U.S. ELECTION ASSISTANCE COMMISSION 

633 3rd St. NW, Suite 200 

Washington, DC 20001 

HAVCP Poll Worker Program Progress Report 

Instructions: Reports due for the period ending March 31 should describe the activities of the previous sixmonth period and reports due for the period ending September 30 should cover the previous 12- month 

period. Final reports should cover the entire performance period from the start of the grant. 

Additional guidance can be found on our website: https://www.eac.gov/grants/help-america-vote-collegeprogram 

EAC grants reports will be made publicly available. Therefore, your report narrative should: 

* Be written in clear, concise, and in plain language 

* Not include sensitive confidential information 

Section I: Cover Page 

Grant Information 

1. Entity Name: 

2. Award Number: 

3. Grant Type: Poll Worker Program 

4. Report Type: □Semi-Annual, □Annual, □Final 

5. Reporting Period: 

Section II: Progress Narrative 

1. Program Activities 

Describe in detail what happened during this reporting period and explain how you implemented the 

approved grant activities in accordance with your Program Narrative. (Note: Your activities should 

align with your expenditures in Section IV and you may use those categories as headings in your 

response as applicable.) 

□ Check if no activity during this reporting period. 

2. Training 

Provide a description of any training conducted. 

□ Check if no training was conducted during this reporting period. 

Tel: (301) 563-3919 www.eac.gov Fax: (301) 734-3108 

Toll free: 1 (866) 747-1471 
U.S. ELECTION ASSISTANCE COMMISSION 

633 3rd St. NW, Suite 200 

Washington, DC 20001 

3. Partnerships 

Describe the partnerships built or fostered during the reporting period. Include collaboration with 

local election offices. 

□ Check if no activity during this reporting period. 

4. Historically Underrepresented Communities 

Describe how your program activities served historically underrepresented groups or locally 

underserved communities. 

□ Check if no activity during this reporting period. 

5. College Students Served 

Provide the total number of unique college students served in the following categories. Enter ‘0’ if 

no students were served in a category or if the category does not apply to your program. 

Metric Reporting Period Total Cumulative Total for Grant 

Enrolled in Poll Worker 

Training 

Completed Poll Worker 

Training 

Enrolled in Election Day 

Participation 

Completed Election Day 

Poll Worker Duties 

Participated in National 

Poll Worker Day Activities 

Community Volunteers 

Engaged in Poll Worker 

Activities 

6. Additional Performance Measures 

Tel: (301) 563-3919 www.eac.gov Fax: (301) 734-3108 

Toll free: 1 (866) 747-1471 
 

U.S. ELECTION ASSISTANCE COMMISSION 

633 3rd St. NW, Suite 200 

Washington, DC 20001 

Input data for your selected Performance Measures. The same measures should be reported on for 

each reporting period. 

Measure Reporting Period Total Cumulative Total for Grant 

Total number of 

partnerships developed 

Number of outreach 

plans developed and 

executed 

Social media 

engagement (Include 

unit of measurement i.e. 

impressions, reach, 

referrals, and 

conversions.) 

Workshops, 

Presentations, Trainings, 

Conferences - number 

of college students 

served (in-person or 

virtual audience) 

Total number of college 

students reached via 

print methods 

(magazine, college 

newspaper, print ads, 

etc.) 

Number of college 

students reached via 

digital platforms (e.g. 

Social Media, Websites, 

Blogs, etc.): 

Number of listeners or 

viewers (podcast, radio, 

TV, Public Service 

Announcements, ads) 

7. Performance Measure Narrative 

Describe in detail how performance measures were achieved during the reporting period. Consider 

the following questions: What activities took place to engage college students? What challenges and 

successes did the program face? What is the relationship between college students/colleges and your 

local election office? How is the College Poll-Worker Program meeting a need in your community? 

Tel: (301) 563-3919 www.eac.gov Fax: (301) 734-3108 

Toll free: 1 (866) 747-1471 
 

U.S. ELECTION ASSISTANCE COMMISSION 

633 3rd St. NW, Suite 200 

Washington, DC 20001 

8. Matching Requirement 

Describe how you are meeting or have met the 10% matching requirement. 

Section III: Challenges and Changes 

9. Issues Encountered 

Describe how and whether the issues were resolved. Also, briefly discuss the implications of any 

unresolved issues or concerns. 

□ Check if no major issues were encountered during this reporting period. 

10. Significant Changes 

Describe any significant changes to your program during the reporting period, including changes to 

your original Program Narrative or favorable developments that improved program efficiency 

and/or service delivery. 

□ Check is no significant changes were made during this reporting period. 

Section IV: Expenditures 

11. Fill out the table below with both the Federal and Program Match expenditures for the current 

reporting period. Include federal and state interest expenditures and write-in any cost areas that do 

not fit into the predefined program categories. If you do not have expenses for a particular category, 

please populate the field with $0.00. Total expenses will be automatically calculated. Please verify 

totals prior to submission. 

Expenditures should be consistent with the activities described in your narrative and with the 

amounts in your financial reports. (EAC uses the difference between your current and previous 

period FFR to calculate current period expenditures). 

Category Federal Program Match 

Personnel 

Fringe 

Equipment 

Tel: (301) 563-3919 www.eac.gov Fax: (301) 734-3108 

Toll free: 1 (866) 747-1471 
 

U.S. ELECTION ASSISTANCE COMMISSION 

633 3rd St. NW, Suite 200 

Washington, DC 20001 

Training 

Contractual/Consultants 

Supplies 

Other 

Indirect Costs 

TOTAL 

Section V: Final Assessment (Final Report Only) 

Instructions: The final progress report is your opportunity to share the significant successes of your 

project and present information about the results your project achieved. The report should cover the 

entire period of performance. 

12. Self-Assessment 

Assess whether the goals set out in your Narrative were met as intended during the grant program. 

Highlight any needs that were not met or ongoing/under resourced areas for future consideration. 

13. Impact and Achievements 

Describe how this grant program impacted college student participation in elections in your area. 

Highlight your accomplishments and successes. 

14. Lessons Learned 

Describe any lessons learned during the grant that may be replicated, expanded and/or help others. 

Section V: Certification 

15. Name and Contact of the authorized certifying official. 

First and Last Name: 

Title: 

Phone Number: 

Email Address: 

Tel: (301) 563-3919 www.eac.gov Fax: (301) 734-3108 

Toll free: 1 (866) 747-1471 
U.S. ELECTION ASSISTANCE COMMISSION 

633 3rd St. NW, Suite 200 

Washington, DC 20001 

Signature: 

Tel: (301) 563-3919 www.eac.gov Fax: (301) 734-3108 

Toll free: 1 (866) 747-1471 
 

U.S. ELECTION ASSISTANCE COMMISSION 

633 3rd St. NW, Suite 200 

Washington, DC 20001 

Privacy Act Statement: EAC–4 

SYSTEM NAME: Election Assistance Commission Federal Financial Assistance and HAVA Grantee Files. 

SYSTEM LOCATION: Located in hard copy files at 1201 New York Avenue, NW., Suite 300, 

Washington, DC 20005; in electronic format on secured servers, data disks, and encrypted thumb drives 

with controlled access. 

CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM: Individuals with whom EAC does 

business for purposes of providing Federal financial assistance and awarding grants. 

CATEGORIES OF RECORDS IN THE SYSTEM: Grantee, federal financial assistance, and peer reviewer 

applications, financial and banking information, correspondence, and legal memoranda. 

AUTHORITY FOR MAINTENANCE OF THE SYSTEM: The Budget and Accounting Procedures Act of 

1950, as amended. 31 U.S.C. 3511, et seq. 

PURPOSE: The information in this system is used to issue grant solicitations, analyze grant applications, 

make award decisions, and manage and oversee grantees. Information in this system is also used to perform 

all administrative functions related to EAC's other Federal financial assistance programs. 

ROUTINE USES OF RECORDS MAINTAINED IN THE SYSTEM, INCLUDING CATEGORIES OF 

USERS AND THE PURPOSES OF SUCH USES: Data in this system is used to administer all aspects of 

EAC's federal financial assistance and grant-making programs; and to conduct statistical research or analyze 

trends associated with these activities. Data may also be used to assist with Congressional oversight of 

Federal funds administered by EAC. Data may be shared with the Department of Health and Human 

Services (HHS) to enable HHS to service EAC grant recipients. Data may be disclosed to the Department of 

Justice, the U.S. Department of the Treasury, or the Government Accountability Office (GAO) in 

connection with payment and debt collection activities. Information may also be disclosed to GAO in 

connection with grant administration and audit activities within GAO's jurisdiction; and to the National 

Institute of Standards and Technology (NIST) in conjunction with joint EAC/NIST grant activities. Access 

to records in the system is limited to authorized personnel whose official duties require such access. 

Permission level assignments allow users access only to those functions for which they are authorized. 

POLICIES AND PRACTICES FOR STORING, RETRIEVING, ACCESSING, RETAINING, AND 

DISPOSTING OF RECORDS IN THE SYSTEM: 

STORAGE: Records are maintained in file folders in locked file cabinets in financial management, grants, 

testing and certification, and research policies and programs staff offices. Electronic records are maintained 

in a secure password protected environment and maintained with safeguards meeting the security 

requirements of the Federal Information Security Management Act (FISMA) of 2002. 

SAFEGUARDS: EAC staff maintain hard copy files in locked file cabinets in controlled access offices by 

Grants; Research, Policy, and Programs; Testing and Certification; and financial management staff. 

Electronic data is stored on magnetic media in a computer system with controlled access that requires 

passwords and identity authentication for users. EAC staff maintain electronic files in a controlled access 

environment. System managers determine user permission levels based on staff duties and responsibilities. 

Only those staff authorized to perform tasks associated with information contained in this system of records 

have permission to access and maintain these files. Network users are also notified when they login to EAC 

systems that improper use of EAC electronic systems may violate applicable law and subject employees to 

disciplinary action. EAC staff who access electronic files remotely may only do so by connecting to EAC's 

servers via a secure remote password-protected connection. 

RETRIEVABILITY: Records are retrieved by name and by Tax Identification Number. 

RETENTION AND DISPOSAL: Records in this system are maintained in accordance with the applicable 

National Archives and Records Administration Records Schedule. 

Tel: (301) 563-3919 www.eac.gov Fax: (301) 734-3108 

Toll free: 1 (866) 747-1471 
 

 

 

 

U.S. ELECTION ASSISTANCE COMMISSION 

633 3rd St. NW, Suite 200 

Washington, DC 20001 

SYSTEM MANAGER(S) AND ADDRESS: Executive Director, U.S. Election Assistance Commission, 

1201 New York Avenue, NW., Suite 300, Washington, DC 20005. After receipt, the Executive Director will 

direct records requests to the appropriate division staff with responsibility for the specific Federal financial 

management or grants records that are the subject of the request. 

NOTIFICATION PROCEDURE: See Preliminary Statement. 

RECORD ACCESS PROCEDURES: See Preliminary Statement. 

CONTESTING RECORD PROCEDURES: See Preliminary Statement. 

RECORD SOURCE CATEGORIES: Information in this system is obtained from documents submitted by 

individuals covered by the system as well as documents issued by EAC financial management staff. 

EXEMPTIONS CLAIMED FOR THE SYSTEM: None. 

Paperwork Reduction Act. In accordance with the Paperwork Reduction Act of 1995 (44 U.S.C. chapter 

35), the information collection requirements associated with the programs, as covered in this Notice, have 

been approved by the Office of Management and Budget (OMB) under OMB Control Number 3265-0025. 

Public burden reporting for this collection of information is estimated to average 1 hour per response for 

individuals completing all parts of this form, including time for reviewing instructions, searching existing 

data sources, gathering, and maintaining the data needed, and completing and reviewing the collection of 

information. You are not required to answer these questions unless this number is displayed. Send 

comments regarding the burden estimate or any other aspect of this collection of information, including 

suggestions for reducing this burden, U.S. Election Assistance Commission, 633 3rd Street NW, Suite 200, 

Washington, DC 20001. 

Tel: (301) 563-3919 www.eac.gov Fax: (301) 734-3108 

Toll free: 1 (866) 747-1471