Form 6259 TRIBAL COLLEGES & UNIVERSITIES ANNUAL REPORT FORM

BIA Form 6259 OMB Control No. 1076-0105

Expires: XX/XX/XXXX

TRIBAL COLLEGES & UNIVERSITIES ANNUAL REPORT FORM

FISCAL YEAR ________

25 CFR 41.9, PUBLIC LAW 95-471, AS AMENDED

DUE ON OR BEFORE DECEMBER 1^ST

Paperwork Reduction Act Statement: This information is collected to meet annual reporting requirements. Response to this request is required by Public Law 95-471, as amended. The information collected is subject to the Paperwork Reduction Act. An agency may not request nor sponsor, and a person need not answer a request for information that does not contain a valid OMB control number. A response to this request is required to obtain a benefit and no action may be taken against the institution in refusing to supply the information. The public reporting burden for this form is estimated to average six hours per response, including the time for reviewing the instructions, gathering and maintaining data, and completing and reviewing the form. Send comments regarding the burden estimate or any other aspect of this form to Attn: Information Collection Clearance Officer – Indian Affairs, 1849 C Street, NW, MS-4141, Washington, DC 20240.

_______________________________________________________________ ___________________

Name of Institution Date

_____________________________________________________________________________________

Mailing Address

1.1 Institutional Accreditation: Accredited Date _______________

(Circle One) Candidate Date _______________

1.2 Does the Institution have a governing board? _________ __________

Y N

1.3 Is the Institution sanctioned by the tribe(s)? _________ __________

Y N

1.4 Does the Institution have the ‘ability to benefit’ as part of their admission requirements?

Ability to Benefit:

_________ __________

Y N

1.5 Provide a comparison of actual accomplishments to the goals established for the academic year.

(Use an attachment if necessary.)

SECTION 2.0 DEGREES CONFERRED

Master of Arts/Master of Science	Indian	Non-Indian
Bachelor Arts/ Bachelor Science	Indian	Non-Indian
Associate Arts/Associate Science	Indian	Non-Indian
Certificate	Indian	Non-Indian
Totals	Indian	Non-Indian

SECTION 3.0 STUDENT HEAD COUNT (Identify number of male and female students enrolled)

	INDIAN MALE	INDIAN FEMALE	NON-INDIAN MALE	NON-INDIAN FEMALE
SUMMER
FALL
WINTER
SPRING
TOTALS

SECTION 4.0 Student Costs of Attendance Per Academic Year

TUITION	$
ROOM & BOARD	$
TRANSPORTATION	$
TEXT BOOKS	$
SUPPLIES	$
PERSONAL EXPENSES	$
MISCELLANEOUS EXPENSES	$
FEES	$

5.0 CURRENT FUNDS REVENUE BY SOURCE

This report covers finance activity for the 12 month fiscal year beginning __________, _____ and ending _________.

LINE NO.	SOURCE OF REVENUE	UNRESTRICTED FUNDS	RESTRICTED FUNDS	TOTAL
01	Tuition & Fees
02	Government Appropriations (excluding PL 95-471)
	a. Title III
	b. Carl Perkins
	c. PL 93-638
	d. School to Work
	e. Work Study
	f. Federal Pell
03	PL 95-471(Operational)1
04	PL 95-471(Technical Assistance)
05	Government Grants & Contracts
06	Endowment Income
07	Tribal Support
08	Auxiliary Enterprise
09	Other Sources
10	Independent Operations
11	Total FY Revenue

^{1. Sum of Line 3 + Sum of Line 4 / Line 11 Unstricted Funds Column = PL 95-471% of Total FY Revenue}

SECTION 5.1 GRANT EXPENDITURES FOR PREVIOUS YEAR

	Total	Salaries & Wages	Benefits	O&M	Depreciation	Interest	All Others
Instruction
Research
Public Service
Academic Support
Student Services
Institutional Support
Auxiliary Enterprises
Scholarship & Fellowships
Independent Operations
O&M of Plant
Total Expenses

SECTION 6.0 Certificate of Authority

“I certify that the information contained in this annual report is complete and accurate and that the report has been filed with the governing body of the Indian tribe(s) chartering this tribally controlled community college”.

_____________________________________________________________________________________

College/University President Date

__________________________________________________________________

Printed or Typed Name

_____________________________________________________________________________________

Authorized College/University Board Member Date

__________________________________________________________________

Printed or Typed Name

TRIBAL COLLEGES & UNIVERSITIES ANNUAL REPORT FORM INSTRUCTIONS

25 CFR 41.9, PUBLIC LAW 95-471, AS AMENDED

Paperwork Reduction Act Statement: This information is collected to meet annual reporting requirements. Response to this request is required by Public Law 95-471, as amended. The information collected is subject to the Paperwork Reduction Act. An agency may not request nor sponsor, and a person need not answer a request for information that does not contain a valid OMB control number. A response to this request is required to obtain a benefit and no action may be taken against the institution in refusing to supply the information. The public reporting burden for this form is estimated to average six hours per response, including the time for reviewing the instructions, gathering and maintaining data, and completing and reviewing the form. Send comments regarding the burden estimate or any other aspect of this form to Attn: Information Collection Clearance Officer – Indian Affairs, 1849 C Street, NW, MS-4141, Washington, DC 20240.

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• Provide the name of the institution, the date the report was completed, and the complete mailing address.

• 1.1. Circle whether the institution is accredited or is a candidate for accreditation, and provide the date accredited or of candidacy.

• 1.2. Indicate whether or not the institution has a governing board.

• 1.3. Indicate whether or not the institution is sanction by the tribe(s).

• 1.4. Indicate whether or not the institution has the “ability to benefit” as part of academic requirements.

“Ability to Benefit” is defined as an exam which demonstrates a student’s ability to benefit from the education offered by the higher education institution. For example, if a student does not have a U.S. high school diploma or recognized equivalent such as a GED, they must take and pass an ability to benefit exam designated by the high education institution to be eligible to attend class and apply for aid.

• 1.5. Provide a comparison of actual accomplishments to the goals established for the reporting academic year.

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• 2.0. Provide the number of degrees conferred for the most recent academic year by Indian and non-Indian numbers.

• 3.0. Identify the number of male and female students enrolled for the most recent academic year by semester and Indian and Non-Indian categories.

• 4.0. Provide data regarding the student costs of attendance per academic year, using the most recent data available.

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• 5.0. Report funds revenue for the most recently completed fiscal year. See General Guidance for Current Funds Revenue by Source on page 7 for source definitions.

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• 5.1. Report data for P.L. 95-471 grant expenditures only using the most recently completed fiscal year’s data. See General Guidance for Expenditures Category on page 8 for category definitions.

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• 6.0. Certificate of Authority—provide the College/University President’s signature and an authorized College/University board member signature.

TRIBALLY CONTROLLED COMMUNITY COLLEGES ANNUAL REPORT FORM

GENERAL GUIDANCE FOR CURRENT FUNDS REVENUE BY SOURCE

Unrestricted Current Funds means resources by an institution that have no limitations or stipulations placed on them by external agencies or donors.

Restricted Current Funds means resources provided to an institution that have externally established limitations or stipulations placed upon their use. Externally imposed restrictions are to be contrasted with internal designations imposed by the governing board on unrestricted funds.

Tuition and Fees means those fees assessed against students for education purposes. Include tuition and fee remissions or exemptions even though there is no intention of collecting from the student.

Government Appropriations means all amounts received by the institution through acts of a legislative body, except grants and contracts. These funds are for meeting current operating expenses, not for specific projects or programs. An example is Federal land-grant appropriations.

Public Law 95-471(Operational) and (Technical Assistance) means those funds available for the general operating fund of the institution to defray expenditures for academic, educational, and administrative purposes. These funds are not to be used for religious worship or sectarian instruction.

Government Grants and Contracts are revenue from governmental agencies that are for specific research projects or other types of programs. Examples are research projects, training programs, similar activities for which amounts are received or expenditures are reimbursable under the terms of a government grant or contract. Related indirect costs recovered should be reported as unrestricted revenues. Amounts equal to direct costs incurred should be recorded as charges against current restricted funds and reported as restricted current funds. Do not include revenues from the Federal Direct Student Loan (FDSL) Program.

Endowment Income means the reporting of (1) unrestricted income of endowment an similar funds; (2) restricted income of endowment and similar funds to the extend expended for current operating purposes; and (3) income from funds held in trust by others under irrevocable trusts. Do not include capital gains or losses unless the institution has adopted a spending formula by which it expends not only the yield but also a prudent portion of the appreciation of the principal; in this case, the amount calculated by the total return concept would be reported. If any such gains are spent for current operations, these should be treated as transfers, not revenues.

Auxiliary Enterprise means revenues generated by auxiliary enterprise operations that exist to furnish a service to students, faculty or staff and that charge a fee that is directly related to the cost of the service. Examples are residence halls, food services, student health services, college unions, college stores and movie theaters.

Other Sources includes all revenue not covered elsewhere. Examples are interest income and gains (net of loses) from investments of unrestricted current funds, miscellaneous rentals and sales, expired term endowments, and terminated annuity or life income agreements, if not material. Include revenues resulting from the sales and services of internal service departments to persons or agencies external to the institution (i.e., sale of computer time).

Independent Operations includes all revenues associated with operations independent of the primary missions of the institution. This category generally includes only those revenue associated with major Federally funded research and development centers. Do not include the net profit, or loss, from operations owned and managed as investments of the institution’s endowment funds.

GENERAL GUIDANCE FOR EXPENDITURES CATEGORIES

Instruction means expenditures of the colleges, schools, departments, and other instructional divisions of the institution and expenditures for departmental research and public service that are not separately budgeted should be included in this classification. Include expenditures for both credit and non-credit activities. Exclude expenditures for academic administration where the primary function is administration (e.g., academic deans - such expenditures should be reported under Academic Support). The instruction category includes general academic instruction, occupational and vocational instruction, special session instruction, community education, preparatory and adult basic education and remedial and tutorial instruction conducted by the teaching faculty for the institution’s students.

Research means all funds expended for activities specifically organized to produce research outcomes and commissioned by an agency either external to the institution or separately budgeted by an organizational unit within the institution. Do not report non-research sponsored programs (e.g. training programs).

Public Service means funds budgeted specifically for public service and expended for activities established primarily to provide non-instructional services beneficial to groups external to the institution. Examples are seminars and projects provided to particular sectors of the community. Include expenditures for community services and cooperative extension services.

Academic Support means support services that are an integral part of the institution’s primary mission of instruction, research, or public service. Include expenditures for libraries, museums, galleries, audio/visual services, academic computing support, academic administration, personnel development, and course and curriculum development. Include expenditures for veterinary and dental clinics if their primary purpose is to support the institutional program.

Student Sevices means those funds expended for admissions, registrar activities, and activities who primary purpose is to contribute to student’s emotional and physical well-being and to their intellectual, cultural, and social development outside the context of the formal instructional program. Examples are career guidance, counseling, financial aid administration, and student health services. Include administrative allowance for Pell Grants.

Institutional Support means expenditures for the day-to-day operational support of the institution, excluding expenditures for physical plant operations. Include expenditures for general administrative services, executive direction and planning, legal and fiscal operations, and public relations/development.

Auxiliary Enterprises means those self-supporting operations of the institution that exist to furnish a service to students, faculty, or staff and that charge a fee that is directly related to, although not necessarily equal to, the cost of the service. Examples are residence halls, food services, student health services, intercollegiate athletics, college unions, college stores and barber shops.

Scholarships and fellowships means all expenditures given in the form of outright grants and trainee stipends to individuals enrolled in formal course work, either for credit or non-credit. Aid to students in the form of tuition or fee remissions should be excluded, (Exclude those remissions that are granted because of faculty or staff status. Charge this to staff benefits). Do not report College Work Study program expenses here; report these expenses where the student served. Do not include expenditures for Federal Direct Student (FDSL) Loan Program.

Independent Operations means all funds expended for operations that are independent of or unrelated to the primary missions of the institution (i.e., instruction, research, public service), although they may contribute indirectly to the enhancement of these programs. This category is generally limited to expenditures of major Federally funded research and development centers. Do not include the expenditures of operations owned and managed as investments of the institution’s endowment funds.

Operation and maintenance of plant means all expenditures for operations established to provide service and maintenance related to grounds and facilities used for educational and general purposes. Also include expenditures for utilities, fire protection, property insurance, and similar items. Do not include expenditures made from the institutional plant funds account.

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