part V OPEID Number 25 State _L_A ED Form OMS no Expires 6/3/212 Part V. Federal Work-Study (FWS) Program for Award Year July 1, 29 through June 3, 21 Section A. Federal Funds Authorized for FWS 1. Final adjusted FWS authorization $ 2299 Section B. Federal Funds Available for FWS Expenditures 2. Federal Perkins Federal Capital Contribution funds transferred to and spent in FWS +$ 3. FSEOG funds transferred to and spent in FWS +$ 4. FWS funds transferred to and spent in: (a) FSEOG -$ (b) Federal Perkins Loan Program -$ FWS funds carried back and spent in $ 6. Additional FWS funds carried back and spent for 21 summer employment +$ funds carried forward and spent in $ funds carried forward to be spent in $ funds carried back and spent in $ 1. Additional funds carried back and spent for 29 summer employment -$ 11. Total federal funds available for FWS (fields ) minus (fields 4(a) + 4(b) ) $ Section C. Total Compensation for FWS 12. Total earned compensation for FWS Program $ 2_2_87_5_7 (a) On-campus earned compensation (b) Off-campus earned compensation for public or private non-profit agencies, excluding amounts reported in Field 12c (c) Off-campus earned compensation for agencies that were unable to pay regular nonfederal share and had a federal share up to 9 percent (d) Off-campus earned compensation for private for-profit organizations $ 2_2_87_5_7 $ $ $ 13. Total institutional share of earned compensation (see instructions) $ ~O Section D. Funds Spent from Federal Share offws 14. Total federal share of FWS earned compensation $ (a) Federal share paid at a rate up to 75 percent $ (b) Federal share paid at a rate up to 1 percent for waivers of nonfederal share $ (c) Federal share paid at a rate up to 9 percent for agencies that were unable to pay regular nonfederal share (d) Federal share paid at a rate up to 5 percent for off-campus, private for-profit organizations $ 15. Administrative cost allowance claimed (see instructions) +$ Federal share of Job Location and Development (JLD) Program expenditures +$ o 17. Total federal funds spent for FWS (fields ) $ $ FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-9

22 ED Form OMB no Expires 6/3/212 Fiscal Operations Report, Part V (continued) OPEID Number 25 State _L_A Part V. Federal Work-Study (FWS) Program for Award Year July 1, 29 through June 3, 21 Section E. Use of FWS Authorization 18. Expended FWS authorization (fields 4(a) + 4(b) ) minus (fields ) $ 2_2_9o_9_ 19. Unexpended FWS authorization (Field 1 - Field 18) $ Section F. Information About the Job Location and Development (JLD) Program 2. Total expenditures for the JLD Program $ 21. Institutional expenditures for the JLD Program (see instructions) $ -' 22. Number of students for whom jobs were located or developed 23. Total earnings of the students in Field 22 above $ Section G. Information About FWS Students Employed in Community Service Activities 24. Number of students in community service employment Federal share of community service earned compensation $ 6_ Nonfederal share of community service earned compensation $ Section H. Information About FWS Students Employed as Reading Tutors of Children or Employed in Family Literacy Activities 27. Number of FWS students employed as reading tutors of children or employed in family literacy activities Federal share of earned compensation for FWS students employed as reading tutors of children or employed in family literacy activities $ 383 (a) Amount of the federal share in Field 28 spent on community service employment $ Total earned compensation for FWS students employed as reading tutors of children or employed in family literacy activities $ ----'-38_3 Section I. Information About FWS Students Employed as Mathematics Tutors of Children 3. Number of FWS students employed as mathematics tutors of children 31. Federal share of earned compensation for FWS students employed as mathematics tutors of children $ 32. Total earned compensation for FWS students employed as mathematics tutors of children $ Section J. Information About FWS Students in Civic Education and Participation Activities 33. Number of students in civic education and participation activities 34. Federal share spent for students in civic education and participation activities $ 35. Total spent for students in civic education and participation activities $ Section K. Information About FWS Disaster-Affected Students 36. Number of disaster-affected students receiving FWS funds 37. Federal share of funds to disaster-affected students $ 38. Total funds to disaster-affected students $ FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-1

23 ED Form OMB no Expires 6/3/212 Fiscal Operations Report, Part VI OPEID Number 25 State LA Part VI. Program Summary for Award Year July 1,29 through June 3, 21 Section A. Distribution of Program Recipients and Expenditures by Type of Student Taxable and Untaxed Income Category Student Type Federal Perkins Loan Recipients Funds (a) (b) FSEOG Recipients Funds (c) (d) FWS Recipients (e) Funds (f) Unduplicated Recipients (g) Undergraduate Dependent 1. $ - $ 5, $6, - $11, $12, - $23, $24, - $29, $3, - $41, $42, - $59, $6, and over Undergraduate Independent 8. $ - $ 1, $2, - $ 3, $4, - $ 7, $8, - $11, $12, - $15, $16, - $19, $2, and over Graduate/Professional does not apply does not apply 16. TOTAL (fields 1-15) Total less-than-full-time students (from fields 1-15) Total "Automatic" Zero EFC students (from fields 1-15) FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-11

24 ED Form OMe no Expires 6/3/212 Fiscal Operations Report, Part VI (continued) OPEID Number 25 State _L_A Part VI. Program Summary for Award Year July 1, 29 through June 3, 21 Section B. Calculating the Administrative Cost Allowance Administrative Cost Allowance Worksheet (Worksheet must be retained for audit and program reviews) Step 1. Calculate the amount spent in on which the administrative cost allowance is based. 1. Total compensation in FWS (amount from Part V, Section C, Field 12) 2. Amount of Federal Perkins Loan funds advanced to students (amount from Part III, Section e, Field 7) 3. Total funds to FSEOG recipients (amount from Part IV, Section C, Field 12) 4. Total amount spent (fields ) $ 2_2_87_5_7 +$ 2 +$ 1_2_64_1_ $ 3_5_7_16_7 Step 2. Calculate the administrative cost allowance. Schools whose total amount spent was $2.75. or less 5. Enter total amount spent (Field 4) 6. Multiply 7. Total administrative cost allowance-go to Step 3 Schools whose total amount spent was more than $2.75. but less than $ Enter total amount spent (Field 4) 9. Subtract 1. Expenditures over $2,75, (Field 8 - Field 9) 11. Multiply 12. Administrative cost allowance on expenditures over $2,75, (Field 1 x Field 11) 13. Add administrative cost allowance on expenditures of $2,75, ($2.75 million x.5) 14. Total administrative cost allowance (Field 12 + Field 13)-g to Step 3 Schools whose total amount spent was $5.5. or more 15. Enter total amount spent (Field 4) 16. Subtract 17. Expenditures of $5,5, or more (Field 15 - Field 16) 18. Multiply 19. Administrative cost allowance on expenditures of $5,5, or more (Field 17 x Field 18) 2. Add administrative cost allowance on expenditures less than $5,5, «$2.75 million x.5) + Field 12) 21. Total administrative cost allowance (Field 19 + Field 2)-g to Step 3 $ x.5 $ $ -$ $ x.4 $ +$ $ $ -$ 5A $ x.3 $ +$ $ Step 3. Decide how much administrative cost allowance your school claimed. 22. How much administrative cost allowance did your school claim? (The amount may be the same or less than the amount calculated in Step 2.) $ ~1...:...c78=5...:: How much administrative cost allowance did your school claim in each program? (a) Federal Perkins Loan (must be the same as Part III, Section e, Field 8) (b) FSEOG (must be the same as Part IV, Section D, Field 15) (c) FWS (must be the same as Part V, Section D, Field 15) $ ---=-=1O~O $ 63_2_ $ -=-.cll"--'4=3~8 FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-12

25 ED Form OMB no Expires 6/3/212 Paperwork Burden Statement According to the Paperwork Reduction Act of 7995, no persons are required to respond to a collection ofinformation unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is The time required to complete this information collection is estimated to average 8.4 hours per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. Ifyou have any comments concerning the accuracy ofthe time estimate(s) orsuggestions for improving this form, please write to: u.s. Department ofeducation, Washington, D. C Ifyou have comments or concerns regarding the status ofyour individual submission ofthis form, write directly to: Grants &Campus-Based Division, u.s. Department ofeducation, 4 Maryland Avenue, S. W, UCP, 62E3, Washington, D. C Fiscal Operations Report and Application to Participate (FISAP) Report: Award Year July 1, 28 through June 3, 29; Application: Award Year July 1, 21 through June 3, 211 Part I. Identifying Information, Certification and Warning Section A. Identifying Information 1 (a) Name and address of school Nicholls State University 96 East First Street Thibodaux LA (b) Mailing address (if different from 1 (a» 2. OPEID Number Type of school (select one) ~3.1 public _ 3.2 private/non-profit _ 3.3 proprietary (Select one!f proprietary) _(a) art _ (b) business _ (c) cosmetology _ (d) trade and technical _ (e) other 4. Length/type of longest program (select one) _ 4.1 less than 1 year _ year but less than 2 years _ years but less than 3 years _ years but less than 4 years _ years (no higher than a baccalaureate degree)..1l years or more _ 4.7 post-baccalaureate only 5. Additional locations Schools with separately eligible additional locations that will be funded under this application must list these locations and their addresses and OPEID Numbers on the screen. You may not file a separate application for any separately eligible school listed herein. We have entered a list of separately eligible additional locations included in this application. yes x no 6. Financial Aid Administrator Name ~C=a=si=e~A~.~Tr=iche == addresscasie.trichela>.nicholls.edu Telephone No. (985) Fax No. (985) Name and address of private financial aid consultant firm, if any Name Address Address 2 City State Zip FISAP Version: Submitted Version Page A-1

26 Section B. Certification and Warning OPEID Number 25 State -=L_A ED Form OMB no Expires 6/3/212 Applicants must review the requirements for certification regarding lobbying included in the regulations cited below before completing this form. Applicants must sign this form to comply with the certification requirements under 34 CFR Part 82, "New Restrictions on Lobbying." This certification is a material representation of fact upon which the Department of Education relies when it makes a grant or enters into a cooperative ag reement. As required by Section 1352, Title 31 of the U.S. Code, and implemented at 34 CFR Part 82, for persons entering into a Federal contract, grant or cooperative agreement over $1,, as defined at 34 CFR Part 82, Sections and 82.11, the applicant certifies that: (a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the making of any Federal grant, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal grant or cooperative agreement; (b) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal grant or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions (Available at the following link: and (c) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subgrants and contracts under grants and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above certification. I further certify that the information contained in this electronic FISAP is in compliance with governing legislation and regulations and is true and accurate. I understand that all information associated with this FISAP is subject to audit and program review by representatives of the Secretary of Education. WARNING: If you purposely give false or misleading information, you may be fined up to $2,, sent to prison, or both. 8. Chief Executive Officer (includes President, Chancel/or, and Director) Signature Date Signed 9/23/ Name Stephen T. Hulbert Telephone No. (985) Title President Fax No. (985) address Stephen.Hulbert(al,NICHOLLS.EDU Mail signed form to: FISAP Administrator 311 Fairview Park Drive Suite 95 Falls Church, VA 2242 FISAP Version: Submitted Version Page A-2

27 Application to Participate, Part II OPEID Number 25 State --'..:L=-A"-----_ Part II. Application to Participate for Award Year July 1,21 through June 3, 211 Section A. Request for Funds for the Award Year 1. Federal Perkins Loan Level of Expenditures $ 2 ED Form OMB no Expires 6/3/ Federal Perkins Loan Federal Capital Contribution $.;,< FSEOG federal funds $ FWS federal funds $ 31 Section B. Federal Perkins Loan Program Liquidation Request (Applies only to certain schools; see instructions) 5. My school wishes to discontinue participation in the Federal Perkins Loan Program. yes x no Section C. Waiver Request for the Underuse of Funds My school has returned more than 1 percent of its Federal Perkins Loan, FSEOG, or FWS allocation for the award year. 6. My school wishes to apply for a waiver of the penalty for the underuse of funds and will provide, on the Additional Information screen, a written explanation of the circumstances. _ yes x no FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-3

28 Application to Participate, Part II (continued) OPEID Number 25 State _L_A Part II. Application to Participate for Award Year July 1,21 through June 3,211 Section D. Information on Enrollment ED Form OMB no Expires 6!3!212 My school's calendar is l Traditional _ Non-Traditional Schools with a non-traditional calendar that had enrollment, fill in fields 9 through 2. Schools with a traditional calendar that had enrollment, Continuing Students New Starts fill in Field 7. (a) (b) Undergraduate Graduate/Professional 9. July 1, 28 (a) (b) 1. August 1 7. Total number of 11. September 1 students, October November 1 Schools with a traditional calendar that did not have December 1 enrollment, fill in Field January 1, 29 U ndergrad uate Graduate!Professional 16. February 1 8. Estimated number of (a) (b) 17. March 1 students, o o 18. April May 1 2. June 1, TOTAL Section E. Assessments and Expenditures Undergraduate Graduate/Professional (a) (b) 22. Total tuition and fees for the award year July 1, 28 to June 3, 29 $ $ Total Title IV, Part A, Subpart I, Grants $ 69_8_71_5_4 (a) Total Federal Pell Grant expenditures for the award year $ 67 26_2_9 (b) Total ACG expenditures for the award year $ 2_4.:...;;99_4_4 (c) Total National SMART Grant expenditures for the award year $ 3_45_8_1 24. Total expended for state grants and scholarships made to undergraduates for the award year July 1, 28 to June 3, 29 $ 56_8_7_7_8 Section F. Information on Eligible Aid Applicants Enrolled in Your School for Award Year Dependent Undergraduate Independent Undergraduate Independent Without Baccalaureate! With Baccalaureate! Without Baccalaureate! With Baccalaureate! Graduate! 1st Prof. Degree 1st Prof. Degree 1st Prof. Degree 1st Prof. Degree Professional (a) (b) (c) (d) (e) 25. Students with an "Automatic" Zero EFC Taxable and Untaxed Income Taxable and Untaxed Income 26. $ - $2,999 6 $ - $ $3, - $5,999 8 $1, - $1, $6, - $8,999 6 $2, - $2, $9, - $11, $3, - $3, $12, - $14, $4, - $4, $15, - $17,999 6 $5, - $5, $18, - $23, $6, - $7, $24, - $29, $8, - $9, $3, - $35, $1, - $11, $36, - $41, $12, - $13, $42, - $47, $14, - $15, $48, - $53, $16, - $17, $54, - $59, $18, - $19, $6, and over $2, and over TOTAL TOTAL FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-4

29 Fiscal Operations Report, Part III OPEID Number 25 State _L_A ED Form OMB no 184S-3 Expires 6/3/212 Part III. Federal Perkins Loan Program for Award Year July 1,28 through June 3, 29 Section A. Fiscal Report (Cumulative) as ofjune 3, 29 Field Item Amount Number of Borrowers Debit Balances Credit Balances (a) (b) (c) (d) 1.1. Cash on hand and in depository as of 6/3/29 $ Cash on hand and in depository as of 1/31/29 $ Funds receivable from federal government $ 3. Funds receivable from school $ 4. Funds advanced to students 1487 $ S. Loan principal collected 1424 $ Loan principal assigned to and accepted by the United States 54 $ Loan grincigal canceled for the following categories: 7. teaching/military service (applies to loans made prior to 7/1/1972) 35 $ certain subject matter teaching service (math, science, foreign languages, bilingual education) $ 9. all other authorized pre-k or K-12 teaching service 14 $ military service (applies to loans made 7/1/1972 and after) $ 11. volunteer service $ 12. law enforcement and corrections officer service 1 $ child/family/early intervention service $ Q 14. nurse/medical technician service 2 $ pre-k or child care program staff member service $ 16. service as an attorney in a public defender organization $ 17. fire fighter service $ 18. Tribal College or University faculty service $ 19. librarian service $ Q 2. speech-language pathology service $ 21. death/disability 13 $ disability based on VA determination <:) $ 23. bankruptcy 9 $ surviving spouses of public service victims of 9-11 terrorist attacks $ 2S. loans discharged due to closed schools $ 26. Loan principal adjustments - other 1 $ Federal Capital Contributions $ Repayments of fund capital to federal government $ Short-term loans to the Fund $ ICC deposited to the Fund $ Institutional Capital Contributions $ Repayment of short-term loans to the fund $ 3.2. Distribution of excess/liquidated fund capital $ Repayments of fund capital to school $ Interest income on loans $ Other income $ Reimbursements to the Fund of the amounts canceled on loans made 7/1/1972 and after $ Administrative cost allowance $ Collection costs $ Administrative cost allowance and collection costs (control) $ 5668 Cost of loan RrinciRal and interest canceled for the following categories: 35. teaching/military service (applies to loans made prior to 7/1/1972) $ certain subject matter teaching service (math, science, foreign languages, bilingual education) $ 37. all other authorized pre-k or K-12 teaching service (applies to loans made 7/1/1972 and after) $ military service (applies to loans made 7/1/1972 and after) $ 39. volunteer service in the Peace Corps or under the Domestic Volunteer Service Act of 1973 $ FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-S

30 Fiscal Operations Report, Part III (continued) OPEID Number 25 State _L_A Part III. Federal Perkins Loan Program for Award Year July 1,28 through June 3,29 Section A. Fiscal Report (Cumulative) as ofjune 3, 29 ED Form OMB no Expires 6/3/212 Field Item Amount Number of Borrowers Debit Balances Credit Balances (a) (b) (c) (d) 4. law enforcement and corrections officer service $ child/family/early intervention service $ 42. nurse/medical technician service $ pre-k or child care program staff member service $ 44. service as an attorney in a public defender organization $ 45. fire fighter service $ 46. Tribal College or University faculty service $ 47. librarian service $ 48. speech-language pathology service $ 49. death/disability $ VA disability determination $ 51. bankruptcy $ surviving spouses of public service victims of 9-11 terrorist attacks $ 53. Cost of loan principal and interest assigned to and accepted by the United States $ Cost of loan principal and interest canceled for loans discharged due to closed schools $ 55. Other costs or losses $ Balancing Adjustments (Debits) $ 57. Balancing Adjustments (Credits) $ 58. Total debits and credits (Sum of fields 1.1 through 57) $ $ Section B. Fund Activity (Annual) During the Award Year (July 1, 28 through June 3, 29) Number of Borrowers (a) 1. Final adjusted Federal Capital Contribution (FCC) authorization 2. FWS funds transferred to the Fund 3. FCC transferred to: (a) FSEOG (b) FWS 4. Total federal funds available for the award year (fields (a) - 3(b)) 5. The unexpended amount of final adjusted authorized FCC for award year that was NOT requested from G5 by June 3, 29. This amount will be reduced from your total award amount next spring (see instructions). 6. Institutional Capital Contribution (ICC) deposited into the Fund between July 1, 28 and June 3, Loans advanced to students from the Fund during the award year (minus award year refunds) 8. Administrative cost allowance claimed for the award year (see instructions) 9. Total principal and interest repaid by borrowers from all sources during the award year 6 1. Total principal repaid by borrowers from all sources during the award year for loans in default for more than 2 years but not more than 5 years o 11. Total principal repaid by borrowers from all sources during the award year for loans in default for more than 5 years o $ +$ Amount (b) -$ -$ $ $ $ $ $ $ 288 $ $ FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT PageA-6

31 Fiscal Operations Report, Part III (continued) OPEID Number 25 State _L_A Part III. Federal Perkins Loan Program for Award Year July 1,28 through June 3,29 Section C. Cumulative Repayment Infonnation as ofjune 3, 29 Status of Borrowers as of June ED Form OMB no Expires 6/3/212 Amount Number of Amount Lent Principal Amount Borrowers Outstanding (a) (b) (c) (d) 1.1. Borrowers whose loans are fully retired 1424 $ Loans that have been purchased $ 2. Borrowers whose loans were assigned to and officially accepted by the U.S. Department of Education as of June 3, 29 (Note: Field 2 equals the sum of Field 2.1 plus Field 2.2.) 54 $ 476 $ Assignments due to default or liquidation 53 $ 4585 $ Assignments due to total and permanent disability discharge $ 175 $ Total borrowers not in repayment status 3 $ Borrowers on schedule in repayment status 3 $ In default less than 24 days (monthly installments) or less than 27 days (other installments) $ 2 $ In default 24 days or more (monthly installments) or 27 days or more (other installments), up to 2 years $ 15 $ In default more than 2 years but not more than 5 years $ 275 $ In default more than 5 years $ $ Cohort Default Rate {Sections D and E} Schools with fewer than 3 borrowers who entered repayment in the award year should skip to Section E. Section D. Schools with 3 or More Borrowers Who Entered Repayment in the Award Year 1.1. Number of borrowers who entered repayment in o 1.2. Number of borrowers from Field 1.1 above with loans in default by June 3, 29 o 1.3. Cohort default rate «Field 1.21 Field 1.1) x 1) o Section E. Schools with Fewer than 3 Borrowers Who Entered Repayment in the Award Year 2.1. Number of borrowers who entered repayment in: 2.2. Number of borrowers with loans in default by: (a) (7/1/25-6/3/26) (a) June 3,27 (those in 2.1(a) only) (b) (7/1/26-6/3/27) (b) June 3,28 (those in 2.1(b) only) o (c) (7/ ) o (c) June 3,29 (those in 2.1(c) only) o 2.3. Total number of borrowers who entered repayment during the three years above (fields 2.1(a) + 2.1(b) + 2.1(c» Total number of borrowers with loans in default during the three years above (fields 2.2(a) + 2.2(b) + 2.2(c» 2.5. Cohort default rate «Field 2.41 Field 2.3) x 1) 5. FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-7

32 ED Form OMS no Expires 6/3/212 Fiscal Operations Report, Part IV OPEID Number 25 State _L_A Part IV. Federal Supplemental Educational Opportunity Grant (FSEOG) Program for Award Year July 1, 28 through June 3, 29 Section A. Federal Funds Authorized for FSEOG 1. Final adjusted FSEOG authorization $ 1_52_3_9_6 Section B. Federal Funds Available for FSEOG Expenditures 2. FWS funds transferred to and spent in FSEOG 3. Federal Perkins Federal Capital Contribution funds transferred to and spent in FSEOG 4. FSEOG funds transferred to and spent in FWS FSEOG funds carried back and spent in Additional FSEOG funds carried back and spent for 29 summer enrollment funds carried forward and spent in funds carried forward to be spent in funds carried back and spent in Additional funds carried back and spent for 28 summer enrollment 11. Total federal funds available for FSEOG (fields ) minus (fields ) +$ +$ -$ --'-- +$ +$ --=-- +$ -----"- -$ -$ -'-- -$ -'-- $ --'1=5=23=9~6 Section C. Funds to FSEOG Recipients 12. Total funds to FSEOG recipients (fields ) 13. Nonfederal share of funds to FSEOG recipients (25 percent of Field 12) (a) Cash outlay contributed (b) Other resources designated Section D. Federal Funds Spent for FSEOG Program 14. Federal share of funds to FSEOG recipients (75 percent of Field 12) 15. Administrative cost allowance claimed 16. Federal funds spent for FSEOG (fields ) Section E. Use of FSEOG Authorization $ $ $ 1_4_51_3_9 $ -----'--- $ 14_5_13_9 +$ 7_2_5_7 $ 15_23_9_6 17. Expended FSEOG authorization (fields ) minus (fields ) 18. Unexpended FSEOG authorization (Field 1 - Field 17) (cannot be negative) $ 15_23_9_6 $ FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT PageA-8

33 Fiscal Operations Report, Part V OPEID Number 25 State _L_A ED Form OMB no Expires 6/3/212 Part V. Federal Work-Study (FWS) Program for Award Year July 1,28 through June 3,29 Section A. Federal Funds Authorized for FWS 1. Final adjusted FWS authorization $ Section B. Federal Funds Available for FWS Expenditures 2. Federal Perkins Federal Capital Contribution funds transferred to and spent in FWS +$ 3. FSEOG funds transferred to and spent in FWS +$ 4. FWS funds transferred to and spent in: (a) FSEOG -$ (b) Federal Perkins Loan Program -$ FWS funds carried back and spent in $ 6. Additional FWS funds carried back and spent for 29 summer employment +$ funds carried forward and spent in $ funds carried forward to be spent in $ funds carried back and spent in $ 1. Additional funds carried back and spent for 28 summer employment -$ 11. Total federal funds available for FWS (fields ) minus (fields 4(a) + 4(b) ) $ Section C. Total Compensation for FWS 12. Total earned compensation for FWS Program $ 21_6_74_6 (a) On-campus earned compensation (b) Off-campus earned compensation for public or private non-profit agencies, excluding amounts reported in Field 12c (c) Off-campus earned compensation for agencies that were unable to pay regular nonfederal share and had a federal share up to 9 percent (d) Off-campus earned compensation for private for-profit organizations $ 2_16_7_46_ $ $ $ 13. Total institutional share of earned compensation (see instructions) $ Section D. Funds Spent from Federal Share of FWS 14. Total federal share of FWS earned compensation $ (a) Federal share paid at a rate up to 75 percent $ (b) Federal share paid at a rate up to 1 percent for waivers of nonfederal share $ (c) Federal share paid at a rate up to 9 percent for agencies that were unable to pay regular nonfederal share $ (d) Federal share paid at a rate up to 5 percent for off-campus, private for-profit organizations $ Administrative cost allowance claimed +$ 16. Federal share of Job Location and Development (JLD) Program expenditures +$ 17. Total federal funds spent for FWS (fields ) $ FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-9

34 ED Form OMB no Expires 6/3/212 Fiscal Operations Report, Part V (continued) OPEID Number 25 State _L_A Part V. Federal Work-Study (FWS) Program for Award Year July 1,28 through June 3,29 Section E. Use of FWS Authorization 18. Expended FWS authorization (fields 4(a) + 4(b) ) minus (fields ) $ Unexpended FWS authorization (Field 1 - Field 18) $ Section F. Information About the Job Location and Development (JLD) Program 2. Total expenditures for the JLD Program $ 21. Institutional expenditures for the JLD Program (see instructions) $ ~O 22. Number of students for whom jobs were located or developed o 23. Total earnings of the students in Field 22 above $ Section G. Information About FWS Students Employed in Community Service Activities 24. Number of students in community service employment Federal share of community service earned compensation $ 5_9_8_2 26. Nonfederal share of community service earned compensation $ Section H. Information About FWS Students Employed as Reading Tutors of Children or Employed in Family Literacy Activities 27. Number of FWS students employed as reading tutors of children or employed in family literacy activities Federal share of earned compensation for FWS students employed as reading tutors of children or employed in family literacy activities $ 2383 (a) Amount of the federal share in Field 28 spent on community service employment $ Total earned compensation for FWS students employed as reading tutors of children or employed in family literacy activities $ 2383 Section I. Information About FWS Students Employed as Mathematics Tutors of Children 3. Number of FWS students employed as mathematics tutors of children o 31. Federal share of earned compensation for FWS students employed as mathematics tutors of children $ 32. Total earned compensation for FWS students employed as mathematics tutors of children $ Section J. Information About FWS Students in Civic Education and Participation Activities 33. Number of students in civic education and participation activities o 34. Federal share spent for students in civic education and participation activities $ 35. Total spent for students in civic education and participation activities $ Section K. Information About FWS Disaster-Affected Students 36. Number of disaster-affected students receiving FWS funds o 37. Federal share of funds to disaster-affected students $ ~O 38. Total funds to disaster-affected students $ ---=- FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-1

35 Fiscal Operations Report, Part VI Name of school Nicholls State Universi!y OPEID Number 25 State LA Part VI. Program Summary for Award Year July 1,28 through June 3,29 Section A. Distribution of Program Recipients and Expenditures by Type of Student ED Form OMB no Expires 6/3/212 Taxable and Untaxed Income Category Student Type Federal Perkins Loan Recipients Funds (a) (b) FSEOG Recipients Funds (c) (d) FWS Recipients (e) Funds (f) Unduplicated Recipients (g) Undergraduate De~endent 1. $ - $ 5, $6, - $11, $12, - $23, $24, - $29, $3, - $41, $42, - $59, $6, and over Undergraduate Inde~endent 8. $ - $ 1, $2, - $ 3, $4, - $ 7, $8, - $11, $12, - $15, $16, - $19, $2, and over Graduate/Professional does not apply does not apply TOTAL (fields 1-15) Totalless-than-full-time students (from fields 1-15) Total "Automatic" Zero EFC students (from fields 1-15) FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-11

36 Fiscal Operations Report, Part VI (continued) OPEID Number 25 State _L_A Part VI. Program Summary for Award Year July 1, 28 through June 3, 29 Section B. Calculating the Administrative Cost Allowance Administrative Cost Allowance Worksheet (Worksheet must be retained for audit and program reviews) Step 1. Calculate the amount spent in on which the administrative cost allowance is based. ED Form OMB no Expires 6/3/ Total compensation in FWS (amount from Part V, Section C, Field 12) 2. Amount of Federal Perkins Loan funds advanced to students (amount from Part III, Section B, Field 7) 3. Total funds to FSEOG recipients (amount from Part IV, Section C, Field 12) 4. Total amount spent (fields ) $ 2_1_67_4_6 +$ +$ 1_45_1_39_ $ Step 2. Calculate the administrative cost allowance. Schools whose total amount spent was $2,75, or less 5. Enter total amount spent (Field 4) 6. Multiply 7. Total administrative cost allowance-go to Step 3 Schools whose total amount spent was more than $2,75, but less than $5,5, 8. Enter total amount spent (Field 4) 9. Subtract 1. Expenditures over $2,75, (Field 8 - Field 9) 11. Multiply 12. Administrative cost allowance on expenditures over $2,75, (Field 1 x Field 11) 13. Add administrative cost allowance on expenditures of $2,75, ($2.75 million x.5) 14. Total administrative cost allowance (Field 12 + Field 13}-g to Step 3 Schools whose total amount spent was $5,5, or more 15. Enter total amount spent (Field 4) 16. Subtract 17. Expenditures of $5,5, or more (Field 15 - Field 16) 18. Multiply 19. Administrative cost allowance on expenditures of $5,5, or more (Field 17 x Field 18) 2. Add administrative cost allowance on expenditures less than $5,5, «$2.75 million x.5) + Field 12) 21. Total administrative cost allowance (Field 19 + Field 2)-g to Step 3 $ x.5 $ 1894 $ -$ $ x.4 $ +$ $ $ -$ $ x.3 $ +$ $ Step 3. Decide how much administrative cost allowance your school claimed. 22. How much administrative cost allowance did your school claim? (The amount may be the same or less than the amount calculated in Step 2.) 23. How much administrative cost allowance did your school claim in each program? (a) Federal Perkins Loan (must be the same as Part III, Section B, Field 8) (b) FSEOG (must be the same as Part IV, Section D, Field 15) (c) FWS (must be the same as Part V, Section D, Field 15) $ $ $ 72_5_7 $ 1_8_3_7 FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-12

37 ED Form OMB no Expires 5/31/211 Fiscal Operations Report and Application to Participate (FISAP) Report: Award Year July 1, 27 through June 3, 28; Application: Award Year July 1, 29 through June 3, 21 Part I. Identifying Information, Certification and Warning Section A. Identifying Information 1 (a) Name and address of school Nicholls State University 96 East First Street Thibodaux LA (b) Mailing address (if different from 1(a» 2. OPEID Number Type of school (select one) ~3.1 public _ 3.2 private/non-profit _ 3.3 proprietary (Select one!f proprietary) _ (a) art _ (b) business _ (c) cosmetology _ (d) trade and technical _ (e) other 4. Length/type of longest program (select one) _ 4.1 less than 1 year _ year but less than 2 years _ years but less than 3 years _ years but less than 4 years _ years (no higher than a baccalaureate degree) years or more _ 4.7 post-baccalaureate only 5. Additional locations Schools with separately eligible additional locations that will be funded under this application must list these locations and their addresses and OPEID Numbers on the screen. You may not file a separate application for any separately eligible school listed herein. We have entered a list of separately eligible additional locations included in this application. yes x no 6. Financial Aid Administrator Name ~C~~~ie~A~.T_r~ic~h~e addresscasie.triche(a).nicholls.edu Telephone No. (985) Fax No. (985) Name and address of private financial aid consultant firm, if any Name Address 1 Address City State Zip FISAP Version: Submitted Version Page A-1

38 ED Form OMB no Expires 5/31/211 Section B. Certification and Warning OPEID Number 25 State L=-::A-=----_ Applicants must review the requirements for certification regarding lobbying included in the regulations cited below before completing this form. Applicants must sign this form to comply with the certification requirements under 34 CFR Part 82, "New Restrictions on Lobbying." This certification is a material representation of fact upon which the Department of Education relies when it makes a grant or enters into a cooperative ag reement. As required by Section 1352, Title 31 of the U.S. Code, and implemented at 34 CFR Part 82, for persons entering into a Federal contract, grant or cooperative agreement over $1,, as defined at 34 CFR Part 82, Sections and 82.11, the applicant certifies that: (a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the making of any Federal grant, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal grant or cooperative agreement; (b) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal grant or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions (Available at the following link: and (c) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subgrants and contracts under grants and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above certification. I further certify that the information contained in this electronic FISAP is in compliance with governing legislation and regulations and is true and accurate. I understand that all information associated with this FISAP is subject to audit and program review by representatives of the Secretary of Education. WARNING: Any person who knowingly provides false or misleading information on this FISAP will be subject to a fine of up to $1, or imprisonment of up to 5 years or both under provisions of Section 11, Title 18 of the U.S. Code. 8. Chief Executive Officer (includes President, Chancellor, and Director) Signature Date Signed -'-9_/2_6/_2_;...;;.8 Name Stephen T. Hulbert Telephone No. (985) Title President Fax No. (985) address Stephen.Hulbert@NICHOLLS.EDU Mail signed form to FISAP Administrator 311 Fairview Park Drive Suite 95 Falls Church, VA 2242 FISAP Version: Submitted Version PageA-2

39 Application to Participate, Part II OPEID Number 25 State...;;;;;L"-'-'A"------_ Part II. Application to Participate for Award Year July 1,29 through June 3,21 Section A. Request for Funds for the Award Year 1. Federal Perkins Loan Level of Expenditures $ 2 ED Form OMB no Expires 5/31/ Federal Perkins Loan Federal Capital Contribution $ -,,- 3. FSEOG federal funds $ FWS federal funds $ 31 Section B. Federal Perkins Loan Program Liquidation Request (Applies only to certain schools; see instructions) 5. My school wishes to discontinue participation in the Federal Perkins Loan Program. _ yes..1l no Section C. Waiver Request for the Underuse of Funds My school has returned more than 1 percent of its Federal Perkins Loan, FSEOG, or FWS allocation for the award year. 6. My school wishes to apply for a waiver of the penalty for the underuse of funds and will provide, on the Additional Information screen, a written explanation of the circumstances. _ yes..l no FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-3

40 Application to Participate, Part II (continued) OPEID Number 25 State _L_A Part II. Application to Participate for Award Year July 1,29 through June 3,21 Section D. Information on Enrollment ED Form OMB no Expires 5/ My school's calendar is ~ Traditional _ Non-Traditional Schools with a non-traditional calendar that had enrollment, fill in fields 9 through 2. Schools with a traditional calendar that had enrollment, Continuing Students New Starts fill in Field 7. (a) (b) Underg rad uate Graduate/Professional 9. July 1, 27 (a) (b) 1. August 1 7. Total number of 11. September 1 students, October 1 Schools with a traditional calendar that did not have November December 1 enrollment, fill in Field January 1, 28 Undergraduate Graduate/Professional 16. February 1 8. Estimated number of (a) (b) 17. March 1 students, o o 18. April May 1 2. June 1, TOTAL Section E. Assessments and Expenditures Undergraduate Graduate/Professional (a) (b) 22. Total tuition and fees for the award year July 1, 27 to June 3, 28 $ $ 2]]8] Total Title IV, Part A, Subpart I, Grants $ (a) Total Federal Pell Grant expenditures for the award year $ (b) Total ACG expenditures for the award year $ (c) Total National SMART Grant expenditures for the award year $ Total expended for state grants and scholarships made to undergraduates for the award year July 1, 27 to June 3,28 $--..;...52wO~58~3'-J-3 Section F. Information on Eligible Aid Applicants Enrolled in Your School for Award Year Dependent Undergraduate Independent Undergraduate Independent Without Baccalaureate/ With Baccalaureate/ Without Baccalaureate! With Baccalaureate! Graduate/ 1st Prof. Degree 1st Prof. Degree 1st Prof. Degree 1st Prof. Degree Professional (a) (b) (c) (d) (e) 25. Students with an "Automatic" Zero EFC Taxable and Untaxed Income Taxable and Untaxed Income 26. $ - $2,999 6 $ - $ $3, - $5,999 7 $1, - $1, ] 28. $6, - $8,999 3 $2, - $2, $9, - $11,999 () $3, - $3, $12, - $14, $4, - $4, $15, - $17,999 ]4 $5, - $5, $18, - $23, $6, - $7, $24, - $29, $8, - $9, $3, - $35, $1, - $11, ] 35. $36, - $41,999 15~ $12, - $13, $42, - $47,999 ]41 Q $14, - $15, $48, - $53, $16, - $17, $54, - $59,999 ]56 $18, - $19, $6, and over $2, and over ]53 4. TOTAL TOTAL FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-4

41 Fiscal Operations Report, Part III OPEID Number 25 State _L_A Part III. Federal Perkins Loan Program for Award Year July 1,27 through June 3, 28 Section A. Fiscal Report (Cumulative) as of June 3, 28 ED Form OMB no Expires 5/31/211 Field Item Amount Number of Borrowers Debit Balances Credit Balances (a) (b) (c) (d) 1.1. Cash on hand and in depository as of 6/3/28 $ Cash on hand and in depository as of 1/31/28 $ Funds receivable from federal government $ 3. Funds receivable from school $ 4. Funds advanced to students 1487 $ Loan principal collected 1466 $ Loan principal assigned to and accepted by the United States S4 $ Loan ~rinci~al canceled for the following categories: 7. teaching/military service (applies to loans made prior to 7/1/1972) 35 $ certain subject matter teaching service (math, science, foreign languages, bilingual education) $ 9. all other authorized teaching service 14 $ military service (applies to loans made 7/1/1972 and after) $ 11. volunteer service $ 12. law enforcement and corrections officer service $ child/family/early intervention service $ 14. nurse/medical technician service 2 $ death/d isability 13 $ bankruptcy 2 $ surviving spouses of public service victims of 9-11 terrorist attacks $ 18. loans discharged due to closed schools $ 19. Loan principal adjustments - other 1 $ Federal Capital Contributions $ Repayments of fund capital to federal government $ Institutional Capital Contributions $ Repayments of fund capital to school $ Interest income on loans $ Other income $ Reimbursements to the Fund of the amounts canceled on loans made 7/1/1972 and after $ Administrative cost allowance $ Collection costs $ Administrative cost allowance and collection costs (control) $ 568 Cost of loan ~rinci~al and interest canceled for the following categories: 28. teaching/military service (applies to loans made prior to 7/1/1972) $ certain subject matter teaching service (math, science, foreign languages, bilingual education) $ 3. all other authorized teaching service (applies to loans made 7/1/1972 and after) $ military service (applies to loans made 7/1/1972 and after) $ 32. volunteer service in the Peace Corps or under the Domestic Volunteer Service Act of 1973 $ 33. law enforcement and corrections officer service $ child/family/early intervention service $ 35. nurse/medical technician service $ death/disability $ bankruptcy $ surviving spouses of public service victims of 9-11 terrorist attacks $ 39. Cost of loan principal and interest assigned to and accepted by the United States $ Cost of loan principal and interest canceled for loans discharged due to closed schools $ FISAP Version: Submitted Version Page A-5

42 ED Form OMB no Expires 5/31/211 Fiscal Operations Report, Part III (continued) OPEID Number 25 State --'L=:.:..A""---_ Part III. Federal Perkins Loan Program for Award Year July 1,27 through June 3,28 Section A. Fiscal Report (Cumulative) as ofjune 3, 28 Field Item Amount (a) Number of Borrowers (b) Debit Balances (c) Credit Balances (d) 41. Other costs or losses 42. Balancing Adjustments (Debits) 43. Balancing Adjustments (Credits) 44. Total debits and credits (Sum of fields 1.1 through 43) $ 1_7_ $ ---"- $ $ $ Section B. Fund Activity (Annual) During the Award Year (July 1, 27 through June 3,28) Number of Borrowers (a) Amount (b) 1. Final adjusted Federal Capital Contribution (FCC) authorization 2. FCC transferred to: (a) FSEOG (b) FWS $ $ $ 3. The unexpended amount of final adjusted authorized FCC for award year that was NOT requested from G5 by June 3, 28. This amount will be reduced from your total award amount next spring (see instructions). 4. Institutional Capital Contribution (ICC) deposited into the Fund between July 1, 27 and June 3, Loans advanced to students from the Fund during the award year (minus award year refunds) 6. Administrative cost allowance claimed for the award year (see instructions) 7. Total principal and interest repaid by borrowers from all sources during the award year 8. Total principal repaid by borrowers from all sources during the award year for loans in default for more than 2 years but not more than 5 years 9. Total principal repaid by borrowers from all sources during the award year for loans in default for more than 5 years $ $ $ $ 3 $ 1354 o $ o $ FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-6

43 ED Form OMB no Expires 5/ Fiscal Operations Report, Part III (continued) OPEID Number 25 State -"L=--A"----_ Part III. Federal Perkins Loan Program for Award Year July 1, 27 through June 3,28 Section C. Cumulative Repayment Information as ofjune 3, 28 Status of Borrowers as of June Amount Number of Amount Lent Principal Amount Borrowers Outstanding (a) (b) (c) (d) 1.1. Borrowers whose loans are fully retired 1422 $ Loans that have been purchased $ 2. Borrowers whose loans were assigned to and officially accepted by the U.S. Department of Education as of June 3, 28 (Note: Field 2 equals the sum of Field 2.1 plus Field 2.2.) 54 $ 476 $ Assignments due to default or liquidation 53 $ 4585 $ Assignments due to total and permanent disability discharge $ 175 $ Total borrowers not in repayment status 6 $ Borrowers on schedule in repayment status 3 $ In default less than 24 days (monthly installments) or less than 27 days (other installments) $ $ 5.2. In default 24 days or more (monthly installments) or 27 days or more (other installments), up to 2 years 2 $ 425 $ In default more than 2 years but not more than 5 years $ $ 5.4. In default more than 5 years $ $ Cohort Default Rate (Sections D and E} Schools with fewer than 3 borrowers who entered repayment in the award year should skip to Section E. Section D. Schools with 3 or More Borrowers Who Entered Repayment in the Award Year 1.1. Number of borrowers who entered repayment in o 1.2. Number of borrowers from Field 1.1 above with loans in default by June 3, 28 o 1.3. Cohort default rate «Field 1.2 1Field 1.1) x 1) o Section E. Schools with Fewer than 3 Borrowers Who Entered Repayment in the Award Year 2.1. Number of borrowers who entered repayment in: 2.2. Number of borrowers with loans in default by: (a) (7/1/24-6/3/25) (a) June 3, 26 (those in 2.1 (a) only) (b) (7/1/25-6/3/26) (b) June 3, 27 (those in 2.1(b) only) (c) (7/1/26-6/3/27) (c) June 3, 28 (those in 2.1(c) only) o 2.3. Total number of borrowers who entered repayment during the three years above (fields 2.1(a) + 2.1(b) + 2.1(c» Total number of borrowers with loans in default during the three years above (fields 2.2(a) + 2.2(b) + 2.2(c» 2.5. Cohort default rate «Field 2.41 Field 2.3) x 1) 3333 FISAP Version: Submitted Version Page A-7

44 Fiscal Operations Report, Part IV OPEID Number 25 State _L_A ED Form OMS no Expires 5/31/211 Part IV. Federal Supplemental Educational Opportunity Grant (FSEOG) Program for Award Year July 1, 27 through June 3, 28 Section A. Federal Funds Authorized for FSEOG 1. Final adjusted FSEOG authorization $ Section B. Federal Funds Available for FSEOG Expenditures 2. FWS funds transferred to and spent in FSEOG +$ 3. Federal Perkins Federal Capital Contribution funds transferred to and spent in FSEOG +$ Q FSEOG funds carried back and spent in $ 5. Additional FSEOG funds carried back and spent for 28 summer enrollment +$ Q funds carried forward and spent in $ funds carried forward to be spent in $ funds carried back and spent in $ 9. Additional funds carried back and spent for 27 summer enrollment.$ 1. Total federal funds available for FSEOG (fields ) $ Section C. Funds to FSEOG Recipients 11. Total funds to FSEOG recipients (fields ) $ Nonfederal share of funds to FSEOG recipients (25 percent of Field 11) $ (a) Cash outlay contributed $ Q (b) Other resources designated $ Section D. Federal Funds Spent for FSEOG Program 13. Federal share offunds to FSEOG recipients (75 percent of Field 11) $ 15_47~6_5 14. Administrative cost allowance claimed +$ 7_7_3~8 15. Federal funds spent for FSEOG (fields ) $ 16_25 3 Section E. Use of FSEOG Authorization 16. Expended FSEOG authorization (fields ) minus (fields ) $ ----'1'--"'6...,25'-"'-"' Unexpended FSEOG authorization (Field 1 Field 16) (cannot be negative) $ ~O FISAP Version: Submitted Version Page A 8

45 ED Form OMB no Expires 5/31/211 Fiscal Operations Report, Part V OPEID Number 25 State _L_A Part V. Federal Work-Study (FWS) Program for Award Year July 1,27 through June 3,28 Section A. Federal Funds Authorized for FWS 1. Final adjusted FWS authorization Section B. Federal Funds Available for FWS Expenditures 2. Federal Perkins Federal Capital Contribution funds transferred to and spent in FWS 3. FWS funds transferred to and spent in FSEOG FWS funds carried back and spent in Additional FWS funds carried back and spent for 28 summer employment funds carried forward and spent in funds carried forward to be spent in funds carried back and spent in Additional funds carried back and spent for 27 summer employment 1. Total federal funds available for FWS (fields ) $ -,-2_43~3-,-2,,- +$ "' -$----~O +$ -"'- +$.><- +$ -=-57'--"'9-=.6 - $ -=24...,3=3-"- - $ --"- -$ '-' $ 2_ '-'"'6.loL.8 Section C. Total Compensation for FWS 11. Total earned compensation for FWS Program (a) On-campus earned compensation $ (b) Off-campus earned compensation for public or private non-profit agencies, excluding amounts reported in Field 11c $ (c) Off-campus earned compensation for agencies that were unable to pay regular nonfederal share and had a federal share up to 9 percent $ (d) Off-campus earned compensation for private for-profit organizations $ 12. Total institutional share of earned compensation (see instructions) Section D. Funds Spent from Federal Share of FWS 13. Total federal share of FWS earned compensation (a) Federal share paid at a rate up to 75 percent $ (b) Federal share paid at a rate up to 1 percent for waivers of nonfederal share $ (c) Federal share paid at a rate up to 9 percent for agencies that were unable to pay regular nonfederal share (d) Federal share paid at a rate up to 5 percent for off-campus, private for-profit organizations $ 14. Administrative cost allowance claimed +$ Federal share of Job Location and Development (JLD) Program expenditures +$ 16. Total federal funds spent for FWS (fields ) $ $ $ $ $ Section E. Use offws Authorization 17. Expended FWS authorization (fields ) minus (fields ) 18. Unexpended FWS authorization (Field 1 - Field 17) $ 2_3 4_2 $ 13_2_6_ Section F. Information About the Job Location and Development (JLD) Program 19. Total expenditures for the JLD Program 2. Institutional expenditures for the JLD Program (see instructions) 21. N umber of students for whom jobs were located or developed 22. Total earnings of the students in Field 21 above FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT $ $ $ O_= Page A-9

46 Fiscal Operations Report, Part V (continued) OPEID Number 25 State _L_A ED Form OMB no Expires 5/31/211 Part V. Federal Work-Study (FWS) Program for Award Year July 1,27 through June 3,28 Section G. Information About FWS Students Employed in Community Service Activities 23. Number of students in community service employment 24. Federal share of community service earned compensation $ 2_7_8_ 25. Nonfederal share of community service earned compensation $ '_ Section H. Information About FWS Students Employed as Reading Tutors ofchildren or Employed in Family Literacy Activities 26. Number of FWS students employed as reading tutors of children or employed in family literacy activities Federal share of earned compensation for FWS students employed as reading tutors of children or employed in family literacy activities $ 5367 (a) Amount of the federal share in Field 27 spent on community service employment $ ---'5'-'.3---=--6_7 28. Total earned compensation for FWS students employed as reading tutors of children or employed in family literacy activities 27 $..:...;53,--6_7 Section I. Information About FWS Students Employed as Mathematics Tutors of Children 29. Number of FWS students employed as mathematics tutors of children 3. Federal share of earned compensation for FWS students employed as mathematics tutors of children $ 31. Total earned compensation for FWS students employed as mathematics tutors of children $ ----=-- FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-1

47 ED Form OMB no Expires 5/ Fiscal Operations Report, Part VI Name of school Nicholls State Universi!}: OPEID Number 25 State LA Part VI. Program Summary for Award Year July 1,27 through June 3, 28 Section A. Distribution of Program Recipients and Expenditures by Type of Student Taxable and Untaxed Federal Perkins Loan FSEOG FWS Unduplicated Income Category Recipients Funds Recipients Funds Recipients Funds Recipients Student Type (a) (b) (c) (d) (e) (f) (9) Undergraduate Del2endent 1. $ - $5, $6, - $11, $12, - $23, $24, - $29, $3, - $41, $42, - $59, $6, and over Undergraduate Indel2endent 8. $ - $1, $2, - $3, $4, - $7, $8, - $11, $12, - $15, $16, - $19, $2, and over Graduate/Professional does not apply does not apply TOTAL (fields 1-15) Total less-than-fu"-time students (from fields 1-15) Total "Automatic" Zero EFC students (from fields 1-15) FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-11

48 ED Form OMB no Expires 5/31/211 Fiscal Operations Report, Part VI (continued) OPEID Number 25 State -=L~A,--_ Part VI. Progranl Summary for Award Year July 1, 27 through June 3, 28 Section B. Calculating the Administrative Cost Allowance Administrative Cost Allowance Worksheet (Worksheet must be retained for audit and program reviews) Step 1. Calculate the amount spent in on which the administrative cost allowance is based. 1. Total compensation in FWS (amount from Part V, Section C, Field 11) 2. Amount of Federal Perkins Loan funds advanced to students (amount from Part III, Section B, Field 5) 3. Total funds to FSEOG recipients (amount from Part IV, Section C, Field 11) 4. Total amount spent (fields ) $ 2 14_3_6 +$ ----=-- +$ 1_54_7_6_5 $ 3_5_62 1 Step 2. Calculate the administrative cost allowance. Schools whose total amount spent was $2,75, or less 5. Enter total amount spent (Field 4) 6. Multiply 7. Total administrative cost allowance-go to Step 3 Schools whose total amount spent was more than $2.75. but less than $5.5, 8. Enter total amount spent (Field 4) 9. Subtract 1. Expenditures over $2,75, (Field 8 - Field 9) 11. Multiply 12. Administrative cost allowance on expenditures over $2,75, (Field 1 x Field 11) 13. Add administrative cost allowance on expenditures of $2,75, ($2.75 million x.5) 14. Total administrative cost allowance (Field 12 + Field 13)-go to Step 3 Schools whose total amount spent was $5.5, or more 15. Enter total amount spent (Field 4) 16. Subtract 17. Expenditures of $5,5, or more (Field 15 - Field 16) 18. Multiply 19. Administrative cost allowance on expenditures of $5,5, or more (Field 17 x Field 18) 2. Add administrative cost allowance on expenditures less than $5,5, «$2.75 million x.5) + Field 12) 21. Total administrative cost allowance (Field 19 + Field 2)-g to Step 3 $ x.5 $ 1781 $ -$ $ x.4 $ +$ $ $ -$ 5A $ x.3 $ +$ $ Step 3. Decide how much administrative cost allowance your school claimed. 22. How much administrative cost allowance did your school claim? (The amount may be the same or less than the amount calculated in Step 2.) 23. How much administrative cost allowance did your school claim in each program? (a) Federal Perkins Loan (must be the same as Part III, Section B, Field 6) (b) FSEOG (must be the same as Part IV, Section, Field 14) (c) FWS (must be the same as Part V, Section, Field 14) $..L17L..J.;8L..L1u...O $ $ --'-7--'--7=-c= 38 $ ~1O~,-,-7",,-2 FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-12

49 ED Form OMB no Expires 6/3/28 Fiscal Operations Report and Application to Participate (FISAP) Report: Award Year July 1, 26 through June 3, 27; Application: Award Year July 1, 28 through June 3, 29 Part I. Identifying Information, Certification and Warning Section A. Identifying Information 1 (a) Name and address of school Nicholls State University 96 East First Street Thibodaux LA (b) Mailing address (if different from 1 (a)) 2. OPEID Number o_o_2 5_o_ 3. Type of school (select one) ~3.1 public _ 3.2 private/non-profit _ 3.3 proprietary (Select one!f proprietary) _ (a) art _ (b) business _ (c) cosmetology _ (d) trade and technical _ (e) other 4. Length/type of longest program (select one) _ 4.1 less than 1 year _ year but less than 2 years _ years but less than 3 years _ years but less than 4 years _ years (no higher than a baccalaureate degree) ~ years or more 4.7 post-baccalaureate only 5. Additional locations Schools with separately eligible additional locations that will be funded under this application must list these locations and their addresses and OPEID Numbers on the screen. You may not file a separate application for any separately eligible school listed herein. We have entered a list of separately eligible additional locations included in this application. yes L no 6. Financial Aid Administrator Name Colette M. Lagarde address Colette.Lagarde\al,NlCHOLLS.EDU Telephone No. (985) Fax No. (985) Name and address of private financial aid consultant firm, if any Name Address Address 2 City State Zip FISAP Version: Submitted Version Page A-1

50 Section B. Certification and Warning ED Form OMB no Expires 6/3/28 Applicants must review the requirements for certification regarding lobbying included in the regulations cited below before completing this form. Applicants must sign this form to comply with the certification requirements under 34 CFR Part 82, "New Restrictions on Lobbying." This certification is a material representation of fact upon which the Department of Education relies when it makes a grant or enters into a cooperative agreement. As required by Section 1352, Title 31 of the U.S. Code, and implemented at 34 CFR Part 82, for persons entering into a Federal contract, grant or cooperative agreement over $1,, as defined at 34 CFR Part 82, Sections and 82.11, the applicant certifies that: (a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the making of any Federal grant, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal grant or cooperative agreement; (b) If any funds other than Federal appropriated funds have been paid or will be paid to any person for in1:luencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal grant or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions (Available at the following link: and (c) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subgrants and contracts under grants and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above certification. I further certify that the information contained in this electronic FISAP is in compliance with governing legislation and regulations and is true and accurate. I understand that all information associated with this FISAP is subject to audit and program review by representatives of the Secretary of Education. WARNING: Any person who knowingly provides false or misleading information on this FISAP will be subject to a fine of up to $1, or imprisonment of up to 5 years or both under provisions of Section 11, Title 18 of the U.S. Code. 8. Chief Executive Officer (includes President, Chancellor, and Director) Signature Date signed...:...9/...:...2_11.=.2.:...:...:...7 Name Steohen T. Hulbert Telephone No. (985) Title President Fax No. (985) address Stephen.Hulbert(a),NICHOLLS.EDU Mail signed form to FISAP Administrator 22 Company, LLC 311 Fairview Park Drive Suite 95 Falls Church, VA 2242 FISAP Version: Submitted Version A-2

51 Application to Participate, Part II OPEID Number 25 State --=L;..:...;A~_ Part II. Application to Participate for Award Year July 1, 28 through June 3, 29 Section A. Request for Funds for the Award Year 1. Federal Perkins Loan Level of Expenditures $ 2 ED Form OMS no Expires 6/3/28 2. Federal Perkins Loan Federal Capital Contribution $ -",- 3. FSEOG federal funds $ FWS federal funds $ 31 Section B. Federal Perkins Loan Program Liquidation Request (Applies only to certain schools; see instructions) 5. My school wishes to discontinue participation in the Federal Perkins Loan Program. yes 1L no Section C. Waiver Request for the Underuse of Funds My school has returned more than 1 percent of its Federal Perkins Loan, FSEOG, or FWS allocation for the award year. 6. My school wishes to apply for a waiver of the penalty for the underuse of funds and will provide, on the Additional Information screen, a written explanation of the circumstances. _ yes x no FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-3

52 Application to Participate, Part II (continued) OPEID Number 25 State -=L;;...::.A Part II. Application to Participate for Award Year July 1, 28 through June 3,29 Section D. Information on Enrollment ED Form OMB no Expires 6/3/28 My school's calendar is.l Traditional _ Non Traditional Schools with a non traditional calendar that had enrollment, fill in fields 9 through 2. Schools with a traditional calendar that had enrollment, Continuing Students New Starts fill in Field 7. (a) (b) Undergraduate Graduate/Professional 9. July 1, 26 (a) (b) 1. August 1 7. Total number of 11. September 1 students, October November 1 Schools with a traditional calendar that did not have December 1 enrollment, fill in Field January 1, 27 Undergraduate Graduate/Professional 16. February 1 8. Estimated number of (a) (b) 17. March 1 students, o o 18. April May 1 2. June 1, TOTAL Section E. Assessments and Expenditures Undergraduate Graduate/Professional (a) (b) 22. Total tuition and fees for the award year July 1, 26 to June 3, 27 $ $ Title IV, Part A, Subpart I, Grants (a) Total Federal Pell Grant expenditures for the award year $ (b) Total ACG expenditures for the award year $ (c) Total National SMART Grant expenditures for the award year $ Total expended for state grants and scholarships made to undergraduates for the award year July 1, 26 to June 3, 27 $..:;...5;;...;4...;;..3=-=2'-'-.4 Section F. Information on Eligible Aid Applicants Enrolled in Your School for Award Year Dependent Undergraduate Independent Undergraduate Independent Without Baccalaureate/ With Baccalaureate/ Without Baccalaureatel With Baccalaureatel Graduate! 1st Prof. Degree 1st Prof. Degree 1st Prof. Degree 1st Prof. Degree Professional (a) (b) (c) (d) (e) 25. Students with an "Automatic" Zero EFC Taxable and Untaxed Income Taxable and Untaxed Income 26. $ -$2,999 3 $ - $ $3,. $5,999 1 $1, $1, $6, $8,999 1 $2,. $2, $9, $11, $3,. $3, $12, - $14, $4, $4, $15, - $17, $5, $5, $18, $23, $6, - $7, $24, $29, $8, $9, $3, $35, $1, - $11, $36, $41, $12, - $13, $42, $47, $14, - $15, $48, $53, $16, - $17, $54, $59, $18, - $19, $6, and over $2, and over TOTAL TOTAL FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A 4

53 Fiscal Operations Report, Part III OPEID Number 25 State --=L:.:...:A,--_ Part III. Federal Perkins Loan Program for Award Year July 1,26 through June 3,27 Section A. Fiscal Report (Cumulative) as of June 3, 27 ED Form OMB no Expires 6/3/28 Field Item Amount Number of Borrowers Debit Balances Credit Balances (a) (b) (c) (d) 1.1. Cash on hand and in depository as of 6/3/27 $ Cash on hand and in depository as of 1/31/27 $ Funds receivable from federal government $ 3. Funds receivable from school $ 4. Funds advanced to students 1487 $ Loan principal collected 1466 $ Loan principal assigned to and accepted by the United States 53 $ Loan ~rinci~al canceled for the following categories: 7. teaching/military service (applies to loans made prior to 7/1/1972) 35 $ certain subject matter teaching service (math, science, foreign languages, bilingual education) $ 9. all other authorized teaching service 14 $ military service (applies to loans made 7/1/1972 and after) $ 11. volunteer service $ 12. law enforcement and corrections officer service $ child/family/early intervention service $ 14. nurse/medical technician service 2 $ death/disability 13 $ bankruptcy 9 $ surviving spouses of public service victims of 9-11 terrorist attacks $ 18. loans discharged due to closed schools $ 19. Loan principal adjustments - other 1 $ Federal Capital Contributions $ Repayments of fund capital to federal government $ Institutional Capital Contributions $ Repayments of fund capital to school $ Interest income on loans $ Other income $ Reimbursements to the Fund of the amounts canceled on loans made 7/1/1972 and after $ Administrative cost allowance $ Collection costs $ Administrative cost allowance and collection costs (control) $ 5558 Cost of loan ~rinci~al and interest canceled for the following categories: 28. teaching/military service (applies to loans made prior to 7/1/1972) $ certain subject matter teaching service (math, science, foreign languages, bilingual education) $ 3. all other authorized teaching service (applies to loans made 7/1/1972 and after) $ military service (applies to loans made 7/1/1972 and after) $ 32. volunteer service in the Peace Corps or under the Domestic Volunteer Service Act of 1973 $ Q 33. law enforcement and corrections officer service $ child/family/early intervention service $ 35. nurse/medical technician service $ death/disability $ bankruptcy $ surviving spouses of public service victims of 9-11 terrorist attacks $ g 39. Cost of loan principal and interest assigned to and accepted by the United States $ Cost of loan principal and interest canceled for loans discharged due to closed schools $ FISAP Version: Submitted Version Page A-5

54 Fiscal Operations Report, Part III (continued) ED Form OMB no Expires 6/3/28 OPEID Number 25 State ----II-LLA>---_ Part III. Federal Perkins Loan Program for Award Year July 1,26 through June 3,27 Section A. Fiscal Report (Cumulative) as of June 3, 27 Field Item Amount Number of Borrowers Debit Balances Credit Balances (a) (b) (c) (d) 41. Other costs or losses $ ----=...;1:...;...7_=_ 42. Balancing Adjustments (Debits) $ -'o.t 43. Balancing Adjustments (Credits) $ 44. Total debits and credits (Sum of fields 1.1 through 43) $ $ Section B. Fund Activity (Annual) During the Award Year (July 1, 26 through June 3, 27) Number of Borrowers (a) Amount (b) 1. Final adjusted Federal Capital Contribution (FCC) authorization $ 2. FCC transferred to: (a) FSEOG $ (b) FWS $ 3. The unexpended amount of final adjusted authorized FCC for award year that was NOT requested from GAPS by June 3, 27. This amount will be reduced from your total award amount next spring (see instructions). $ 4. Institutional Capital Contribution (ICC) deposited into the Fund between July 1, 26 and June 3, 27 $ 5. Loans advanced to students from the Fund during the award year (minus award year refunds) $ 6. Administrative cost allowance claimed for the award year (see instructions) $ 7. Total principal and interest repaid by borrowers from all sources during the award year 3 $ Total principal repaid by borrowers from all sources during the award year for loans in default for more than 2 years but not more than 5 years o $ 9. Total principal repaid by borrowers from all sources during the award year for loans in default for more than 5 years o $ FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-6

55 ED Form OMB no Expires 6/3/28 Fiscal Operations Report, Part III (continued) OPEID Number 25 State _L_A Part III. Federal Perkins Loan Program for Award Year July 1,26 through June 3,27 Section C. Cumulative Repayment Information as ofjune 3, 27 Status of Borrowers as of June Amount Number of Amount Lent Principal Amount Borrowers Outstanding (a) (b) (c) (d) 1.1. Borrowers whose loans are fully retired 1421 $ Loans that have been purchased $ 2. Borrowers whose loans were assigned to and officially accepted by the U.S. Department of Education as of June 3, 27 (Note: Field 2 equals the sum of Field 2.1 plus Field 2.2.) 53 $ 466 $ Assignments due to default or liquidation 52 $ 4485 $ Assignments due to total and permanent disability discharge $ 175 $ Total borrowers not in repayment status $ Borrowers on schedule in repayment status 2 $ In default less than 24 days (monthly installments) or less than 27 days (other installments) 2 $ 375 $ In default 24 days or more (monthly installments) or 27 days or more (other installments), up to 2 years Q $ $ 5.3. In default more than 2 years but not more than 5 years $ 15 $ In default more than 5 years $ 1 $ 841 Cohort Default Rate {Sections D and E} Schools with fewer than 3 borrowers who entered repayment in the award year should skip to Section E. Section D. Schools with 3 or More Borrowers Who Entered Repayment in the Award Year 1.1. Number of borrowers who entered repayment in o 1.2. Number of borrowers from Field 1.1 above with loans in default by June 3, 27 o 1.3. Cohort default rate «Field 1.2 1Field 1.1) x 1) o Section E. Schools with Fewer than 3 Borrowers Who Entered Repayment in the Award Year 2.1. Number of borrowers who entered repayment in: 2.2. Number of borrowers with loans in default by: (a) (7/1/23-6/3/24) 3 (a) June 3, 25 (those in 2.1 (a) only) (b) (7/1/24-6/3/25) (b) June 3, 26 (those in 2.1 (b) only) o (c) (7 1/25-6/3/26) o (c) June 3,27 (those in 2.1(c) only) o 2.3. Total number of borrowers who entered repayment during the three years above (fields 2.1(a) + 2.1{b) + 2.1(c» Total number of borrowers with loans in default during the three years above (fields 2.2(a) + 2.2(b) + 2.2(c» 2.5. Cohort default rate «Field 2.4 1Field 2.3) x 1) 25 FISAP Version: Submitted Version Page A 7

56 ED Form OMB no Expires 6/3/28 Fiscal Operations Report, Part IV OPEID Number 25 State _L_A Part IV. Federal Supplemental Educational Opportunity Grant (FSEOG) Program for Award Year July 1, 26 through June 3, 27 Section A. Federal Funds Authorized for FSEOG 1. Final adjusted FSEOG authorization $ 17 Section B. Federal Funds Available for FSEOG Expenditures 2. FWS funds transferred to and spent in FSEOG 3. Federal Perkins Federal Capital Contribution funds transferred to and spent in FSEOG FSEOG funds carried back and spent in Additional FSEOG funds carried back and spent for 27 summer enrollment funds carried forward and spent in funds carried forward to be spent in funds carried back and spent in Additional funds carried back and spent for 26 summer enrollment 1. Total federal funds available for FSEOG (fields ) +$ +$ +$ +$ +$ -$ -$ -$ $ ]1 Section C. Funds to FSEOG Recipients 11. Total funds to FSEOG recipients (fields ) 12. Nonfederal share of funds to FSEOG recipients (25 percent of Field 11) (a) Cash outlay contributed $ (b) Other resources designated $ Section D. Federal Funds Spent for FSEOG Program 13. Federal share of funds to FSEOG recipients (75 percent of Field 11) 14. Administrative cost allowance claimed 15. Federal funds spent for FSEOG (fields ) Section E. Use offseog Authorization 16. Expended FSEOG authorization (fields ) minus (fields ) 17. Unexpended FSEOG authorization (Field 1 - Field 16) (cannot be negative) $ ]6195 $ $ $ 895 $ 17 $ --=-17:...;:..::;...::...;" $ "' FISAP Version:Submirted Version Page A-8

57 Fiscal Operations Report, Part V OPEID Number 25 State _L_A ED Form OMS no Expires 6/3/28 Part V. Federal Work-Study (FWS) Program for Award Year July 1,26 through June 3,27 Section A. Federal Funds Authorized for FWS 1. Final adjusted FWS authorization Section B. Federal Funds Available for FWS Expenditures $ --'2:...:.6..:..:52:...:.6...:: Federal Perkins Federal Capital Contribution funds transferred to and spent in FWS 3. FWS funds transferred to and spent in FSEOG FWS funds carried back and spent in Additional FWS funds carried back and spent for 27 summer enrollment funds carried forward and spent in funds carried forward to be spent in funds carried back and spent in Additional funds carried back and spent for 26 summer enrollment 1. Total federal funds available for FWS (fields ) +$ ---'- -$ ----"- +$ -----"- +$ -"- +$ -...:2=8"-'-7..:::..8 - $...:::..57.:..,:.9'-"..6 -$ ----"- -$ -----"'- $ --=2=62"""3"--'4=2 Section C. Total Compensation for FWS 11. Total earned compensation for FWS Program (a) On-campus earned compensation (b) Off-campus earned compensation for public or private non-profit agencies, excluding amounts reported in Field 11c (c) Off-campus earned compensation for agencies that were unable to pay regular nonfederal share and had a federal share up to 9 percent (d) Off-campus earned compensation for private for-profit organizations 12. Total institutional share of earned compensation (see instructions) $ 2_49_8_5_ $ $ $ $ 2_49_8_5_ $ Section D. Funds Spent from Federal Share of FWS 13. Total federal share of FWS earned compensation (a) Federal share paid at a rate up to 75 percent (b) Federal share paid at a rate up to 1 percent for waivers of nonfederal share (c) Federal share paid at a rate up to 9 percent for agencies that were unable to pay regular nonfederal share (d) Federal share paid at a rate up to 5 percent for off-campus, private for-profit organizations 14. Administrative cost allowance claimed 15. Federal share of Job Location and Development (JLD) Program expenditures 16. Total federal funds spent for FWS (fields ) Section E. Use offws Authorization 17. Expended FWS authorization (fields ) minus (fields ) 18. Unexpended FWS authorization (Field 1 - Field 17) $ $ $ $ $ $ $ $ $ $ o Section F. Information About the Job Location and Development (JLD) Program 19. Total expenditures for the JLD Program 2. Institutional expenditures for the JLD Program (see instructions) 21. Number of students for whom jobs were located or developed 22. Total earnings of the students in Field 21 above FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT $ $ $ -'-- Page A-9

58 ED Form OMB no Expires 6/3/28 Fiscal Operations Report, Part V (continued) OPEID Number 25 State _L_A Part V. Federal Work-Study (FWS) Program for Award Year July 1,26 through June 3, 27 Section G. Information About FWS Students Employed in Community Service Activities 23. Number of students in community service employment Federal share of community service earned compensation $ 2_43_1_3 25. Nonfederal share of community service earned compensation $ ----'-'- Section H. Information About FWS Students Employed as Reading Tutors of Children or Employed in Family Literacy Activities 26. Number of FWS students employed as reading tutors of children or employed in family literacy activities Federal share of earned compensation for FWS students employed as reading tutors of children or employed in family literacy activities $ 3431 (a) Amount of the federal share in Field 27 spent on community service employment $ 3_4_3_1 28. Total earned compensation for FWS students employed as reading tutors of children or employed in family literacy activities $ 3_4_3_1 Section I. Information About FWS Students Employed as Mathematics Tutors of Children 29. Number of FWS students employed as mathematics tutors of children o 3. Federal share of earned compensation for FWS students employed as mathematics tutors of children $ 31. Total earned compensation for FWS students employed as mathematics tutors of children $ FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-1

59 ED Form OMB no Expires 6/3/28 Fiscal Operations Report, Part VI Name of school Nicholls State Universi!J:: OPEID Number 25 State LA Part VI. Program Summary for Award Year July 1,26 through June 3,27 Section A. Distribution of Program Recipients and Expenditures by Type of Student Taxable and Untaxed Income Category Student Type Federal Perkins Loan Recipients Funds (a) (b) FSEOG Recipients Funds (c) (d) FWS Recipients (e) Funds (f) Unduplicated Recipients (g) Undergrad uate Dependent 1. $ - $5, $6, - $11, $12, - $23, $24, - $29, $3, - $41, $42, - $59, $6, and over Q Undergraduate Inde~endent 8. $ - $1, $2, - $3, $4, - $7, $8, - $11, $12, - $15, $16, - $19, $2, and over Graduate/Professional does not apply does not apply TOTAL (fields 1-15) Totalless-than-full-time students' (from fields 1-15) Total "Automatic" Zero EFC students (from fields 1-15) FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-11

60 ED Form OMB no Expires 6/3/28 Fiscal Operations Report, Part VI (continued) OPEID Number 25 State..=L:..:...:A,--_ Part VI. Program Summary for Award Year July 1,26 through June 3,27 Section B. Calculating the Administrative Cost Allowance Administrative Cost Allowance Worksheet (Worksheet must be retained for audit and program reviews) Step 1. Calculate the amount spent in on which the administrative cost allowance is based. 1. Total compensation in FWS (amount from Part V, Section C, Field 11) 2. Amount of Federal Perkins Loan funds advanced to students (amount from Part III, Section B, Field 5) 3. Total funds to FSEOG recipients (amount from Part IV, Section C, Field 11) 4. Total amount spent (fields ) $ ---=2::...:4..::...:98=5~ +$ " +$ --=-1~61:;...:..9...::..5"- $ 4.:...::.1..::...;17~5~5 Step 2. Calculate the administrative cost allowance. Schools whose total amount spent was $2.75, or less 5. Enter total amount spent (Field 4) 6. Multiply 7. Total administrative cost allowance-go to Step 3 Schools whose total amount spent was more than $2.75. but less than $ Enter total amount spent (Field 4) 9. Subtract 1. Expenditures over $2,75, (Field 8 Field 9) 11. Multiply 12. Administrative cost allowance on expenditures over $2,75, (Field 1 x Field 11) 13. Add administrative cost allowance on expenditures of $2,75, ($2.75 million x.5) 14. Total administrative cost allowance (Field 12 + Field 13)-go to Step 3 Schools whose total amount spent was $5,5. or more 15. Enter total amount spent (Field 4) 16. Subtract 17. Expenditures of $5,5, or more (Field 15 Field 16) 18. Multiply 19. Administrative cost allowance on expenditures of $5,5, or more (Field 17 x Field 18) 2. Add administrative cost allowance on expenditures less than $5,5, «$2.75 million x.5) + Field 12) 21. Total administrative cost allowance (Field 19 + Field 2)-go to Step 3 $ x.5 $ 2588 $.$ $ x.4 $ +$ $ $ -$ $ x.3 $ +$ $ Step 3. Decide how much administrative cost allowance your school claimed. 22. How much administrative cost allowance did your school claim? (The amount may be the same or less than the amount calculated in Step 2.) 23. How much administrative cost allowance did your school claim in each program? (a) Federal Perkins Loan (must be the same as Part III, Section B, Field 6) (b) FSEOG (must be the same as Part IV, Section, Field 14) (c) FWS (must be the same as Part V, Section, Field 14) $ ---'2==5""'-87~ $ $ 8 95_ $ 12_4_92_ FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-12

61 ED Form OMB no Expires 6/3/27 Fiscal Operations Report and Application to Participate (FISAP) Report: Award Year July 1,25 through June 3, 26; Application: Award Year July 1,27 through June 3, 28 Part I. Identifying Information, Certi'fications and Warning Debarment Form and Signature Page Section A. Identifying Information 1a. Name and address of school 1b. Mailing address (if different from 1 a) Nicholls State University 96 East First Street Thibodaux LA OPEID Number 2_o_o5_o_o 3. Type of school (select one) 4. Length/type of longest program (select one) ~3.1 public _ 4.1 less than 1year _ 3.2 private/non-profit _ 4.2 1year but less than 2 years _ 3.3 proprietary _ years but less than 3 years _ years but less than 4 years (Select one if proprietary) _ years (no higher than a baccalaureate degree) ~ years or more _ a) art _ 4.7 postbaccalaureate only _ b) business _ c) cosmetology _ d) trade and technical _ e) other 5. Additional locations Schools with separately eligible additional locations that will be funded under this application must list these locations and their addresses and OPEID Numbers on the screen. You may not file a separate application for any separately eligible school listed herein. We have entered a list of separately eligible additional locations included in this application. _ yes x no 6. Financial Aid Administrator Name Colette M. Lagarde Telephone No. (985) address Coiette.Lagarde(a),NICHOLLS.EDU Fax No. (985) Name and address of private financial aid consultant firm, if any Name Address 1 Address 2 City State Zip Section B. Certifications and Warning Certifications Regarding Lobbying; Debarment, Suspension, and Other Responsibility Matters; and Drug-Free Workplace Requirements Applicants should review the regulations and the instructions for certification included in the regulations before completing this form. Signature of this form provides for compliance with certification requirements under 34 CFR Part 82, "New Restrictions on Lobbying," and 34 CFR Part 85, "Government-wide Debarment and Suspension (Non procurement) and Government-wide Requirements for Drug Free Workplace (Grants)." The certifications shall be treated as a material representation of fact upon which reliance will be placed when the Department of Education determines to award the covered transaction, grant, or cooperative agreement. FISAP Version: Submitted Version Page A-1

62 ED Form OMB no Expires 6/3/27 Debarment Form and Signature Page OPEID Number 25 State --- LA 1. Lobbying As required by Section 1352, Title 31 of the U.S. Code, and implemented at 34 CFR Part 82, for persons entering into a grant or cooperative agreement over $1,, as defined at 34 CFR Part 82, Sections and 82.11, the applicant certifies that: a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the making of any Federal grant, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal grant or cooperative agreement; b) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal grant or cooperative agreement, the undersigned shall complete and submit Standard Form - LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions; c) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subgrants, contracts under grants and cooperative agreements, and subcontracts) and that all subrecipients shall certify and disclose accordingly. 2. Debarment, Suspension, and Other Responsibility Matters As required by Executive Order 12549, Debarment and Suspension, and implemented at 34 CFR Part 85, for prospective participants in primary covered transactions, as defined at 34 CFR Part 85, Sections and A. The applicant certifies that it and its principals: a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; b) Have not within a three-year period preceding this application been convicted of, or had a civil judgement rendered against them for, commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; c) Are not presently indicted for, or otherwise criminally or civilly charged by, a governmental entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (2)(b) of this certification; and d) Have not within a three-year period preceding this application had one or more public transactions (Federal, State, or local) terminated for cause or default; and B. Where the applicant is unable to certify to any of the statements in this certification, he or she shall attach an explanation to this application. 3. Drug-Free Workplace (Grantees Other Than Individuals) As required by the Drug-Free Workplace Act of 1988, and implemented at 34 CFR Part 85, Subpart F, for grantees, as defined at 34 CFR Part 85, Sections and A. The applicant certifies that it will, or will continue to, provide a drug-free workplace by: a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the grantee's workplace and specifying the actions that will be taken against employees for violation of such prohibition; b) Establishing an on-going drug-free awareness program to inform employees about: 1) The dangers of drug abuse in the workplace; 2) The grantee's policy of maintaining a drug-free workplace; 3) Any available drug counseling, rehabilitation, and employee assistance programs; and 4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; c) Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement required by paragraph (a); d) Notifying the employee in the statement required by paragraph (a) that, as a condition of employment under the grant, the employee will: 1) Abide by the terms of the statement; and 2) Notify the employer in writing of the employee's conviction for a violation of a criminal drug statute occurring in the workplace no later than five calendar days after such conviction; FISAP Version: Submitted Version Page A-2

63 Debarment Form and Signature Page ED Form OMB no Expires 6/3/27 Name ofschool Nicholls State University OPEID Number 25 State _L_A e) Notifying the agency, in writing, within 1 calendar days after receiving notice under subparagraph (d)(2) from an employee or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide such a notice, including position title, to: Director, Grants Policy and Oversight Staff, U.S. Department of Education 4 Maryland Avenue, S.W. (Room 765, Potomac Center Plaza) Washington, DC The notice shall include the identification number(s) of each affected grant; f) Taking one of the following actions, within 3 calendar days of receiving notice under subparagraph (d)(2), with respect to any employee who is so convicted: 1) Taking appropriate personnel action against such an employee, up to and including termination, consistent with the requirements of the Rehabilitation Act of 1973, as amended; or 2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; g) Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (a), (b), (c), (d), (e), and (f). B. The applicant may insert in the space provided below the site(s) for the performance of work done in connection with the specific grant: Place of Performance (Street address. city, county, state, zip code) Check [ ] if there are workplaces on file that are not identified here. 4. Drug-Free Workplace (Grantees Who Are Individuals) As required by the Drug-Free Workplace Act of 1988, and implemented at 34 CFR Part 85, Subpart F, for grantees, as defined at 34 CFR Part 85, Sections and A. As a condition of the grant, I certify that I will not engage in the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance in conducting any activity with the grant; and B. If convicted of a criminal drug offense resulting from a violation occurring during the conduct of any grant activity, I will report the conviction, in writing, within 1 calendar days of the conviction, to: Director, Grants Policy and Oversight Staff, Department of Education, 4 Maryland Avenue, S.W. (Room 765, Potomac Center Plaza), Washington, DC Notice shall include the identification number(s) of each affected grant. I CERTIFY THAT MY SCHOOL WILL COMPLY WITH THE ABOVE CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS; AND DRUG-FREE WORKPLACE REQUIREMENTS. I FURTHER CERTIFY THAT THE INFORMATION CONTAINED IN THIS ELECTRONIC FISAP IS IN COMPLIANCE WITH GOVERNING LEGISLATION AND REGULATIONS AND IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT ALL INFORMATION ASSOCIATED WITH THIS FISAP IS SUBJECT TO AUDIT AND PROGRAM REVIEW BY REPRESENTATIVES OF THE SECRETARY OF EDUCATION. WARNING: ANY PERSON WHO KNOWINGLY PROVIDES FALSE OR MISLEADING INFORMATION ON THIS FISAP WILL BE SUBJECT TO A FINE OF UP TO $1, OR IMPRISONMENT OF UP TO 5 YEARS OR BOTH UNDER PROVISIONS OF THE UNITED STATES CRIMINAL CODE TITLE 18 SECTION Chief Executive Officer (President, Chancellor, CEO, Director) Signature...,..---:=-:::-=--:-:-- N arne Stephen T. Hulbert Title President addressstephen.hulbert(a).nicholls.edu Date signed _9_12_5_12 6 Telephone No. (985) Fax No. (985) Mail form to FISAP Administrator 1951 Kidwell Drive, Eighth Floor Vienna, Virginia FISAP Version: Submitted Version Page A-3

64 Application to Participate, Part II Name ofschool Nicholls State University OPEID Number 25 State _L_A ED Form OMB no Expires 6/3/27 Part II. Application to Participate for Award Year July 1, 27 through June 3, 28 Section A. Request for Funds for the Award Year 1. Federal Perkins Loan Level of Expenditures $ 2 2. Federal Perkins Loan Federal Capital Contribution $ 3. FSEOG federal funds $ FWS federal funds $ 31 Section B. Federal Perkins Loan Program Liquidation Request (Applies only to certain schools; see instructions) 5. My school wishes to discontinue participation in the Federal Perkins Loan Program. yes x no Section C. Waiver Request for the Underuse offunds My school has returned more than 1 percent of its Federal Perkins Loan, FSEOG, or FWS allocation for the award year. 6. My school wishes to apply for a waiver of the penalty for the underuse of funds and will provide, on the additional information screen, a written explanation of the circumstances. _ yes x no FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-4

65 Application to Participate, Part II (continued) OPEID Number 25 State _L_A Part II. Application to Participate for Award Year July 1,27 through June 3,28 Section D. Information on Enrollment 23. Total Federal Pell Grant expenditures for the award year $ 6_9_16_1_22_ 24. Total expended for state grants and scholarships made to undergraduates for the award year July 1, 25 to June 3, 26 $ ED Form OMB no Expires 6/3/27 My school has a traditional calendar. ~ yes no Schools with a non-traditional calendar that had enrollment, fill in fields 9 through 2. Schools with a traditional calendar that had enrollment, Continuing Students New Starts fill in Field 7. (a) (b) Undergraduate Graduate/Professional 9. July 1, 25 (a) (b) 1. August 1 7. Total number of 11. September 1 students, October November 1 Schools with a traditional calendar that did not have enrollment, 14. December 1 fill in Field January 1, 26 Undergraduate Graduate/Professional 16. February 1 8. Estimated number of (a) (b) 17. March 1 students, o o 18. April 1 Section E. Assessments and Expenditures 19. May 1 2. June 1, TOTAL Undergraduate (a) Graduate/Professional (b) 22. Total tuition and fees for the award year July 1, 25 to June 3, 26 $ $ 2 64_7_83_ Section F. Information on Eligible Aid Applicants Enrolled in Your School for Award Year Dependent Undergraduate Independent Undergraduate Independent Graduatel Without Baccalaureatel With Baccalaureatel Without Baccalaureatel With Baccalaureatel Professional 1st Prof. Degree 1st Prof. Degree 1st Prof. Degree 1st Prof. Degree (a) (b) (c) (d) (e) 25. Students with an "Automatic" Zero EFC Taxable and Untaxed Income Taxable and Untaxed Income 26. $ - $2, o $ - $ $3, - $5,999 5 o $1, - $1, $6, - $8, o $2, - $2, $9, - $11, $3, - $3, $12, - $14, $4, - $4, $15, - $17, $5, - $5, $18, - $23, o $6, - $7, $24, - $29, o $8, - $9, $3, - $35, o $1,-$11, $36, - $41, $12, - $13, $42, - $47, o $14, - $15, $48, - $53, $16, - $17, $54, - $59, $18, - $19, $6, and over $2, and over TOTAL TOTAL FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-5

66 Fiscal Operations Report, Part III OPEID Number 25 State LA Part III. Federal Perkins Loan Program for Award Year July 1,25 through June 3,26 ED Form OMB no Expires 6/3/27 Section A. Fiscal Report (Cumulative) as ofjune 3, 26 Field Item Amount Number of Borrowers Debit Balances Credit Balances (a) (b) (c) (d) 1.1. Cash on hand and in depository as of 6/3/26 $ Cash on hand and in depository as of 1/31/26 $ Funds receivable from federal government $ 3. Funds receivable from school $ 4. Funds advanced to students 1487 $ Loan,principal collected 1466 $ Loan principal assigned to and accepted by the United States 52 $ Loan I2rincil2al canceled: 7. -for teaching/military service (applies to loans made prior to 7/1/1972) 35 $ for certain subject matter teaching service (math, SCience, foreign languages, bilingual education) $ 9. -for all other authorized teaching service 14 $ for military service (applies to loans made 7/1/1972 and after) $ 11. -for volunteer service $ 12. -for law enforcement and corrections officer service $ 13. -for child/family/early intervention service $ 14. -for nurse/medical technician service 4 $ for death/disability 13 $ for bankruptcy 8 $ for loans discharged due to closed schools $ 18. Loan principal adjustments - other 1 $ Federal Capital Contributions $ Repayments of fund capital to federal government $ Institutional Capital Contributions $ Repayments of fund capital to school $ Interest income on loans $ Other income $ Reimbursements to the Fund of the amounts canceled on loans made 7/1/1972 and after $ 9356 allowance Administrative cost $ Collection costs $ Administrative cost allowance and collection costs (control) $ 5528 Cost of loan I2rincil2al and interest canceled: 27. -for teaching/military service (applies to loans made prior to 7/1/1972) $ for certain subject matter teaching service (math, science, foreign languages, bilingual education) $ 29. -for all other authorized teaching service (applies to loans made 7/1/1972 and after) $ for military service (applies to loans made 7/1/1972 and after) $ 31. -for volunteer service in the Peace Corps or under the Domestic Volunteer Service Act of 1973 $ 32. -for law enforcement and corrections officer service $ 33. -for child/family/early intervention service $ 34. -for nurse/medical technician service $ because of death/disability $ because of bankruptcy $ Cost of loan principal and interest assigned to and accepted by the United States $ Cost of loan principal and interest canceled for loans discharged due to closed schools $ 39. Other costs or losses $ Total debits and credits (sum of fields 1.1 through 39) $ $ FISAP Version: Submitted Version Page A-6

67 Fiscal Operations Report, Part III (continued) OPEID Number 25 State _L_A Part III. Federal Perkins Loan Program for Award Year July 1, 25 through June 3, 26 ED Form OMB no Expires Section B. Fund Activity (Annual) During the Award Year (July 1, 25 through June 3, 26) Number of Borrowers (a) Amount (b) 1. Final adjusted Federal Capital Contribution (FCC) authorization 2. FCC transferred to: a. FSEOG b.fws 3. The unexpended amount of final adjusted authorized FCC for award year that was NOT requested from GAPS by June 3, 26. This amount will be reduced from your total award amount next spring (see instructions). 4. Institutional Capital Contribution (ICC) deposited into the Fund between July 1, 25 and June 3, Loans advanced to students from the Fund during the award year (minus award year refunds) 6. Administrative cost allowance claimed for the award year (see instructions) 7. Total principal and interest repaid by borrowers from all sources during the award year 8. Total principal repaid by borrowers from all sources during the award year for loans in default for more than 2 years but not more than 5 years 9. Total principal repaid by borrowers from all sources during the award year for loans in default for more than 5 years $ $ $ $ $ $ 1 $ 5 3 $ 332 o $ o $ FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-7

68 Fiscal Operations Report, Part III (continued) OPEID Number 25 State _L_A Part III. Federal Perkins Loan Program for Award Year July 1, 25 through June 3, 26 Section C. Cumulative Repayment Information as ofjune 3, 26 Status of borrowers as of June 3, 26 Amount Number of Amount Lent Borrowers (a) (b) (c) 1.1. Borrowers whose loans are fully retired 1.2. Loans that have been purchased $ 2. Borrowers whose loans were assigned to and officially accepted by the U.S. Department of Education as of June 3, 26 (Note: Field 2 equals the sum of Field 2.1 plus Field 2.2) 2.1. Assignments due to default or liquidation 2.2. Assignments due to total and permanent disability discharge 3. Total borrowers not in repayment status 4. Borrowers on schedule in repayment status 5.1. In default less than 24 days (monthly installments) or less than 27 days (other installments) 5.2. In default 24 days or more (monthly installments) or 27 days or more (other installments), up to 2 years 5.3. In default more than 2 years but not more than 5 years 5.4. In default more than 5 years 1418 $ $ $ $ $ 275 $ $ $ ED Form OMB no Expires 6/3/27 Principal Amount Outstanding (d) $ $ $ $ $ 114 $ 169 $ $ 259 $ 298 Cohort Default Rate (Sections D and E) My school had less than 3 borrowers who entered repayment in the award year. x yes no Section D. Schools with 3 or More Borrowers Who Entered Repayment in the Award Year 1.1. Number of borrowers who entered repayment in Number of borrowers from Field 1.1 above with loans in default by June 3, Cohort default rate «Field 1.2 I Field 1.1) x 1) Section E. Schools with Fewer than 3 Borrowers Who Entered Repayment in the Award Year 2.1. Number of borrowers who entered repayment in: (a) (7/1/22-6/3/23) (b) (7/1/23-6/3/24) Number of borrowers with loans in default by: (a) June 3, 24 (those in 2.1(a) only) (b) June 3,25 (those in 2.1(b) only) (c) (7-1/24-6/3/25) (c) June 3,26 (those in 2.1(c) only) o o o o o 2.3. Total number of borrowers who entered repayment during the three years above (fields 2.1 (a) (b) (c» Total number of borrowers with loans in default during the three years above (fields 2.2(a) + 2.2(b) + 2.2(c» 2.5. Cohort default rate «Field 2.4/ Field 2.3) x 1) 2. FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-8

69 Fiscal Operations Report, Part IV ED Form OMB no Expires 6/3/27 OPEID Number 25 State --- LA Part IV. Federal Supplemental Educational Opportunity Grant (FSEOG) Program for Award Year July 1, 25 through June 3, 26 Section A. Federal Funds Authorizedfor FSEOG 1. Final adjusted FSEOG authorization $ Section B. Federal Funds Available for FSEOG Expenditures 2. FWS funds transferred to and spent in FSEOG +$ 3. Federal Perkins Federal Capital Contribution funds transferred to and spent in FSEOG +$ FSEOG funds carried back and spent in $ 5. Additional FSEOG funds carried back and spent for 26 summer enrollment +$ funds carried forward and spent in $ funds carried forward to be spent in $ funds carried back and spent in $ 9. Additional funds carried back and spent for 25 summer enrollment -$ 1. Total federal funds available for FSEOG (fields ) $ Section C. Funds to FSEOG Recipients 11. Total funds to FSEOG recipients (fields ) $ 1_5_73_7_ 12. Non-federal share of funds to FSEOG recipients (25 percent of Field 11) $ a. Cash outlay contributed $ b. Other resources designated $ Section D. Federal Funds Spent for FSEOG Program 13. Federal share of funds to FSEOG recipients (75 percent of Field 11) $ 15_73_7_ 14. Administrative cost allowance claimed +$ 7_8_6_9 15. Federal funds spent for FSEOG (fields ) $ 1_6_52_3_9 Section E. Use offseog Authorization 16. Expended FSEOG authorization «fields ) minus (fields » $ 1_65_2_39_ 17. Unexpended FSEOG authorization (Field 1 - Field 16) (cannot be negative) $_--- FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-9

70 Fiscal Operations Report, Part V OPEID Number 25 State LA --- Part V. Federal Work-Study (FWS) Program for Award Year July 1, 25 through June 3, 26 ED Form OMB no Expires 6/3/27 SectionA. Federal Funds AuthorizedJor FWS 1. Final adjusted FWS authorization $ Section B. Federal Funds Available Jor FWS Expenditures 2. Federal Perkins Federal Capital Contribution funds transferred to and spent in FWS +$ 3. FWS funds transferred to and spent in FSEOG -$ FWS funds carried back and spent in $ 5. Additional FWS funds carried back and spent for 26 summer enrollment +$ funds carried forward and spent in $ funds carried forward to be spent in $ funds carried back and spent in $ 9. Additional funds carried back and spent for 25 summer enrollment -$ 1. Total federal funds available for FWS (fields ) $ Section C. Total Compensation Jor FWS 11. Total earned compensation for FWS Program $ a. On-campus earned compensation $ 2_37_6_39_ b. Off-campus earned compensation for public or private non-profit agencies, excluding amounts reported in Field 11 c c. Off-campus earned compensation for agencies that were unable to pay regular non-federal share and had a federal share up to 9 percent $ $ d. Off-campus earned compensation for private for-profit organizations $ 12. Total school share of earned compensation (see instructions) $ Section D. Funds Spent from Federal Share ojfws 13. Total federal share of FWS earned compensation $ a. Federal share paid at a rate up to 75 percent $ b. Federal share paid at a rate up to 1 percent for waivers of non-federal share $ c. Federal share paid at a rate up to 9 percent for agencies that were unable to pay regular non-federal share $ d. Federal share paid at a rate up to 5 percent for off-campus, private for-profit organizations $ Administrative cost allowance claimed +$ Federal share of Job Location and Development (..ILD) Program expenditures +$ o 16. Total federal funds spent for FWS (fields ) $ Section E. Use ojfws Authorization 17. Expended FWS authorization «fields ) minus (fields » $ 2_4_25_1_2 18. Unexpended FWS authorization (Field 1 - Field 17) $ --=-2 Section F. Information About the Job Location and Development (JLD) Program 19. Total expenditures for the JLD Program $ 2. School expenditures for the JLD Program (see instructions) $ 21. Number of students for whom jobs were located or developed o 22. Total earnings of the students in Field 21 above $ FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-1

71 Fiscal Operations Report, Part V (continued) Name ofschool Nicholls State University OPEID Number 25 State --- LA Part V. Federal Work-Study (FWS) Program for Award Year July 1,25 through June 3,26 Section G. Information About FWS Students Employed in Community Service Activities 23. Number of students in community service employment Federal share of community service earned compensation $ 2_46_9_3 25. Non-federal share of community service earned compensation $ ----'- Section H Information About FWS Students Employed as Reading Tutors ofchildren or Employed in Family Literacy Activities 26. Number of FWS students employed as reading tutors of children or employed in family literacy activities Federal share of earned compensation for FWS students employed as reading tutors of children or employed in family literacy activities a. Amount of the federal share in Field 27 spent on community service employment $ 1_5_2 $ 1_5_2 28. Total earned compensation for FWS students employed as reading tutors of children or employed in family literacy activities $ 1_5_2 Section 1. Information About FWS Students Employed as Mathematics Tutors ofchildren 29. Number of FWS students employed as mathematics tutors of children o 3. Federal share of earned compensation for FWS students employed as mathematics tutors of children $ 31. Total earned compensation for FWS students employed as mathematics tutors of children $ ED Form OMB no Expires 6/3/27 FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-11

72 ED Form OMB no Expires 6/3/27 Fiscal Operations Report, Part VI OPEID Number 25 State LA Part VI. Program Summary for Award Year July 1,25 through June 3,26 Section A. Distribution ofprogram Recipients and Expenditures by Type ofstudent Taxable and Untaxed Income Category Student Type Federal Perkins Loan Recipients Funds (a) (b) FSEOG Recipients Funds (c) (d) FWS Recipients (e) Funds (f) Unduplicated Recipients (g) U ndergrad uate Dependent 1. $ - $ 5, $6, - $11, $12, - $23, $24, - $29, $3, - $41, $42, - $59, $6, and over Undergraduate Independent 8. $ - $ 1, $2, - $ 3, $4, - $ 7, $8, - $11, $12, - $15, $16, - $19, $2, and over Graduate/Professional does not apply does not apply Total Total less-than-full-time students Total "Automatic" Zero EFC students FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-12

73 ED Form OMB no Expires 6/3/27 Fiscal Operations Report, Part VI (continued) OPEID Number 25 State _L_A Part VI. Program Summary for Award Year July 1, 25 through June 3, 26 Section B. Calculating the Administrative Cost Allowance Administrative Cost Allowance Worksheet (Worksheet must be retained for audit and program reviews) Step 1. Calculate the amount spent in on which the administrative cost allowance is based 1. Total compensation in FWS (amount from Part V, Section C, Field 11) 2. Amount of Federal Perkins Loan funds advanced to students (amount from Part III, Section B, Field 5) 3. Total funds to FSEOG recipients (amount from Part IV, Section C, Field 11) 4. Total amount spent (fields ) $ 2_3_76_3_9 +$ 1 +$ 1_57_3_7_ $ 3_9_6 9 Step 2. Calculate the administrative cost allowance Schools whose total amount spent was $2,75, or less 5. Enter total amount spent (Field 4) 6. Multiply 7. Total administrative cost allowance-go to Step 3 Schools whose total amount spent was more than $2,75, but less than $5,5, 8. Enter total amount spent (Field 4) 9. Subtract 1. Expenditures over $2,75, (Field 8 - Field 9) 11. Multiply 12. Administrative cost allowance on expenditures over $2,75, (Field 1 x Field 11) 13. Add administrative cost allowance on expenditures of $2,75, ($2.75 million x.5) 14. Total administrative cost allowance (Field 12 + Field 13)-go to Step 3 Schools whose total amount spent was $5,5, or more 15. Enter total amount spent (Field 4) 16. Subtract 17. Expenditures over $5,5, (Field 15 - Field 16) 18. Multiply 19. Administrative cost allowance on expenditures over $5,5, (Field 17 x Field 18) 2. Add administrative cost allowance on expenditures of $5,5, ([$2.75 million x.5] + Field 12) 21. Total administrative cost allowance (Field 19 + Field 2)-go to Step 3 $ 3969 x.5 $ 198 $ -$ $ x.4 $ +$ $ $ -$ $ x.3 $ +$ $ Step 3. Decide how much administrative cost allowance your school claimed 22. How much administrative cost did your school claim? (The amount may be the same or less than the amount calculated in Step 2.) 23. How much administrative cost did your school claim in each program? a. Federal Perkins Loan (must be the same as Part III, Section B, Field 6) b. FSEOG (must be the same as Part IV, Section D, Field 14) c. FWS (must be the same as Part V, Section D, Field 14) $ 1_98 $...:.5-=- $ -'-'78:...:..6'-9 $ 1_18_8_1 FISAP Version: Submitted Version DO NOT SEND THESE PAGES TO THE DEPARTMENT Page A-13

74 ED Form OMB no Expires Fiscal Operations Report and Application to Participate (FISAP) Report: Award Year July 1,24 - June 3, 25; Application: Award Year July 1,26 - June 3, 27 Part I. Identifying Information, Certifications and Warning Debarment Form and Signature Page Section A. Identifying Information 1a. Name and address of school 1b. Mailing address (if different from 1a) Nicholls State University 96 East First Street Thibodaux LA OPEID Number Type of school (select one) 4. Length/type of longest program (select one) ~ 3.1 public _ 4.1 less than 1 year _ 3.2 private/non-profit _ 4.2 1year but less than 2 years _ 3.3 proprietary _ years but less than 3 years _ years but less than 4 years (Select one if proprietary) _ years (no higher than a baccalaureate degree) ~ years or more _ a) art _ 4.7 postbaccalaureate only _ b) business _ c) cosmetology _ d) trade and technical _ e) other 5. Additional locations Schools with separately eligible additional locations that will be funded under this application must list these locations and their addresses and OPElD Numbers on the screen. You may not file a separate application for any separately eligible school listed herein. We have entered a list of separately eligible additional locations included in this application. yes x no 6. Financial Aid Administrator Name Colette M. Lagarde Telephone No. (985) address Colette.Lagarde~NICHOLLS.EDU Fax No. (985) Name and address of private financial aid consultant firm, if any Name Address Address 2 City State Zip Section B. Certifications and Warning Certifications Regarding Lobbying; Debarment, SuspenSion, and Other Responsibility Matters; and Drug-Free Workplace Requirements Applicants should review the regulations and the instructions for certification included in the regulations before completing this form. Signature of this form provides for compliance with certification requirements under 34 CFR Part 82, "New Restrictions on Lobbying," and 34 CFR Part 85, "Government-wide Debarment and Suspension (Nonprocurement) and Government-wide Requirements for Drug Free Workplace (Grants)." The certifications shall be treated as a material representation of fact upon which reliance will be placed when the Department of Education determines to award the covered transaction, grant, or cooperative agreement. FISAP Version: Submitted Version Page A-1

75 ED Form OMS no Expires 7/31/26 Debarment Form and Signature Page OPEID Number 25 State _L_A 1. Lobbying As required by Section 1352, Title 31 of the U.S. Code, and implemented at 34 CFR Part 82, for persons entering into a grant or cooperative agreement over $1,, as defined at 34 CFR Part 82, Sections and 82.11, the applicant certifies that: a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the making of any Federal grant, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal grant or cooperative agreement; b) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal grant or cooperative agreement, the undersigned shall complete and submit Standard Form - LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions; c) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subgrants, contracts under grants and cooperative agreements, and subcontracts) and that all subrecipients shall certify and disclose accordingly. 2. Debarment, Suspension, and Other Responsibility Matters As required by Executive Order 12549, Debarment and Suspension, and implemented at 34 CFR Part 85, for prospective participants in primary covered transactions, as defined at 34 CFR Part 85, Sections and A. The applicant certifies that it and its principals: a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; b) Have not within a three-year period preceding this application been convicted of or had a civil judgement rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; c) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (2)(b) of this certification; and d) Have not within a three-year period preceding this application had one or more public transactions (Federal, State, or local) terminated for cause or default; and B. Where the applicant is unable to certify to any of the statements in this certification, he or she shall attach an explanation to this application. 3. Drug-Free Workplace (Grantees Other Than Individuals) As required by the Drug-Free Workplace Act of 1988, and implemented at 34 CFR Part 85, Subpart F, for grantees, as defined at 34 CFR Part 85, Sections and A. The applicant certifies that it will, or will continue to, provide a drug-free workplace by: a) Publishing, a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the grantee's workplace and specifying the actions that will be taken against employees for violation of such prohibition; b) Establishing an on-going drug-free awareness program to inform employees about: 1) The dangers of drug abuse in the workplace; 2) The grantee's policy of maintaining a drug-free workplace; 3) Any available drug counseling, rehabilitation, and employee assistance programs; and 4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; c) Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement required by paragraph (a); d) Notifying the employee in the statement required by paragraph (a) that, as a condition of employment under the grant, the employee will: 1) Abide by the terms of the statement; and 2) Notify the employer in writing of his or her conviction for a violation of a criminal drug statute occurring in the workplace no later than five calendar days after such conviction; FISAP Version: Submitted Version Page A-2