Application for Texas Classroom Connectivity Special Construction State Match

Application for Texas Classroom Connectivity Special Construction State Match (CCI.A)
County District Number*
CDN
NCES Number:*
School District or Consortium*
is hereby applying to the Texas Education Agency for Texas Classroom Connectivity Special Construction State Match funds to be used for E-rate Category 1 eligible special construction project(s) for the 2018 E-rate funding year (FY18).

Information pertaining the applicant’s E-rate Form 471 request is below:
FY 18 Form 471 Application Number:*
FY 18 Special Construction FRN*
Enter Funding Request Numbers separated by commas
Applicant E-rate discount percentage:*
Enter percentage using two decimal places. Example .50
Total eligible special construction project amount: *
Example: $9,999,999.99
Total State Matching fund request:*
Example: $9,999.99
If USAC seeks a commitment adjustment, or COMAD, from the applicant for special construction charges because of violations of rules and regulations of the E-rate program, the Commissioner, or his or her designee, at his or her sole discretion, may seek to recover any state funds granted to Texas applicants for special construction charges.

The district/consortium understands that any awarded funds will be expended only for the stated purpose and that any undiscounted portions of the work shall be at the sole cost of the district.
Superintendent's Name:*

First NameLast Name
Superintendent's Email (Enter and Confirm email address)*

Confirmation Emailexample@example.com
Certification:*
Date*

MonthDayYear
Date
Contact Name*

First NameLast Name
Contact Email (Enter and Confrim email address)*

Confirmation Emailexample@example.com
E-rate Consultant Name:

First NameLast Name
E-rate Consultant Email: (Enter and Confrm email address)

Confirmation Emailexample@example.com
Should be Empty:

Application for Texas Classroom Connectivity Special Construction State Match (CCI.A)