The Catholic University of America

Department of Education, The Catholic University of America

EXIT AGREEMENT

For Students Receiving Financial Assistance From IDEA Training Grants for Master's Level Training


I, _________________________, have received financial assistance (scholarship) in the form of tuition and/or a stipend from funds awarded under the Individuals with Disabilities Education Act (IDEA) through a personnel preparation grant to The Department of Education at The Catholic University of America (CUA). This assistance is subject to the requirements for a "Service Obligation" under 20 USC §1473(h).

I understand and agree with the terms and conditions of this exit certification.

A. Amount and Length of Service Obligation

1. I have an obligation to repay the scholarship assistance I received by the employment obligation described below, which shall be referred to as the "Service Obligation". To satisfy this Service Obligation, I must work on a full-time or a full-time equivalent basis[1] for a period of at two least years for each full time equivalent academic year for which I received assistance. I must work providing special education or related services to children with disabilities or early intervention services to infants or toddlers with disabilities and their families. In providing such service, a majority of the persons I serve must be persons with disabilities, or a majority of my time must be spent providing special education, related services or early intervention services to children with disabilities. This Service Obligation will be met if the primary purpose of my being in a general education setting is to provide IDEA services.

(a) I received this scholarship assistance for a period of _______ FTE academic years, starting in __________ and ending in ___________.

(b) To repay the Service Obligation through work, I must work full-time for _____ years, or the full time equivalent.

(c) After completing my master's level training at the CUA Department of Education, I have ____ years within which to satisfy my Service Obligation. I must complete my Service Obligation by ________, 20__.

(d) I received total scholarship assistance in the amount of $ _______.

2. If I am unable or decide not to satisfy the Service Obligation within the designated period of time, I must pay back to the federal government that portion of the scholarship assistance I received that I have not satisfied through service. I will owe the federal government an amount equal to the portion of the scholarship that I have not repaid through service, plus interest and collection fees that the federal government may levy upon me.

B. Information on Progress in Satisfying Service Obligation

1. At least annually, I will provide in writing or in such electronic form as the CUA Department of Education determines acceptable, information required to verify that I am complying with my Service Obligation. No later than September 15 each year, I will provide information while I am subject to the requirements of the Service Obligation. At a minimum I will report to the CUA Department of Education:

a. My current address, telephone number, and e-mail ;

b. The name, address, telephone number and e-mail of my employer(s) where I am engaged in employment consistent with my Service Obligation under this agreement;

c. Information, including any verification requested by the CUA Department of Education needed to consider any request I make for an exception or a deferral from the repayment requirements under this agreement; and

d. Any other information the CUA Department of Education may request to determine or verify my progress in fulfilling the requirements of this agreement.

2. I will provide the above information to the CUA Department of Education until I am informed that my Service Obligation has been met. If I do not provide the above information, I understand that CUA will report to the US Secretary of Education that I have failed to meet my Service Obligation.

C. Deferrals of and Exceptions to the Service Obligation

1. I may request and may be granted by the CUA Department of Education an exception to the Service Obligation if I am unable to complete the obligation because of a disability that is expected to continue indefinitely. Such request must be made in writing, according to procedures established by the CUA Department of Education and the CUA Office of Student Accounts.

2. I may request and may be granted by the CUA Department of Education a deferral of the Service Obligation for the reasons specified below. Such requests must be made in writing, according to procedures established by the CUA Department of Education and the Office of Student Accounts. In general, deferrals may be granted if I am engaged in any of the following:

· a full-time course of study at an institution of higher education;

· active duty in the armed forces (not to exceed three years),

· volunteering in the Peace Corps,

· volunteering (full time) under Title I of the Domestic Volunteer Service Act of 1973

Other reasons for which a deferral may be granted include a disability which prevents me from working (a deferral under this provision may not exceed three years) or inability to secure employment due to caring for a disabled family member, (a deferral under this provision may not exceed 12 months.)

D. Consent for Release of Information

1. About Employment. I give my consent to the CUA Department of Education to contact my employer(s), if necessary, to confirm information about my employment that is relevant to determining my progress in satisfying my Service Obligation. I specifically consent and authorize my employer to respond to inquiries from the CUA Department of Education and to release records related to my employment to CUA as follows:

  • verifying my employment;
  • verifying my hours of employment; and
  • verifying the extent to which my employment involves the provision of special education, related services or early intervention services.

I understand that the CUA Department of Education does not intend to routinely contact my employer(s) while I am fulfilling my Service Obligation. I understand the CUA Department of Education intends to contact my employer only when there is uncertainty about some aspect of my employment that requires clarification in order to track my progress in meeting the Service Obligation.

2. About Student Location. I give my consent to the CUA Department of Education to contact offices within CUA or the CUA alumni association for the purpose of obtaining information that may be needed in order to contact me regarding the status of and/or progress in satisfying my Service Obligation.

3. School and Student Information

Grant Project Director:

_____________________________________________

Grant Number: ­­­­­­­­­­­_____________________________________________

Student Name: _____________________________________________

Permanent Address: _____________________________________________

_____________________________________________

_____________________________________________

Telephone Number: _____________________________________________

E-Mail Address: _____________________________________________

Name and Address of Parents or

Other Party who will always have

An Address for you _____________________________________________

_____________________________________________

IN WITNESS WHEREOF, the parties have executed this Agreement on the day and year set forth below:

___________________________________________ _____________________

Student Signature Date

___________________________________________ _____________________

CUA Department of Education Representative Date



[1]Part time employment may be used to accrue the hours necessary to fulfill the Service Obligation, as long as the hours needed to fulfill the obligation are worked within the necessary time frame (three years plus the number of years owed). If the Service Obligation is two years, and you work half-time for four years in a qualifying position, then the Service Obligation will have been met.