Ds-576 Request for Assistance

REQUEST FOR ASSISTANCE
INSTRUCTIONS
Submit original and one copy by November 1.

IV.

Sections I through IV of this form should normally be
prepared by the chief administrative official of the school in
consultation with the school board. Section V should be
prepared by the Foreign Service Post. In order to provide
proper information on page 3 of this form, please note that
funds being requested in November of any given year are
from current U.S. Government Fiscal Year funds. If granted,
the funds would be spent by the school during the next
school year.
I.

BACKGROUND AND OBJECTIVES: This section
should provide:
(1) A summary statement describing the extent to
which the school now meets the dual objectives
of the overseas schools program as stated in 2
FAM 611.2 of (a) providing educational facilities
for U.S. Government dependents overseas, and
(b) demonstrating U.S. education abroad and
otherwise increasing mutual understanding.
(2)

II.

The discussion should conclude with a brief
statement of the nature and purpose of the balance
of school reserve funds, excluding undrawn U.S.
grants. It is understood that sound administrative
practice requires independent schools to establish
reserve funds adequate to maintain orderly
operations and to meet unforeseen contingencies.

A brief general statement of the school's
long-range objectives and development plans and
the measures being taken to realize the plans,
including efforts to obtain material support from
sources other than the U.S. Government.

ENROLLMENT/STAFF/TUITION PROJECTION DATA:
The purpose of this section is to secure quantitative
projections of key educational data for the next school
year. The data should reflect the development and
improvements which are feasible and necessary for the
school to undertake in that school year. The projected
budget, Form DS574, should contain fiscal information
consistent with the information provided in this section.

III. TYPES AND ESTIMATED COST OF NEW
ASSISTANCE REQUESTED: This section should be
used to summarize the types and estimated costs in
dollars of new assistance requested by the school
according to the categories shown, including the dollar
equivalent of such costs which can be expended in
local currency. Note also that when grant funds have
been made available in category 5, a form JF-45,
Special Educational Projects, must be submitted to the
Department, A/OS for approval.

DISCUSSION AND JUSTIFICATION: Describe the
essential details (number, quantities, types, duration,
etc.) of the project to be financed under each of the
categories of assistance listed in Section III and state
how each item of requested assistance fits into the
school's development plans and advances the
objectives of the overseas schools program. This
discussion should be organized in the sequence of
the categories shown in Section III. Following the
discussion of each item of requested assistance,
designate the rating it should be accorded in terms of
the school's development program by designating it
"Priority 1, 2, etc." Brief reference should be made to
any previous grants made for the same purpose and
to future grants which may be requested for the
same purpose.

The chief administrative official of the school and the
chairman of the school's governing board should
sign the request at the places indicated.
V.

POST RECOMMENDATION: Pursuant to 2 FAM
613 and 622, the principal officer responsible for
coordinating school activities at the Foreign Service
Post should ensure that the request for assistance is
carefully reviewed in light of the policies and criteria
for granting assistance set forth in 2 FAM 600 and is
justifiable in terms of these policies and criteria. The
appropriate officer should prepare and sign the
recommendation at the place indicated. No request
for assistance will be considered unless Section V is
properly completed.
Completion of this form is voluntary.

*Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time required for
searching existing data sources, gathering the necessary data, providing the information required, and reviewing the final collection. Send
comments on the accuracy of this estimate of the burden and recommendations for reducing it to Office of Overseas Schools, U.S. Department of
State, Room H-328, 2401 C Street, NW, Washington, DC 20522-0103.
DS-576
XX-XXXX

Instruction Page 1 of 1

OMB APPROVAL NUMBER 1405-0036
EXPIRATION DATE XX/XX/XXXX
*ESTIMATED BURDEN: 30 MINUTES

U.S. Department of State

Name of Foreign Service Post

OVERSEAS SCHOOLS PROGRAM

REQUEST FOR ASSISTANCE

Name of School

(Submit original and one copy)
(Please read instructions on page 1 before completing form)

REQUEST FOR U.S GOVERNMENT FISCAL YEAR

FUNDS (See instructions, page 1)

TO BE EXPENDED DURING THE SCHOOL FISCAL YEAR EXTENDING FROM

TO
Date (mm-dd-yyyy)

Date (mm-dd-yyyy)

I. BACKGROUND AND OBJECTIVES

(If additional space is required, continue on separate sheet and attach to this form.)

II. ENROLLMENT/STAFF/TUITION PROJECTION DATA (See instructions, page 1 and below.)
1. Enrollment of regular students (exclude adult program)
2. Pupil-teacher ratio
3. Number of teachers (include rounded sum of fractions representing
part-time teachers)
4. Number of other professional instructional and administrative staff
(superintendents, principals, guidance counselors, librarians, business
manager. Include rounded sum of fractions as in 3. Avoid double counting
as between 3 and 4)
5. Total professional staff (sum of 3 and 4)
6. Project annual tuition rate(s) by grade group (show full rates only)

PLEASE NOTE: The information provided in this section should reflect your best estimate of the next school year, the year for which
assistance is being requested. This should not repeat information concerning the current school year.
DS-576
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Page 1 of 3

III. TYPES AND ESTIMATED COSTS OF NEW ASSISTANCE REQUESTED
ESTIMATED COSTS
TYPES OF ASSISTANCE
1.

Support of salary and related costs for professional staff

2.

Educational materials and equipment

3.

Scholarships for host country nationals

4.

Construction and equipment (before assistance for construction can
be made available, architectural and engineering plans,
specifications and cost estimates must be submitted. These should
be submitted at a later date upon request by the Department of
State. Note that per 2 FAM 614, assistance in this category will be
made available only in special circumstances.)

5.

Special educational projects
A. School-to-school and university-to-school projects
B. Other (including consultants, workshops, community
relations projects, special English programs, area studies,
in-service training)
TOTAL AMOUNT OF NEW ASSISTANCE REQUESTED

(In terms of U.S. dollars)

(

(Dollar amount which can be
expended in local currency)

) (

)

IV. DISCUSSION AND JUSTIFICATION

DS-576
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Page 2 of 3

(Section IV continued)

(If additional space is required, continue on separate sheet and attach to this form.)
CHIEF ADMINISTRATIVE OFFICIAL OF SCHOOL

CHAIRMAN OF THE SCHOOL GOVERNING BOARD
Signature
Typed Name
Date (mm-dd-yyyy)

V. POST RECOMMENDATION

(If additional space is required, continue on separate sheet and attach to this form.)
POST PRINCIPAL OFFICER OR OTHER AUTHORIZED
OFFICER MAKING RECOMMENDATION
Signature
Date (mm-dd-yyyy)

Typed Name
Title

DS-576
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