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OMB Approval No.: 1840-0777

 Expiration Date: 01/31/2013

U.S. DEPARTMENT OF EDUCATION

Gaining Early Awareness and Readiness for Undergraduate Programs

(GEAR UP)

Annual Performance Report for Partnership and State Projects

COVER SHEET

1. PR/Award Number: _________________________________________________________

 (Located in block 5 of your grant award notification)

2. Name of Grantee: ___________________________________________________________

3. Address: __________________________________________________________________

4. Name of Project Director/Contact Person: ________________________________________

 Phone Number: ______________________ Fax: ______________________________

 E-mail Address: _____________________________________________________________

5. Name of Certifying Official: ___________________________________________________

 Phone Number: _______________________ E-mail Address: ______________________

6. Report Period: _____________________________ to ________________________________

Month/Day/Year Month/Day/Year

We certify that to the best of our knowledge, the information reported herein is accurate and complete.

_____________________________________ ______________________________________

Name of Project Director (Print) Name of Certifying Official (Print)

_____________________________________ ______________________________________

Signature and Date Signature and Date

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a 

valid OMB control number. The valid OMB control number for this information collection is 1840-0777. The time required to complete 

this information collection is estimated to average 40 hours per response, including the time to review instructions, search existing data 

sources, gather the data needed, and complete and review the information collection. 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, 

DC 20202-4651. If you have comments or concerns regarding the status of your individual submission of the form, write directly 

to: The GEAR UP Program, U.S. Department of Education, 1990 K Street, N.W., 7014, Washington, DC 20006-8524.
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INSTRUCTIONS:

The following set of forms are the Annual Performance Report (APR) for GEAR UP State and Partnership projects. The 

APR is used by the Department of Education to determine whether substantial progress is met when meeting the objectives 

of your project as outlined in your grant application and/or work plan for this reporting period. Under section 75.590 of 

Education Department General Administrative Regulations (EDGAR), each eligible recipient that is awarded a GEAR UP 

grant must submit an APR describing their progress in meeting project goals and objectives. As required by the 

Government Performance and Results Act of 1993, the APR is also used to collect data addressing the performance of the 

GEAR UP program on a national level. Annual submission of the APR is a requirement of your grant and will be used 

to determine continuation of funding.

The APR consists of a cover sheet and six sections. The cover sheet must be completed and signed by the project director 

and the certifying official and returned to the Department of Education along with the six sections on or before the due date. 

A separate announcement including these instructions and due date will be mailed to each grantee annually. Grantees are 

expected to complete all questions in the APR. Please define all terms specific to your program and spell out all acronyms 

the first time they are used. 

Except where otherwise indicated, the reporting period for this report is as follows:

 If this is the first award year of your grant, the reporting period includes the time period from the beginning of 

your grant through March 31

st of this year. 

 If this is the second through sixth or seventh award year of your grant, the reporting period includes the period 

of time from the end of your last reporting period through March 31

st of this year.
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SECTION I: EXECUTIVE SUMMARY

1. Please provide a brief description (1-2 pages) of the current status of your project. Describe the 

extent to which you have implemented all program activities and components planned for this 

reporting period. Highlight your major outcomes, successes, and concerns.
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SECTION II: NARRATIVE INFORMATION

1. The mission of the GEAR UP program is to significantly increase the number of low-income 

students who are prepared to enter and succeed in postsecondary education. Briefly describe 

how your project is furthering the mission of the GEAR UP program. Specifically, address 

how your project is: a) improving academic performance of students in the GEAR UP cohort; 

b) increasing educational expectations of participating students and their parents; c) improving 

student and family knowledge regarding postsecondary education preparation and financing; 

and d) working to improve high school graduation and college enrollment rates.

2. What aspects of your program do you think are most successful (have the greatest impact)? 

Why?

3. What barriers or problems have you encountered in planning, developing, implementing, 

 and/or administering your grant? How have you addressed these problems?

4. Describe briefly the progress that you have made during this reporting period in implementing 

your evaluation plan as described in your approved application for GEAR UP funding. 

5. Describe how your project’s activities and outcomes are likely to be sustained over time. What 

systemic changes have occurred in your school(s)?

6. Please provide any additional information about your project that you think would be helpful to 

the Department of Education in evaluating your performance or understanding the contents of 

your annual report. 
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7. Describe the progress that your project has made towards accomplishing the objectives of your 

project for this reporting period as outlined in your grant application or work plan. Please list 

your objectives in the table below, and indicate what activities have taken place, the 

quantitative results of those activities, and actions required (what, if any, changes do you intend 

to make in response to the results that you have seen). You may extend this table on to another 

page as needed.

Objectives: List the approved 

objectives from your grant 

application or work plan. 

Where applicable, provide 

baseline data.

Activities: List the activities 

that have been conducted to 

meet the objective. 

Results: Has the objective 

been met? If not, what 

progress have you made in 

reaching the objective?

Actions required: Are you 

planning to make changes to 

the grant in response to the 

results? 

Example: 1. Enrollment in 

7

th grade pre-algebra, 8th

grade algebra, and 8th grade 

advanced science classes 

will increase by 5% by next 

year.

Baseline:

Pre-algebra 7th grade -- 10%

Algebra 8th grade -- 5%

Adv. Sci. 8th grade -- 20%

 

Example: Instructional 

support services, staff 

development to improve 

instruction, and articulation 

with elementary schools

Example: Enrollment 

changes from 2008/09 to 

2009/10: 1) 7th grade prealgebra: +65% 

2) 8th grade algebra: +5%

3) 8th grade advanced 

science: -6% (due to 

increased standards for 

enrollment).

Example: Continue to 

identify students needing 

intervention services based 

on achievement scores. Add 

science component to after 

school tutoring program.

1.

2.

3.

4.

5.

6.

7.

8.
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SECTION III: GRANT ADMINISTRATION AND BUDGET INFORMATION

1. In the following table, please provide information about your actual and anticipated Federal 

expenditures for the current budget period. The current budget period can be found in Section 

6 of your current Grant Award Notification (GAN). You do not need to fill in the shaded boxes, 

but please indicate total amounts in line E for all columns. *If this is the first award year of 

your grant, the reporting period includes the time period from the beginning of your grant 

through March 31

st of this year.

Federal Budget Summary

Total Federal 

Funds Awarded 

for Current 

Budget Period

(See Current 

GAN)

Carryover Funds 

Available (Include Funds 

Carried Over From 

Previous

Budget Period(s))

Actual Federal

Expenditures from

Current Budget Period 

(GAN Start Date) thru

March of APR 

Submission Year

Anticipated Federal 

Expenditures from

April to Current 

Budget Period End 

Date

Anticipated 

Carryover to Next 

Budget Period (if 

applicable)

1. Salaries and Wages

2. Employee Benefits

3. Travel

4. Materials & Supplies

5. Consultants & 

Contracts

6. Other

A. Total Direct Costs:

 (Lines 1 – 6)

B. Total Indirect Costs:

C. Equipment 

D. Scholarships/ 

Tuition Assistance

E. Total Costs 

(A+B+C+D)
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2. In the following table, provide information about your actual and anticipated non-Federal 

matching contributions for the current budget period. Current budget period can be found 

in Section 6 of your current Grant Award Notification (GAN). *If this is the first award year 

of your grant, the reporting period includes the time period from the beginning of your grant 

through March 31

st of this year.

Non-Federal Matching Budget Summary

Matching Contributions 

Proposed For Current 

Budget Period

(See Current GAN)

Actual Matching 

Contributions for

Current

Budget Period

April – March*

Anticipated Matching 

Contributions from

April to Current Budget 

Period End Date

1. Salaries and Wages

2. Employee Benefits

3. Travel

4. Materials & Supplies

5. Consultants & Contracts

6. Other

A. Total Direct Costs:

 (Lines 1 – 6)

B. Total Indirect Costs:

C. Equipment 

D. Scholarships/ Tuition 

 Assistance

E. TOTAL COSTS

(A+B+C+D)

  If you requested a match reduction in your original application, please check the box.
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3. In the following table, please provide information about your actual Federal and matching expenditures for previous, completed 

budget periods. For example, for grants that began in Fiscal Year 2009, the Year 1 budget period would be July 2009 through 

June 2010. First year grantees do not need to fill out this table. If you are in the second through seventh years of your grant, fill 

out information only for completed budget periods.

Actual 

Federal 

Expenditures

Year 1

Actual 

Matching 

Contributions 

Year 1

Actual 

Federal 

Expenditures 

Year 2

Actual 

Matching 

Contributions 

Year 2

Actual 

Federal 

Expenditures 

Year 3

Actual 

Matching 

Contributions 

Year 3

Actual 

Federal 

Expenditures 

Year 4

Actual 

Matching 

Contributions 

Year 4

Actual 

Federal 

Expenditures 

Year 5

Actual 

Matching 

Contributions 

Year 5

Actual 

Federal 

Expenditures 

Year 6

Actual 

Matching 

Contributions 

Year 6

1. Salaries 

and Wages

2. Employee 

Benefits

3. Travel

4. Materials 

& Supplies

5. 

Consultants 

& Contracts

6. Other

A. Total 

Direct Costs: 

(Add lines 1 –

6)

B. Total 

Indirect 

Costs

C. 

Equipment 

D. 

Scholarships/ 

Tuition 

Assistance

E. TOTAL 

COSTS

(A+B+C+D)
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4. If you are not expending Federal or matching funds as originally budgeted, please provide an 

explanation for the change. Please describe how you plan to expend carryover funds and/or how you

plan to meet your matching requirements.

5. Describe any significant changes in your project design since the approval of your grant application 

(e.g., changing from individual tutoring to group tutoring or placing more emphasis on enrichment 

activities rather than remediation). Do you anticipate making changes to your project design in the 

coming year? If so, please describe. How have any changes or anticipated changes affected your 

budget? How will these changes impact quantitative outcomes and your ability to meet the project’s 

goals?

6. Please list the names and titles of all individuals paid by GEAR UP Federal or matching funds, and 

indicate the percentage of time each individual spends working on the GEAR UP grant. (If the 

percentage of time is not available, you may indicate the number of hours that individual was paid 

with GEAR UP funds instead.)

7. Describe any changes to key personnel of this grant that have come about over the past year, 

including changes in titles, changes in percentage of time that a person is devoting to the project, 

hiring of a key staff person, departure of a key staff person, or addition or elimination of a position. 

Discuss any significant changes to key personnel proposed or anticipated for the coming reporting 

period. (Do not request replacement of key personnel or the addition / elimination of position(s) here. 

That type of request is a change that requires an administrative action and must be addressed 

separate from this report. Your response should be a summary of approved and completed changes 

that have take place during this reporting period.) 

8. Describe any changes to the roles of your partners during the past year. Have any partners been 

added to your grant? Have any partners discontinued their participation in your grant? Has the role 

of any existing partner changed significantly? 

9. Describe briefly your project’s record keeping system for collecting and reporting student 

outcome/achievement data and participation in GEAR UP activities. Specifically, how frequently are

data collected, and what method(s) does your project use to collect and maintain data regarding 

student, parent, and teacher participation in GEAR UP activities? 

10. How do you link student outcome/achievement data with student participation? How does your 

project use the data collected to evaluate and guide the project?

11. Describe your record-keeping system for maintaining source documentation for all federal and nonfederal expenditures (e.g., time and effort record (which include percentage of time spent on grant 

activities), transportation cost, equipment, supplies, college field trips, and other GEAR UP 

expenditures). Who is responsible for maintaining the documentation?

12. If your project has a scholarship component for postsecondary education, please provide: a) 

information about the amount of scholarship money (Federal and/ or non-Federal matching funds) 

that has been reserved and/or obligated; b) information regarding where scholarship funds are held 

pending distribution to former GEAR UP students (e.g., are the funds in a trust account?); and c) how 

the funds will be disbursed and to whom. If you have already disbursed scholarship money to 

students, please indicate the amount of money disbursed, the number of students who received 
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scholarships, and the average amount of the scholarships awarded. NOTE: Scholarship funds are 

subject to audits or monitoring by authorized representatives of the Secretary throughout the 

life of the funds.

13. Please indicate the number of GEAR UP 12th grade students who have completed the Free 

Application for Federal Student Aid (FAFSA) - ______ (number of students).

14. Please complete the following table. List all partners and indicate with an “X” whether they are 

original partners listed in the application or new partners added during implementation. If any of these 

partners have become inactive and are no longer participating in the grant, please indicate this with an 

“X” in the column provided. If a partner is new, indicate with an “X” if you have provided the 

program office with a Partner Identification Form and Cost Share Worksheet to update the 

application. 

 Rows can be added to this table if you have more partners. 

Partner Name Original New Inactive Submitted Partner 

Identification Form 

and Cost Share 

Worksheet

Type of Partner

(IHE)

1

2

3

4

5

6

7

8

9

10

11

12

13

14

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Please indicate the type of partner from the following options and enter the letter in the column provided:

C = Community Organization, F = Faith-based Organization, B = Historically Black College and University

(HBCU), H = Hispanic Serving Institution (HIS), O = Other Type of Organization, P = Other Postsecondary

Institute, and S = School/District, IHE= Institute of Higher Education.
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15. Indirect Cost Agreement: Indirect cost reimbursement on a training grant is limited to the recipient’s 

actual indirect costs, as determined by its negotiated indirect cost rate agreement, or eight percent of the 

modified total cost base, whichever amount is less. In order to claim an indirect cost on next year’s 

budget, the grantee must provide information on their current agreement. Check one of the three 

options.

1.  Current Indirect Cost Agreement: Effective date of agreement: Beginning date: _____

Ending date: _________, Current rate:_________

2.  Requesting indirect Cost Agreement: If you’ve requested an indirect cost rate agreement

but have not receive one, you should provide your program officer with evidence of your contact 

with the cognizant agency and their response. If a negotiated indirect cost rate agreement was not 

awarded, a grantee using the training rate of eight percent is required to have documentation 

available for audit that shows that its indirect rate equals or exceeds the eight percent. Please 

indicate whether your program officer has documentation of your attempt to secure an indirect cost 

rate agreement Yes  No 

3.  Do not claim indirect cost. 

16. Scholarship Funds: Please report on all Federal and non-Federal funds reserved and held for GEAR UP 

 Scholarships and the disbursement of those scholarship funds to eligible students. NOTE: Scholarship 

 funds are subject to audits or monitoring by authorized representatives of the Secretary 

 throughout the life of the funds.

1. Federal Scholarship Funds:

 $________________: Amount of funds reserved for GEAR UP students

 $________________: Amount of funds disbursed to GEAR UP students

 $________________: Total number of students receiving scholarships

 $________________: Amount of unexpended funds to be returned to the Department

2. Non-Federal Scholarship Funds:

$________________: Amount of funds reserved for GEAR UP students

 $________________: Amount of fund disbursed to GEAR UP students

 $________________: Total number of students receiving scholarships

 

 
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SECTION IV: DEMOGRAPHIC DATA AND DATA REGARDING SERVICES 

PROVIDED

1. Demographic Data: Please complete the following tables requesting demographic data on GEAR UP 

students. 

A. Students Served: Please complete the following table indicating the number of students 

served by your project. 

Number of Students

Number of students you proposed to serve during the reporting period 

(information supplied from application by the program office)

Actual number of students in your cohort(s) during the reporting period 

(i.e., number of students served)

State grants only: If you are serving students through a statewide initiative please indicate that number here. 

These numbers do not include those students stated on the Student Served Form in your proposal and 

reported in the actual students served count shown above. 

(An example of this may be a statewide homework hotline where students can call in and receive assistance 

with their assignments.)

Number of Students served under statewide initiatives________

B. Participant Distribution by Ethnic Background: The following table regarding the 

ethnicity/race background of GEAR UP students is mandatory and will be used by the 

Department of Education in reporting on the ethnicity/race characteristics of students 

served by the program. The ethnicity/race categories used in this section are consistent with 

the Department of Education’s policy on the collection of racial and ethnic information. 

These categories are defined as follows:

1. Ethnicity

Hispanic or Latino – A person of Mexican, Puerto Rican, Cuban, Central or South American or other 

Spanish culture or origin, regardless of race.

2. Race

American Indian or Alaska Native – A person having origins in any of the original peoples of North 

America, and who maintains cultural identification through tribal affiliations or community recognition.

Asian – A person having origins in any of the original peoples of the Far East, Southeast Asia, and the 

Indian subcontinent. This area includes, for example, China, India, Japan, Korea, and the Philippine 

Islands. 

Black or African American – A person having origins in any of the black racial groups of Africa.

Native Hawaiian or Other Pacific Islander – A person having origins in any of the original peoples of 

Hawaii or other pacific islands such as Samoa and Guam.
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White – A person having origins in any of the original peoples of Europe, North Africa, or the Middle 

East.

Two or more races 

Ethnicity and/or Race Unknown 

Ethnicity: Number of GEAR UP Students

Hispanic or Latino

Race:

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Two or More Races

Race and/or Ethnicity Unknown

Total

C. Participation by Gender: Complete the following table regarding the gender of GEAR UP 

students.

Gender: Number of GEAR UP students

Male

Female

Total Students Served

(should equal total number of students in cohort in Section IV, 1A)

 D. Participant Distribution by Grade and New or Continuing Status: Please complete the 

following table indicating the number of students in each grade that are new to GEAR UP 

(received GEAR UP services for the first time during the reporting period) and the number of 

current students who are continuing (received GEAR UP services during a prior period). 

Grade Level: Number of New GEAR UP 

Students

Number of Continuing 

GEAR UP Students

K-4

5

6

7

8

9

10

11

12

First Year IHE Enrollment

Total
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E. Participants with Limited English Proficiency: Completion of this table is not mandatory but 

is extremely helpful to the Department of Education in reporting on the characteristics of students 

served by the GEAR UP program. If you choose to do so, please complete the following table 

indicating the number of GEAR UP students with Limited English Proficiency served by your 

project during the reporting period.

Limited English Proficiency: For the purposes of this table, Limited English Proficiency means a person 

whose native language is other than English and who has sufficient difficulty speaking, reading, writing, 

or understanding the English language to deny that individual the opportunity to learn successfully in 

classrooms in which English is the language of instruction.

Number of GEAR UP Students

GEAR UP students with Limited English 

Proficiency

F. Participants with Individualized Education Programs (IEPs) as Required by the Individuals 

with Disabilities in Education Act Amendment of 1997 (IDEA): Completion of this table is not 

mandatory but is extremely helpful to the Department of Education in reporting on the 

characteristics of students served by the GEAR UP program. If you choose to do so, please 

complete the following table indicating the number of GEAR UP students with Individualized 

Education Programs.

Number of GEAR UP Students

GEAR UP students with Individualized 

Education Programs
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2. Participating Schools and Housing Projects: Please complete the appropriate table below 

indicating the schools or housing projects participating in your grant.

A. Participating Schools: If your grant is a partnership grant using a cohort model, please list 

all of the schools participating in your GEAR UP project. A participating school is a partner 

school identified in your GEAR UP application or is a school in which GEAR UP services are 

provided. Please include all schools you identified in your application, even if they do not 

yet have students participating in GEAR UP (e.g., if the GEAR UP cohort consists of 7th

graders, please list the GEAR UP high school(s) that the students will attend). In appropriate 

boxes, indicate all relevant grade levels separated by commas (e.g., 6, 7, 8). State grants and 

partnership grants using a public housing model do not need to complete this table.

Name of School Grade 

Levels 

Offered

Grade Levels 

Served by 

GEAR UP

Percentage of Students Eligible 

for Free and Reduced Price 

Lunch

City State Zip Code

B. Participating Housing Projects: Complete this table only if your project uses a public 

housing model. If your project is serving a public housing authority, please provide the 

name(s) of the public housing project(s). Indicate grade levels separated by commas (e.g., 6, 

7, 8).

Name of Public 

Housing Project

Grade Levels 

Served by GEAR 

UP

City State Zip Code

C. State Grants only: Number of Schools Participating in State GEAR UP Projects Please 

indicate the number of schools participating in your GEAR UP project during the current year. 

Partnership grants do not complete this table.

Number of Schools Participating in the State GEAR UP 

Project
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3. Services Provided to Students: In the following table, place an “X” in the first column next to the 

types of services provided by your project with GEAR UP Federal or matching funds. For each type 

of service provided, indicate the number of students who received the service during the reporting 

period and the average number of hours of service provided per student during the reporting period.

Place an “X” in this 

column if your project 

provides this type of 

service

Type of Service

R= Required Activity

Number of Students in the

GEAR UP Cohort Who 

Received the Service

Average Hours of Service 

Per Participant Receiving 

the Service Per Year

Supportive Services (R)

Rigorous academic curricula (R)

Comprehensive Mentoring (R)

Financial aid counseling/ advising

(R)

Counseling/ advising/ academic 

planning/career counseling (R)

College visit/college student 

shadowing

Job site visit/job shadowing

Summer programs

Educational field trips

Workshops

Family/cultural events

Other (please specify)

4. Services Provided to Parents: In the following table, place an “X” in the first column next to the 

types of services provided by your project using GEAR UP Federal or matching funding. For each 

type of service provided, indicate the number of parents (or guardians) who received the service 

during the reporting period and the average number of hours of service provided per parent during the

reporting period.

Place an “X” in this 

column if your 

project provides this 

type of service

Type of Service

Number of Parents of 

Students in the GEAR UP 

Cohort Who Received the 

Service

Average Hours of Service 

Per Participant Receiving 

the Service Per Year

Workshops on college 

preparation/financial aid

Counseling/advising

College visits

Family events

Other (please specify)
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5. Services Provided to Teachers: Please complete the following table indicating professional 

development provided to GEAR UP teachers. Include all teachers who taught GEAR UP students, 

whether or not their salaries are paid using GEAR UP funding.

Number of Teachers Who 

Taught GEAR UP Students 

During the Reporting Period

Number of Teachers of GEAR UP 

Students Who Participated in GEAR UP 

Sponsored Professional Development 

During the Reporting Period (April 

through March)

Average Hours of Professional 

Development Per Participating 

Teacher During the Reporting 

Period

6. Services Provided to Schools: Please complete the following table indicating services provided to 

GEAR UP schools.

Place an “X” in this column if your 

project provides this type of 

service

Type of Service

Curriculum development

Dual or current enrollment programs

Other (please specify)
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SECTION V: GEAR UP STUDENT OUTCOMES

This section of the report requests outcome information for current participants. Please report on your current 

GEAR UP students’ grades as of the time this report is submitted. Grantees are not required to report end of 

the year school grades.

1. Students Enrolled in Advanced Courses by Grade Level: Please complete the following table 

indicating the number of current GEAR UP students enrolled in advanced courses. “Advanced 

courses” are classes that are identified as above grade level by the student’s school. If an advanced 

course is not offered, please respond “N/A”.

Current grade 

level

Number of Students 

Enrolled in Advanced 

Mathematics Courses

Number of Students 

Enrolled in Advanced 

English/Language Arts 

Courses

Number of Students 

Enrolled in Advanced 

Science Courses

6

7

8

9

10

11

12

First year 

IHE 

Total
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2. Course Completion: Please complete the following table indicating the number of GEAR UP 

students who have successfully completed the courses identified. The names for math classes can 

vary among schools. Classify courses based on the content of the course. “Advanced Placement” 

classes are courses designed to prepare students for the Advanced Placement Exams. Grantees in 

their first year do not need to complete this question. Enter the numbers in the grade level the 

cohort was in when the course was completed.

Grade 

student 

was in 

when 

course 

was 

completed 

PrealgebraAlgebra I 

or 

equivalent

Geometry Algebra 

II

Calculus Chemistry Physics At least 

one 

Advanced 

Placement 

class

6

7

8

9

10

11

12

First 

Year 

IHE

Total

Grade 

student 

was in 

when 

course 

was 

completed 

Trigonometry PreCalculusBiology At least one 

International 

Baccalaureate

class

At least two 

years of math 

beyond 

Algebra I

6

7

8

9

10

11

12

First 

Year 

IHE

Total
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3. Educational Progress by Current GEAR UP Students: Please complete the table below indicating 

educational progress of current GEAR UP students. Where available, use standardized test scores to 

determine whether a student is performing at or above grade level. New grantees in their first year 

of implementation should not complete the two columns on performance. Enter the numbers in 

the row that coincides with the grade the students are in during the current school year. (e.g. If 

you served sixth grade during the first year of the grant and a standardized test was administered the 

first year to that sixth grade, please report on results of that standardized test when submitting the 

APR in the second year placing the information in the row for 7th grade since those students would be 

seventh graders in the second year.) 

 

Current 

Grade 

Number of Students 

Performing at or 

above Grade Level 

in English/Language 

Arts

Number of 

Students 

Performing at or 

above Grade Level 

in Mathematics

Number of 

Students 

Promoted to the 

Next Grade 

Level at the End 

of the Prior 

School Year

Number of Students 

with 5 or More 

Unexcused Absences 

During the First 2 

Quarters of the 

School Year

Number of 

Students Taking 

the PSAT or 

PLAN by end of 

10th Grade

Number of 

Students Taking 

ACT or SAT Exam

by the end of 11th

Grade

6

7

8

9

10

11

12

Total

4. Baseline High School Graduation and College Enrollment Data: This table will be completed 

once at the time the students of the first cohort are 11th graders. 

For each target high school, give the number of 12th graders, the number graduating with a high school 

diploma, and the number enrolled in post-secondary institutions (enrollment in less than 2 year,

2 year, and 4 year institutions) for the previous two years (e.g. if your first cohort are 11th graders in the 

current school year (2009-2010), then you would complete this table using figures from the 2007-2008 

and 2008-2009 school years).

* 12th graders are those students who have the credits required to be considered a 12th grader / senior.

Example

High School School year Number of 

12th grade 

students

Number who 

graduated

Number 

enrolled in 

post 

secondary 

institution

Madison H.S 2007-2008 1050 955 750

Madison H.S 2008-2009 950 802 670
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Fulton H.S. 2007-2008 750 500 125

Fulton H.S. 2008-20069 807 567 145

Graduation rate and enrollment rates will be calculated.

Graduation rate 79.4% Enrollment rate 47.6%

Rows can be added to the table.

High School School year Number of 

12th grade 

students

Number 

who 

graduated

Number 

enrolled in 

post 

secondary 

institution

Graduation rate and enrollment rates will be calculated.

Graduation rate Enrollment rate 
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SECTION VI: SURVEY DATA

In order to complete the APR, you will need to administer surveys to GEAR UP students and parents at least 

every two years. Separate surveys should be provided to GEAR UP students and parents. Each survey must 

include certain mandatory questions. Mandatory questions for the student survey are listed in Appendix A. 

Mandatory questions for the parent survey are listed in Appendix B. If desired, you may translate these 

questions into other languages. If you would like to add additional questions to the surveys for your internal 

purposes, you may do so. If you are in the first award period of your grant and you have not yet conducted 

student and parent surveys, you may respond “N/A” to the questions in this section. Please aim to give a 

copy of the survey to each student and one of his/her parents

1. A. Survey Administration: In the following box, please describe how your student and parent 

surveys are administered. When are the surveys distributed and how (e.g., are the surveys 

distributed in the classroom, at GEAR UP events, through the mail, or during home visits)? 

Describe the Administration of Your Surveys

B. Adequate response rates for the surveys have been set at 50% for the parent survey, and 

80% for student survey. Please list the response rates for your parent and student surveys. 

Parent Response Rate ____ % Student Response Rate ____ %

If your response rates for the parent and/or student surveys are lower than the percentages given, 

please answer the following:
23

What steps will you take to ensure that rates will increase the next time the survey(s) is administered? 

2. Student Survey Results: Please complete the following tables indicating the results of your 

student survey.

A. Grade Level of Survey Respondents: Please complete the following table indicating 

the number of GEAR UP students at each grade level who were given and responded 

to the survey.

Grade Level Number of students given the 

survey

Number of students who responded to 

the survey

6

7

8

9

10

11

12

Other

Total

Explain why the target survey response rate(s) was not met. 
24

B. Number of Students who have spoken with someone about College Entrance 

Requirements and Financial Aid: Please complete the following table indicating 

student response to survey questions 2 and 3 in Appendix A (Surveys).

Grade level Number of students 

who have spoken 

with someone about 

college entrance 

requirements. 

(Students who responded 

positively to question No. 

2 from Appendix A.)

Number of students 

who have not spoken 

with someone about 

college entrance 

requirements. 

(Students who responded 

negatively to question No. 

2 from Appendix A.)

Number of students 

who have spoken 

with someone about 

the availability of 

financial aid. 

(Students who responded 

positively to question No. 

3 from Appendix A.)

Number of students 

who have not spoken 

with someone about 

the availability of 

financial aid. 

(Students who responded 

negatively to question No. 

3 from Appendix A.)

6

7

8

9

10

11

12

Other

Total

C. Perceptions of Affordability: Please complete the following table indicating student 

response to question #6 from Appendix A, “Do you think that you could afford to 

attend a public 4-year college using financial aid, scholarships, and your family’s 

resources?”

Response Number of Students Responding

Definitely

Probably

Not sure 

Probably not

Definitely not

 

3. Parent Survey Results: Please complete the following tables indicating the results of your 

parent survey.

A. Number of Parents who were given and completed the Survey: Please complete 

the following table indicating the number of parents who were given and responded to the 

survey.

Number of Parents Given Survey Number of Parents Who Completed Survey
25

B. Number of Parents who have spoken with someone about College Entrance 

 Requirements and Financial Aid: Please complete the following table indicating 

 parent response to survey questions 1 - 3 from Appendix B.

Response Total Number of Parents Responding

Question 1A, Yes (have spoken with someone 

about college entrance requirements)

Question 1B, No (have not spoken with someone 

about college entrance requirements)

Question 2A, Yes (have spoken with someone 

about financial aid)

Question 2B, No (have not spoken with someone 

about financial aid)

 C. Number of Parents who have spoken with their children about College:

 Please complete the following table indicating parent response to survey question 

 #4 from Appendix B, “Have you talked with your child about attending college?”

Response Total Number of Parents Responding

Yes

No

D. Educational Expectations: Please complete the following table indicating parent 

responses to survey question #5 in Appendix B, “What is the highest level

of education that you think your child will achieve?”

Response Total Number of Parents Responding

High school or less

Some college, but less than a 4-year college 

degree

4-year college degree or higher

E. Perceptions of Affordability: Please complete the following table indicating parent 

 response to question #6 from Appendix B, “Do you think that your child could 

 afford to attend a public 4-year college using financial aid, scholarships, and family

 resources?”

Response Number of Parents Responding

Definitely

Probably

Not sure 

Probably not
26

Definitely not
27

APPENDIX A

The student survey must contain the following questions:

1. What is your current grade level?

a. Grade 6

b. Grade 7

c. Grade 8

d. Grade 9

e. Grade 10

f. Grade 11

g. Grade 12

h. Other

2. Has anyone from your school or GEAR UP ever spoken with you about college 

entrance requirements? 

a. Yes

b. No

3. Has anyone from your school or GEAR UP ever spoken with you about the availability 

of financial aid to help you pay for college? 

a. Yes

b. No

4. Are you knowledgeable about financial aid and the cost and benefits to you of going to 

college

(YES)_______________ 

(NO) _______________

5. What is the highest level of education that you expect to obtain?

a. High school or less

b. Some college but less than a 4-year college degree 

c. 4-year college degree or higher

 6. Do you think that you could afford to attend a public 4-year college using financial aid, 

 scholarships, and your family’s resources?

(YES)_______________ 

(NO) _______________
28

APPENDIX B

The parent survey must contain the following questions:

1. Has anyone from your child’s school or GEAR UP ever spoken with you about college 

entrance requirements? 

a. Yes

b. No

2. Has anyone from your child’s school or GEAR UP ever spoken with you about the 

availability of financial aid to help you pay for college? 

a. Yes

b. No

3. Are you knowledgeable about financial aid and the cost and benefits of your child pursuing 

postsecondary

(YES)_______________ 

(NO) _______________

4. Have you talked with your child about attending college?

a. Yes

b. No

5. What is the highest level of education that you think your child will achieve?

a. High school or less

b. Some college but less than a 4-year college degree 

c. 4-year college degree or higher

6. Do you think that your child could afford to attend a public 4-year college using financial 

aid, scholarships, and your family’s resources?

(YES)_______________ 

(NO) _______________