**OMB Approval No: 1840**  **- 0525**  **Expiration Date: XX/XX/2017**  

### Student Support Services Program **2013 -**  **14 Annual Performance Report**  **Section I, Part 1**

**— Project Identification/Characteristics**  **Certification and Warning Statements A. Project Identification**  1 PR/Award Number: [pre

- populated ] **P042A**

_______________ 2. Ty pe of Institution [pre

- populated ]

_____________________ ___ 3. Project Type: [pre

- populated]

______

___ _______ ___________ 4. Reporting Period: [pre

- populated]

___________

____ ____ ____ 5. GPA Scale: [

pre - populated)

___________

______ ______ 6. Name of Grantee Institution : [pre

- populated]

___________________________________ ______________ 7. Address:

__

_____ ______________________ ___ __________

_____________________________________ ____ ________

__ ______ _____________________ _____ __ _ ________ City State Zip + 4 **B. Project Director and Data Entry Person Inform**  **ation 8.**  **Project Director Inform ation**  [pre

- populated] 8 a . Name of Project Director:

___________________

___ ___ _____

____ __ ______ _ First Name MI Last Name 8 b
. Telephone # : (______) ________________________

Area Code Number Ext. 8 c. Fax #: (______) ________________________

Area Code Number 8 d. Email Address:

__________________ ______ ____ _ ___ _ **9. Data Entry Person Information**

9a. Name of Data Entry Person:

____________________ ____ _________________ First Name MI Last Name 9b. Telephone # : (______) _______________________

Area Code Number Ext. 9c. Email Address:____________

_________________ **C. Project Characteristics**  10a. Has a Summer Bridge Program? Y e s N o 10b. If yes in field #10a, number of summer bridge participants served: _____________ 10c. Used Federal grant funds to provide Grant Aid? Y e s N o 10d. Required to provide matching funds for Grant Aid? Y e s N o 10e. If yes in field #10d, please enter the dollar amount for the reporting period: $_____________.00. 10f
. Received institutional or other non
- federal funds? Y e s N o 10g. If yes in field #10f, please enter the dollar amount for the reporting period: $_____________.00.
**D. Certification:**  We certify that the performance report information reported and submitted electronically on ____/____/______ is readily verifiable. The information reported is accurate and complete to the best of our knowledge.

__________________

______________________________ _________________ _____________________________ Name of Pro

ject Director (Print) Name of Certifying Official (Print) ________________________________ ____/____/______ ________________________________ ____/____/___ _ Signature Date Signature Date **E. Warnings:**  Any person who knowingly makes a false statement or misrepresentation on this report is subject to penalties which may include fines, imprisonment, or both, under the United S tates Criminal Code and 20 U.S.C. 1097
. Further Federal funds or other benefits may be withheld under this program unless this report is completed and filed as required by existing law (20 U.S.C.) 1231a) and regulations (34 CFR 75.590 and 75.720). **Autho rity: Public Law 104**  **- 13, as amended**  **. Paperwork Burden Statement**  : According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. Public repor ting burden for this collection of information is estimated to average 15 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 Title IV, Part A, Subpart 2, Chapter 1, Section 402D of the Higher Education Act of 1965, as amended; the program regulations in 34 CFR Part 646; and the Education Department General Adminis trative Regulations (EDGAR) in 34 CFR 74.51, 75.720 and 75.732 . Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to regulations.gov during the public comment period for this collection of information. If you have specific questions about the form, instrument or survey, please contact (202) 502
- 7600 ).

### Section I , Part 2

—Project Required Services For further information regarding th e definition of “ Number of participants receiving service that was provided by the project” and “ Number of participants referred to another service provider”, please refer to the Definitions That Apply located in the instructions.

**Required Services Numbe**  **r of participants receiving service that was**  **provided by project Number of participants**  **referred to another service provider**   Academic Tutoring

**______ ______**   Advice and assistance in postsecondary course selection

**______ ______**   Education/counseling to im prove financial and economic literacy

**______ ______**   Information in applying for Federal Student Aid

**______ ______**   Assistance in completing and applying for Federal Student Aid

**______ ______**   Assistance in applying for admission to Graduate School and obtaining Federal student aid (not applicable to 2
-year institutions) **______ ______** 
 Assisting in applying for admission to 4
- Year Institution and obtaining Federal student aid (not applicable to 4
-year institutions) **______ ______** **OM B Approval No:**  **1840 -**  **0525 Expiration Date:**  **XX/XX/2017**
**STUDENT SUPPORT SERVICES (SSS)**  **PROGRAM 2013**  **- 14**  **ANNUAL PERFORMANCE REPORT (APR)**  **SECTION II --**  **RECORD STRUCTURE FOR PARTICIPANT LIST** A grantee must submit student records in Excel or CSV format. For additional informati on regarding data submission, please see the instructions under “ **HOW MAY THE REPORT BE SUBMITTED?”**  **REPORTING REQUIREMENT: T**  **he Departm ent require**  **s grantees**  **to submit**  **participant records for all**  **s tudents served by**  **the project in the past six year**  **s (i.e., co**  **hort years 2008**  **- 09**  **through 2013**  **- 14**  **) in the case of a 4**  **- year institution and four years**  **(i.e., cohort years**  **2010 -**  **11 through**  **2013 -**  **14 )**  **in the case of a 2 -** **year institution.** For additional information on data submission requirements, please see the instruction s. 

### Field # **Field Name Database Column**  **Name Valid Field Content**  

## II.A. **Project Identifiers (pre**  **- populated)** 

1 PR/Award Number PR The eleven
- digit PR/Award Number can be found in Block 5 of the project’s Grant Award Notification for the reporting ye ar. 2 Batch Year BatchAY 2013 for Project Year 2013
- 14 

## II.B. **Participant Demographic Information , Eligibility and Cohort Status, and Project Entry Information**  **The f ields**  **(#3 -**  **#21) in this section do not require annual updates.**  3 Social Security

Numb er SSN 001010001 to 999999998 Unknown = 000000000 **NOTE** : Please format the SSN in nine digits greater than 0. If using EXCEL, you may use dashes (e.g., 123
-45
- 5667 or 123456789). D o not use letters. T he information in this field should be the same as provided in the previous reporting period and cannot be changed in future reporting years. 

### 4 Student’s Last Name LastNM 0 to 9 Uppercase A to Z . (period) ‘ (apostrophe)

- (dash) **NOTE:** First position will be justified with an uppercase A
- Z. **No blanks**  **w ill**  **be accepted.** The information in this field should be the same as provided in 

### the previous reporting period and cannot be changed in future reporting ye ars. 5 Student’s First Name FirstNM 0 to 9

### Field # **Field Name Database Column**  **Name Valid Field Content** 

Uppercase A to Z . (period) ‘ (apostrophe)

- (dash) **N OTE:**  First position will be justified with an uppercase A
- Z. **No blanks**  **will be**  **accepted.** The information in this field should be the same as provided in the previous reporting period and cannot be changed in future reporting years. 

### 6 Student’s Middle

Initial MI Uppercase A to Z Blank = No response 7 Student’s Date of

Birth DOB **Participant’s date of birth is: Format is MM/DD/CCYY**  MM = 01

– 12 DD = 01

– 31 CC = 19

– 20 YY = 00

– 99 00/00/0000 = No response/Unknown **NOTE:** The information in this field should be the same as provided in the previous reporting period and cannot be changed in future reporting years. 

### 8 Gender GenderCD **Participant is a:** 1 = Male 2 = Female 0 = No response/Unknown 9 Ethnicity

—Hispanic Hispanic **Participant is identified as H ispanic/Latino.**  1 = Yes 2 = No **NOTE:** Hispanic/Latino refers to a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race . As such, every Hispanic/Latino person has an associated race(s). 

### Please provide race information for **every participant, ethnicity notwithstanding.**  **Please see instructio ns for additional detail for**  **field s #10 through #14**  **.** 10 Race

—

American Indian/Alaskan Native AmIndAK **Participant is identified as American Indian/Alask**  **an Native .**  1 = Yes 2 = No

### Field # **Field Name Database Column**  **Name Valid Field Content** 

**NOTE:** American Indian/Alaskan Native refers to a person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment. 

### 11 Rac e
— Asian Asian **Participant is identified as Asian**  **.** 1 = Yes 2 = No **NOTE:** Asian refers to a person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. 

### 12 Race

—Black or

African American BlackAfrAm **Participant is identified as Black or African American.** 1 = Yes 2 = No **NOTE:** Black or African American refers to a person having o rigins in any of the black racial groups of Africa. Terms such as "Haitian" or "Negro" can be used in addition to "Black or African American." 

### 13 Race

—White White **Participant is identified as White**  **.** 1 = Yes 2 = No **NOTE:** White refers to a person having origins in any of the original peoples of Europe, the Middle East, or North Africa. 

### 14 Race

— Native Hawaiian or Other Pacific Islander HIPacIslndr **Participant is identified as Native Hawaiian or Other Pacific Islander.** 1 = Yes 2 = No **NOTE:** Native Hawaiian or Other Pacific Islander refers to a person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. 

### 1 5 Eligibility EligibilityCD **Participant is :**  1 = Low
- In come and First
- Generation 2 = Low Income only 3 = First
- Generation only 4 = Disabled 5 = Disabled & Low Income 0 = No response/Unknown

### Field # **Field Name Database Column**  **Name Valid Field Content**  1 6 Academic Need

(at initial selection) 

### NeedCD **Participant’s academic need is based on:** 1 = Low high school grades 2 = Low admission test scores 3 and 4 = No longer used 5 = Predictive indicator 6 = Academic proficient tests 7 = Low college grades 8 = High school equivalency 9 = Failing grades 10 = Out of the academic pipeline for 5 or more ye ars 11 = Other 12 = Limited English proficiency 1 3 = Lack of educatio nal and/or career goals 1 4 = Lack of academic preparedness for college level course work 1 5 = Need for academic support to raise grade(s) in required course(s)/academic major 0 = No response/Unknown **NOTES** : S elect the criterion that best describes the participant’s academic need. Since many students may qualify for project services based on more than one criterion , please select the main criterion that was used to determine the individual’s need for project services. Please use option #11, “ Other” sparingly. **Predictive indicator**  is a composite variable for estimating the potential success of a student in college using a variety of factors that may include indicators such as high school GPA, SAT or ACT test scores, high school preparedness, etc. **Academ ic**  **proficient tests**  include tests used for clinical purposes such as to determine learning disabilities as well as placement tests and study skills inventories. 

### 17 First Enrollment Date

(at grantee institution) 

### FirstEnrollDT **Participant’s first enrollment date at the grantee institution is:**  **Format is MM/DD/CCYY** MM = 01

– 12 DD = 01

– 31 CC = 19

– 20 YY = 00

– 99 00/00/0000= No response/Unknown 18 Date of First First ServiceDT **Participant’s date of first project**  **service is:**

### Field # **Field Name Database Column**  **Name Valid Field Content**  Project Service **Format is MM/ DD/CCYY**  MM = 01

– 12 DD = 01

– 31 CC = 19

– 20 YY = 00

– 99 00/00/0000= No response/Unknown 19 College Grade Level

(entry into project) 

### EnterGradeLV **Participant’s college grade level at entry into the project is:** 1 = 1st y r., never attended 2 = 1st y r., attended before 3 = 2nd yr ./sophomore 4 = 3rd yr./junior 5 = 4th y r./senior 6 = 5th y r./other undergraduate 0 = No response/Unknown **NOTE:** Use your institution’s classification grade level when determining the participant’s college grade level. Use options 3, 4, 5, and 6 **only for**  **students who**  **have the**  **required number**  **of credits**  **and GPA**  to be classified at the institution as sophomore, junior, senior, and other undergraduate , respectively. 

### 20 Enrollment Status

(in academic year first served ) 

### First ServEnrollCD **Participant enrollm ent status**  **in the year first served is:**  1 = Full
- time (at least 24 credit hours or 36 clock hours in an academic ye ar) 2 = 3/4 time (at least 18 credits hours or 27 clock hours in an academic ye ar) 3 = 1/2 time (at least 12 credit hours or 18 clock hours in an academic ye ar) 4 = Less than 1/2 time (fewer than 12 cre dit hours or less than 18 clock hours in an academic year) 9 = Not applicable ( for prior year participants no longer enrolled for whom grantee is unable to establish the participant’s enrollment status in the academic year first served) 10 = Not applicable (New participant

— summer session particip ants who did not earn college credits ) 0 = No response/Unknown **NOTE:** If a p articipant is “New” in this reporting period, then the Enrollment

### Field # **Field Name Database Column**  **Name Valid Field Content** 

Status in the academic year first served (field #20) and the Enrollment Status at the end of the reporting period (field #23 ) are the same. If the participant is a new summer participant w ho did not earn college credits in this reporting period, please select option #10 in both fields #20 and #23
. Select option 9 only if you do not know the enrollment status in the academic year the participant was first served. I f you have already provided in a previous reporting period the enrollment status for prior year participants no longer enrolled (i.e., options 1

– 4), do not change the response. 

### 21 Student Cohort Year StuCohortYR **Participant’s Student Cohort Year is:** 1 = Other (prior 200 5
- 0 6 ) 2 through 6 = No longer used 7 = 2005
- 06 8 = 2006
- 07 9 = 2007
- 08 10 = 2008
- 09 11 = 2009
- 10 12 = 2010
- 11 13 = 2011
- 12 14 = 2012
- 13 15 = 2013
- 14 16 = 2014
- 15 17 = Not applicable **NOTE:** Select option 17 if the student is a continuing participant in this reporting period (field 22, option 2) but was not on your 2012
- 13 data file. If the student is a prior
- year participant and they are not on your 2012
- 13 APR data file, select option 17. For additional instructions, refer to the instructions
. . 

## II **.C. Participant’s Status and Academic Status**  **The following fields (#22**  **- #25**  **) may require annual updates , dependent on a per** **- participant basis**  **.** 22 Participant Statu s

(during academic year) 

### PartCD **Participant is a:** 1 = New participant (part of 20 13
- 14 cohort for this reporting period) 2 = Continuing participant 3 = Prior
- ye ar participant (enrolled but not receiving SSS services) 4 = Prior
- ye ar participant (no longer enrolled at grantee institution)

### Field # **Field Name Database Column**  **Name Valid Field Content** 

5 through 7 = No longer used 8 = New Summer parti cipant

—Earned College Credits ( 2014 summer session only ; part of 2014
- 15 cohort) 9 = New Summer participant

— **Did n ot**  Earn College Credits ( 2014 summer session only ; part of 2014
- 15 cohort) A **new p**  **articipant** is an individual who was served by the SSS proje ct for the **first time**  in this reporting period (PY 2013
- 14 ) and meets the definition of parti cipant in 34 CFR 646.7(b ) of the SSS program regulations. A **continuing participant**  is an individual who was served by the SSS project for the first time in **a ny**  prior reporting period and also received services in the 2013
- 14 reporting period. For APR reporting purposes, a participant who left the grantee institution in a previous reporting period but reentered the institution and was served by the pro

je ct in 2013
- 1 4 , is considered a “continuing” participant
. A **prior -** **year participant**  **enrolled at**  **grantee institution**  is an individual served by the SSS project in **a ny**  prior reporting period that was enrolled at the grantee institution during the current reporting perio d but did not receive project services on a continual basis during the reporting period. T his definition includes a prior
year participant who received a certificate/diploma from a program that is less than two years in duration and is pursuing an associate’s degree at the grantee institution. A participant who left the grantee institution in a previous reporting period but reentered the institution and **was not**  served by the project in 2013
- 14 , is considered a “prior
-year participant enrolled at grantee institution”. A **prior -** **year participant not enrolled at the grantee institution** is an individual who was not enrolled at the grantee institution during the current reporting period ( 2013
- 14 ). A **new p**  **articipant --**  **summer session**  **only who**  **earned college**  **credit s**  is an individual served by the SSS project for the first time during the summer session preceding the participant’s first academic year at the grantee institution (i.e., served during summer 2014 prior to the 2014
- 15 academic year) and earned college cre dits
. This student is thus part of the next year’s cohort (i.e., 2014
- 15 , field #21 , option “ 16 ” ). This definition does not include a student enrolled at the grantee institution prior to the summer session but who received services from the SSS project fo r the first time during the summer 2014 . This individual would meet the definition of “new participant” ( field #22 , option “1” and would be in the 2013
- 14 cohort ( field #21 , option “ 15 ” ).

### Field # **Field Name Database Column**  **Name Valid Field Content** 

A **new participant** **-- summer session only**  **who did not earn**  **college cre**  **dits** is an individual served by the SSS project for the first time during the summer session preceding the participant’s first academic year at the grantee institution (i.e., served during summer 2014 prior to the 2014
- 15 academic year) and did not earn any college credits
. This student is thus part of the next year’s cohort (i.e., 2014
- 15 , field #21 , option “ 16 ” ). T his definition does not include a student enrolled at the grantee institution prior to the summer session but who received services from the S SS project for the first time during the summer 2014
. This individual would meet the definition of “new par ticipant” ( field #22 , option “1” and would be in the 2013
- 14 cohort ( field #21 , option “ 15 ” ). **NOTE :**  The sum of the number of new ( option # 1); continuing ( option #2 ); and new summer session only ( options # 8 and # 9 ) should equal the total number of participants the project served during the 2013
- 14 academic year
. 

### 23 Enrollment Status

(at the end of the academic year) 

### EnrollCD **Participant ’s**  **enrollmen t status at the end of**  **the academic year is:**  1 = Full
- time (at least 24 credit hours or 36 clock hours in an academic ye ar) 2 = 3/4 time (at least 18 credits hours or 27 clock hours in an academic ye ar) 3 = 1/2 time (at least 12 cre dit hours or 18 clock hours in an academic ye ar) 4 = Less than 1/2 time (fewer than 12 cre dit hours or less than 18 clock hours in an academic year) 9 = Not applicable (prior year participants no longer enrolled) 10 = Not applica

ble (New participant

—201 3 summer session participants who **did not** earn college credits) 0 = No response/Unknown 24 Academic Standing AcamStandCD **Participant’s academic standing is:** 1 = Good standing 2 = Not in good standing 9 = Not applicable (prior
- ye ar participant no longer enrolled) 10 = Not applicable (New participant

—201 3 summer session participants who **did not** earn college credits ) 0 = No response/Unknown

### Field # **Field Name Database Column**  **Name Valid Field Content** 

**NOTE** : U se your institution’s definiti on of good academic standing. P lea se c omplete for all new, continuing participants, prior
-ye ar participants still enrolled, and new summer participants who earned college credit s . Use option “9” (Not applicable) for prior
-year participants no longer enrolled . Use option “10” for new summer only participants who did not earn any college credits. 

### 2 5 Cumulative GPA CumGPA **Participant’s cumulative GPA is:** 0.000 to 5.000 9.999 = Not applicable (prior
- year participant no longer enrolled and new summer participants who did not earn college credits) Blank = No response/Unknown **NOTE :**  Complete for all new, continuing, prior
-year participants still enrolled, and new summer participants who earned college credits. U se “9.999” for prior
year participants no longer enrolled and new summer participants who did not earn any college credits. 

## II.D. Academic Progress/Persistence **The following fields (#26 -**  **#34) may require annual updates, dependent on a per -**  **participant basis.** 26 College Grade Level

(at the beginning of the academic year) 

### BegCurrentGradeLV **Participant ’**  **s college grade level at the beginning of the academic year was**  **:** 1 = 1st y r., never attended 2 = 1st y r., attended before 3 = 2nd y r./sophomore 4 = 3rd yr./junior 5 = 4th y r./senior 6 = 5th y r./other undergraduate 7 = Dual degree program 8 = Graduate/Professional Student 15 = Not applicable (New summer participant

—2014 summer session) 99 = Not applicable (prior
- year participant no longer) 0 = No response/Unknown **NOTE:** Use grade level options 3, 4, 5, and 6 **only f**  **or students**  **who have**  **the required**  **number of** 

**c redits**  **and GPA**  to be classified by the participant’s grantee institution as a sophomore, ju nior, senior, and other undergraduate respectively**.** Use option “7” for an individual enrolled in a program that awards both the bachelor’s and a graduate degree upon successful completion of the program of study. Use option “8” for a student who graduated with a bachelor’s degree and then entered graduate/professional school during the academic year.

### Field # **Field Name Database Column**  **Name Valid Field Content** 

Use option “15 ” for an individual who is a new summer participant (i.e., field #22, options 8 or 9 )
. Use option “99” for an individual who is a prior
-year participant no longer enrolled at the grantee institution including students who received a bachelor’s degree or equival ent in a previous reporting period. 

### 2 7 College Grade Level

(at the end of the academic year) 

### CurrentGradeLV **Participant ’**  **s college grade level at the end**  **of the academic year is:** 1 = No longer used 2 = 1st y r. 3 = 2nd y r./sophomore 4 = 3rd yr./junior 5 = 4th y r./senior 6 = 5th y r./other undergraduate 7 = Dual degree program 8 = Graduate/Professional Student 1 0 = Not applicable (New summer participant

—2014 summer session only not earning college credits) 99 = Not applicable (prior
- year parti cipant no longer enrolled) 0 = No response/Unknown **NOTE:** Use grade level options 3, 4, 5, and 6 **only for**  **students who**  **have the**  **required number**  **of**

**c redits**  **and GPA**  to be classified by the participant’s postsecondary institution as a sophomore, junior, senior, and other undergraduate respectively**.** Use option #6 if a student received a bachelor’s degree or equivalent in this reporting period. I f the student received a bachelor’s degree or equivalent in a previous reporting period, use option “99”. Use option “7” for an individual enrolled in a program that awards both the bachelor’s and a graduate degree upon successful completion of the program of study. Use option “8” for a student who graduated with a bachelor’s degree and then entered graduate/profess ional school during the academic year. Use option “10 ” for participants who were served by the SSS project for the first time during the summer session preceding the participant’s first academic year at the grantee institution and **did not**  earn any college credits. Use option “99” for an individual who is a prior
-year participant no longer enrolled at the grantee institution including students who received a bachelor’s degree or equivalent in a previous reporting period. 

### 28 Date of Last Project

Service La stSerDT **Participant’s date of last project service is: Format is MM/DD/CCYY**  MM = 01

– 12 DD = 01

– 31 CC = 19

– 20

### Field # **Field Name Database Column**  **Name Valid Field Content** 

YY = 00

– 99 88/88/8888 = Not applicable, still enrolled in project 00/00/0000= No response/Unknown Provide the date of last project servic e for all prior
- ye ar participants

– those prior participants still enrolled at the grantee institutions, those prior participants no longer enrolled, and for current year participants who have graduated, transferred or withdrawn from the institution. It w ould be best to use the date the participant last attended a SSS activity or received a service from the project. If the date is not available, you may use the date the project dropped the student from its list of current participants. For those students who stay

in the program until graduation, the date of last project service would be the college graduation date. Enter “88/88/8888” for an individual still participating in the SSS project at the end of the reporting year (or the beginning of the next acad emic year). 29 Reason for

Withdrawal or Not Returning ReaforWith **Reason participant withdrew/did not return is:** 1 = Academic dismissal 2 = Dismissal for non
- academic reasons 3 = Withdrew/Did not return for financial reasons 4 = Withdrew/Did not return for health reasons 5 = Withdrew/Did not return for academic reasons 6 = Withdrew/Did not return for personal reasons 7 = Not applicable (called for military service or deceased) 8 = Not applicable (student still enrolled, completed certificate program, graduated or transferred) 0 = No response/Unknown Use option 8 for students still enrolled, completed certificate/diploma program, graduated or transferred. This field may not require an update if the participant withdrew or did not return to your institution in a previous reporting and this status remains in place in this reporting period. 30 Transfers Transfers **Participant’s transfer status is:** 1 = Transferred from a 2
- ye ar institution to another 2
- year institution 2 = Transferred from a 2
- ye ar institution to a 4
- ye ar institution 3 = Transferred from a 4
- ye ar institution to another 4
- year institution 4 = Transferred from a 4
- ye ar institution to a 2
- ye ar institution 8 = Did not transfer, still enrolled or graduated (participant is still enrolled at the grantee
- institution, graduated with a bachelor’s degree, received an associate’s degree or certificate and did not transfer to a 4 ye ar

### Field # **Field Name Database Column**  **Name Valid Field Content** 

institution) 9 = Did not transfer, not enrolled at grantee institution (participant withdrew, did not return, was called for mi litary service or is deceased) 0 = No response/Unknown 31 Undergraduate

Degree/Certificate Completed at Grantee Institution DegreeCD **Participant’s degree /certificate**  **status is:** 1 = C ertificate/diploma for occupational, educational program (less than two - ye ar program)

—**D id**  **not transfer from a 2 to a 4 year institution**  2 = Certificate/diploma for occupational, educational program ( at least two - ye ar program)

—**D id**  **not transfer from a 2 to a 4 year institution**  3 = No longer used 4 = 1 st 

### Bachelor’s degree 5 = No longer used 6 = Equivalent of Bachelor’s Degree 7 = No longer used 8 = No degree/certificate, still enrolled at grantee 9 = No degree, not enrolled (withdrew from grantee institution prior to obtaining degree/certificate, did not return to grantee institution including those students who transferred without getting a degree/certificate and second bachelor’s degree without receiving a first bachelor’s degree from the grantee institution) 10 = Associate’s degree only

—**D id**  **not transfer from a 2 to a 4 year**  **institution** 11 = Associate’s degree **AND** transferred f rom a 2 to a 4 year institution within the academic year or b y the beginning of the next academic ye ar. 12 = Certificate **AND** transferred from a 2 to a 4 year institution within the academic year or b y the beginning of the next academic ye ar. 0 = No response/Unknown **Select option #1 or #2** if the student received a certificate only. Once a certificate has been reported, please do not change this response in subsequent reporting years unless you reported it incorrectly or the participant earned an associate’s degree only (option 10)
. **Select option**  **#4** if a student received a first bachelor’s degree. Once you report the first bachelor’s degree, please do not update this field in subsequent reporting

### Field # **Field Name Database Column**  **Name Valid Field Content** 

periods. If the participant received a first bachelor’s degree and later on received a second bachelor’s degree within the six year time frame, please select option #4 and provide the date the first bachelor’s degree was awarded in field #32. Unless you reported the attainment of a bachelor’s degree incorrectly, o nce you report this degree , please do not change this response in subsequent reporting years. If the participant did not receive a first bachelor’s degree from the grantee institution but received a second bachelor’s from the grantee institution, please select option #9. **Select option**  **#6** if the student is enrolled in a dual degree program and has completed all of the requirements for a bachelor’s degree
. Unless you reported the attainment of equivalent of a bachelor’s degree incorrectly, once you report this status, please do not change this response in subsequent reporting years. **Select option #8** if the student i s still enrolled at the grantee institution but ha s not yet completed their undergraduate program of study. **Select option**  **#9** for participants who withdrew from the grantee institution prior to obtaining a degree/certificate, did not return to grantee institution, or transferred without receiving a degree including students who transferred from a 2
-year to a 4
-year institution. Also select this option if the participant attained a second bachelor’s without attaining a first bachelor’s from the grantee institution. **Select option**  **#10** if the student received an associate’s degree **only**
. Unless you reported the attainment of an associate’s degree incorrectly, o nce you report this degree , please do not change this response in subsequent reporting years. Select option #11 if the student received an associate’s degree and transferred from a 2
- year to a 4
- year institution within the academic year or by the beginning of the next academic year. Also select option 11 if the student received an associate’s degree and transferred to a four year program at the grantee institution within the academic year or by the beginning of the next academic year. Select option #12 if the student received a certificate and transferred from a 2
-year to a 4
-year institution within the academic year or by the beginning of the next academic year. Also select option 12 if the student received a certificate and transferred to a four year program at the grantee institution within the academic year or by the beginning of the next academic year.

### Field # **Field Name Database Column**  **Name Valid Field Content** 

For two -year institutions

— Unless you report the attainment of a certificate/associate’s degree and transferred to a 4
-year institution incorrectly , once you report this status (option 11 or 12) , please do not change this response in subsequent reporting periods. 

### 32 Date of

Undergraduate Degree/Certificate DOUD **Date the participant attained the degree or certificate**  **:** Format is MM/DD/CCYY, e.g., 05/23/20 10 MM = 01
- 12 DD = 01
- 31 CC = 20 YY = 00
- 99 (e.g., 10 = 2010 ) 88/88/8888 = No degree earned ye t 00/00/0000 = No response/Unknown **NOTE** : This date must be the date of the degree/certificate noted in field #31. I f you do not know the exact date, use 15 for the day and use your best estimate for the month. 

### 33 Field of Study

Degree/Certificate Earned DegCertFieldErnd **Participant earned degree in**  **:** 1 = Humanities 2 = Social/Behavioral Sciences 3 = Life Sciences 4 = Physical Sciences 5 = Mathematics 6 = Computer/Information Science 7 = Engineering 8 = Teacher Education (Teacher Prep) 9 = Education
- Research & Administration 10 = Business/Management 11 = Health Professions & Related Sciences 12 = Vocational/Technical 13 = Communication/Journalism/Technologies 14 = General Studies/Transfer Degree 1 5 = Other technical/professional 1 6 = Has not earned a degree/certificate 0 = Unknown **N OTES:**  If the participant ( i.e., all current and prior
-year participants ) **received** a certificate or degree, please select the field of study (options 1
- 15) in which the degree or certificate was earned
. If the participant has not earned a degree/certificate , select

### Field # **Field Name Database Column**  **Name Valid Field Content** 

option “16”. I f you do not know the field of study in which the degree or certificate was earned, sele ct option “0

— Unknown
. ” 

### Option 14 is for two - year institutions who do not offer a degree/certificate in a specific field of study
. S elect thi s option if the student has met all of the requirements for a degree, certificate, and/or transfer. All other two ye ar institutions who do offer a degree/certificate in a specific field of study should indicate the student’s major field of study in which the degree or certificate was **attained**
. 

### 34 Persistence Status

(at the beginning of the 2013

- 1 4 academic year) 

### CurPerstStatus **Participant’s enrollment sta tus at the beginning of the**  **2013 -**  **1 4**  **academic year was**  **:** 1 = Enrolled at grantee institution 2 = Has graduated from the grantee institution with an associate's degree or received a certificate **and** transferred from a 2 to a 4
- ye ar institution 3 = Has transferred from the grantee institution (i.e., 2
- year) to a 4
- year institution without receiving an as sociate 's degree or certificate 4 = Has graduated from the grantee institution with an associate’s degree or received a certificate **but did not transfer** to a 4
- ye ar institution
. 5 = Has graduated from the grantee institution with a bachelor’s degree or equivalent 6 = Not enrolled at grantee institution 0 = No response/Unknown **NOTE** : U se option “1” if the student is still enrolled at the grantee institution at the beginning of the 2013
- 1 4 academic year. U se option “2” only if the student graduated from the grantee institution with an associate’s degree or received a certificate **and** transferred from a 2 to a 4
-year institution. U se option “3” for students who transferred from a 2 to a 4 year institution **but did**  **not** receive an associate's degree or certificate fro m the grantee institution. U se option "4" for students who received an associate's degree or certificate from the grantee institution **but did not** transfer to a 4
-year institution. Use option “5” for students who graduated with a first bachelor's degree o r equivalent at the grantee institution. Use option “6” for students who are no longer enrolled at the grantee institution , 

### that is, the student did not return to the grantee institution in the Fall 2014 term. These include all other transfers except stud ents who transferred from a 2
- ye ar to a 4
- year institution. **Options 2,**  **3, and**  **4 only**  **apply to 2 -** 

**year institutions. Option 5 only applies to 4 -**  **year institutions.** 

## II.E. Student Financial Assistance

### Field # **Field Name Database Column**  **Name Valid Field Content**  **Fields #35 and #36 re quire annual updates**  **and should be c ompleted for**  **current year participants**  **and prior -** **year participants still enrolled. Field # 37 may be updated annually and Field # 38 cannot be updated.**  35 Amount of Financial

Aid Received FinAidRecvd **Am ount of financial**  **aid received by**  **the participant is**  **:** 00000 to 99999 (e.g. 05000 for $5,000) Leave this field blank for prior
- year participants no longer enrolled
. **NOTE** : P rovide the dollar amount (whole dollars only) of the financial aid received of each participant as determined by the financial aid offi ce. Do not include the amount of SSS Grant Aid awarded. 

### 36 Amount of SSS Grant

Aid Awarded SSSGrantAid **Am ount of grant aid awarded to the participant is:**  00000 to 99999 (e.g. 05000 for $5,000) Leave this field blank for prior
- year participants. **NOTE** : Provide the amount of SSS grant aid awarded (whole dollars only) for the academic year. For this reporting period, individual grant aid awards should not be less than the minimum Pell Grant award of $ 582 nor exceed the maximum Pell grant award of $ 5,645
. 

## II. **F .**  **Additional Participant Information** 37 Participant Name

Change PartNameChange If the participant changed his/her name and this information will ensure uniformity

and accuracy

in tracking/reporting the participant, please enter the participant’s ful l name (i.e., first and last name). If there is no change in the participant’s name as provided in fields 4 and 5, you may leave this field blank. Examples of how to enter a participant’s full name: John Doe, John D. Doe; Dr. John Doe; Jane Doe
- John; Jo hn Doe II; John Doe, Jr., Note: The information in this field can be changed in subsequent reporting periods, as necessary
. 38 Student’s Case

Number StudCaseNum The “Student ’s Case Number” is a TRIO generated number and is one of several “match keys” th at assists in tracking participants across reporting periods. Grantees may

download the EXCEL file with this information from the APR web application for use in matching and tracking their participants. **( Note**  **to Data**  **Collector :**  **Please en**  **sure that**  **when you**  **are collecting**  **this information**  **from students**  **that they**  **are informed**  **of why**  **they are**  **being asked to provide their Social Security numbers. )**  **P RIVACY**  **A CT**  In accordance with the Privacy Act of 1974 (P ublic Law No. 93
- 579, 5 U.S.C. 552a), you are hereby notified that the Department of Education is authorized to collect information to im

plement the Student Support Services Program under Title IV of the Higher Education Act of 1965, as amended (Pub. Law 102
- 325, Sec. 402D). Inaccordance with this authority, the Department receives and ma intains personal information on participants in the Student Support Services program. T he p rincipal

purpose for collecting this information is to administer the program, including tracking and evaluating participant progre ss. P roviding the information on this form, including a social security number (SSN) is voluntary; failure to disclose a SSN will not result in the denial of any right, benefit or privilege to which the participant is entitled. T he information that is co llected on this form will be retained in the program files and may be released to other Department officials in the performance of their official duties.