**OMB Approval No: 1840**  **- 0640**  **Expiration Date: xx/xx/20xx**  

### << DRAFT >> **Ronald E. McNair Postbaccalaureate Achievement (McNair) Program**

**Annual Performance Report**

**– Program Year**  **2012**

**– 13**  **Section I, Pa**  **rt 1**

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

- populated ] **P 217**  **A**

_______________ 2. Institutional Sector [pre

- populated ]

_ ___________________

___ 3. Project Type: [pre

- populated]

______

___ _______ ___________ 4. Reporting Period: [pre

- populated]

___________

____ ____ ____ 5
. Name of Grantee Institution : [pre

- populated]

___________________________________ ______________ 6. IPEDS UnitID for Grantee Institution: [pre

- populated]

_______
**B. Project Director and Data Entry Person Inform**  **ation 7**  **. Project Director Inform**  **ation** [pre

- populated] 7 a . Name of Project Director:

___________________

___ ___ _____

____ __ ______ _ First Name MI Last Name 7 b
. Telephone # : (______) ___________________________

Area Code Number Ext. 7 c. Fax #: (______) _______________________________

Area Code Number 7 d. Email Address:

__________________ ______ ____ _ ___ _ **8 . Data Entry Person Information**  8 a. Name of Data Entry Person:

____________________ ____ _________________ First Name MI Last Name 8 b. Telephone # : (______) _______________________

Area Code Number Ext. 8 c. Email Address:____________

_________________

____ **C. Project Characteristics** 9 a . Has your project r eceived institutional or other non
federal funds? Y e s N o 9 b. If “ Y es ” , please enter the dollar amount for the reporting period: $_____________.00. 9 c . What type of GPA scale does your institution use? 4 point scale 5 p o int s c al e O th e r 9 d
. Has your project implemented a plan for increasing the number of STEM participants? Y e s N o 9 e . Has your project developed an evidence
-based system for evaluating its own performance? Y e s N o

**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 Project 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 includ e fines, im prisonment, or both, under the United States 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 regu lations (34 CFR 75.590 and 75.720). **Authority: 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 su ch collection displays a valid OMB control number. T he valid OMB control number fo r this information collection is 1840
- 0640. The time required to complete this information collection is estimated to average 11 hours per response, including the time to review instructions, search existing data resources, gather required data, and complete and r eview the information collection. The obligation to respond to this collection is required to obtain or retain benefit under T itle IV, Section 402E, of the Higher Education Act of 1965, as amended (Public Law 102
- 325)
. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to **:** U.S. Department of Education, Washington, D.C. 20202
-4536

. I f you have comments or concerns regarding the status of your individual submission of this form, write directly to: Federal TRIO Programs, U.S. Department of Education, 1990 K Street, N.W., Suite 7000, Washington, D.C. 20006
- 8510.

### Section I, P **art 2**

**— Project Services** 

**Definitions:** The **“Number of participants receiving service that was provided by project”** is defined as those participants that were offered services by the project and subsequently received services from the project. This figure does not include participants that were offered services by the project but declined them (e.g., due to lack of ne ed, participant refused the service, etc.). The **“Number of** **participants referred**  **to another**  **service provider”**  is defined as those participants that were offered services by the project but were subsequently referred to another service provider. Note that the Department is not asking projects to report on whether participants actually received services from the service provider or for projects to follow
-up with these participants to ensure services were rendered. T he Department is only requesting that the projects report on the number of participants that we re referred to another service provider. The Department is asking projects to report on the number of participants, not the number of contacts. For instance, if a participant received a service that was provided by a project mu ltiple times, he/she should only be counted once f or the purposes of this report. However, it is possible for a participant to be counted once in each of the two columns for a given service; that is, a parti cipant received a servic e that was provided by the project and was also referred to another service provider. Seminars/workshops means group activities that provide participants with the opportunity to receive information or practice methodology in one or more areas necessary for the successful navigation of the educational system relative to the attainment/completion of their doctoral studies. Tutoring means individual or small group tutoring provided by a graduate student or a professional staff person. Academic counseling means assisting students in making educational plans, selecting appropriate courses, me eting academic requirements, and planning for graduation and graduate education. Financial aid assistance to graduate s chool means assisting students individually or in small groups in com pleting financial aid applications and securing fellowships and other forms of financial assistance for graduate study. Admission assistance to graduate s chool means assisting students in choosing graduate or professional programs and applying f or admission to those programs. Mentoring means professionals, other than project staff, working with project students to expose them to careers that require doctoral degrees. Exposure to cultural events and academic programs means any project sponsored activities, such as field trips, special lectures, and symposiums that have as their purpose the improvement of the project participants’ academic progress and personal development
. **Required Services Number of participants**  **receiving service that was provided by project**  **Number of participants referred to another**  **service provider**  Seminars/Workshops

**______ ______**   Tutoring

**______ ______**   Academic Counseling

**______ ______**   Financial aid assistance to graduate s chool

**______ ______**   Admission assistance to graduate s chool

**______ ______**  **Perm issible Services**   Education/counseling to improve financial and economic literacy

**______ ______**   Mentoring

**______ ______**   Exposure to cultural events/academic programs

**______ ______** **OM B Approval No:**  **1840 -**  **0640 Expiration Date:**  **xx/xx/20xx** 

### << DRAFT >> **RONALD E. MCNAIR POSTBACCALAUREATE ACHIEVEMENT (MCNAIR** **) PROGRAM**  **2012**

**– 13**  **ANNUAL PERFORMANCE REPORT (APR)**  **SECTION II**

**– RECORD STRUCTURE FOR PARTICIPANT LIST**  A grantee must submit student records in Excel or CSV format. For additional information regarding data submission, please see the instructions under “ **HOW MAY THE REPORT BE SUBMITTED?”**  **Beginning with the 2012**  **- 13**  **APR, the Department require**  **s projects**  **to submit participant records**  **for all stu dents served by the project who attained a**  **bachelor’s degree for academic years (cohort years) starting in 2002 -**  **03 and must retain this records on the APR data file for a period of ten (10) years. Field**  **# Field Name**  **Database Column Nam**  **e 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 year. 2 Batch Year BatchAY 2012 for Project Year 2012

– 13 

### II.B. Participant’s Personal Information **(Fields #3 through #7 cannot be update.)** 3 Social Security Number SSN 001010001 to 999999998 Unknown = 000000000 **NOTE** : Please format the SSN in nine digits greater than 001010001 unless the SSN is unknown. If using Excel, you may use dashes (e.g., 123
- 45
- 5667 or 123456789). Do not use letters. The information in this field should not be changed in subsequent data submissions. 4 Student’s Last

Name LastNM 0 to 9 Uppercase A to Z . (period) ’ (apostrophe)

- (dash) First position will be justified with an uppercase A
- Z. **No blanks will be accepted. NOTE:**  The information in this field should not be changed in subsequent data submissions. 5 Student’s First

Name FirstNM 0 to 9 Uppercase A to Z . (period) ’ (apostrophe)

- (dash) First position will be justified with an uppercase A
- Z. **No blanks will be accepted. NOTE:**  The information in this field should not be changed in subsequent data submissions. 6 Student’s MI Uppercase A to Z**Field #**  **Field Name Database Column**  **Nam e**  **Valid Field Content**  Middle Initial Blank = No response 7 Student’s Date

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

– 12 DD = 01

– 31 CC = 19

–20 YY = 00

– 99 00/00/0000 = Unknown **NOTE:** The information in this field should not be changed in subsequent data submissions. 

### II.C **. Participant ’s**  **Demographic Inf ormation and Eligibility Status**  8 Gender GenderCD **Participant’s gender is:** 1 = Male 2 = Female 0 = Unknown 9 Ethnicity

— Hispanic Hispanic **Participant is identified as Hispanic/Latino?**  1 = Yes 2 = No 0 = Unknown 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 associate d race(s). **Please provide race inform ation for**  **every participant, ethnicity notwithstanding.**  10 Race

— American Indian/Alaskan Native AmIndAK **Participant is identified as Am**  **erican Indian/Alaskan Native ?**  1 = Yes 2 = No 0 = Unknown 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 Race

—Asian Asian **Participant is identified as Asian**  **?** 1 = Yes 2 = No 0 = Unknown 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 0 = Unknown**Field #**  **Field Name Database Column**  **Nam e**  **Valid Field Content** 

Black or African American refers to a person having origins 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 0 = Unknown 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 0 = Unknown 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. 15 Number of Hours Worked Per Week HoursWorked **On average, how m any hours each**  **week did the participant work at a job or internship in this reporting period?** 1 = 0 2 = 1

– 15 3 = 16

– 30 4 = 30

– 40 5 = 40 or more 0 = Unknown Please select the average number of hours worked each week during the 2012
- 13 academic year. This includes regular jobs, work
study, assistantships, and traineeships. Please provide this information for both undergraduate and graduate students who were enrolled in the reporting period
. 1 6 Lo w - income EligLowInc **Participant is low -**  **incom e?**  1 = Yes 2 = No 0 = Unknown 1 7 First
generation EligFirstGen **Participant is a first -**  **generation college student?** 1 = Yes 2 = No 0 = Unknown 1 8 Under
represented racial/ethnic group EligUnderrep **Participant is from a group underrepresented in graduate education?**  1 = Yes 2 = No 0 = Unknown **NOTE:** The following ethnic and racial groups are currently underrepresented in graduate education: Black (non
- Hispanic), Hispanic, American Indian/Alaskan Native, and Native Hawaiian or other Pacific Islander.**Field #**  **Field Name Database Column**  **Nam e**  **Valid Field Content**  

### II.D **. Participant ’s**  **Project Enrollment Information**  1 9 First School Enrollment Date (Postsecondary Education) FirstEnrollDT **Participant’s date of first enrollm ent into postsecondary education is:**  **Form at is MM/DD/CCYY**  MM = 01

– 12 DD = 01

– 31 CC = 19

–20 YY = 00

– 99 00/00/0000 = Unknown 20 Project Entry

Date ProjEntryDT **Participant’s date of first project service is: Form**  **at is MM/DD/CCYY** MM = 01

– 12 DD = 01

– 31 CC = 19

–20 YY = 00

– 99 00/00/0000 = Unknown 21 Grade Level at Project Entry EnterGradeLV **Participant’s college grade level at entry into the project is:**  1 = 1st yr., never attended 2 = 1st yr., attended before 3 = 2nd yr./sophomore 4 = 3rd yr./junior 5 = 4th yr./senior 6 = 5th yr./other undergraduate 7 = Graduate student (any year level) 0 = Unknown **NOTE:** Use options 3, 4, 5, and 6 **only for students who had the required number of credits and GPA** to be classified at the institution at the time of project entry as sophomore, junior, senior, and other undergraduate, respectively. 2 2 Participant

Status (during academic year being reported) PartCD **Participant is a:** 1 = New Participant 2 = Continuing Participant 3 = Prior
- Year Participant 4 = Prior
- Year Participant, Deceased 

### Notes:  A **new participant** is an individual who was served by the project for the **first tim e**  in this reporting period (PY 2012

– 13).  A **continuing participant** is an individual who was served by the project for the first time in **any** prior reporting period and also received services in the 2012

– 13 reporting period.  A **prior -**  **year participant** is an individual served by the project in **any** prior reporting period but has not received services during the academic year being reported (PY 2012

– 13).  A **prior -**  **year participant who is deceased** is an individual served by the project in **any** prior reporting period but is now deceased.**Field #**  **Field Name Database Column**  **Nam e**  **Valid Field Content**  2 3 Enrollment

Status (during academic year being reported) EnrollCD **Participant’s enrollm ent status is:**  1 = Full academic year (both semesters or three quarters) 2 = Part of academic year (one semester or one or two quarters) 3 = Summer only 4 = Full academic year and summer 5 = Part of academic year and summer 99 = Not enrolled 0 = Unknown Please provide this information for both undergraduate and graduate students. 2 4 Project Participation (during academic year being reported) ProjPart **Participated during:** 1 = Full academic year (both semesters or three quarters) 2 = Part of academic year (one semester or one or two quarters) 3 = Summer only 4 = Full academic year and summer 5 = Part of academic year and summer 9 9 = Not applicable

– prior
- ye ar participant 0 = Unknown **NOTE:** Complete this field for new and continuing students. Select “9” for prior
- year participants. 2 5 Funding

Source FundSource **T ypes of funds used to support this participant during the reporting y**  **ear are:**  1 = Federal funds 2 = Non
- federal funds 3 = Partially supported with non
- federal funds 9 9 = Not applicable

– prior
- ye ar participant 0 = Unknown **NOTE** : Com

plete this field for new

and continuing students. Select “ 9” for prior
- year participants. 

### II.E. Participant’s Academic and Degree Status 26 Main field of undergraduate study UnderGradField **P articipant’s undergraduate m**  **ain field of study is:** 

###  0 = Unknown Please use the “ **Main Field of Study ”**  **list** located in the instructions and provide the 3
- digit code for the participant’s undergraduate main field of study. Please provide the participant’s main field of study for participants who are ENROLLED in undergraduate studies. If the participant attained a bachelor ’s degree in this reporting period, please provide the main field of study. For all other participants (including graduate students) , please enter “001”. Also enter “001” if you do not know the participant’s undergraduate main field of study
.**Field #**  **Field Name Database Column**  **Nam e**  **Valid Field Content**  27 Cumulative GPA (upon graduation with a bachelor’s degree) CumGPA **P articipant’s cumulative GPA upon grad**  **uation with a bachelor’s degree is:** 0.001 to 5.000 9.999 = Not applicable, participant has not received bachelor’s degree 0.000 = Unknown **NOTE:** Provide cumulative GPA for all McNair participants who have graduated with a bachelor’s degree. Do not provide any other GPA in this field. 28 Attendance at Community College UGTransfer **Participant transfer from a community college (2**  **- year institution)?**  1 = Yes 2 = No 0 = Unknown Please do not respond “Yes” if the participant earned college credit through a dual enrollment program. 29 Bachelor’s or Equivalent Degree BADegree **Participant earned a bachelor’s degree?** 1 = Yes 2 = No 0 = Unknown 30 Date of Bachelor’s or Equivalent Degree DateBADegree **Date participant earn**  **ed bachelor’s degree is:**  **Form at is MM/DD/CCYY**  MM = 01

– 12 DD = 01

– 31 CC = 19

–20 YY = 00

– 99 99/99/9999 = No bachelor’s earned yet 00/00/0000 = Unknown 31 Academic (Cohort) Year of Bachelor’s Degree AYB ADegCohort **Academic year the participant earned their bachelor’s degree is:** 1 = Prior to 2002
- 03 2 = 2002
- 03 3 = 2003
- 04 4 = 2004
- 05 5 = 2005
- 06 6 = 2006
- 07 7 = 2007
- 08 8 = 2008
- 09 9 = 2009
- 10 10 = 2010
- 11 11 = 2011
- 12 12 = 2012
- 13 99 = No first b achelor’s degree earned ye t Note: The academic year of the bachelor’s degree (i.e., bachelor’s degree cohort year) should align with field #30, Date of**Field #**  **Field Name Database Column**  **Nam e**  **Valid Field Content** 

Bachelor’s Degree. For example, if the participant earned a bachelor’s degree on May 1 5, 2006, then the participant’s bachelor’s degree cohort year is option #5, 2005
- 06. 

### II.F. Participant’s Research and Internships during the Academic Year 32 Research

(2012

– 13 academic year ) Research **To what extent d id the student participate in a research**  **activity?** 1 = Participated in research but did not complete all of the components of the research activity 2 = Did **not** participate in Research 3 = Completed **all** of the components of the Research activity 9 9 = Not applicable, prior
- year participant 0 = Unknown 33 Internships

(2012

– 13 academic year) Internship **To what extent d id the student participate in a research**  **activity?** 1 = Participated in research but did not complete all of the components of the research activity 2 = Did **not** participate in Research 3 = Completed **all** of the components of the Research activity 9 9 = Not applicable, prior
- year participant 0 = Unknown 

### II.G **. Participant’s Graduate School**  **Information** 34 Graduate

School Admissions Test GradAdmTest **Participant com pleted a graduate school admissions test?**  1 = Yes 2 = No 0 = Unknown 35 Number of

Graduate School Applications GradSchApp **Participant’s number of graduate school applications submitted during the reporting period is:** 1 = 0 2 = 1 3 = 2

– 4 4 = 5 or more 0 = Unknown 36 Graduate

School Enrollment Status (at the beginning of the **2013**

**– 14**  academic year) GradEnrollStatus **Participant’s graduate enrollment status**  **in the Fall of the 2013 -**  **14 academ ic year (i.e., for participants who received a**  **bachelor’s degree in this reporting period) is:**  1 = Enrolled in a post
-baccalaureate degree program (for participants who received a bachelor’s degree or equivalent in this reporting period) 2 = Did not enroll in a post
-baccalaureate degree program (for participants who received a bachelor’s degree or equivalent in this reporting period) 3 = Other (for students who did not receive a bachelor’s degree or equivalent in this rep orting period) 0 = Unknown Select option #1 if the student **received** a bachelor’s degree in this reporting period and **enrolled** in a post baccalaureate degree program in the Fall term of the next academic year. S elect option #2 if the student **received** a ba chelor’s degree in this reporting period and **did not enroll** in a post baccalaureate degree program in the Fall term of the next academic year.**Field #**  **Field Name Database Column**  **Nam e**  **Valid Field Content** 

Select option #3 if the student **did not receive** a bachelor’s degree in this reporting period or received a bachelor’s degree in a previous reporting period. 37 Date of First

Graduate School Enrollment FirstGradEnrollDT **Graduate student’s first enroll**  **me nt date in graduate school is:**  **Form at is**  **MM/DD/CCYY** MM = 01

– 12 DD = 01

– 31 CC = 19

–20 YY = 00

– 99 99/99/9999 = Has not yet enrolled in graduate school 00/00/0000 = Unknown **NOTE** : Please enter a valid date of entry only once and do not edit this date in future submissions . If you do not know the complete date, use 15 for the day and use your best estimate for the month. 38 Institution Attended for First Year Graduate Students 1 stYrGradIPEDS **NCES IPEDS ID of the graduate institution attended for graduate students is:**  888888 = Not applicable, has not completed undergraduate studies 999999 = Not applicable, completed undergraduate studies but never enrolled in graduate school 000000 = Unknown Provide the six
- digit postsecondary institution NCES IPEDS ID for 1 st year graduate students only. Once a valid NCES IPEDS ID is provided, please do not update this information in subsequent reporting periods. You can obtain the NCES IPEDS ID from th e following web site: http://nces.ed.gov/globallocator/ 39 Graduate Student’s Main Field of S tudy Grad StudField **P articipant’**  **s graduate m**  **ain field of study is:** 

###  0 = Unknown Please use the “ **Main Field of Study ” list**  located in the instructions and provide the 3
- digit code for the participant’s graduate main field of study. If the participant is not in graduate school (e.g., participant is still in undergraduate program or di d not enroll in graduate school), please enter “001”. **N OTE:**  Report a field of graduate study only f or enrolled graduate students. All other participants should be reported as either “001” or “0” for unknown. 40 Graduate Assistantships GradAsstshp **Graduate student receive an**  **assistantship during the reporting period?** 1 = Teaching Assistantship 2 = Research Assistantship 3 = Other 4 = No Assistantship 99 = Not applicable, student is not enrolled in graduate school 0 = Unknown If the participant is not enrolled in graduate school (e.g., undergraduates), please select “99”.**Field #**  **Field Name Database Column**  **Nam e**  **Valid Field Content**  41 First
- Year

Graduate Student Persistence Status (at the beginning of the **2013**

**– 14**  academic year) FYGradPersistStatus **For a participant who is 1 st**  **year graduate student in this reporting period, what is the graduate enrollm ent status at the**  **beginning of the 2013**  **- 14 academic year**  **?** 1 = Still enrolled in a post
-baccalaureate degree program (for participants who were 1st year graduate students in this reporting period) 2 = No longer enrolled in a post
-baccalaureate degree program (for participants who were 1st year graduate students in this reporting period) 3 = Other (for students who were not first
- year graduate students in this reporting period) 0 = Unknown S elect op tion #1 if the student **was a first -**  **year graduate student** in **this** reporting period and **was still enrolled** in a post
baccalaureate degree program at the beginning of the 2013
- 14 academic year
. Select option #2 if the student **was a first -**  **year graduate studen t**  in **this** reporting period and **was NOT enrolled** in a post
baccalaureate degree program at the beginning of the 2013
- 14 academic year. Select option #3 if the student **was NOT a first -**  **year graduate student** in this reporting period. 42 Reason Left

Graduate School ReaLftGradSch **Reason participant left graduate school is:** 1 = Academic Problems 2 = Change in f

amily s tatus 3 = Change in p rogram 4 = Done taking classes 5 = Scheduling or availability 6 = Job or military conflict 7 = Needed to work or other financial reasons 8 = Taking time off 9 = Personal p roblems other than financial 10 = Pursue other interests 11 = Other 88 = Not applicable, still enrolled in graduate school 99 = Not applicable, undergraduate student or never enrolled in graduate school 0 = Unknown 43 Highest

Graduate Degree Earned (as of the end of the academic year) GradDegreeCD **Participant’s highest**  **graduate degree earned to date, as of the end of the academ** **ic year is:** 1 = Master’s Degree 2 = Doctor of Philosophy (Ph.D.) 3 = Doctor of Education (Ed.D) 4 = Doctor of Engineering (D.Eng./D.E.SC/D.E.S) 5 = Doctor of Business Administration (D.B.A.) 6 = Doctor of Science (D.Sc./Sc.D) 7 = Doctor of Health/Nursing Sciences (D.H.Sc/D.N.Sc) 8 = Doctor of Psychology/Social Work (Psy.D/D SW) 9 = First
-professional Degree (Law, Medicine, Dentistry, Optometry, Veterinary medicine, Osteopathic medicine, Theology, etc.)**Field #**  **Field Name Database Column**  **Nam e**  **Valid Field Content** 

99 = Not applicable, no graduate degree earned 0 = Unknown **NOTE** : Use the degree code that indicates the highest graduate de gree obtained ( regardless of year earned ). Repeat each degree reporting code every year until a new or more advanced degree ha s been earned. If no graduate degree has been earned including those who have earned a bachelor’s degree **only** , please select opti on #99
. 44 Date Highest

Graduate Degree Earned HiGradDegDate **Date participant earn**  **highest graduate degree is: Form**  **at is MM/DD/CCYY** MM = 01

– 12 DD = 01

– 31 CC = 19

–20 YY = 00

– 99 99/99/9999 = No graduate d egree earned 00/00/0000 = Unknown **NOTE** : Repeat the same date until a new and more advanced degree is earned. If you do not know the complete date, use 15 for the day and use your best estimate for the month. If no graduate degree has been earned including those who have earned a bachelor’s d egree **only** , please enter 99/99/9999
. **Once the doctorate degree has been provided, please do not change the response in subsequent reporting periods.**  45 Institution

Where Doctorate wa s Earned GradStudDoc IPEDS **NCES IPEDS ID where the participant earned their doctorate**  **is:** 888888 = Not applicable, has not completed undergraduate/graduate studies 999999 = Not applicable, completed undergraduate/graduate studies but did not earn a doctorate degree
. 000000 = Unkno wn Provide the six
- digit postsecondary institution NCES IPEDS ID for participants who attained a doctorate degree Once a valid NCES IPEDS ID is provided, please do not update this information in subsequent reporting periods. You can obtain the NCES IPE DS ID from the following web site: http://nces.ed.gov/globallocator/ 46 Doctorate

Student’s Em ployment Activity DocEm pAct **Doctorate recipient primarily**  **em ployed in a:** 

1 = Teaching Ac tivity 2 = Research Activity 3 = Other Activity 99 = Not applicable, did not earn a doctorate degree 0 = Unknown **PRIVACY ACT** In accordance with the Privacy Act of 1974 (Public Law No. 93
- 579, 5 U.S.C. 552a), you are hereby notified that the Department of Education is authorized to collect information to implement the Ronald E. McNair Postbaccalaureate Achievement (McNair) Program under Title IV of the Higher Education Act of 1965, as amended (Pub. Law 102
- 325, Sec. 402E ). In accordance with this authority, the Department receives and maintains personal information on participants in the Student Support Services program. The principal purpose for collecting this information is to administer the program, including tracking and evaluati ng participant progress. Providing the information on this form, including a social security number (SSN) is voluntary; failure to disclose an SSN will not result in the denial of any right, benefit or privilege to which the participant is entitled. The information that is collected 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.