Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 1 - **C ollege Assistance Migrant Program**  **U.S. Department of Education Annual Performance Report Form and**  **Final Performance Report** Sample University S149A _ _ _ _ _ _ **Introduction** The College Assistance Migrant Program (CAMP) is intended to a ssist migrant and s easonal farm worker students to successfully complete their first academic year of college and to continue at a postsecondary education institution. The legislation that authorizes the CAMP program, the Higher Education Act of 1965 , as amended, Title IV, Sec. 418A; 20 U.S.C
. 1070d
- 2 , and the Education Department General Administrative Regulations (EDGAR), 34 CFR 75.253 require each of the funded projects to submit an annual performance report demonstrating that substantial progress has been made towards me eting the approved objectives of the project. In addition, grantees are required to report on their progress toward meeting the performance measures established for the ED grant program. This Annual Performance Report is the tool designated by the Department for reporting. The CAMP GPRA indicators (program performance measures) are listed below: **Objective 1 of 2 :**  All CAMP students will complete their first academic year at a postsecondary institution in good standing. **Measure 1.1 of 1:** The percentage* of College Assistance Migrant Program (CAMP) participants completing the first year of their academic or postsecondary program. (Desired direction: increase 1 ) **Calculation** : This measure is calculated by dividing the number of CAMP first academic year completers ( the number of CAMP eligible students who successfully completed their first academic year of college by the end of the budget period) by the total number funded, as per the approved application by OME, or the number actually served (whichever i s greater) , MINUS the number of persisters. For example:

a. For grantees who actually serve **LESS** than the number funded to be served or serve **exactly** the total number funded to be served Project
- level GPRA Measure 1= total number of CAMP first academic year completers [total no. funded to be served minus total number of persisters] b. For grantees who actually serve **MORE** than the number funded to be served: Project
- level GPRA Measure 1= total numbe r of CAMP first academic year completers [total no. actually served minus total number of persisters]

1 Note: increasing percentages of CAMP participants c ompleting the first year of their academic or postsecondary program is the goal for the program office at the national level. P rojects will be assessed individually, on an annual basis, as to their capacity to in crease these measures and meet the national GPRA targets.Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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OMB No. 1810 -XXXX CAMP Annual Performance Report Exp. 

### - 2 - **Example:**

**Grant Year**  **Incoming Students Outgoing Students**  **GPRA 1.1 (Percent**  **com pleting**  **1 st**  **yea r of**  **college )**  **Total Funded**  **New Returning**  **from Previous**  **Year Total** 

**Funded CAMP** 

**first academ** **ic year**  **com pleters**  **Withdrawals Persisters**  **(com ing**  **back in subsequent**  **year)** Year 1 100 100 0 100 65 30 5 68% Year 2 100 95 5 100 70 25 5 74% In this example, fo r grant year 1, the denominator equals 95 (100 total funded minus 5 persisters). The numerator equals 65 ( CAMP first academic year completers ), for a “success rate” of 65/95 or 68 percent. For grant year 2, the denominator equals 95 (100 total funded minus 5 persisters). The numerator equals 70 ( CAMP first academic year completers ), for a success rate of 70/95 or 74 percent. **Note: The**  **APR does**  **not address**  **the total number**  **recruited to**  **be served.**  **Each grantee**  **may be**  **serving fewer students than they recru**  **it. For reporting, the key variable is the number funded to be served (not recruited).**  **Objective 2 of 2 :**  A maj ority of CAMP students who successfully complete their first academic year of college will continue in postsecondary education. **Measure 2.1 o f 1:**  The percentage* of College Assistance Migrant Program (CAMP) participants who, after completing the first academic year of college, continue their postsecondary education. (Desired direction: increase) **Calculation:** This measure is calculated by dividing the number of CAMP first academic year completers who continue their postsecondary education by the total number of CAMP first academic year completers
. **Example:**

**Grant Year Total # of** 

**CAMP first academ** **ic year com** **pleters Total # of**  **CAM P first acad**  **emic year com pleters** 

**who continued in Postsecondary Education**

**Programs GPRA 2.**  **1 ( percent**  **achieving placem ent** **)** Year 1 65 60 92% Year 2 70 50 71% In this example, for grant year 1, data collected in the first quarter of grant year 2 indicates that, of the 65 CAMP first academic year completers, 60 continued in postsecondary educations programs. The numerator is 60, the number of CAMP first academic year completers who continued in postsecondary education programs. The denominator is 65, the number of CAMP first academic year completers, for a placement of 60/65, or 92 percent. For grant year 2, in which there were 70 CAMP first academic year completers, the numerator equals 50, for a success rate of 50/70 or 71 percent.Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 3 - **Efficiency Measure 1 of 2:** Proj ect success efficiency ratios are calculated as, per budget period, the total budget awarded for that budget period divided by the number of CAMP first academic year completers that continue in post
- secondary education
. **Efficiency Measure 2 of 2:** Project s ervices efficiency ratios are calculated as, per budget period, the total budget awarded for that budget period divided by the number of students served in CAMP .
**Public Burden Statem ent:**  According to the Paperwork Reduction Act of 1 995, no persons are r equired to respond to a collection of information unless such collection displays a valid OMB control number. Public reporting burden for this collection of information is estimated to average 40 hours per response, including time for reviewing instructio ns, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. T he obligation to respond to this collection is required to obtain or retain benefit ( Higher Education Act of 1 965 , as amended, Title IV, Sec. 418A; 20 U.S.C
. 1070d
- 2). Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Education, Washington, D.C. 2 0202 -4651. I f you have comments or concerns regarding the status of your individual submission of this form, write directly to: M igrant CAMP program, U.S. Department of Education, 400 Maryland Avenue, SW, Washington, D.C. 20202
- 4651



### Instructions for **Migrant CAMP**  **Annual Performance Report Form** This annual performance report covers the reporting period for the budget period stated in Section 6 of your Grant Award Notification (GAN) and must be completed and submitted by 5th of each project year unle ss it is a fifth
- year report and an extension has been granted. If this form is being submitted as a final performance report, the form covers the reporting period for the budget period stated in Section 6 of your Grant Award Notification (GAN) and must be submitted by 5th of the final project year unless it is a fifth
-year report and an extension has been granted. T his Migrant CAMP Annual Performance Report (APR) information will be collected via an online form accessible only to grantees. If you have questions about how to complete this form, contact your assigned program officer. This CAMP performance report is divided into a **Cover Sheet** and the following six sections: **Section A**
**– CAMP**  **Project Statistics and Reporting for GPRA Section B** 
**– CAMP**  **P roject Student Participant Information**  **Section C**
**– CAMP**  **Project Services Information Section D** 
**– CAMP**  **Project Goals and Objectives Section E** 
**– CAMP**  **P roject Budget Information**  **Section F**
**– GP**  **RA 1 Documentation and Additional Information**  **Data Utilization** Together, these sections will be used to answer the following evaluation questions decided upon by the program office: 1. To what extent have program goals been accomplished? (Section A; GPRA reporting)Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 4 - 2. What service models had the most positive outcomes? (Se ctions, B and C) 3. What service models had the best efficiency ratios? (Sections C and E) 4. What percentage of project goals was achieved (i.e., met or exceeded)? (Section D) Findings from aggregated grantee reports, as they pertain to the above stated evaluation questions, will be published for public record and for program and grantee use in better understanding effective service models and strategies. **5. Instructions for Cover Sheet**  Complete the Cover Sheet with the appropriate information. Instructions for items 1, 3, 4 and 6 are included on the Cover Sheet. Instructions for items 2 and 5 and items 7 through 11 are included in this instruction sheet. **Question 2. Grantee NCES ID Number /Item 2** 

**-- Annual and Final Performance Reports:**  Please note that the EMAPS reporting field for the National Center for Education Statistics (NCES) ID number /Item 2 is not writable and it defaults to “0”/zero
. You are not required to report the NCES ID number in EMAPS, but the Office of Migrant Education recommends that you locate and record it for your records
. **Please Note:** It em

2 only applies to grantees that are Institutions of Higher Education (IHE), SEAs, Local Educational Agencies (LEA), public libraries, and public, charter, and private elementary or secondary s chools. Grantees that are State Educational Agencies (SEA) should locate and record their state's FIPS (Federal Information Processing Standards) code in lieu of the NCES ID number To locate your NCES ID number or FIPS code, p lease go to the applicable w ebsite listed below. Depending on your organization type, this number will range from 2 to 12 numeric digits.

 IHEs (IPEDS ID); Public Libraries (Library ID); and Public, Charter and Private Schools (NCES School ID): http://nces.ed.gov/globallocator  LEAs (NCES District ID): http://nces.ed.gov/ccd/districtsearch/  SEAs (FIPS code): To obtain your state's FIPS code, please search on any public school district in your state at: http://nces.ed.gov/ccd/districtsearch/ . The FIPS code is the first two digits of the NCES District ID number for any public school district in a state. **Question 5. Gran tee Address**  **Instructions for Submitting Address Changes**

**-- Annual and Final Performance Reports:**  If the certifying representative’s address that is listed in Block 1 of your GAN has changed, submit the new name and contact information in section F, A dditional Information. **Question 7. Reporting Period**

**-- Annual Performance Reports:** Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 5 - **Due Date:**  Annual performance reports must be submitted by 5th of each project year . I f you receive a no - cost time extension from ED for the budget period, the annual performance report is due 90 days after the revised project period end date. P lease follow instructions from the program office regarding the specific due date of the annual performance report for your grant. This reporting period is aligned with the cur rent budget period. The start date for your current budget period may be found in Block 6 of the GAN. C omplete data on all measures are due with this performance report.

**-- Final Performance Reports:**  **Due Date:**  Final performance reports must be submitted by 5th of the final project year. If you receive a no - cost time extension from ED for the fifth year of this grant, the final performance report is due 90 days after the revised project period end date. This final performance report is separate from and in addition to the APR for the fifth year of the project. Please enter the start and end date for the entire performance period of your grant from Block 6 of the GAN. T he reporting period for your final performance report covers the entire performanc e period (five years). Complete data on all performance measures are due with this final performance report. **Question 8. Budget Expenditures [Also See Section E] The**  **budget expenditure**  **information requested**  **in items**  **8a.**
**– 8**  **b .**  **must be**  **completed by**  **your Business Office.**  **Note: For the purposes of this report, the term budget expenditures means allowable grant obligations incurred during the periods specified below**  **. (See EDGAR, 34 CFR 74.2; 75.703; 75.707; and 80.3, as applicable.)**  **For budget expenditu res made with Federal grant funds, you must provide an explanation in**  **Section E (Budget Information), if you have not drawn down funds from the Grant Administration and Payment System (GAPS) to pay for these budget expenditures.** 

**-- Annual Performance Re** **ports:**
 Report your actual budget expenditures for the current budget period to date (i.e., through 30 days before the due date of this report) in item 8a. Please separate expenditures into Federal grant funds and non
- Federal funds (match/cost
- share) expe nded for the project during the current budget period to date.

**-- Fina**  **l Performance Reports:**

 Report your actual budget expenditures for the entire final budget period in item 8 a . Please separate expenditures into Federal grant funds and non
- Federal funds (match/cost
- share) expended for the project during the entire final budget period.  Report your actual budget expenditures for the entire project period (performance period) in item 8 b
. Please separate expenditures into Federal grant funds and non
- Fed eral funds (match/cost
- share) expended for the project during the entire project period. Your project period (performance period) start and end dates are found in Block 6 of the GAN.Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 6 - **Question 9. Indirect Costs The indirect cost information requeste**  **d in Items 9a.**
**– 9d. must be completed by your Business**  **Office.**

**-- Annual and Final Performance Reports:** 

 It em 9a -- Please check “yes” or “no” in item 9a. to indicate whether or not you are claiming indirect costs under this grant.  It em 9b.
-- If you checked “yes” in item 9a., please indicate in item 9b. whether or not your organization has an Indirect Cost Rate Agreement that was approved by the Federal government.  It em 9c. -- If you checked “yes” in item 9b., please indicate in item 9c. the beginning and ending dates covered by the Indirect Cost Rate Agreement. In addition, please indicate whether ED or another Federal agency (Other) issued the approved agreement. If you check “Other,” please specify the name of the Federal agency that issued the approved agreement. For final performance reports only, check the appropriate box to indicate  It em 9d.

– For grants under Restricted Rate Programs (EDGAR, 34 CFR 75.563), please indicate whether you are using a restricted indirect cost rate that is included on your approved Indirect Cost Rate Agreement or whether you are using a restricted indirect cost rate that complies with 34 CFR 76.564(c)(2). Note: State or Local government agencies may not use the provision for a restricted indirect cost rate spec ified in EDGAR, 34 CFR 76.564(c)(2). Check only one response. Leave blank, if this item is not applicable. **Question 10. Annual Institutional Review Board (IRB) Certification**

**-- Annual Performance Reports Only:**  Annual certification is required if Attac hment HS1, Continuing IRB Reviews, was attached to the GAN. Attach the IRB certification. **Question 11. Certification**

**-- Annual and Final Performance Reports:**  **The grantee’s authorized representative must sign the certification for this form** . The authorized representative is the person who signed the grant application or has been officially designated to sign this performance report. The Office of Migrant Education should receive documentation indicating who the authorized representatives are **and** whether changes have occurred since signing of the grant application. If the grantee has any known internal control weaknesses concerning data quality (as disclosed through audits or other reviews), this information must be disclosed under Section F (Additio nal Information), as well as the remedies taken to ensure the accuracy, reliability, and completeness of the data.Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 7 - **Instructions for Sections A,**  **B ,**  **and C** 

 If the value to be reported is zero, then enter a “0” in the cell; do not leave the cell blank.

 If the data prompt to be reported is not applicable to your project, then enter “N/A” in the cell; do not leave the cell blank. **Instructions for Sections A and B**  Sections A and B contain columns for years one through five of the project and for the final p erformance report. F ill in the column that corresponds to the project year that is being reported. In year one, this would be column Y1. In year two, this would be Y2, etc. N ote that successive annual performance reports will maintain prior year’s data ; this data will be pre -populated by the program office for previous years. A lso, the final performance report figures, entered into column F, will be cumulative counts of the prior five years. Example: In **year one** of a project funded to serve 100 total students per year, data entry would look like: **Example Y1**  **Y2 Y3**  **Y4 Y5**  **F** a. Number funded to be served 100 In **year two** , the APR should take the following format: **Example Y1**  **Y2 Y3**  **Y4 Y5**  **F** a. Number funded to be served 100 100 The **final p erformance report**  should take the following format: **Example Y1**  **Y2 Y3**  **Y4 Y5**  **F** a. Number funded to be served 100 100 100 100 100 500Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 8 -

**Instructions for Section A** 
**– CAMP**  **Project Statistics and Reporting for GPRA** Section A collects data on the number of s tudents served and the number of students achieving program and project objectives. Items from S ection A are used to calculate GPRA and efficiency measures. **Item A1** It em A 1 requests information on the number of students served during the budget perio d. Item A1a requests data on the number of students that the project was funded to serve. Item A1b requests data on the number of students actually served in first academic year college instruction, which is further disaggregated in items A1b1 and A1b2 into the number of students served in first academic year college instruction who were new participants and returning participants, respectively. **Definitions**  **Budget Period:** 12 -month period of time beginning on the date found in Block 6 of the GAN.  **Num ber**  **funded to**  **be served**  : Number of participants officially funded by the CAMP grant to be enrolled in CAMP instruction in your CAMP project in this budget period.  **Num ber served in CAMP instruction**  : The number of CAMP eligible students who completed intake and were enrolled and attending college courses past the Add/Drop deadline assigned by the project’s IHE.  **New participant:**  The number of CAMP eligible students who were new to the project (i.e. not enrolled in CAMP services in the immediately previous budge t period), completed intake, and were enrolled and attending college courses past the Add/Drop deadline assigned by the project’s IHE. (This is a subset of the number served.) **Note:** 1.) Students who participated in CAMP services during budget periods oth er than the immediately previous budget period are considered “New Participants.” **2.** This count would also include any students who participated in CAMP services in the immediately previous budget period, but were not counted as persisters at the end of th at budget period because they did not enroll in the CAMP services during the current budget period until after the APR was submitted on December 1
.  **Returning participant:**  The number of CAMP first academic year college eligible students who met the following criteria: o completed intake in the budget period immediately previous to the one being reported, o did not complete first academic year college in the budget period immediately previous to the one being reported, and o was enrolled and attending CAMP first academic year college instruction past the Add/Drop deadline assigned by the project’s IHE within the reported budget period. (This is a subset of the number served.) **Note:** 1) This count should equal the number of persisters from the budget period **immediate ly**  **previous to**  **the one**  **being reported.**  In other words, the previous reporting period’s persisters are the current year’s returning students
. 2) Students from the immediately previous budget period who returned to the reported budget period after the 5th due date for the APR, must be reported as “New Participants” in the reported budget period. 3) Similarly, students who return to CAMP in the reported budget period from any other budget period other than the immediately previous budget period are to be reported as “New Participants” in the reported budget period. 4. Projects in Year 1 of the grant will have no returning participants.Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 9 - **Data quality check**  The number of students reported in items A1b1 and A1b2 should sum exactly to the number of students reported in item A1b (no. served).  The number of returning students (item A1b2) should equal the number of persisters reported in Item A2d in the previous year’s APR. **Reporting Block, Item A1** (For illustration purposes only; do not report data here) A1 . Number of students served during budget period. **Y1 Y2**  **Y3 Y4**  **Y5 F**  a. Number funded to be served. 60 60 60 60 b. Number served in college courses ( Note: A1b1 + A1b2 should sum to equal A1b). 48 60 60 1. Number served who were **new participants** (first academic year in CAMP) (subset of A1b). 2. Number served who were **returning participants** (not first academic year in CAMP) (subset of A1b). **Item A2** It em A2 collects data on the status of student participants at the end of the reported budget period. It em A2a requests the definition of “first academic year” as it is defined by your project’s IHE. Item A2b requests data on the total number of students who completed their first academic year of college during the reported budget period (GPRA 1) while item A2c requests data on the total number of students who withdrew from the project. Item A2d requests data on the number of persisters who returned for services in the subsequent year. N ote that students may be classified **into one status**  **group only**  (i.e., provide an unduplicated count of students). All CAMP projects are also required to submit to OME, as a supplement to their APR, a list of CAMP students who completed their first year at the IHE (as define d by that IHE) during the reporting period. This documentation supports the information reported in item A2b (GPRA I). The list should include:
o S tudents' names , o S tudent ID numbers, and o A statement that these students were enrolled in the CAMP program and completed their first year at the IHE during the reporting period. This list must be verified and signed by the IHE’s Registrar. This list should be uploaded as an attachment in Section F in EMAPS, via PDF, WORD, or Excel
. Note: If the program did no t establish a **target number**  of CAMP first academic year completers in its application, do not write in a target in item A2b (no. of first academic year completers). **Definitions**  **First academic**  **year** : “First Academic Year” will be defined by the IHE, in whic h the CAMP student is currently enrolled. (Please provide your IHE’s definition of “academic year” in the space provided in section A2a of the APR.)Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 10 -  **CAMP first**  **academic year**  **completers:** The number of CAMP eligible students who complete their first academi c year. T he “First Academic Year” will be defined by the IHE, in which the CAMP student is currently enrolled. To best capture this data, the number of students who completed their first academic year of college will be compiled and calculated any time af ter the first academic year of college is completed and before the performance report is due. T his procedure will apply to all counts for which **actual** (as opposed to projected) data is necessary.  **Withdrawals:** The number of CAMP eligible students who: o comp leted intake and was enrolled and attending college courses past the IHE’s Add/Drop deadline assigned by the project’s IHE, but o left the CAMP program without completing the first academic year of college, and o did not re
- enroll for instruction in the subs equent budget period. This count also should include students who earned some college credits, but did not complete the first academic year of college. (A withdrawal indicates that students have left the project, or have not re - enrolled in the subsequent budget periods for whatever reason.)  **Persisters:** The number of CAMP first academic year college eligible students who: o completed intake and were enrolled and attending college courses past the Add/Drop deadline assigned by the project’s IHE, but o did not complete their first academic year of college, however, o re - enrolled for continuing instructional services in support of completing their first academic year of postsecondary education in the **subsequent** budget period prior to the December 1st APR submiss ion due date.  **Target Number**  **of CAMP**  **First Academic**  **Year Completers:**  the target for total number of first academic year completers served over the entire project period, which was established by each project in its approved application.  “In Good Standing”: “In good standing” will be defined by the IHE, in which the CAMP student is currently enrolled. Even though “in good standing” is included in GPRA Objective 1, please note that “in good standing” is not a requirement of the measurement for GPRA Objective 1. **Data quality checks**  The sum of items A2b
- d should equal the count reported in item A1b (no. served).  The number of persisters reported here would be equal to the participants in the subsequent budget period’s APR. **Reporting Block, Item A2** (For illus tration purposes only; do not report data here) A2. **Status at the end of budget period.** ( Note: A2b
- d should sum to equal the number reported in A1b). **Y1 Y2**  **Y3 Y4**  **Y5 F**  a. Explain how “academic year” is defined in your project’s IHE in the space provided be low:

b. Number of CAMP first academic year completers. **(Obj. 1 National**  **Target: 86%**  **) (GPRA 1)** 39 37 29 c. Number of withdrawals. d. Number of persisters (coming back to continue in the subsequent budget p eriod; persisters were enrolled in instructional services in the budget period reported but didProject Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 11 - not yet complete their first academic year of college and have returned in the subsequent budget period to continue instructional services). **Item A3 (GPRA 2)** It em A 3a collects data on the status of CAMP first academic year completers at the end of the budget period (GPRA 2). The count reported in item A3a is a subset of the total number of first academic year completers who received follow
-up (reported on in It em A4). T his count is a subset or equal to the count reported in A2b (no. of CAMP first academic year completers). A s a subset, the count reported in item A3a should be equal to or less than the count reported in It em A4, which should be equal to or less than the count reported in Item A2b (no. of CAMP first academic year completers). Completion of Item A3a requires follow
-up with first academi c year completers; data regarding follow
-up is described in Item A4. Note: If the program did not establish a **target number**  of CAMP first academic year completers who continued in postsecondary education in its application, do not write in a target in item A3a. **Definitions**  **Continuing CAMP**  **First Academic**  **Year Completers:**  Of those students who completed their first academic year of college in this budget period, the number who continued in postsecondary education programs. T his measure should be taken any time after the **first academic**  **year of**  **college is**  **completed** and before the performance report is due, and should be based on **actual enrollment**  and not on anticipated enrollment.  **Target number**  **of CAMP**  **first academic**  **year com**  **pleters who**  **continued in**  **po stsecondary**  **education programs:**  the target for total number of CAMP first academic year completers who continued in postsecondary education programs. **Data quality check s**   The count reported in Item A3a should be equal to or less than the count reported in It em A4.  The count reported in It em A3a cannot be greater than the count reported in It em A2b (no. of first academic year completers). **Reporting Block, Item A3a** (For illustration purposes only; do not report data here) A3. Status of CAMP first academic year completers from question A2b above at the end of budget period. **Y1 Y2**  **Y3 Y4**  **Y5 F**  a. Unduplicated number of CAMP first academic year completers who continued in postsecondary education programs. (This amount should not be greater than the amount in A2b above.) **(Obj. 2 National**  **Target: 84%**  **) (**  **GPRA 2 )**  **Item A4** It em A4 collects data on the number of CAMP first academic year completers for whom fol low
up data was collected. The count reported in item A4 cannot be greater than the count reported in It emProject Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 12 - A2b (no. of first academic year completers). The count reported in Item A4 is the number of CAMP first academic year completers with whom follow
-up contact was successfully made. F ollow
- up must be attempted with every CAMP first academic year completer. **Definition**  **No. of**  **CAMP First**  **Academic Year**  **Completers you**  **were able**  **to track**  **for follow**  **- up**  **data :**  The program office’s expectation is that all CAMP first academic year completers will receive follow
-up to determine if they continued in postsecondary education programs. F ollow
-up should occur in a timely fashion (i.e., within 90 days of the end of the budget period), such that annual performance reporting can be completed. **Reporting Block, Item A4a** (For illustration purposes only; do not report data here) **Y1 Y2**  **Y3 Y4**  **Y5 F**  A4. Number of CAMP first academic year completers you were able to track for follow
- up data **Item A5**
**–**

**A7** It em s A5

– A7 collects data on the status of CAMP first academic year completers at the end of the budget period. C ompletion of It em s A5

– A7 requires follow
-up with CAMP first academic year completers; data regarding follow
-up is described in Item A4. **Definiti on**   **Former CAMP**  **Students:** The number of students who participated in your CAMP project prior to the current budget period. **This count**  **may include**  **those students**  **wh o**  **may have**  **graduated from**  **an IHE**  **that doesn’t**  **partner with**  **your CAMP.**  This count may also include students who participated in your project from a previous 5 year grant cycle. **Y1 Y2**  **Y3 Y4**  **Y5 F**  A5. Number of your former CAMP students who graduated from college with Bachelor’s Degree this budget period. **Y1 Y2**  **Y3 Y4**  **Y5 F**  A6. Number o f your former CAMP students who graduated from college with an Associate’s Degree this budget period. **Y1 Y2**  **Y3 Y4**  **Y5 F**  A7. Number of your former CAMP students who transferred to other IHEs. **Item A8** It em A 8 collects data on the amount of time necessary for first academic year college completion by successful project participants who completed their first academic year of college in the reported budget period. Item s A8a
- c request unduplicated counts of the number of CAMP first academic ye ar com pleters who completed their first academic year of college within one year, between one and two years, and afterProject Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 13 - more than two years in the project, respectively. Each CAMP first academic year completer will be classified into one group. N ote that f ollow
-up with CAMP first academic year completers should not be necessary to report these counts. Rather, project documentation should contain the relevant records necessary to complete these items. **Data quality check**  The counts reported in Items A8a
- c s hould sum to the count reported in Item A2b (no. of CAMP first academic year completers). **Reporting Block, Item A8** (For illustration purposes only; do not report data here)

**Instructions for Section B**
**– CAMP Project Student Participant Information**  **Item B1** It em B 1 collects data on the number of students who received Supportive, Instructional, and Financial Services received by students enrolled in CAMP p roject services in the reported budget period. It em s B1a - d request data on:  Total number of students receiving varied Supportive and Instructional services,  Total number of students receiving varied Financial services  Total number of students receiving re ferrals to other services, and  Total number of referrals made to students **Definitions**  **Supportive and**  **Instructional Services:**  CAMP
- funded services provided to CAMP students in support of their first academic year that do not involve giving money directly t o students. This count does not include other services provided to CAMP students by the university. Examples include personal, academic & career counseling, tutoring, mentoring, health services, and assistance with special admissions.  **Financial Services :**  CAMP
- funded, monetary services provided to CAMP students in support of their first academic year. T his count does not include other services provided to CAMP students by the university. Examples include stipends, scholarships, transportation, career - oriented work
- study, books and supplies, tuition and fees, and room and board.  **Tutoring:** additional instructional services provided by CAMP in support of a specific curriculum, course or course of study. A8. Time to completion for CAMP first academic year completers from question A2b above. (Note: A8a
- c should sum to equal the number reported in A2b). **Y1 Y2**  **Y3 Y4**  **Y5 F**  a. Number of CAMP first academic year completers who completed their first academic year of college within one calendar year in your project. b. Number of CAMP first ac ademic year completers who completed one year of college after more than one year, but within two calendar years in your project. c. Number of CAMP first academic year completers who completed one year of college after more than two calendar years in your project.Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 14 -  **Mentoring or**  **coaching:** advisory services provided by CAMP in support of general academic career and post
- first academic year college placement.  **Counseling or**  **guidance services**  **:** services provided by CAMP in support of work
- life balance and other psycho
- social aspects of first academic year of college completi on and post- first academic year college placement  **Stipend:** an allocation of project financial resources made directly to students to offset living or educational expenses. Stipends are not to be used as incentives.  **Career**

**- oriented**  **Work**

**- study:**  Guided emplo yment that provides opportunities for the CAMP student to develop or enhance his or her career skills. T his definition of “career
- oriented work
- study” is not limited to any particular work
- study program. Students may be counted for this service whether or not the work
- study is funded by CAMP, as long as the guidance that is provided to students is funded by CAMP funds. **Data quality checks**  The counts reported in It em B1a 1 - 6 and in B1b 1 - 8 may be duplicated, as some students may receive multiple Supportive & Instructional or Financial Services. H owever, the value of any individual count cannot exceed the count reported in Item A1b (no. served).  The count reported in B1c must be equal to or less than the count reported in A1b (no. served). **Reporting Block, Item B1**  (For illustration purposes only; do not report data here) B1. Supportive & Instructional Services and Financial Services provided only by CAMP funds and received by CAMP
- enrolled students during the budget period. This count does not include oth er services provided to CAMP students by the university. **Y1 Y2**  **Y3 Y4**  **Y5 F**  a. Count the total number of CAMP students served with the following ty pes of supportive & instructional services. Students may appear in mo re than one row

if they received more than one service. 1. Counseling or guidance services to CAMP students (personal, academic, and career services provided in support of school
- life balance and other psycho
- social aspects of college completion). 2. Tutoring ( additional instruc tional services provided in support of a specific curriculum, course, or course of study). 3. Mentoring or coaching ( advisory services provided in support of general academic career). 4. Health services. 5. Assistance with special admissions. 6. Other __________________________________. b. Count the total number of CAMP students served with the following ty pes of financial services. Please indicate the number of students receiving support services. Students may appear in more than one row if they received more than one service. 1. Stipends. 2. Scholarships. 3. Transportation. 4. Career
- oriented work
- study.Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 15 - B1. Supportive & Instructional Services and Financial Services provided only by CAMP funds and received by CAMP
- enrolled students during the budget period. This count does not include oth er services provided to CAMP students by the university. **Y1 Y2**  **Y3 Y4**  **Y5 F**  5. Books and supplies. 6. Tuition and fees. 7. Room and Board. 8. Other ____________________________. c. Number of students receiving referrals to other services. d. Total number of referrals to other services. **Item B2** It em B 2 collects data on the characteristics of students who were enrolled in CAMP project services during the reported budget period. Items B2a
- m request data on:  Sex  Age  Residential stability  Number of commuting students  Number of students enrolled in remedial or developmental courses  Number of students admitted to an IHE under special admissions  Number of first generation college students  Number of students referred to CAMP by MEP, HEP, NFJP, etc.  Number of students receiving financial services from an agency/program other than CAMP  Number of students with English Language Learners **Definitions**  **Educational Impairments:**  The number of students enrolled and served in college courses past the Add/Drop deadline assigned by the project’s IHE, during this budget period, that had educational impairments, as veri fied through standardized assessments of special needs or learning disabilities.  **English Language**  **Learner (ELL):**  The number of students enrolled and served in college courses past the Add/Drop deadline assigned by the project’s IHE, during this budget peri od, that had need of English as a Second Language as determined by a language assessment test administered by the project or the project’s institution.  **“Special Admissions”:**  “special admissions” will be defined by the IHE, in which the CAMP student is currently enrolled. **Data quality check s**   The sum of counts reported in It ems B2a and B2b must be equal to the total number of students served (Item A1b) for the reported budget period. Similarly, the sum of counts reported in Items B2 c and B2d must be equal to the total number of students served (Item A1b) for the reported budget period.  The counts reported in each of It ems B2e, B2f, B2g, B2h, B2i, B2j, B2k, B2l, B2m, and B2n1 cannot exceed the total number of students served (Item A1b) for the reported budget period.Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 16 - 2 **Note: Only**  **count students**  **who commute**  **on a**  **daily basis.**  **D o**  **not count**  **students who**  **relocate a**  **significant distance**  **(i.e., 800 miles) to participate in programming.**  B2. Characteristics of the CAMP enrolled students during this budget period. (Note: [B2a and B2b] and [B2c and B2d] should sum to equal the number reported in A1b (no. served)). **Y1 Y2**  **Y3 Y4**  **Y5 F**  a. Number of students who report themselves a s male. b. Number of students who report themselves as female. c. Number of students who are 21 years old or younger. d. Number of students who are over 21 years old. e. Number of students who travel 20 miles or more (one
- way) to attend pos tsecondary education program classes. Please count all students who attend the program whose home or permanent address is 20 or more miles away. 2 f. Number of students who enrolled during the budget period and required placement in developmental or remedial courses (i.e. courses that do count toward graduation). g. Number of students that were admitted under special admissions. h. Number of first generation college students. i. Number of students who were referred from MEP and accepted into CAMP. j. Number of students who were referred from HEP and accepted into CAMP. k. Number of students who were referred from NFJP and accepted into CAMP. l. Number of students who were referred from any other program and accepted into CAMP. m. Number of students who received other financial services paid for by an agency or program other than CAMP. n. Does your project screen students for English language proficiency as determined by a language assessment test? If “No,” skip to question C1. Mark Y for yes, or N for no. Y N Y N Y N Y N Y N Y N 1. Number of students who enrolled during the budget period and had English as a second language needs as determined by a language assessment test.Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 17 -

**Instructions for Section C**
**– CAMP Project Services Information**  **Item C1** It e m C1 collects data on the project model being reported. Items C1a and C1bc request data on the commuter or residential status of the project and the time
-to - com pletion for the project’s IHE (i.e. whether the IHE is a two - year or four
- year institution). Items C1a and C1b contain check
-boxes for the allowable responses. There should be no other written response to these items. **Reporting Block, Item C1** (For illustration purposes only; do not check boxes here) C1. Project Model Characteristics a. Is this p roject a commuter or residential project or a combination of both? Commuter Residential Combination of commuter and residential b. Is this project in a four
- year or two -year institution? Four -Year Institution Two -Year Institution **Item C2** It em C2 collects data on the personnel associated with project services. Items C2 a
- c request data on the number of teaching staff and instructional support staff, both funded and not funded by the CAMP grant. **Definitions:**  **FTE (full** 

**- time**  **equivalent) for**  **Administrative Staff**  **& Instructional**  **Support Staff:**  FTE is a measure equal to one staff person working a full
-time work schedule for one year. o To calculate the total FTE: For ea ch administrative staff person or support person, divide the total number of hours that employee works in your CAMP project each year by the number of hours your organization considers full time for one year. When all calculations on individual administrative staff persons and support persons are complete, sum across all administrative staff persons for the total administrative staff FTE and sum across all support staff persons for the total support staff FTE. o For example , if your organization considers 1,920 hours annually to be full time, and administative staff me mber Jane Smith works 1,440 hours per year, her FTE is .75 (1,440 divided by 1,920). S um Jane Smith’s FTE with the FTEs from all other administrative staff to calculate the total FTE for administrative staff.  **Num ber**  **of FTE**  **Adm inistrative**  **Staff:** Staff funded by the CAMP grant that serve to manage the project. Grantees should report the total number of **CAMP -**  **funded,** FTE administrative staff contributing to the project in It em C2a. Grantees should report the total number of **non -**  **CAMP**   ** fu** **nded,** FTE administrative staff contributing to the project in Item C2c.  **Num ber**  **of FTE**  **Supportive and**  **Instructional Staff:**  Staff who provide, supportive & instructional services (i.e. personal, academic & career coun seling, tutoring, mentoring, health services, and assistance with special admissions) funded by the CAMP grant. Grantees should report the total number of **CAMP -**  **funded,** FTE supportive & instructional staff contributing to the project. in It em C2b. Grantee s should report the total number of **non -**  **CAMP -**  **funded** , FTE supportive & instructional staff contributing to the project in Item C2c.Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 18 - **Reporting Block, Item C2** (For illustration purposes only; do not report data here) C2. Project Personnel Characteristics a. Num ber of FTE administrative staff funded by the CAMP grant.

___________ b. Number of FTE supportive and instructional staff (tutors, coaches, mentors, counselors, etc.) funded by the CAMP grant. ___________ c. Number of FTE administrative staff **and** supportive and instructional staff contributing to the project’s CAMP services, not funded by the CAMP grant. ___________ **Item C3** It em C 3 collects data on student assessments that determine IHE enrollment. Item s C3a, C3b, and C3c contain check
-boxes for the all owable responses. Items C3a1
- 4, C3b1
- 4, and C3c1
- 4 allow a written response, if applicable. **Data quality check**  If the answer to Items C3a, C3b, and C3c are “no”, the grantee should not report Items C3a1
- 4, C3b1
- 4, and C3c1
- 4 respectively, then report “N/A.” **Reporting Block, Item C3** (For illustration purposes only; do not report data here) C3. Test Information a. Does your project’s IHE use SAT scores during the intake process? Yes No 1. What is th e average score for all IHE students? English __________

__ Math

______________ 2. What is the range of scores for all IHE students? Engl. Min__ Engl. Max__ Math Min__ Math Max__ 3. What is the average score for CAMP students? Eng lish ____________ Math ______________ 4. What is the range of scores for CAMP students? Engl. Min__ Engl. Max__ Math Min__ Math Max__ b. Does your project’s IHE use ACT scores during the intake process? Yes No 1. What is the average score for all IHE students? English ____________ Math ______________ 2. What is the range of scores for all IHE students? Engl. Min__ Engl. Max__ Math Min__ Math Max__ 3. What is the average score for CAMP students? English ____________ Math ______________ 4. What is the range of scores for CAMP students? Engl. Min__ Engl. Max__ Math Min__ Math Max__ c. Does your project’s IHE use a Student Placement Exam for all students? Yes No 1. What is the name of the Student Placement Exam? Engl. Min__ Engl. Max__ Math Min__ Math Max__ 2. What is the average score for all IHE students? English ____________ Math ___ ___________ 3. What is the range of scores for all IHE students? Engl. Min__ Engl. Max__ Math Min__ Math Max__ 4. What is the average score for CAMP students? English ____________Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 19 - Math ______________ 5. What is the range of scores for CAMP students? Engl. Min__ Engl. Max__ Math Min__ Math Max__ **Item C4** It em C4 collects data on the nature of project services. Grantees must provide a short description (no more than 300 words) of project services that includes:  services offered,  maj or collaborators, and  O ther aspects of project design that were strong influences on service delivery and success. **Reporting Prompt, Item C4** C4. Please describe, in a paragraph not to exceed 300 words, the nature of project servi ces with regard to a) services offered and b) major collaborators (e.g., partners whose collaboration is necessary to project implementation and success) and any other aspect of project design that is a strong influence on service delivery and success.Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 20 - **Instructions for Section D**
**– CAMP Project Goals and Objectives**  In your approved grant application, you established project objectives stating what you hope to achieve with your funded grant project. Generally, one or more performance measures also were e stablished for each project objective that serve to demonstrate whether you have met or are making progress towards meeting each project objective. Report on the results to date of your project evaluation as required under EDGAR, 34 CFR 75.590. According to the instructions below, for each project objective included in your approved grant application, provide quantitative and/or qualitative data for each associated performance measure and a description of preliminary findings or outcomes that demonstrate that you have met or are making progress towards meeting the performance measure. You will also explain how your data on your performance measures demonstrate that you have met or are making progress towards meeting each project objective. **Note:** Co mplete data must be submitted for any project
- specific performance measures that were included in your approved grant application. **Section 1) Project Objective:** Enter each project objective that is included in your approved grant application. Only one project objective should be entered per row. Project objectives should be numbered sequentially, i.e. 1., 2., 3., etc. Data on GPRA objectives should only be entered in section A of this form, and should not be reported in this section. **Performance Mea sure:**  For each project objective, enter each associated performance measure. There may be multiple performance measures associated with each project objective. Enter only one performance measure per row. Each performance measure that is associated with a particular project objective should be labeled using an alpha indicator. Example: The first performance measure associated with project objective “1” should be labeled “1.a.,” the second performance measure for project objective “1” should be labeled “ 1.b.,” etc. For each performance measure use the row that corresponds to your project funding year (year 1, 2 3, 4 or 5 OR “F” for final performance report). **Quantitative Data: Target and Actual Performance Data**  Provide the target you established for me eting each performance measure and provide actual performance data demonstrating progress towards meeting or exceeding this target. O nly quantitative (numeric) data should be entered in the Target and Actual Performance Data boxes. The Target and Actual Performance Data boxes are each divided into three columns: **Raw N**  **umber; Ratio; and Percentage (%).**  For performance measures that are stated in terms of a single number (e.g., the number of workshops that will be conducted or the number of students that wi ll be served), the target and actual performance data should be reported as a single number under the **Raw N**  **umber column**  (e.g., **10** workshops or **80** students). P lease leave the **Ratio and**  **Percentage (%)**  **columns** blank. F or performance measures that are stated in terms of a percentage (e.g., percentage of students that attain proficiency), complete both the **Ratio column** and the **Percentage (%) column** . Please leave the **Raw Number column** blank.Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 21 - Inthe **Ratio column**  (e.g., **80/100** ), the numerator represents the n umerical target (e.g., the number of students that are expected to attain proficiency) or actual performance data (e.g., the number of students that attained proficiency), and the denominator represents the number of students funded to be served under each obj ective. P lease enter the corresponding percentage (e.g., **80** % **)** in the **Percentage (%)**  **column** . Note: the denominator may vary across objectives, depending upon the number of students each objective is designed to reach. If the collection of quantitative data is not appropriate for a particular performance measure, please leave the Target and Actual Performance Data boxes blank and provide an explanation and any relevant qualitative data for the performance measure in the section entitled, **Explanation of Progress (Section 2)**  . Note: I f you are using weighted data, please indicate how the data are weighted in the section entitled, **Explanation of Progress (Section 2). Special instructions for grants in their first budget period**  : I f baseline data for a performance measure were not included in your approved application and targets were not set for the first budget period, then enter either the number **999** under the **Raw N**  **umber column**  or the ratio **999/999** under the **Ratio column**  of the **Target box**  , depending on how your data will be reported in the future. The **999** or **999/999** indicates that baseline data are being collected on the measure during the first budget period and targets have not yet been set. Unless otherwise instructed by the program office in the attached “Dear Colleague Letter,” report baseline data collected during the first budget period under either the **Raw Number**  **column** or the **Ratio and**  **Percentage (%)**  **columns** of the **Actual Performance**  **Data box,**  as appropriate. After baseline data have been c ollected during the first budget period, grantees are expected to set targets for the second and any subsequent budget periods and report actual performance data in their annual performance reports. Section D also requests that data from multiple project years be entered, according to the project year reported. T his data will be pre -populated by the program office for previous years. D ata entry should follow the process described above for sections A and B. T he final performance report should AVERAGE s uccess rates across each of the project years. **Example:** In year one of a project funded to serve 100 students per year with a target of awarding financial aid to 100 percent of students, data entry would look like this: 1.a. Performance Measure **Quantit ative Data**  **Aw ard financial aid to 100**  **percent of students. Target**  **Actual Performance Data Raw**  **Nu m**  **ber Ratio**  **% Raw**  **Number Ratio**  **% /**  **/** Year One 100 100/100 100% 100 80/100 80% Year Two Year Three Year Four Year Five Fin alProject Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 22 - In year two, the APR should take the following form: 1.a. Performance Measure **Quantitative Data Aw**  **ard financial aid to 100 percent of students.**  **Target Actual Performance Data**  **Raw Nu**  **m ber**  **Ratio %**  **Raw Number**  **Ratio %**  **/ /**  Year One 100 100/100 100% 100 80/100 80% Year Two 100 100/100 100% 100 85/100 85% Year Three Year Four Year Five Final The final performance report should take the following form: 1.a. Performance Measure **Quantitative Data Aw**  **ard financ ial aid to 100**  **percent of students. Target**  **Actual Performance Data Raw**  **Nu m**  **ber Ratio**  **% Raw**  **Number Ratio**  **% /**  **/** Year One 100 100/100 100% 100 80/100 80% Year Two 100 100/100 100% 100 85/100 85% Year Three 100 100/100 100% 100 90/100 90% Year Fo ur 100 100/100 100% 100 95/100 95% Year Five 100 100/100 100% 100 100/100 100% Final 100 500/500 100% 500 450/500 90% **Section 2) Explanation of Progress (Includes Qualitative Data and Data Collection Information)**  **(maximum 2500 words) :**  1. For each project objective and associated performance measures, indicate what data (quantitative and/or qualitative) were collected and when they were collected, the evaluation methods that were used, and how the data were analyzed. Clearly identify and explain any deviations from your approved evaluation plan, including changes in design or methodology, or the individual or organization conducting the evaluation. 2. Based on your data, provide a description of preliminary findings or outcomes, including information to show whether you are making progress towards meeting each performance measure. Further, indicate how your performance measures data show that you have met or are making progress towards meeting the stated project objective. In your discussion, provide a brie f description of your activities and accomplishments for the reporting period that are related to each project objective. 3. If expected data were not attained, expected progress was not made toward meeting a performance measure or project objective, or a planned activity was not conducted as scheduled, provide an explanation. Include a description of the steps and schedules for addressing the problem(s) or issue(s). 4. Indicate how you used your data and information from your evaluation to monitor the progress of your grant, and if needed, to make improvements to your original project plan (e.g., project activities and milestones) which are consistent with your approved objectives and scope of work.Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 23 - **Note: Short**  **anecdotes are**  **welcome additions**  **to the**  **“explanatio n**  **of progress”**  **section. A**  **lso, please use this section to**  **detail any positive or negative impacts of this reporting framework. Section**  **3) Final**  **Performance Report**  **ONLY:** this information covers the entire project report period (five years) (maximum 2500 w ords)
. Grantees must answer each of the three questions identified below: 1. Utilizing your evaluation results, draw conclusions about the success of the project and/or its impact. Describe any unanticipated outcomes or benefits from your project and any barriers that you may have encountered. 2. What would you recommend as advice to other educators that are interested in your project? How did your original ideas change as a result of conducting the project? 3. If applicable, describe your plans for continuing the project (sustainability; capacity building) and/or disseminating the project results. 4. Please list the cumulative totals for the following reporting requirements:  What is the cumulative total of the **number of students you s e** **rved** over the course of the five years of your grant? _____________  What is the cumulative total of the **number of first academic year completers (GPRA 1)** over the course of the five years of your grant? _____________  What is the cumulative total of the **unduplicated number of CAMP fi** **rst academic year completers who continued in postsecondary education programs (GPRA 2)**  over the course of the five years of your grant? _______________Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 24 - **Instructions for Section E**
**– CAMP Project Budget Information** 

**-- Annual and Final Performance Reports:**  **Cover Sheet -**  Report budget expenditure data in items 8a.

– 8b . of the Cover Sheet, as applicable. **1. Section**  **E**

– Report the following items 1. a. – 1. d. in Section E of this report. 1.a. For budget expenditures made with Federal grant funds, you m ust provide an explanation if funds have not been drawn down from GAPS to pay for the budget expenditure amounts reported in items 8a.

– 8b of the Cover Sheet. 1.b. Provide an explanation if you did not expend funds at the expected rate during the reporting p eriod. 1.c. Describe any changes to your budget that affected your ability to achieve your approved project activities and/or project objectives. 1.d. Describe any significant changes to your budget resulting from modification of project activities.

**-- For Annual Performance Reports Only:**  **2. For Annual Performance Reports Only** 

– Using the specific budget categories as in Form ED 524, comparatively report in column (a) your previously submitted revised budget amounts for this reporting peri od, identifying any amounts that include carryover funds from the previous budget period with an asterisk. In column (b) report your project’s actual expenditures for this performance period. Additionally, briefly explain any difference in the total amou nts of these two budget columns.Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 25 -

**Instructions for Section F**
**– GPRA**  **1Documentation & Additional Information** 

**-- Annual**  **Performance Reports Only:** All CAMP projects are required to submit to OME, as a supplement to their APR, a list of CAMP students who co mpleted their first year at the IHE (as defined by that IHE) during the reporting period. This documentation supports the information reported in item A2b (GPRA I). The list should include:
o S tudents' names , o S tudent ID numbers, and o A statement that thes e students were enrolled in the CAMP program and completed their first year at the IHE during the reporting period. This list must be verified and signed by the IHE’s Registrar. This list should be uploaded as an attachment in this Section (i.e., Section F) in EMAPS, via PDF, WORD, or Excel.

 If applicable, please provide a list of current partners on your grant and indicate if any partners changed during the reporting period. Please indicate if you anticipate any change in partners during the next budge t period. If any of your partners changed during the reporting period, please describe whether this impacted your ability to achieve your approved project objectives and/or project activities.  If instructed by the program office, please report on any statutory reporting requirements for this grant program.  Note: Do not submit requests in this report for supplemental funds or any changes that you wish to make in the grant’s activities for the next budget period . Requests for these actions must be made sepa rately to the program office for review and approval decisions.  If you are requesting changes to the approved key personnel listed in Block 4 of your GAN for the next budget period, please indicate the name, title and percentage of time of the requested key personnel. Additionally, please attach a resume or curriculum vitae for the proposed key personnel when you submit your performance report.  Note: Do not report on any key personnel changes made during the current or previous budget period(s). Departmental approval must be requested and received prior to making key personnel changes.  Provide any other appropriate information about the status of your project including any unanticipated outcomes or benefits from your project.Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 26 - **Cover Sheet**
**– CAMP Annual**  **Performance Report Check only one box per Program Office instruction.**  **[ ] Annual Performance Report (check one:**  **□ Y1**  **□ Y2**  **□ Y3**  **□ Y4**  **□ Y5**  **) □**  **Final Performance Report General Inform**  **ation** 1. PR/ Number:

_____________ 2. NCES ID#: __________ (Block 5 of t

he Grant Award Notification
- 11 Characters.) (See Instructions
- Up to 12 Characters.) 3 Project Title: _________ (Enter the same title as on the approved application.) 4. Grantee Name (Block 1 of the Grant Award Notification): Sam ple University 5. Grantee Address (See Instructions.) 6. Project Director Name: __________ Title: __________ Ph #: ( ) ____
- _____ Ext: ( ) Fax # : ( ) _____
- _____ Email Address: __________ **Reporting Period Inform ation**  **(See Instructions.)** 7. Reporting Period: From : ___/___/___ To: ___/___/___ (mm/dd/yyyy) 7b. Reporting Period: (For Final Performance Reports only) From : ___/___/___ To: ___/___/___ (mm/dd/yyyy) **Budget Expenditures (To be completed by your Business Office. See**  **instructions. Also see Section E**  **.)** 8. Budget Expenditures **Federal Grant Funds Non**  **- Federal Funds**  **(Match/Cost Share)**  a . Current Budget Period b . Entire Project Period (For Final Performance Reports only) **Indirect Cost Inform ation**  **(To be completed b y your Business Office. See instructions.)**  9. Indirect Costs a. Are you claiming indirect costs under this grant? ___Yes ___No b. If yes, do you have an Indirect Cost Rate Agreement approved by the Federal Government? ___Yes ___No c. If yes, provid e the following information: Period Covered by the Indirect Cost Rate Agreement: From: ___/ ___/___ To: ___/___/___ (mm/dd/yyyy) Approving Federal agency: ___ED ___Other (Please specify): __________ d. For Restricted Rate Programs (check one)
-- Are you using a restricted indirect cost rate that: ___ Is included in your approved Indirect Cost Rate Agreement? ___ Complies with 34 CFR 76.564(c)(2)? **Hum an Subjects**  **(See Instructions.)** 10. Annual Certification of Institutional Review Board (IRB) Approval? ___Yes ___No ___N/A **Perform ance Measures Status and Certification**  **(See Instructions.)** 11. To the best of my knowledge and belief, all data in this performance report are true and correct and the report fully discloses all known weaknesses concerning the accuracy, reliability, and completeness of the data.

_____________________________ Title: _____________ Name of Authorized Repr e sentative:

_____________________________________________________ Date: ___/___/____ Signature:Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 27 - **A. CAMP**  **Project Sta tistics and Reporting for GPRA**  A1. Number of students served during budget period. **Y1 Y2**  **Y3 Y4**  **Y5 F**  a. Number funded to be served
. b. Number served in college courses ( N ote: A1b1 + A1b2 should sum to equal A1b)
. 1. Number served who were **new p articipants**  (first academic year in CAMP) (subset of A1b)
. 2. Number served who were **returning participants** (not first academic year in CAMP ) (subset of A1b)
. A2. Status at the end of budget period. ( Note : A2a
- c should sum to equal the num ber reported in A1b). **Y1 Y2**  **Y3 Y4**  **Y5 F**  a. Explain how “academic year” is defined in your project’s IHE in the space provided below:

b. Number of CAMP first academic year completers
. **(Obj. 1 National**  **Target: 86%**  **) (GPRA 1)** * Supporting documentation required. See instructions for It em A2. c. Number of withdrawals
. d. Number of persisters (coming back to continue in the subsequent budget period; persisters were enrolled in instructional services in the budget period reported but did not yet complete their first academic year of college and have returned in the subsequent budget period to continue instructional services)
. A3. Status of CAMP first academic year completers from question A2a above at the end of budget period
. **Y1 Y2**  **Y3 Y4**  **Y5 F**  a. Unduplicated number of CAMP first academic year completers who continued in postsecondary education programs. (This amount should not be greater than the amount in A2a above .) **(Obj. 2 National Target:**  **84%) (GPR**  **A 2 )**  **Y1 Y2**  **Y3 Y4**  **Y5 F**  A4. Number of CAMP first academic year completers you were able to track for follow
-up data
.Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 28 - **Y1 Y2**  **Y3 Y4**  **Y5 F**  A5 . Number of your former CAMP students who graduated from college with Bachelor’s Degree this budget period.
**Y1 Y2**  **Y3 Y4**  **Y5 F**  A6 . Number of your former CAMP students who graduated from college with Associate’s Degree this budget period.
**Y1 Y2**  **Y3 Y4**  **Y5 F**  A7 . Number of your former CAMP students who transferred to other IHEs
.
A 8 . Time to completion for CAMP first academic year completers from question A2a above. ( Note : A8a - c should sum to equal the number reported in A2a )
. **Y1 Y2**  **Y3 Y4**  **Y5 F**  a. Number of CAMP first academic year completers who completed their first academic year of college within one calendar year in your project
. b. Number of CAMP first academic year completers who completed one year of college after more than one year, but within two calendar years in your project
. c. Number of CAMP first acade mic year completers who completed one year of college after more than two calendar years in your project
.Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 29 - B **. CAMP Project Student Participant Information**  B1. Supportive & Instructional Services and F inancial Services provided only by CAMP fun ds and received by CAMP
- enrolled stud ents during the budget period. This count does not include other services provided to CAMP students by the u niversity. **Y1 Y2**  **Y3 Y4**  **Y5 F**  a . Count the total number of CAMP students served with the following types of su

pportive & instructional services. Students may appear in more than one row if they received more than one service
. ( Calculation of t otal hours received or vis its received, etc. are not necessary)
. 1. Counseling or guidance services to CAMP students (personal, academic, and career services provided in support of school
- life balance and other psycho
- social aspects of college completion)
. 2. Tutoring ( additional instructional services provided in support of a specific curriculum, course, or course of study)
. 3 . Mentoring or coaching ( advisory services provided in support of general academic career)
. 4 . Health services
. 5. Assistance with special admissions
. 6. Other __________________________________
. b
. Count the total number of CAMP students served with the following types of financial services. Please indicate the number of students receiving support services. Students may appear in more than one row if they received more than one service
. ( Calculation o f t otal hours received or visits received, etc. are not necessary .) 1 . Stipends
. 2. Scholarships
. 3. Transportation
. 4. Career
- oriented work
- study
. 5. Books and supplies
. 6. Tuition and fees
. 7. Room and Board
. 8. Other ____________________________
. c . Number of students receiving referrals to other services
. d . Total number of referrals to other services
.Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 30 - 3 **Note: Only**  **count students**  **who commute**  **on a**  **daily basis.**  **D o**  **not coun**  **t students**  **who relocate**  **a significant**  **distance (i.e.,**  **800 miles) to participate in programming.** B2. Characteristics of the CAMP enrolled students du ring this budget period. (

Note : [B2a and B2b] and [B2c and B2d] should sum to equal the number reported in A1b). **Y1 Y2**  **Y3 Y4**  **Y5 F**  a. Number of students who report themselves as male
. b. Number of students who report themselves as female
. c. Number of students who are 21 years old or younger
. d. Number of students who are over 21 years old
. e. Number of students who travel 20 miles or more to attend post - secondary education program classes. Please count all students who attend the program whose home or permanent address is 20 or more miles away. 3 f. Number of students who enrolled during the budget period and required placement in developmental or remedial courses (i.e. courses that do count toward graduation). g. Number of students that were admitted under special admissions. h. Number of first generation college students. i. Number of students who were referred from MEP and accepted into CAMP
. j. Number of students who were referred from HEP and accepted into CAMP
. k. Number of students who were referred from NFJP and accepted into CAMP
. l. Number of students who were referred from any other program and accepted into CAMP
. m. Number of students who received other financial services paid for by an agency or program other than CAMP. n. Does your project screen students for English language development placement? If “No,” skip to question C1. Mark Y for yes, or N for no. Y N Y N Y N Y N Y N Y N 1. Number of ELL students who enrolled during the budget period and had English as a second language needs.Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 31 - **C. CAMP Project Services Information**  C1. Project Model Characteristics a. Is this project a commuter or residential project or a combination of both? Commuter Residential Combination of commuter and residential b. Is this project in a four
- year or two -year institution? Four -Year Institution Two -Year Institution C2. Project Personnel Characteristics a. Number of FTE administrative staff funded by the CAMP grant .

___________ b. Number of FTE support staff (tutors, coaches, mentors, counselors, etc.) funded by the CAMP grant
. ___________ c. Number of FTE support staff contributing to the project’s CAMP s ervices , not funded by the CAMP grant
. ___________
C3. Test Information a. Does your project’s IHE use SAT scores during the intake process? Yes No 1. What is the average score for all IHE students? English ____________ Math ______________ 2. What is the range of scores for all IHE students? Engl. Min__ Engl. Max__ Math Min__ Math Max__ 3. What is the average score for CAMP students? English ____________ Math ______________ 4. What is the range of scores for CAMP students? Engl. Min__ Engl. Max__ Math Min__ Math Max__ b. Does your project’s IHE use ACT scores during the intake process? Yes No 1. What is the average score for all IHE students? English _________ ___ Math ______________ 2. What is the range of scores for all IHE students? Engl. Min__ Engl. Max__Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 32 - Math Min__ Math Max__ 3. What is the average score for CAMP students? English ____________ Math ______________ 4. Wh at is the range of scores for CAMP students? Engl. Min__ Engl. Max__ Math Min__ Math Max__ c. Does your project’s IHE use a Student Placement Exam for all students? Yes No 1. What is the name of the S tudent Placement Exam? Engl. Min__ Engl. Max__ Math Min__ Math Max__ 2. What is the average score for all IHE students? English ____________ Math ______________ 3. What is the range of scores for all IHE students? Engl. Min__ Engl. Max__ Math Min__ Math Max__ 4. What is the average score for CAMP students? English ____________ Math ______________ 5. What is the range of scores for CAMP students? Engl. Min__ Engl. Max__ Math Min__ Math Max__ **Reporti ng Prompt, Item C4**  C4. Please describe, in a paragraph not to exceed 300 words, the nature of project services with regard to a) services offered and b) maj or collaborators (e.g., partners whose collaboration is necessary to project implementation and success) and any o ther aspect of project design that is a strong influence on service delivery and success.Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 33 - **D . CAMP Project Goals and Objectives**  **Project Performance Objectives Information** (Use as many pages as necessary.) **Project Ye ar:**  **(check one: Y1**  **□ Y2**  **□ Y3**  **□ Y4**  **□ Y5**  **□ F** **□ )**  **Section 1. Project Objective** 1.a. Performance Measure **Quantitative Data Target**  **Actual Performance Data Raw**  **Nu m**  **ber Ratio**  **% Raw**  **Number Ratio**  **% /**  **/ Year One**  **Year Two Year Three**  **Year Four Year Five**  **Final** 1.b. Performance Measure **Quantitative Data Target**  **Actual Performance Data Raw**  **Nu m**  **ber Ratio**  **% Raw**  **Number Ratio**  **% /**  **/ Year One**  **Year Two Year Three**  **Year Four Year F**  **ive Final** Project Name : Sample University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 34 - **Section 2:** Explanation of Progress (Include Qualitative Data, Data Resulting from Experimental or Quasi
- Experimental Design, and Data Collection Information) (maximum 2500 words)

**Section 3: FINAL PERFORMANCE REPORT ONLY (** This information covers the entire project period, or five years) (maximum 2500 words)
. Grantees must answer each of the three questions identified below and in the attached reporting document, 1. Utilizing your evaluation results, draw conclusions about the succ ess of the project and its impact. D escribe any unanticipated outcomes or benefits from your project and any barriers that you may have encountered. 2. What would you recommend as advice to other educators that are interested in your project? H ow did your original ideas change as a result of conducting the project? 3. If applicable, describe your plans for continuing the project (sustainability; capacity building) and/or disseminating the project results. 4. Please list the cumulative totals for the following reporting requirements:  What is the cumulative total of the **number of students you served** over the course of the five years of your grant? _____________  What is the cumulative total of the **number of first academic year completers (GPRA 1)** over the course of the five years of your grant? _____________  What is the cumulative total of the **unduplicated n umber of CAMP first academic year completers who continued in postsecondary**  **education programs (GPRA 2)** over the course of the five years of your grant? ________

_______Project Name : Samp le University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 35 - **E. CAMP Project Budget Information (see instructions)**  1. Report budget expenditure data in items 8a.

– 8b
. of the Cover Sheet per the **I nstructions for**  **Cover Sheet , Question 8.**  Refer to the **Instructions for Section E** for applicable sub
instructions 1.a
. – 1.d. and enter your applicable responses 1.a.

– 1.d here, below.

2. **For Annual Performance Reports Only**

– Using the specific budget categories as in Form ED 524, comparatively report in column (a) your previously submitte d revised budg et amounts for this reporting period , identifying any amounts that include carryover funds from the previous budget period by checking the box . In column (b) report your project’s actual expenditures for this performance period. Additionally, briefly exp lain any difference in the total amounts of these two budget columns. Budget Categories (a) Revised Budget Amounts (b)

Actual Expenditure Amounts 1. Personnel 2. Fringe Benefits 3. Travel 4. Equipment 5. Supplies 6. Contractual 7. Con struction 8. Other 9. Total Direct Costs (lines 1
- 8) 10. Indirect Costs* 11. Training Stipends 12. Total Amounts (lines 9
- 11) * Note: Mark your category amounts in this column (a) with an asterisk if the amount includes any carryover fro m the prior budget period. Also, report the amount of your total carryover that is included in the total
- cell 12.(a). If the total amounts in columns (a) and (b) are different, explain this difference , below
.Project Name : Samp le University PR Number: S149A_ _ _ _ _ _ Reporting Period: 00/00/20_ _
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### - 36 - **F. GPRA 1**  **Documentation & Additional Information (see instructions)**  Do not include requests for budget revisions, supplemental funding or changes to your application’s activities in this performance report.