Research in Disabilities Education (RDE) Monitoring System

Attachment H1

Research in Disabilities Education (RDE)

Monitoring System

Table of Contents

RDE: Crosswalk – Alliance Track 3

RDE: Crosswalk – Research Track 104

RDE: Number of Respondents, Frequency of Response, and Annual Hour Burden 142

RDE: Hour Burden Estimates by Each Form and Aggregate Hour Burdens 143

RDE: Estimates of Annualized Cost to Respondents for the Burden Hours 144

RDE: Estimates of Costs to the Federal Government 145

RDE: Questions – Alliance Track 146

RDE: Questions – Research Track 248

RDE: Crosswalk – Alliance Track

	Sections/Questions	Data Elements	Staff & Project Participant Characteristics1	Project Implementation Characteristics2	Project Outputs3
	Alliance Award
	Award Details
	1. Verify Award Details - NSF Award Data
	1	Awards are asked to verify: Award Track NSF Award Number Award Title Principal Investigator Primary Institution Award Start Date Previous Award Number Collaborative Award? (Yes/No) (If part of a collaborative award, awards are also asked to verify the NSF Award Number, Award Institution, Award Title, and Principal Investigator for all collaborating awards.) Are the above data correct and complete for your institution's award and any collaborative awards? -Yes -No Was the current award preceded by another NSF RDE award? -Yes -No	X	X
	2. Previous NSF RDE Award
	2a	Was the current award preceded by another NSF RDE award? -Yes -No	X
	2b	Previous NSF Award Number	X
	2c	Previous NSF Award Title	X
	2d	Previous RDE Award Track: <dropdown list> -Alliance -Research -Enrichment -Demonstration -Dissemination	X
	Funding Sources
	1	Full name of funding source		X
	2	Name of funding program		X
	3	Amount of funding		X
	4a	Type of funding: <dropdown list> -Federal -State -Local -Business/industry -University		X
	4b	If funding type is "Federal," specify Grant or Award ID		X
	Data Corrections
	Institution Data Corrections: Higher Education Institutions
	1. Student Data
	1	What is the source of your student data? (Select all that apply.) -Disability services office -Registrar -Office of Institutional Research	X
	2	Complete the following tables for the reporting year and the baseline year.
	General Data
		Total number of students	X
		Students receiving disability services via this institution	X		X
	Full/Part Time
		Students enrolled full time	X
		Students enrolled part time	X
	Candidates
		Enrolled degree candidates	X
		Enrolled certificate candidates	X
		Students taking classes (not for degree or certificate)	X
	Academic Level Data
		Freshmen	X
		Sophomores	X
		Juniors	X
		Seniors	X
		Master's students	X
		Doctoral students	X
		Other students	X
	Gender
		Total female students	X
		Total male students	X
		Institution declined to report	X
		Project declined to report	X
	Ethnicity
		Hispanic or Latino	X
		Not Hispanic or Latino	X
		Institution declined to report	X
		Project declined to report	X
	Race
		American Indian or Alaska Native	X
		Asian	X
		Black or African American	X
		Native Hawaiian or Other Pacific Islander	X
		White	X
		Institution declined to report	X
		Project declined to report	X
	Condition
		None	X
		Asperger’s syndrome/autism spectrum disorder	X
		Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD)	X
		Deaf or hard-of-hearing (D/HoH)	X
		Physical impairment/orthopedic/mobility impairment	X
		Systemic health/medical condition	X
		Psychological/psychiatric condition	X
		Learning disorder	X
		Blind or visual impairment	X
		Speech impairment	X
		Acquired/traumatic brain injury	X
		Other condition	X
		Institution declined to report	X
		Project declined to report	X
	U.S. Military Service Status
		Active duty	X
		Reserve or National Guard	X
		Previous military service	X
		No military service	X
		Institution declined to report	X
		Project declined to report	X
	2. Students Enrolled in RDE-Defined STEM Majors
	2-1	Complete the following tables for the reporting year and baseline year.
	Degree Types for All RDE-Defined STEM Majors
		All students in RDE-defined STEM majors—A.A./A.S./A.A.S.	X
		All students in RDE-defined STEM majors—B.A./B.S.	X
		All students in RDE-defined STEM majors—M.A./M.S.	X
		All students in RDE-defined STEM majors—Ph.D.	X
	Enrollment, RDE- Defined STEM Majors with Conditions
		Total number of RDE-defined STEM majors with conditions	X		X
	Degree Types for RDE-Defined STEM Majors with Conditions
		Students with conditions in RDE-defined STEM majors--A.A./A.S./A.A.S.	X		X
		Students with conditions in RDE-defined STEM majors--B.A./B.S.	X		X
		Students with conditions in RDE-defined STEM majors--M.A./M.S.	X		X
		Students with conditions in RDE-defined STEM majors--Ph.D.	X		X
	Gender
		Total female students	X
		Total male students	X
		Institution declined to report	X
		Project declined to report	X
	Ethnicity
		Hispanic or Latino	X
		Not Hispanic or Latino	X
		Institution declined to report	X
		Project declined to report	X
	Race
		American Indian or Alaska Native	X
		Asian	X
		Black or African American	X
		Native Hawaiian or Other Pacific Islander	X
		White	X
		Institution declined to report	X
		Project declined to report	X
	Condition
		Asperger’s syndrome/autism spectrum disorder	X
		Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD)	X
		Deaf or hard-of-hearing (D/HoH)	X
		Physical impairment/orthopedic/mobility impairment	X
		Systemic health/medical condition	X
		Psychological/psychiatric condition	X
		Learning disorder	X
		Blind or visual impairment	X
		Speech impairment	X
		Acquired/traumatic brain injury	X
		Other condition	X
		Institution declined to report	X
		Project declined to report	X
	U.S. Military Service Status
		Active duty	X
		Reserve or National Guard	X
		Previous military service	X
		No military service	X
		Institution declined to report	X
		Project declined to report	X
	3. Students Who Graduated From RDE‑ Defined STEM Majors
	3-1	Complete the following tables for the reporting year and baseline year.
	Degree Types for All RDE-Defined STEM Graduates
		All RDE-defined STEM graduates—A.A./A.S./A.A.S.	X
		All RDE-defined STEM graduates—B.A./B.S.	X
		All RDE-defined STEM graduates—M.A./M.S.	X
		All RDE-defined STEM graduates—Ph.D.	X
	RDE-Defined STEM Graduates with Conditions
		Total number of RDE-defined STEM graduates with conditions	X		X
	Degree Types for RDE-Defined STEM Graduates with Conditions
		RDE-defined STEM graduates with conditions—A.A./A.S./A.A.S.	X		X
		RDE-defined STEM graduates with conditions—B.A./B.S.	X		X
		RDE-defined STEM graduates with conditions—M.A./M.S.	X		X
		RDE-defined STEM graduates with conditions—Ph.D.	X		X
	Gender
		Total female students	X
		Total male students	X
		Institution declined to report	X
		Project declined to report	X
	Ethnicity
		Hispanic or Latino	X
		Not Hispanic or Latino	X
		Institution declined to report	X
		Project declined to report	X
	Race
		American Indian or Alaska Native	X
		Asian	X
		Black or African American	X
		Native Hawaiian or Other Pacific Islander	X
		White	X
		Institution declined to report	X
		Project declined to report	X
	Condition
		Asperger’s syndrome/autism spectrum disorder	X
		Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD)	X
		Deaf or hard-of-hearing (D/HoH)	X
		Physical impairment/orthopedic/mobility impairment	X
		Systemic health/medical condition	X
		Psychological/psychiatric condition	X
		Learning disorder	X
		Blind or visual impairment	X
		Speech impairment	X
		Acquired/traumatic brain injury	X
		Other condition	X
		Institution declined to report	X
		Project declined to report	X
	U.S. Military Service Status
		Active duty	X
		Reserve or National Guard	X
		Previous military service	X
		No military service	X
		Institution declined to report	X
		Project declined to report	X
	K-12 Schools
	1. Student Data
	1	What is the source of your student data? (Select all that apply.) -State Department of Education -School district office -National Center for Education Statistics -High school administrator	X
	2	Complete the following tables for the reporting year and the baseline year.
	General Data
		Total number of students	X
	Academic Level
		Freshmen	X
		Sophomores	X
		Juniors	X
		Seniors	X
	Gender
		Total female students	X
		Total male students	X
		Institution declined to report	X
		Project declined to report	X
	Ethnicity
		Hispanic or Latino	X
		Not Hispanic or Latino	X
		Institution declined to report	X
		Project declined to report	X
	Race
		American Indian or Alaska Native	X
		Asian	X
		Black or African American	X
		Native Hawaiian or Other Pacific Islander	X
		White	X
		Institution declined to report	X
		Project declined to report	X
	Condition
		None	X
		Asperger's syndrome/autism spectrum disorder	X
		Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADH D)	X
		Deaf or hard-of-hearing (D/HoH)	X
		Physical impairment/orthopedic/mobility impairment	X
		Systemic health/medical condition	X
		Psychological/psychiatric condition	X
		Learning disorder	X
		Blind or visual impairment	X
		Speech impairment	X
		Acquired/traumatic brain injury	X
		Other condition	X
		School declined to report	X
		Project declined to report	X
	School Districts
	1. Student Data
	1	What is the source of your student data? (Select all that apply.) -State Department of Education -School district office -National Center for Education Statistics	X
	2	Complete the following tables for the reporting year and the baseline year.
	General Data
		Total number of students	X
	Academic Level
		Freshmen	X
		Sophomores	X
		Juniors	X
		Seniors	X
	Gender
		Total female students	X
		Total male students	X
		Institution declined to report	X
		Project declined to report	X
	Ethnicity
		Hispanic or Latino	X
		Not Hispanic or Latino	X
		Institution declined to report	X
		Project declined to report	X
	Race
		American Indian or Alaska Native	X
		Asian	X
		Black or African American	X
		Native Hawaiian or Other Pacific Islander	X
		White	X
		School district declined to report	X
		Project declined to report	X
	Condition
		None	X
		Asperger's syndrome/autism spectrum disorder	X
		Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADH D)	X
		Deaf or hard-of-hearing (D/HoH)	X
		Physical impairment/orthopedic/mobility impairment	X
		Systemic health/medical condition	X
		Psychological/psychiatric condition	X
		Learning disorder	X
		Blind or visual impairment	X
		Speech impairment	X
		Acquired/traumatic brain injury	X
		Other condition	X
		School declined to report	X
		Project declined to report	X
	School Groups
	1. Student Data
	1	What is the source of your student data? (Select all that apply.) -State Department of Education -School district offices -National Center for Education Statistics -High school administrators	X
	2	Complete the following tables for the reporting year and the baseline year.	X
	General Data
		Total number of students	X
	Academic Level
		Freshmen	X
		Sophomores	X
		Juniors	X
		Seniors	X
	Gender
		Total female students	X
		Total male students	X
		Institution declined to report	X
		Project declined to report	X
	Ethnicity
		Hispanic or Latino	X
		Not Hispanic or Latino	X
		Institution declined to report	X
		Project declined to report	X
	Race
		American Indian or Alaska Native	X
		Asian	X
		Black or African American	X
		Native Hawaiian or Other Pacific Islander	X
		White	X
		School group declined to report	X
		Project declined to report	X
	Condition
		None	X
		Asperger's syndrome/autism spectrum disorder	X
		Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADH D)	X
		Deaf or hard-of-hearing (D/HoH)	X
		Physical impairment/orthopedic/mobility impairment	X
		Systemic health/medical condition	X
		Psychological/psychiatric condition	X
		Learning disorder	X
		Blind or visual impairment	X
		Speech impairment	X
		Acquired/traumatic brain injury	X
		Other condition	X
		School declined to report	X
		Project declined to report	X
	Institutions
	Higher Education Institutions
	1. Institution Data
	1-1a	Institution State: <dropdown list> -Standard 50 States plus -Outside U.S. (Foreign) -Armed Forces America -Armed Forces Europe -Armed Forces Pacific -American Samoa -District of Columbia -DoDEA -Guam -Northern Mariana Islands -Puerto Rico -US Territories -Virgin Islands	X	X
	1-1b	Institution name: <dropdown list>	X	X
	1-1c	Address line 1	X	X
	1-1d	Address line 2	X	X
	1-1e	Address line 3	X	X
	1-1f	City	X	X
	1-1g	ZIP Code	X	X
	1-2	Institution type: -Public institution -Private institution	X	X
	1-3	Carnegie Basic Classification: <dropdown list>	X	X
	1-4	Ethnicity characteristics: (Select all that apply.) -Historically Black College or University (HBCU) -Tribal College or University (TCU) -Hispanic-Serving Institution (HSI) -Minority-Serving Institution (MSI) -None of the above	X	X
	1-5	Gender characteristics: -Single gender—male -Single gender—female -Coed	X	X
	1-6	Campus characteristics: -Virtual campus -Traditional campus -Virtual and traditional campus	X	X
	1-7	Project role: -Primary awardee institution or organization -Subawardee -Non-award partner -Consultant	X	X
	2. Project Impacts
	2-1	Has this project affected policies at this institution regarding educating students with conditions during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, what changed? If yes, what changed?			X
	2-2	Has this project affected practices at this institution regarding educating students with conditions during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, what changed? If yes, what changed?			X
	2-3	Has this project affected services provided by this institution's office for students with conditions during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, what changed?			X
	2-4	Were any courses at this institution retrofitted for Universal Design for Learning (UDL) during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?			X
	2-5	Were any new courses at this institution created using UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?			X
	2-6	Were any student laboratory facilities or experiments at this institution retrofitted for UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?			X
	2-7	Were any new student laboratory facilities or experiments at this institution created using UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?			X
	2-8	Were any fieldwork experiences at this institution changed because of UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?			X
	2-9	Were any new fieldwork experiences created at this institution using UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?			X
	3. Student Data
	3-1	What is the source of your student data? (Select all that apply.) -Disability services office -Registrar -Office of Institutional Research	X
	3-2	Complete the following tables for the reporting year:
	General Data
		Total number of students	X
		Students receiving disability services via this institution	X		X
	Full/Part Time
		Students enrolled full time	X
		Students enrolled part time	X
	Candidates
		Enrolled degree candidates	X
		Enrolled certificate candidates	X
		Students taking classes (not for degree or certificate)	X
	Academic Level
		Freshmen	X
		Sophomores	X
		Juniors	X
		Seniors	X
		Master's students	X
		Doctoral students	X
		Other students	X
	Gender
		Total female students	X
		Total male students	X
		Institution declined to report	X
		Project declined to report	X
	Ethnicity
		Hispanic or Latino	X
		Not Hispanic or Latino	X
		Institution declined to report	X
		Project declined to report	X
	Race
		American Indian or Alaska Native	X
		Asian	X
		Black or African American	X
		Native Hawaiian or Other Pacific Islander	X
		White	X
		Institution declined to report	X
		Project declined to report	X
	Condition
		None	X
		Asperger's syndrome/autism spectrum disorder	X
		Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADH D)	X
		Deaf or hard-of-hearing (D/HoH)	X
		Physical impairment/orthopedic/mobility impairment	X
		Systemic health/medical condition	X
		Psychological/psychiatric condition	X
		Learning disorder	X
		Blind or visual impairment	X
		Speech impairment	X
		Acquired/traumatic brain injury	X
		Other condition	X
		Institution declined to report	X
		Project declined to report	X
	U.S. Military Service Status
		Active duty	X
		Reserve or National Guard	X
		Previous military Service	X
		No military service	X
		Institution declined to report	X
		Project declined to report	X
	4. Students Enrolled in RDE-Defined STEM Majors
	4-1	Complete the following tables for the reporting year:
	Degree Types for All RDE-Defined STEM Majors
		All students in RDE-defined STEM majors—A.A./A.S./A.A.S.	X
		All students in RDE-defined STEM majors—B.A./B.S.	X
		All students in RDE-defined STEM majors—M.A./M.S.	X
		All students in RDE-defined STEM majors—Ph.D.	X
	Enrollment, RDE- Defined STEM Majors with Conditions
		Total number of RDE-defined STEM majors with conditions	X		X
	Degree Types for All RDE-Defined STEM Majors with Conditions
		Students with conditions in RDE-defined STEM majors—A.A.	X		X
		Students with conditions in RDE-defined STEM majors—B.A./B.S.	X		X
		Students with conditions in RDE-defined STEM majors—M.A./M.S.	X		X
		Students with conditions in RDE-defined STEM majors—Ph.D.	X		X
	Gender
		Total female students	X
		Total male students	X
		Institution declined to report	X
		Project declined to report	X
	Ethnicity
		Hispanic or Latino	X
		Not Hispanic or Latino	X
		Institution declined to report	X
		Project declined to report	X
	Race
		American Indian or Alaska Native	X
		Asian	X
		Black or African American	X
		Native Hawaiian or Other Pacific Islander	X
		White	X
		Institution declined to report	X
		Project declined to report	X
	Condition
		None	X
		Asperger's syndrome/autism spectrum disorder	X
		Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADH D)	X
		Deaf or hard-of-hearing (D/HoH)	X
		Physical impairment/orthopedic/mobility impairment	X
		Systemic health/medical condition	X
		Psychological/psychiatric condition	X
		Learning disorder	X
		Blind or visual impairment	X
		Speech impairment	X
		Acquired/traumatic brain injury	X
		Other condition	X
		Institution declined to report	X
		Project declined to report	X
	U.S. Military Service Status
		Active duty	X
		Reserve or National Guard	X
		Previous military service	X
		No military service	X
		Institution declined to report	X
		Project declined to report	X
	5. Students Who Graduated From RDE-Defined STEM Majors
	5-1	Complete the following tables for the reporting year.
	Degree Types for All RDE-Defined STEM Graduates
		All RDE-defined STEM graduates—A.A./A.S./A.A.S.	X
		All RDE-defined STEM graduates—B.A./B.S.	X
		All RDE-defined STEM graduates—M.A./M.S.	X
		All RDE-defined STEM graduates—Ph.D.	X
	RDE-Defined STEM Graduates with Conditions
		Total number of RDE-defined STEM graduates with conditions	X		X
	Degree Types for RDE-Defined STEM Graduates with Conditions
		RDE-defined STEM graduates with conditions—A.A./A.S./A.A.S.	X		X
		RDE-defined STEM graduates with conditions—B.A./B.S.	X		X
		RDE-defined STEM graduates with conditions—M.A./M.S.	X		X
		RDE-defined STEM graduates with conditions—Ph.D.	X		X
	Gender
		Total female students	X
		Total male students	X
		Institution declined to report	X
		Project declined to report	X
	Ethnicity
		Hispanic or Latino	X
		Not Hispanic or Latino	X
		Institution declined to report	X
		Project declined to report	X
	Race
		American Indian or Alaska Native	X
		Asian	X
		Black or African American	X
		Native Hawaiian or Other Pacific Islander	X
		White	X
		Institution declined to report	X
		Project declined to report	X
	Condition
		None	X
		Asperger's syndrome/autism spectrum disorder	X
		Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADH D)	X
		Deaf or hard-of-hearing (D/HoH)	X
		Physical impairment/orthopedic/mobility impairment	X
		Systemic health/medical condition	X
		Psychological/psychiatric condition	X
		Learning disorder	X
		Blind or visual impairment	X
		Speech impairment	X
		Acquired/traumatic brain injury	X
		Other condition	X
		Institution declined to report	X
		Project declined to report	X
	U.S. Military Service Status
		Active duty	X
		Reserve or National Guard	X
		Previous military Service	X
		No military service	X
		Institution declined to report	X
		Project declined to report	X
	K-12 Schools
	1. School Data
	1-1a	Full school name	X	X
	1-1b	School type: -Public institution -Private institution	X	X
	1-1c	If "Public institution" was selected, specify district	X	X
	1-1d	Address line 1	X	X
	1-1e	Address line 2	X	X
	1-1f	Address line 3	X	X
	1-1g	City	X	X
	1-1h	School State: <dropdown list>	X	X
	1-1i	ZIP Code	X	X
	1-2	School characteristic: -High school -Middle school/junior high school -Elementary school -Multi-age school for students with conditions -Multi-age school	X	X
	1-3	Project role: -Primary awardee institution or organization -Subawardee -Non-award partner -Consultant	X	X
	2. Project Impacts
	2-1	Has this project affected policies at this school regarding educating students with conditions during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, what changed?			X
	2-2	Has this project affected services and/or practices at this school regarding educating students with conditions during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, what changed?			X
	2-3	Were any courses at this school retrofitted for Universal Design for Learning (UDL) during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?			X
	2-4	Were any new courses at this school created using UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?			X
	2-5	Were any student laboratory facilities or experiments at this school retrofitted for UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?			X
	2-6	Were any new student laboratory facilities or experiments at this school created using UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?			X
	2-7	Were any fieldwork experiences at this school changed because of UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?			X
	2-8	Were any new fieldwork experiences created at this school using UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?			X
	3. Student Data
	3-1	What is the source of your student data? (Select all that apply.) -State Department of Education -School district office -National Center for Education Statistics -High school administrator	X
	3-2	Complete the following tables for the reporting period.
	General Data
		Total number of students	X
	Academic Level
		Freshmen	X
		Sophomores	X
		Juniors	X
		Seniors	X
	Gender
		Total female students	X
		Total male students	X
		Institution declined to report	X
		Project declined to report	X
	Ethnicity
		Hispanic or Latino	X
		Not Hispanic or Latino	X
		Institution declined to report	X
		Project declined to report	X
	Race
		American Indian or Alaska Native	X
		Asian	X
		Black or African American	X
		Native Hawaiian or Other Pacific Islander	X
		White	X
		Institution declined to report	X
		Project declined to report	X
	Condition
		None	X
		Asperger's syndrome/autism spectrum disorder	X
		Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADH D)	X
		Deaf or hard-of-hearing (D/HoH)	X
		Physical impairment/orthopedic/mobility impairment	X
		Systemic health/medical condition	X
		Psychological/psychiatric condition	X
		Learning disorder	X
		Blind or visual impairment	X
		Speech impairment	X
		Acquired/traumatic brain injury	X
		Other condition	X
		Institution declined to report	X
		Project declined to report	X
	School Districts
	1. School District Data
	1-1a	School district name	X	X
	1-1c	School district office address line 1	X	X
	1-1d	School district office address line 2	X	X
	1-1e	School district office address line 3	X	X
	1-1f	City	X	X
	1-1g	School district State: <drop down list>	X	X
	1-1h	ZIP Code	X	X
	1-2	Project role: -Primary awardee institution or organization -Subawardee -Non-award partner -Consultant	X	X
	1-3	Schools in the school district: List each school in the school district on a separate line in the following format: School Name, City, State School Name, City, State ͙	X	X
	1-4	How many high schools are in this school district?	X	X
	1-5	How many middle/junior high schools are in this school district?	X	X
	1-6	How many elementary schools are in this school district?	X	X
	1-7	How many multi-age schools for students with conditions are in this school district?	X	X
	1-8	How many multi-age schools are in this school district?	X	X
	2. Project Impacts
	2-1	Has this project affected policies in this school district regarding educating students with conditions during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, what changed?			X
	2-2	Has this project affected services and/or practices in this school district regarding educating students with conditions during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, what changed?			X
	2-3	Were any courses in this school district retrofitted for Universal Design for Learning (UDL) during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?			X
	2-4	Were any new courses created in this school district using UDL during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?			X
	2-5	Were any student laboratory facilities or experiments in this school district retrofitted for UDL during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?			X
	2-6	Were any new student laboratory facilities or experiments created in this school district using UDL during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?			X
	2-7	Were any fieldwork experiences in this school district changed because of UDL during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?			X
	2-8	Were any new fieldwork experiences created in this school district using UDL during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?			X
	General Student Data (Enter data for high school students only)
		Total number of students	X
	Academic Level
		Freshman	X
		Sophomores	X
		Juniors	X
		Seniors	X
	Gender
		Total female students	X
		Total male students	X
		Institution declined to report	X
		Project declined to report	X
	Ethnicity
		Hispanic or Latino	X
		Not Hispanic or Latino	X
		Institution declined to report	X
		Project declined to report	X
	Race
		American Indian or Alaska Native	X
		Asian	X
		Black or African American	X
		Native Hawaiian or Other Pacific Islander	X
		White	X
		School district declined to report	X
		Project declined to report	X
	Condition
		None	X
		Asperger's syndrome/autism spectrum disorder	X
		Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADH D)	X
		Deaf or hard-of-hearing (D/HoH)	X
		Physical impairment/orthopedic/mobility impairment	X
		Systemic health/medical condition	X
		Psychological/psychiatric condition	X
		Learning disorder	X
		Blind or visual impairment	X
		Speech impairment	X
		Acquired/traumatic brain injury	X
		Other condition	X
		Institution declined to report	X
		Project declined to report	X
	School Groups
	1. School Group Data
	1-1	School group name	X	X
	1-2	Schools in the school group: List each school in the school group on a separate line in the following format: School Name, City, State School Name, City, State ...	X	X
	1-3	Project role: -Primary awardee institution or organization -Subawardee -Non-award partner -Consultant	X	X
	1-4	How many public schools are in this school group?	X	X
	1-5	How many private schools are in this school group?	X	X
	1-6	How many high schools are in this school group?	X	X
	1-7	How many middle/junior high schools are in this school group?	X	X
	1-8	How many elementary schools are in this school group?	X	X
	1-9	How many multi-age schools for students with conditions are in this school group?	X	X
	1-10	How many multi-age schools are in this school group?	X	X
	2. Project Impacts
	2-1	Has this project affected policies in this school group regarding educating students with conditions during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, what changed?			X
	2-2	Has this project affected services and/or practices in this school group regarding educating students with conditions during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, what changed?			X
	2-3	Were any courses in this school group retrofitted for Universal Design for Learning (UDL) during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?			X
	2-4	Were any new courses created in this school group using UDL during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?			X
	2-5	Were any student laboratory facilities or experiments in this school group retrofitted for UDL during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?			X
	2-6	Were any new student laboratory facilities or experiments created in this school group using UDL during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?			X
	2-7	Were any fieldwork experiences in this school group changed because of UDL during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?			X
	2-8	Were any new fieldwork experiences created in this school group using UDL during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?			X
	Non-Academic Organizations
	1. Organization Data
	1-1	Full organization name	X	X
	1-2a	Address line 1	X	X
	1-2b	Address line 2	X	X
	1-2c	Address line 3	X	X
	1-2d	City	X	X
	1-2e	State: <dropdown list>	X	X
	1-2f	ZIP Code	X	X
	1-3	Organization characteristics: -Industry -Non-profit organization -Local government organization -State government organization -Federal government organization -Non-university/non-industry lab	X	X
	1-4	Project role: -Primary awardee institution or organization -Subawardee -Non-award partner -Consultant	X	X
	2. Project Impacts
	2-1	Has this project affected policies at this organization regarding people with conditions during the reporting period? -Yes -No -Organization declined to report -Project declined to report If yes, what changed?			X
	2-2	Has this project affected practices at this organization regarding people with conditions during the reporting period? -Yes -No -Organization declined to report -Project declined to report If yes, what changed?			X
	2-3	Were any laboratories/offices/workspaces at this organization retrofitted for Universal Design for Learning (UDL) during the reporting period? -Yes -No -Organization declined to report -Project declined to report If yes, how many?			X
	2-4	Were any new laboratories/offices/workspaces at this organization created using UDL during the reporting period? -Yes -No -Organization declined to report -Project declined to report If yes, how many?			X
	Project Personnel
	1. Contact Information
	1-1a	Title	X
	1-1b	First name	X
	1-1c	Middle name	X
	1-1d	Last name	X
	1-1e	Suffix	X
	Institutional Affiliation
	1-2a	Institution State: <dropdown list>	X
	1-2b	Choose a type of institution for this person, and then select or enter a name: -This person is affiliated with a higher education institution. -Higher education institution name: <dropdown list> -This person is affiliated with another type of organization that is not a higher education institution -School or organization name:	X
	Office Address
	1-3a	Office address line 1	X
	1-3b	Office address line 2	X
	1-3c	Office address line 3	X
	1-3d	City	X
	1-3e	State: <dropdown list>	X
	1-3f	ZIP Code	X
	1-3g	Country: <dropdown list>	X
	1-4a	E-mail address	X
	1-4b	Office phone number & Extension	X
	1-4c	Office fax number	X
	1-4d	Cell phone number	X
	2. Academic Fields
	2	-Select this project personnel member's academic field(s): <extensive list>	X
Select at least one project roe for this person:	3. Project Roles
	3-1	Employment title	X
		Select at least one project role for this person	X
		Principal Investigator
		Co-Principal Investigator (Co-PI)
		Project Director
		Associate/Assistant Project Director
		Project Manager
		Associate/Assistant Project Manager
		Coordinator; please specify area of coordination
		Internal Project Evaluator
		External Project Evaluator
		College/University Administrator
		Staff—Full Professor
		Staff—Associate Professor
		Staff—Assistant Professor
		Staff—Instructor
		Staff—Senior Researcher
		Staff—Associate Researcher
		Staff—Assistant Researcher
		Staff—Research Assistant
		Staff—Admin Assistant/Secretary
		Staff—Technology Support
		Post-Doctoral Fellow
		Student—Doctoral
		Student—Master’s
		Student—Baccalaureate
		Student—Associate’s
		Student—High School
		Consultant
		Mentor
		None
	4. Demographic
	Information
	4-1	Birth year	X
	4-2	Gender: -Male -Female -Project declined to report-Institution declined to report Personnel declined to report	X
	4-3	Ethnicity: -Hispanic or Latino -Not Hispanic or Latino -Project declined to report -Institution declined to report -Personnel declined to report	X
	4-4	Race: (Mark one or more.) -American Indian or Alaska Native -Asian -Black or African American -Native Hawaiian or Other Pacific Islander -White -Project declined to report -Institution declined to report -Personnel declined to report	X
	4-5	Citizenship: -U.S. citizen -Permanent resident -U.S. national (born in American Samoa or Swains Island, or descendent of U.S. national) -Non-U.S. citizen -Project declined to report -Institution declined to report -Personnel declined to report	X
	4-6	U.S. military service status: -Active duty -Reserve or National Guard -Previous military service -No military service -Project declined to report -Institution declined to report -Personnel declined to report	X
	5. Conditions and Support
	5-1	Does this person have a condition? -Yes -No -Project declined to report -Institution declined to report -Personnel declined to report Select condition(s) & Select Primary: -Asperger's syndrome/autism spectrum disorder -Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD) -Deaf or hard-of-hearing (D/HoH) -Physical impairment/orthopedic/mobility impairment -Systemic health/medical condition -Psychological/psychiatric condition -Learning disorder -Blind or visual impairment -Speech impairment -Acquired/traumatic brain injury -Other condition	X
	5-2	During the 2010-2011 reporting period, was this person registered with the campus disability services office? -Yes -No -Project declined to report -Institution declined to report -Personnel declined to report	X
	5-3	During the 2010-2011 reporting period, did this person receive services from the campus disability services office? -Yes -No -Project declined to report -Institution declined to report -Personnel declined to report	X
	6. Mentoring and Tutoring
	Activity as a Mentor
	6-1a	Did this person serve as a mentor? -Yes -No		X
	6-1b	If yes, whom did this person mentor? (Select all that apply.) -Elementary school students -Middle/junior high school students -High school students -Non-credit post-secondary students -Undergraduate students (2-year) -Undergraduate students (4-year) -Graduate students -Faculty/staff members -Industry/business members -Parents		X
	6-1c	Approximately how many mentoring sessions did this person have during this reporting period?		X
	6-1d	Of those sessions, indicate the number of each type: Face-to Face: Phone: Virtual:		X
	Activity as a Mentee
	6-2a	Was this person a mentee? -Yes -No		X
	6-2b	If yes, what kind of mentor(s) did they have? (Select all that apply.) -Faculty/staff members -Industry/business members		X
	6-2c	Approximately how many mentoring sessions did this person receive during this reporting period?		X
	6-2d	Of those sessions, indicate the number of each type: Face-to Face: Phone: Virtual:		X
	Activity as a Tutor
	6-3a	Did this person serve as a tutor? -Yes -No		X
	6-3b	If yes, whom did this person tutor? (Select all that apply.) -Elementary school students -Middle/junior high school students -High school students -Non-credit post-secondary students -Undergraduate students (2-year) -Undergraduate students (4-year) -Graduate students		X
	6-3c	Approximately how many tutoring sessions did this person have during this reporting period?		X
	7. Learning Experiences
	Learning Community Experiences
	7-1a	Did this person participate in a student learning community sponsored by this project? -Yes -No		X
	7-1b	If yes, was this community: (Select all that apply.) -Related to a course -A virtual community -A living learning community		X
	7-1c	Did this person participate in a faculty/staff learning community sponsored by this project? -Yes -No		X
	7-1d	If yes, was this community: (Select all that apply.) -Related to a course -A virtual community -A living learning community		X
	Universal Design for Learning (UDL) Experiences
	7-2a	Did this person provide UDL trainings? -Yes -No		X
	7-2b	If yes, how many trainings were provided?		X
	7-2c	Did this person receive UDL trainings? -Yes -No		X
	7-2d	If yes, how many trainings were received?		X
	8. International Experiences
	8-1	City		X
	8-2	Country: <dropdown list>		X
	8-3	Organization		X
	8-4	Program name		X
	8-5	What kind of activity was this experience? (Select all that apply.) -Teaching elementary school students -Teaching middle/junior high school students -Teaching high school students -Teaching undergraduate students -Teaching graduate students -Research: data gathering -Research: data analysis		X
	8-6	How many weeks did the experience last?		X
	8-7	What was the average number of hours worked each week?		X
	Project Participants
	Students
	1. Contact Information
	1-1a	Title	X
	1-1b	First name	X
	1-1c	Middle name	X
	1-1d	Last name	X
	1-1e	Suffix	X
	1-2	Other ID	X
	Institutional Affiliation
	1-3a	Institution State: <dropdown list>	X
	1-3b	Choose a type of institution for this person, and then select or enter a name: -This person is affiliated with a higher education institution. -Higher education institution name: <dropdown list> -This person is affiliated with another type of organization that is not a higher education institution -School or organization name:	X
	Current Contact Information
	1-4a	Current address line 1	X
	1-4b	Current address line 2	X
	1-4c	Current address line 3	X
	1-4d	Current city	X
	1-4e	Current State: <dropdown list>	X
	1-4f	Current ZIP Code	X
	1-4g	Current country: <dropdown list>	X
	1-5a	Current phone number & Extension	X
	1-5b	Current e-mail address	X
	Permanent Contact Information
		The current contact information is the same as the student's permanent contact information.	X
	1-6a	Permanent address line 1	X
	1-6b	Permanent address line 2	X
	1-6c	Permanent address line 3	X
	1-6d	Permanent city	X
	1-6e	Permanent State: <dropdown list>	X
	1-6f	Permanent ZIP Code	X
	1-6g	Permanent country: <dropdown list>	X
	1-7a	Permanent phone number & Extension	X
	1-7b	Permanent e-mail address	X
	1-7c	Cell phone number	X
	2. Student Information
	2-1	Student type: -Graduate student -Undergraduate student (4-year school) -Undergraduate student (2-year school) -Non-credit post-secondary student -High school student (Senior-12th Grade) -High school student (Junior-11th Grade) -High school student (Sophomore-10th Grade) -High school student (Freshman-9th Grade) -Middle/junior high school student -Elementary school student	X
	2-2	If this participant is a graduate or undergraduate student, indicate the student's major: <extensive list> This student has not declared an academic major.	X
		Questions 2-3 through 2-4 are required for high school, undergraduate, and graduate students.
	2-3a	What degree or certification is this student pursuing? -None -Certificate of completion -High school diploma -Associate's degree -Baccalaureate degree -Master's degree -Ph.D.	X
	2-3b	How many years has the student been pursuing this degree or certification? (Enter a number between 1 and 10.)	X
	2-4a	During the current reporting period, did this student receive a degree or certification? -Yes -No			X
	2-4b	If yes, what degree or certification did the student receive? -Certificate of completion -High school diploma -Associate's degree -Baccalaureate degree -Masters degree -Ph.D.			X
	2-4c	If yes, what does the student plan to do during the next academic year? -Pursue associate's degree -Pursue baccalaureate degree in an RDE-defined STEM field -Pursue graduate degree in an RDE-defined STEM field -Pursue non-STEM degree -Enter the workforce -Pursue certificate/other training in an RDE-defined STEM field -Pursue non-STEM certificate/training -Unknown/undecided			X
	3. Demographic Information
	3-1	Birth year	X
	3-2	Gender: -Male -Female -Project declined to report -Institution declined to report -Participant declined to report	X
	3-3	Ethnicity: -Hispanic or Latino -Not Hispanic or Latino -Project declined to report -Institution declined to report -Participant declined to report	X
	3-4	Race: (Mark one or more.) -American Indian or Alaska Native -Asian -Black or African American -Native Hawaiian or Other Pacific Islander -White -Project declined to report -Institution declined to report -Participant declined to report	X
	3-5	Citizenship: -U.S. citizen -Permanent resident -U.S. national (born in American Samoa or Swains Island, or descendent of U.S. national) -Non-U.S. citizen -Project declined to report -Institution declined to report -Participant declined to report	X
	3-6	U.S. military service status: -Active duty -Reserve or National Guard -Previous military service -No military service -Project declined to report -Institution declined to report -Personnel declined to report	X
	4. Conditions and Support
	4-1	Does this person have a condition? -Yes -No -Project declined to report -Institution declined to report -Personnel declined to report Select condition(s) & Select Primary: -Asperger's syndrome/autism spectrum disorder -Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD) -Deaf or hard-of-hearing (D/HoH) -Physical impairment/orthopedic/mobility impairment -Systemic health/medical condition -Psychological/psychiatric condition -Learning disorder -Blind or visual impairment -Speech impairment -Acquired/traumatic brain injury -Other condition	X
	4-2	During the 2010-2011 reporting period, was this student registered with the campus disability services office or did this student have an IEP or 504 Plan? -Yes -No -Project declined to report -Institution declined to report -Participant declined to report	X
	4-3	During the 2010-2011 reporting period, did this student receive services from the campus disability services office or did this student receive services as specified in an IEP or 504 Plan? -Yes -No -Project declined to report -Institution declined to report -Participant declined to report	X
	4-4a	Did this person participate in any of the following transition activities? (Select all that apply.) -Individualized Education Program (IEP) - Individual transition counseling services - Group transition counseling services - For-credit course dealing with transition - Single transition workshop - Transition workshop series - None of the above		X
	4-4b	If "transition workshop series" was selected, how many sessions were held in the series?		X
	5. Mentoring and Tutoring
	Activity as a Mentor
	5-1a	Did this person serve as a mentor? -Yes -No		X
	5-1b	If yes, whom did this person mentor? (Select all that apply.) - Elementary school students - Middle/junior high school students - High school students - Non-credit post-secondary students - Undergraduate students (2-year) - Undergraduate students (4-year) - Graduate students		X
	5-1c	Approximately how many mentoring sessions did this person have during this reporting period?		X
	5-1d	Of those sessions, indicate the number of each type: Face-to Face: Phone: Virtual:		X
	Activity as a Mentee
	5-2a	Was this person a mentee? -Yes -No		X
	5-2b	If yes, what kind of mentor(s) did they have? (Select all that apply.) - Non-credit post-secondary students - Undergraduate students (2-year) - Undergraduate students (4-year) - Graduate students - Faculty/staff members -Industry/business members		X
	5-2c	Approximately how many mentoring sessions did this person receive during this reporting period?		X
	5-2d	Of those sessions, indicate the number of each type: Face-to Face: Phone: Virtual:		X
	Activity as a Tutor
	5-3a	Did this person serve as a tutor? -Yes -No		X
	5-3b	If yes, whom did this person tutor? (Select all that apply.) -Elementary school students -Middle/junior high school students -High school students -Non-credit post-secondary students -Undergraduate students (2-year) -Undergraduate students (4-year) -Graduate students		X
	5-3c	Approximately how many tutoring sessions did this person have during this reporting period?		X
	Activity for Receiving Tutoring
	5-4a	Did this person receive tutoring? -Yes -No		X
	5-4b	If yes, what kind of tutor(s) did this person have? (Select all that apply.) -Non-credit post-secondary students -Undergraduate students (2-year) -Undergraduate students (4-year) -Graduate students -Faculty/staff members -Industry/business members		X
	5-4c	Approximately how many tutoring sessions did this person receive during this reporting period?		X
	6. Learning Experiences
	Learning Community Experiences
	6-1a	Did this person participate in a student learning community sponsored by this project? -Yes -No		X
	6-1b	If yes, was this community: (Select all that apply.) -Related to a course -A virtual community -A living learning community		X
	Universal Design for Learning (UDL) Experiences
	6-2a	Did this person provide UDL trainings? -Yes -No		X
	6-2b	If yes, how many trainings were provided?		X
	6-2c	Did this person receive UDL trainings? -Yes -No		X
	6-2d	If yes, how many trainings were received?		X
	7. International Experiences
	7-1	City		X
	7-2	Country: <dropdown list>		X
	7-3	Organization		X
	7-4	Program name		X
	7-5	What kind of activity was this experience? (Select all that apply.) -Teaching elementary school students -Teaching middle/junior high school students -Teaching high school students -Teaching undergraduate students -Teaching graduate students -Research: data gathering -Research: data analysis		X
	7-6	How many weeks did the experience last?		X
	7-7	What was the average number of hours worked each week?		X
	8. Stipend Information
	8-1a	Did this person receive a stipend during the 2010 - 2011 reporting period? -Yes -No		X
	8-1b	Was the stipend based on participation in project activities? -Yes -No		X
	8-1c	Was the stipend based on academic performance? -Yes -No		X
	8-1d	Award stipend amount provided to this person from the award during the 2010-2011 reporting period.		X
	8-1e	Non-award stipend amount provided to this person during the 2010-2011 reporting period (i.e., funding from sources other than the award)		X
	9. Academic Achievements
	9-1	Student's grade point average as of August 31, 2010: ___ out of ___			X
	New Academic Achievement Record
	9-1	Title		X	X
	9-2	Type: -Monetary award -Non-monetary award		X	X
	9-3	Awarding organization or institution		X	X
	10. Internships, Externships, and Fieldwork
	Internship
	10-1	Program/laboratory name		X
	10-2	Duration: -Summer -Academic quarter/semester -Full academic year		X
	Externship
	10-1	Institution/business name		X
	10-2	Institution/business city		X
	10-3	Institution/business State: <dropdown list>		X
	10-4	Duration: -Summer -Academic quarter/semester -Full academic year		X
	Fieldwork
	10-1	Fieldwork program name		X
	10-2	Fieldwork program city		X
	10-3	Fieldwork program State: <dropdown list>		X
	10-4	Duration: -Summer -Academic quarter/semester -Full academic year		X
	Higher Education Faculty and Staff
	1. Contact Information
	1-1a	Title	X
	1-1b	First name	X
	1-1c	Middle name	X
	1-1d	Last name	X
	1-1e	Suffix	X
	1-2	Other ID (if applicable)	X
	Institutional Affiliation
	1-3a	Institution State: <dropdown list>	X
	1-3b	Higher education institution name: <dropdown list>	X
	Current Contact Information
	1-4a	Current address line 1	X
	1-4b	Current address line 2	X
	1-4c	Current address line 3	X
	1-4d	Current city	X
	1-4e	Current State: <dropdown list>	X
	1-4f	Current ZIP Code	X
	1-4g	Current country: <dropdown list>	X
	1-5a	Current phone number & Extension	X
	1-5b	Current e-mail address	X
	2. Participant Information
	2-1	Faculty and staff type: -College/university faculty -College/university administrator -College/university staff	X
	2-2	Select this higher education faculty and staff member's academic field(s): <extensive list> Does not apply: this person does not work in any academic field.	X
	3. Demographic Information
	3-1	Birth year	X
	3-2	Gender: -Male -Female -Project declined to report -Institution declined to report -Participant declined to report	X
	3-3	Ethnicity: -Hispanic or Latino -Not Hispanic or Latino -Project declined to report -Institution declined to report -Participant declined to report	X
	3-4	Race: (Mark one or more.) -American Indian or Alaska Native -Asian -Black or African American -Native Hawaiian or Other Pacific Islander -White -Project declined to report -Institution declined to report -Participant declined to report	X
	3-5	Citizenship: -U.S. citizen -Permanent resident -U.S. national (born in American Samoa or Swains Island, or descendent of U.S. national) -Non-U.S. citizen -Project declined to report -Institution declined to report -Participant declined to report	X
	3-6	U.S. military service status: -Active duty -Reserve or National Guard -Previous military service -No military service -Project declined to report -Institution declined to report -Participant declined to report	X
	4. Conditions and Support
	4-1	Does this person have a condition? -Yes -No -Project declined to report -Institution declined to report -Participant declined to report Select condition(s) & Select Primary: -Asperger's syndrome/autism spectrum disorder -Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD) -Deaf or hard-of-hearing (D/HoH) -Physical impairment/orthopedic/mobility impairment -Systemic health/medical condition -Psychological/psychiatric condition -Learning disorder -Blind or visual impairment -Speech impairment -Acquired/traumatic brain injury -Other condition	X
	4-2	During the 2010-2011 reporting period, was this person registered with the campus disability services office? -Yes -No -Project declined to report -Institution declined to report -Participant declined to report	X
	4-3	During the 2010-2011 reporting period, did this person receive services from the campus disability services office? -Yes -No -Project declined to report -Institution declined to report -Participant declined to report	X
	5. Mentoring and Tutoring
	Activity as a Mentor
	5-1a	Did this person serve as a mentor? -Yes -No		X
	5-1b	If yes, whom did this person mentor? (Select all that apply.) -Elementary school students - Middle/junior high school students - High school students - Non-credit post-secondary students - Undergraduate students (2-year) - Undergraduate students (4-year) - Graduate students - Faculty/staff members -Industry/business members -Parents		X
	5-1c	Approximately how many mentoring sessions did this person have during this reporting period?		X
	5-1d	Of those sessions, indicate the number of each type: Face-to Face: Phone: Virtual:		X
	Activity as a Mentee
	5-2a	Was this person a mentee? -Yes -No		X
	5-2b	If yes, what kind of mentor(s) did they have? (Select all that apply.) -Faculty/staff members -Industry/business members		X
	5-2c	Approximately how many mentoring sessions did this person receive during this reporting period?		X
	5-2d	Of those sessions, indicate the number of each type: Face-to Face: Phone: Virtual:		X
	Activity as a Tutor
	5-3a	Did this person serve as a tutor? -Yes -No		X
	5-3b	If yes, whom did this person tutor? (Select all that apply.) -Elementary school students -Middle/junior high school students -High school students -Non-credit post-secondary students -Undergraduate students (2-year) -Undergraduate students (4-year) -Graduate students -Other		X
	5-3c	Approximately how many tutoring sessions did this person have during this reporting period?		X
	6. Learning Experiences
	Learning Experiences
	6-1a	Did this person participate in a student learning community sponsored by this project? -Yes -No		X
	6-1b	If yes, was this community: (Select all that apply.) -Related to a course -A virtual community -A living learning community		X
	6-1c	Did this person participate in a faculty/staff learning community sponsored by this project? -Yes -No		X
	6-1d	If yes, was this community: (Select all that apply.) -Related to a course -A virtual community -A living learning community		X
	Universal Design for Learning (UDL) Experiences
	6-2a	Did this person provide UDL trainings? -Yes -No		X
	6-2b	If yes, how many trainings were provided?		X
	6-2c	Did this person receive UDL trainings? -Yes -No		X
	6-2d	If yes, how many trainings were received?		X
	7. International Experiences
	7-1	City		X
	7-2	Country: <dropdown list>		X
	7-3	Organization		X
	7-4	Program name		X
	7-5	What kind of activity was this experience? (Select all that apply.) -Teaching elementary school students -Teaching middle/junior high school students -Teaching high school students -Teaching undergraduate students -Teaching graduate students -Research: data gathering -Research: data analysis		X
	7-6	How many weeks did the experience last?		X
	7-7	What was the average number of hours worked each week?		X
	8. Stipend Information
	Stipends
	8-1a	Did this person receive a stipend during the2010-2011 reporting period? -Yes -No		X
	8-1b	Was the stipend based on participation in project activities? -Yes -No		X
	8-1c	Award stipend amount provided to this person from the award during the 2010-2011 reporting period		X
	8-1d	Non-award stipend amount provided to this person during the 2010 - 2011 reporting period (i.e., funding from sources other than the award)		X
	K-12 Teachers and Staff
	1. Contact Information
	1-1a	Title	X
	1-1b	First name	X
	1-1c	Middle name	X
	1-1d	Last name	X
	1-1e	Suffix	X
	1-2	Other ID (if applicable)	X
	Institutional Affiliation
	1-3a	Institution State: <dropdown list>	X
	1-3b	Higher education institution name: <dropdown list>	X
	Current Contact Information
	1-4a	Current address line 1	X
	1-4b	Current address line 2	X
	1-4c	Current address line 3	X
	1-4d	Current city	X
	1-4e	Current State: <dropdown list>	X
	1-4f	Current ZIP Code	X
	1-4g	Current country: <dropdown list>	X
	1-5a	Current phone number & Extension	X
	1-5b	Current e-mail address	X
	2. Participant Information
	2-1	Participant type: -High school teacher -Middle/junior high school teacher -Elementary school teacher -Pre–K teacher -Administrator -Guidance counselor -Teaching assistant	X
	2-2	Teaching Specialty: (Not applicable to administrators or guidance counselors) -General -Mathematics -Science -Technology -Special Education	X
	3. Demographic Information
	3-1	Birth year	X
	3-2	Gender: -Male -Female -Project declined to report -Institution declined to report -Participant declined to report	X
	3-3	Ethnicity: -Hispanic or Latino -Not Hispanic or Latino -Project declined to report -Institution declined to report -Participant declined to report	X
	3-4	Race: (Mark one or more.) -American Indian or Alaska Native -Asian -Black or African American -Native Hawaiian or Other Pacific Islander -White -Project declined to report -Institution declined to report -Participant declined to report	X
	3-5	Citizenship: -U.S. citizen -Permanent resident -U.S. national (born in American Samoa or Swains Island, or descendent of U.S. national) -Non-U.S. citizen -Project declined to report -Institution declined to report -Participant declined to report	X
	3-6	U.S. military service status: -Active duty -Reserve or National Guard -Previous military service -No military service -Project declined to report -Institution declined to report -Participant declined to report	X
	4. Conditions and Support
	4-1	Does this person have a condition? -Yes -No -Project declined to report -Institution declined to report -Participant declined to report Select condition(s) & Select Primary: -Asperger's syndrome/autism spectrum disorder -Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD) -Deaf or hard-of-hearing (D/HoH) -Physical impairment/orthopedic/mobility impairment -Systemic health/medical condition -Psychological/psychiatric condition -Learning disorder -Blind or visual impairment -Speech impairment -Acquired/traumatic brain injury -Other condition	X
	4-2	During the 2010-2011 reporting period, was this person registered with the campus disability services office? -Yes -No -Project declined to report -Institution declined to report -Participant declined to report	X
	4-3	During the 2010-2011 reporting period, did this person receive services from the campus disability services office? -Yes -No -Project declined to report -Institution declined to report -Participant declined to report	X
	5. Mentoring and Tutoring
	Activity as a Mentor
	5-1a	Did this person serve as a mentor? -Yes -No		X
	5-1b	If yes, whom did this person mentor? (Select all that apply.) -Elementary school students - Middle/junior high school students - High school students - Non-credit post-secondary students - Undergraduate students (2-year) - Undergraduate students (4-year) - Graduate students - Faculty/staff members -Industry/business members - Parents		X
	5-1c	Approximately how many mentoring sessions did this person have during this reporting period?		X
	5-1d	Of those sessions, indicate the number of each type: Face-to Face: Phone: Virtual:		X
	Activity as a Mentee
	5-2a	Was this person a mentee? -Yes -No		X
	5-2b	If yes, what kind of mentor(s) did they have? (Select all that apply.) -Faculty/staff members -Industry/business members		X
	5-2c	Approximately how many mentoring sessions did this person receive during this reporting period?		X
	5-2d	Of those sessions, indicate the number of each type: Face-to Face: Phone: Virtual:		X
	Activity as a Tutor
	5-3a	Did this person serve as a tutor? -Yes -No		X
	5-3b	If yes, whom did this person tutor? (Select all that apply.) -Elementary school students -Middle/junior high school students -High school students -Non-credit post-secondary students -Undergraduate students (2-year) -Undergraduate students (4-year) -Graduate students		X
	5-3c	Approximately how many tutoring sessions did this person have during this reporting period?		X
	6. Learning Experiences
	Learning Community Experiences
	6-1a	Did this person participate in a student learning community sponsored by this project? -Yes -No		X
	6-1b	If yes, was this community: (Select all that apply.) -Related to a course -A virtual community -A living learning community		X
	6-1c	Did this person participate in a faculty/staff learning community sponsored by this project? -Yes -No		X
	6-1d	If yes, was this community: (Select all that apply.) -Related to a course -A virtual community -A living learning community		X
	Universal Design for Learning (UDL) Experiences
	6-2a	Did this person provide UDL trainings? -Yes -No		X
	6-2b	If yes, how many trainings were provided?		X
	6-2c	Did this person receive UDL trainings? -Yes -No		X
	6-2d	If yes, how many trainings were received?		X
	7. International Experiences
	7-1	City		X
	7-2	Country: <dropdown list>		X
	7-3	Organization		X
	7-4	Program name		X
	7-5	What kind of activity was this experience? (Select all that apply.) -Teaching elementary school students -Teaching middle/junior high school students -Teaching high school students -Teaching undergraduate students -Teaching graduate students -Research: data gathering -Research: data analysis		X
	7-6	How many weeks did the experience last?		X
	7-7	What was the average number of hours worked each week?		X
	8. Stipend Information
	8-1a	Did this person receive a stipend during the2010-2011 reporting period? -Yes -No		X
	8-1b	Was the stipend based on participation in project activities? -Yes -No		X
	8-1c	Award stipend amount provided to this person from the award during the 2010 - 2011 reporting period:		X
	8-1d	Non-award stipend amount provided to this person during the 2010 - 2011 reporting period (i.e., funding from sources other than the award)		X
	Other Participants
	1. Contact Information
	1-1a	Title	X
	1-1b	First name	X
	1-1c	Middle name	X
	1-1d	Last name	X
	1-1e	Suffix	X
	1-2	Other ID (if applicable)	X
	Organization Affiliation
	1-3a	Organization State: <dropdown list>	X
	1-3b	Choose a type of organization for this person, and then select or enter a name: -This person is affiliated with a higher education institution. Higher education institution name: <dropdown list> -This person is affiliated with another type of organization that is not a higher education institution. School or organization name:	X
	Current Contact Information
	1-4a	Current address line 1	X
	1-4b	Current address line 2	X
	1-4c	Current address line 3	X
	1-4d	Current city	X
	1-4e	Current State: <dropdown list>	X
	1-4f	Current ZIP Code	X
	1-4g	Current country: <dropdown list>	X
	1-5a	Current phone number & Extension	X
	1-5b	Current e-mail address	X
	2. Participant Information
	2-1	Participant type: -Community organization representative -Externship/internship mentor -Industry representative	X
	Academic Fields
	2-2	-Does not apply: this person does not work in any academic field. Select this participant's academic field(s): <extensive list>	X
	3. Demographic Information
	3-1	Birth year	X
	3-2	Gender: -Male -Female -Project declined to report -Institution declined to report -Participant declined to report	X
	3-3	Ethnicity: -Hispanic or Latino -Not Hispanic or Latino -Project declined to report -Institution declined to report -Participant declined to report	X
	3-4	Race: (Mark one or more.) -American Indian or Alaska Native -Asian -Black or African American -Native Hawaiian or Other Pacific Islander -White -Project declined to report -Institution declined to report -Participant declined to report	X
	3-5	Citizenship: -U.S. citizen -Permanent resident -U.S. national (born in American Samoa or Swains Island, or descendent of U.S. national) -Project declined to report -Institution declined to report -Participant declined to report	X
	3-6	U.S. military service status: -Active duty -Reserve or National Guard - Previous military service -No military service -Project declined to report -Institution declined to report -Participant declined to report	X
	4. Conditions
	4-1	Does this person have a condition? -Yes -No -Project declined to report -Institution declined to report -Participant declined to report Select condition(s) & Select Primary: -Asperger's syndrome/autism spectrum disorder -Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD) -Deaf or hard-of-hearing (D/HoH) -Physical impairment/orthopedic/mobility impairment -Systemic health/medical condition -Psychological/psychiatric condition -Learning disorder -Blind or visual impairment -Speech impairment -Acquired/traumatic brain injury -Other condition	X
	5. Mentoring and Tutoring
	Activity as a Mentor
	5-1a	Did this person serve as a mentor? -Yes -No		X
	5-1b	If yes, whom did this person mentor? (Select all that apply.) - Elementary school students - Middle/junior high school students - High school students - Non-credit post-secondary students - Undergraduate students (2-year) - Undergraduate students (4-year) - Graduate students - Faculty/staff members -Industry/business members - Parents		X
	5-1c	Approximately how many mentoring sessions did this person have during this reporting period?		X
	5-1d	Of those sessions, indicate the number of each type: Face-to Face: Phone: Virtual:		X
	Activity as a Tutor
	5-2a	Did this person serve as a tutor? -Yes -No		X
	5-2b	If yes, whom did this person tutor? (Select all that apply.) -Elementary school students -Middle/junior high school students -High school students -Non-credit post-secondary students -Undergraduate students (2-year) -Undergraduate students (4-year) -Graduate students		X
	5-2c	Approximately how many tutoring sessions did this person have during this reporting period?		X
	6. Learning Experiences
	Learning Community Experiences
	6-1a	Did this person participate in a student learning community sponsored by this project? -Yes -No		X
	6-1b	If yes, was this community: (Select all that apply.) -Related to a course -A virtual community -A living learning community		X
	6-1c	Did this person participate in a faculty/staff learning community sponsored by this project? -Yes -No		X
	6-1d	If yes, was this community: (Select all that apply.) -Related to a course -A virtual community -A living learning community		X
	Universal Design for Learning (UDL) Experiences
	6-2a	Did this person provide UDL trainings? -Yes -No		X
	6-2b	If yes, how many trainings were provided?		X
	6-2c	Did this person receive UDL trainings? -Yes -No		X
	6-2d	If yes, how many trainings were received?		X
	7. International Experiences
	7-1	City		X
	7-2	Country: <dropdown list>		X
	7-3	Organization		X
	7-4	Program name		X
	7-5	What kind of activity was this experience? (Select all that apply.) -Teaching elementary school students -Teaching middle/junior high school students -Teaching high school students -Teaching undergraduate students -Teaching graduate students -Research: data gathering -Research: data analysis		X
	7-6	How many weeks did the experience last?		X
	7-7	What was the average number of hours worked each week?		X
	8. Stipend Information
	8-1a	Did this person receive a stipend during the2010-2011 reporting period? -Yes -No		X
	8-1b	Was the stipend based on participation in project activities? -Yes -No		X
	8-1c	Award stipend amount provided to this person from the award during the 2010 - 2011 reporting period:		X
	8-1d	Non-award stipend amount provided to this person during the 2010 - 2011 reporting period (i.e., funding from sources other than the award):		X
	Dissemination Activities
	Professional Publications
	1	Publication citation			X
	2	Publication file (Upload an Adobe PDF document containing the publication. Limit: One)			X
	3	URL of publication [ ] Publication is not yet available online.			X
	4	Publication type: (Select all that apply.) -Peer reviewed -Invited -Non-peer reviewed			X
	5	Was this publication created with personnel from the other award(s) in this collaboration? -Yes -No			X
	Professional Presentations
	1	Presentation title			X
	2	Presentation type: (Select all that apply.) -Conference -Media -Classroom -College/university/department event			X
	3	Professional organization			X
	4	URL of presentation			X
	5	Estimate the number of people in the audience			X
	6	Was this presentation created with personnel from the other award(s) in this collaboration? -Yes -No			X
	New Tools, Measurement Methods, and Other Materials
	1	Tool name			X
	2	Tool type: (Select all that apply.) -Survey -Questionnaire -Assessment tool -Instruction material -Replication manual -Other guide/manual -Brochure/newsletter -Software			X
	3a	How many people was this tool distributed to this year?			X
	3b	Who were the primary users of this material? (Select all that apply.) -STEM faculty -Educators, general -Educators, special education -STEM careers -General public -K-12 students -Post-secondary students			X
	4	Was this tool, measurement method, or other material created with personnel from the other award(s) in this collaboration? -Yes -No			X
	Online Resources
	1	Online resource name			X
	2	Resource type: (Select all that apply.) -Web site -Wiki -Blog -E-mail list -Social networking community -Virtual environment, please describe:			X
	3	Current URL or other location			X
	4	What was the number of "hits" this resource received during the 2010 - 2011 reporting period?			X
	5	If you have a unique login system, enter the number of unique logins. If this is an e-mail list, please enter the number of subscribers. Enter “0” if not applicable:			X
	6	Was this resource created with personnel from the other award(s) in this collaboration? -Yes -No			X
	Additional Proposals
	1	Proposal title			X
	2	Funding organization: Federal government organization -Department of Education -Department of Energy -National Institutes of Health -National Science Foundation -National Oceanic and Atmospheric Administration -Other federal government organization, please specify Non-federal government organization -State government organization, please specify -Local government organization, please specify -Non-profit organization, please specify -Industry, please specify			X
	3	Funding organization program			X
	4	Proposal number			X
	Project Highlight
		Enter a short title for this project highlight:			X
	Highlight Description
		Upload an Adobe PDF document containing the detailed highlight description. Limit: One			X
	Highlight Photo(s)
		Upload at least one highlight photo (.jpg, .jpeg, or .gif file).			X
	Photo Release Form(s)
		Upload at least one Adobe PDF document of the signed photo release form for each of the photos submitted above.			X
	Data Collection Feedback
	1	Approximately how many hours were spent collating and entering data for this project in preparation for submission?		X
	2	Enter any comments regarding the project data collection process:		X	X

RDE: Crosswalk – Research Track

	Section/Question	Data Element	Staff & Project Participant Characteristics4	Project Implementation Characteristics5	Project Outputs6
	Research Award
	Award Details
	1. Verify Award Details - NSF Award
	1	Awards are asked to verify: Award Track NSF Award Number Award Title Principal Investigator Primary Institution Award Start Date Previous Award Number Collaborative Award? (Yes/No) (If part of a collaborative award, awards are also asked to verify the NSF Award Number, Award Institution, Award Title, and Principal Investigator for all collaborating awards.) Award Institution, Award Title, and Principal Investigator for all collaborating awards.) Are the above data correct and complete for your institution's award and any collaborative awards? -Yes -No Was the current award preceded by another NSF RDE award? -Yes -No	X	X
	2. Previous NSF RDE Award
	2a	Was the current award preceded by another NSF RDE award? -Yes -No	X
	2b	Previous NSF Award Number	X
	2c	Previous NSF Award Title	X
	2d	RDE Award Track: <dropdown list> -Alliance -Research -Enrichment -Demonstration -Dissemination
	Funding Sources
	1	Full name of funding source		X
	2	Name of funding program		X
	3	Amount of funding		X
	4a	Type of funding: <dropdown list> -Federal -State -Local -Business/industry -University		X
	4b	If funding type is "Federal," specify Grant or Award ID		X
	Institutions
	Higher Education Institutions
	1. Institution Data
	1-1a	Institution State: <dropdown list> -Standard 50 States plus -Outside U.S. (Foreign) -Armed Forces America -Armed Forces Europe -Armed Forces Pacific -American Samoa -District of Columbia -DoDEA -Guam -Northern Mariana Islands -Puerto Rico -US Territories -Virgin Islands	X	X
	1-1b	Institution name: <dropdown list>	X	X
	1-1c	Address line 1	X	X
	1-1d	Address line 2	X	X
	1-1e	Address line 3	X	X
	1-1f	City	X	X
	1-1g	ZIP Code	X	X
	1-2	Institution type: -Public institution -Private institution	X	X
	1-3	Carnegie Basic Classification :<dropdown list>	X	X
	1-4	Ethnicity characteristics: (Select all that apply.) -Historically Black College or University (HBCU) -Tribal College or University (TCU) -Hispanic-Serving Institution (HSI) -Minority-Serving Institution (MSI) -None of the above	X	X
	1-5	Gender characteristics: -Single gender—male -Single gender—female -Coed	X	X
	1-6	Campus characteristics: -Virtual campus -Traditional campus -Virtual and traditional campus	X	X
	1-7	Project role: -Primary awardee institution or organization -Subawardee -Non-award partner -Consultant	X	X
	2. Project Impacts
	2-1	Has this project affected policies at this institution regarding educating students with conditions during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, what changed? If yes, what changed?			X
	2-2	Has this project affected practices at this institution regarding educating students with conditions during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, what changed?			X
	2-3	Has this project affected services provided by this institution's office for students with conditions during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, what changed?			X
	2-4	Were any courses at this institution retrofitted for Universal Design for Learning (UDL) during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?			X
	2-5	Were any new courses at this institution created using UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?			X
	2-6	Were any student laboratory facilities or experiments at this institution retrofitted for UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?			X
	2-7	Were any new student laboratory facilities or experiments at this institution created using UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?			X
	2-8	Were any fieldwork experiences at this institution changed because of UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?			X
	2-9	Were any new fieldwork experiences created at this institution using UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?			X
	K-12 Schools
	School Data
	1-1a	Full school name	X	X
	1-1b	School type: -Public institution -Private institution	X	X
	1-1c	If "Public institution" was selected, specify district	X	X
	1-1d	Address line 1	X	X
	1-1e	Address line 2	X	X
	1-1f	Address line 3	X	X
	1-1g	City	X	X
	1-1h	School State :<dropdown list>	X	X
	1-1i	ZIP Code	X	X
	1-2	School characteristic: -High School -Middle school/junior high -Elementary school -Multi-age school for students with conditions -Multi-age school	X	X
	1-3	Project role: -Primary awardee institution or organization -Subawardee -Non-award partner -Consultant	X	X
	2. Project Impacts
	2-1	Has this project affected policies at this school regarding educating students with conditions during the reporting period? -Yes -No -School declined to report -Project declined to report If yes, what changed?			X
	2-2	Has this project affected services and/or practices at this school regarding educating students with conditions during the reporting period? -Yes -No -School declined to report -Project declined to report If yes, what changed?			X
	2-3	Were any courses at this school retrofitted for Universal Design for Learning (UDL) during the reporting period? -Yes -No -School declined to report -Project declined to report If yes, how many?			X
	2-4	Were any new courses at this school created using UDL during the reporting period? -Yes -No -School declined to report -Project declined to report If yes, how many?			X
	2-5	Were any student laboratory facilities or experiments at this school retrofitted for UDL during the reporting period? -Yes -No -School declined to report -Project declined to report If yes, how many?			X
	2-6	Were any new student laboratory facilities or experiments at this school created using UDL during the reporting period? -Yes -No -School declined to report -Project declined to report If yes, how many?			X
	2-7	Were any fieldwork experiences at this school changed because of UDL during the reporting period? -Yes -No -School declined to report -Project declined to report If yes, how many?			X
	2-8	Were any new fieldwork experiences created at this school using UDL during the reporting period? -Yes -No -School declined to report -Project declined to report If yes, how many?			X
	School Districts
	1. School District Data
	1-1a	School district name	X	X
	1-1b	School district office address line 1	X	X
	1-1c	School district office address line 2	X	X
	1-1d	School district office address line 3	X	X
	1-1e	City	X	X
	1-1f	School district State :<dropdown list>	X	X
	1-1g	ZIP Code	X	X
	1-2	Project Role: -Primary awardee institution or organization -Subawardee -Non-award partner -Consultant	X	X
	1-3	Schools in the school district: List each school in the school district on a separate line in the following format: School Name, City, State School Name, City, State	X	X
	1-4	How many high schools are in this school district?	X	X
	1-5	How many middle/junior high schools are in this school district?	X	X
	1-6	How many elementary schools are in this school district?	X	X
	1-7	How many multi-age schools for students with conditions are in this school district?	X	X
	1-8	How many multi-age schools are in this school district?	X	X
	2. Project Impacts
	2-1	Has this project affected policies at this school district regarding educating students with conditions during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, what changed?			X
	2-2	Has this project affected services and/or practices at this school district regarding educating students with conditions during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, what changed?			X
	2-3	Were any courses at this school district retrofitted for Universal Design for Learning (UDL) during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?			X
	2-4	Were any new courses created in this school district using UDL during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?			X
	2-5	Were any student laboratory facilities or experiments in this school district retrofitted for UDL during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?			X
	2-6	Were any new student laboratory facilities or experiments in this school district created using UDL during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?			X
	2-7	Were any fieldwork experiences in this school district changed because of UDL during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?			X
	2-8	Were any new fieldwork experiences created in this school district using UDL during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?			X
	School Groups
	1.School Group Data
	1-1	School group name	X	X
	1-2	Schools in the school group List each school in the school group on a separate line in the following format: School Name, City, State School Name, City, State …	X	X
	1-3	Project role: -Primary awardee institution or organization -Subawardee -Non-award partner -Consultant	X	X
	1-4	How many public schools are in this school group?	X	X
	1-5	How many private schools are in this school group?	X	X
	1-6	How many high schools are in this school group?	X	X
	1-7	How many middle/junior high schools are in this school group?	X	X
	1-8	How many elementary schools are in this school group?	X	X
	1-9	How many multi-age schools for students with conditions are in this school group?	X	X
	1-10	How many multi-age schools are in this school group?	X	X
	2. Project Impacts
	2-1	Has this project affected policies in this school group regarding educating students with conditions during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, what changed?			X
	2-2	Has this project affected services and/or practices in this school group regarding educating students with conditions during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, what changed?			X
	2-3	Were any courses in this school group retrofitted for Universal Design for Learning (UDL) during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?			X
	2-4	Were any new courses created in this school group using UDL during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?			X
	2-5	Were any student laboratory facilities or experiments in this school group retrofitted for UDL during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?			X
	2-6	Were any new student laboratory facilities or experiments created in this school group using UDL during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?			X
	2-7	Were any fieldwork experiences in this school group changed because of UDL during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?			X
	2-8	Were any new fieldwork experiences created in this school group using UDL during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?			X
	Non-Academic Organizations
	Organization Data		X	X
	1-1	Full Organization Name	X	X
	1-2a	Address line 1	X	X
	1-2b	Address line 2	X	X
	1-2c	Address line 3	X	X
	1-2d	City	X	X
	1-2e	State: <dropdown list>	X	X
	1-2f	ZIP code	X	X
	1-3	Organization Characteristics: -Industry -Non-profit organization -Local government organization -State government organization -Federal government organization -Non-university/non-industry lab	X	X
	1-4	Project role: -Primary awardee institution or organization -Subawardee -Non-award partner -Consultant	X	X
	Project Impacts
	2-1	Has this project affected policies at this organization regarding people with conditions during the reporting period? -Yes -No -Organization declined to report -Project declined to report If yes, what changed?			X
	2-2	Has this project affected practices at this organization regarding people with conditions during the reporting period? -Yes -No -Organization declined to report -Project declined to report If yes, what changed?			X
	2-3	Were any laboratories/offices/workspaces at this organization retrofitted for Universal Design for Learning (UDL) during the reporting period? -Yes -No -Organization declined to report -Project declined to report If yes, how many?			X
	2-4	Were any new laboratories/offices/workspaces at this organization created using UDL during the reporting period? -Yes -No -Organization declined to report -Project declined to report If yes, how many?			X
	Project Personnel
	1.Contact Information
	1-1a	Title	X
	1-1b	First Name	X
	1-1c	Middle Name	X
	1-1d	Last Name	X
	1-1e	Suffix	X
	2.Institutional Affiliation
	1-2a	Institution State: <dropdown list>	X
	1-2b	Choose a type of institution for this person, and then select or enter a name: -This person is affiliated with a higher education institution. -Higher education institution name: <dropdown list> -This person is affiliated with another type of organization that is not a higher education institution -School or organization name	X
	Office Address
	1-3a	Office address line 1	X
	1-3b	Office address line 2	X
	1-3c	Office address line 3	X
	1-3d	City	X
	1-3e	State: <dropdown list>	X
	1-3f	ZIP Code	X
	1-3g	Country: <dropdown list>	X
	1-4a	E-mail address	X
	1-4b	Office phone number & Extension	X
	1-4c	Office fax number	X
	1-4d	Cell phone number	X
	2. Academic Fields
	2	-Select this project personnel member's academic field(s): <extensive list>	X
	Project Roles
	3-1	Employment title	X
	3-2	Select at least one project role for this person: -Principal Investigator -Co-Primary Investigator (Co-PI) -Project Director -Associate/Assistant Project Director -Project Manager -Associate/Assistant Project Manager -Coordinator; please specify area of coordination: -Internal Project Evaluator -External Project Evaluator -College/University Administrator -Staff--Full Professor -Staff--Associate Professor -Staff--Assistant Professor -Staff--Instructor -Staff--Senior Researcher -Staff--Associate Researcher -Staff--Assistant Researcher -Staff—Research Assistant -Staff—Admin Assistant/Secretary -Staff—Technology Support -Post-Doctoral Fellow -Student—Doctoral -Student--Master's -Student—Baccalaureate -Student—Associate -Student--High School -Consultant -Mentor -None	X
	Demographic Information
	4-1	Birth year	X
	4-2	Gender: -Male -Female -Project declined to report -Institution declined to report -Personnel declined to report	X
	4-3	Ethnicity: -Hispanic or Latino -Not Hispanic or Latino -Project declined to report -Institution declined to report -Personnel declined to report	X
	4-4	Race: (Mark one or more.) -American Indian or Alaska Native -Asian -Black or African American -Native Hawaiian or Other Pacific Islander -White -Project declined to report -Institution declined to report -Personnel declined to report	X
	4-5	Citizenship: -U.S. citizen -Permanent resident -U.S. national (born in American Samoa or Swains Island, or descendent of U.S. national) -Non-U.S. Citizen -Project declined to report -Institution declined to report -Personnel declined to report	X
	4-6	U.S. military service status: -Active duty -Reserve or National Guard -Previous military service -No military service -Project declined to report -Institution declined to report -Personnel declined to report	X
	Conditions and Support
	5-1	Does this person have a condition? -Yes -No -Project declined to report -Institution declined to report -Personnel declined to report Select condition(s) & Select Primary: -Asperger's syndrome/autism spectrum disorder -Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD) -Deaf or hard-of-hearing (D/HoH) -Physical impairment/orthopedic/mobility impairment -Systemic health/medical condition -Psychological/psychiatric condition -Learning disorder -Blind or visual impairment -Speech impairment -Acquired/traumatic brain injury -Other condition	X
	5-2	During the 2010-2011 reporting period, was this person registered with the campus disability services office? -Yes -No -Project declined to report -Institution declined to report -Personnel declined to report	X
	5-3	During the 2010-2011 reporting period, did this person receive services from the campus disability services office? -Yes -No -Project declined to report -Institution declined to report -Personnel declined to report	X
	6. International Experiences
	6-1	City		X
	6-2	Country: <dropdown list>		X
	6-3	Organization		X
	6-4	Program name		X
	6-5	What kind of activity was this experience? (Select all that apply.) -Teaching elementary school students -Teaching middle/junior high school students -Teaching high school students -Teaching undergraduate students -Teaching graduate students -Research: data gathering -Research: data analysis		X
	6-6	How many weeks did the experience last?		X
	6-7	What was the average number of hours worked each week?		X
	Research Studies
	1. Study Design
	1-1	Enter a name to identify this research study record		X
	1-2	List the hypotheses that this study tests		X
	1-3	What research methodologies were used in this research study?		X
	2. Subject Groups
	2-1a	Enter a name to identify this subject group	X
	2-1b	Enter the total number of subjects in this subject group	X
	2-1c	Subject group type: -Control group -Descriptive group -Experimental group -Extant dataset	X
	2-1d	How many participants in this subject group received monetary and/or non-monetary compensation?	X
	Subject Gender
		Total female subjects	X
		Total male subjects	X
		Institution declined to report	X
		Project declined to report	X
	Subject Ethnicity
		Hispanic or Latino	X
		Not Hispanic or Latino	X
		Institution declined to report	X
		Project declined to report	X
	Subject Race
		American Indian or Alaska Native	X
		Asian	X
		Black or African American	X
		Native Hawaiian or Other Pacific Islander	X
		White	X
		Institution declined to report	X
		Project declined to report	X
	Subject Age Level
		0-5	X
		6-12	X
		13-16	X
		17-18	X
		19-21	X
		22-25	X
		26-35	X
		36-45	X
		46 and over	X
		Institution declined to report	X
		Project declined to report	X
	Subject Academic Level
		Pre-K	X
		Grades K-6	X
		Grades 7-8	X
		High school	X
		Associate's degree candidate	X
		Baccalaureate candidate	X
		Master's degree candidate	X
		Ph.D. candidate	X
		Not applicable	X
		Institution declined to report	X
		Project declined to report	X
	Subject U.S. Military Service Status
		Active duty	X
		Reserve or National Guard	X
		Previous military service	X
		No military service	X
		Institution declined to report	X
		Project declined to report	X
	Subject Condition Status
		None	X
		Asperger's syndrome/autism spectrum disorder	X
		Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADH D)	X
		Deaf or hard-of-hearing (D/HoH)	X
		Physical impairment/orthopedic/mobility impairment	X
		Systemic health/medical condition	X
		Psychological/psychiatric condition	X
		Learning disorder	X
		Blind or visual impairment	X
		Speech impairment	X
		Acquired/traumatic brain injury	X
		Other condition	X
		Institution declined to report	X
		Project declined to report	X
	3. Study Inputs
	3-1a	Did your study use data from any NSF-RDE Alliance projects? -Yes -No <List of awards>		X
	4. Study Outputs
	4-1a	Did your study produce a replication manual? -Yes -No			X
	4-1b	If yes, provide the URL to access the manual, if available			X
	4-2a	Did your study disseminate findings directly to NSF-RDE Alliance projects? -Yes -No <List of awards>			X
	Dissemination Activities
	Professional Publications
	1	Publication citation			X
	2	Publication file (Upload an Adobe PDF document containing the publication. Limit: One)			X
	3	URL of publication [ ] Publication is not yet available online.			X
	4	Publication type: (Select all that apply.) -Peer reviewed -Invited -Non-peer reviewed			X
	5	Was this publication created with personnel from the other award(s) in this collaboration? -Yes -No			X
	Professional Presentations
	1	Presentation title			X
	2a	Presentation type: (Select all that apply.) -Conference -Media -Classroom -College/university/department event			X
	3	Professional organization			X
	4	URL of presentation			X
	5	Estimate the number of people in the audience			X
	6	Was this presentation created with personnel from the other award(s) in this collaboration? -Yes -No			X
	New Tools, Measurement Methods, and Other Materials
	1	Tool name			X
	2	Tool type: (Select all that apply.) -Survey -Questionnaire -Assessment tool -Instructional material -Replication manual -Other guide/manual -Brochure/newsletter -Software			X
	3a	How many people was this tool distributed to this year?			X
	3b	Who were the primary users of this material? (Select all that apply.) -STEM faculty -Educators, general -Educators, special education -STEM careers -General public -K-12 students -Post-secondary students			X
	4	Was this tool, measurement method, or other material created with personnel from the other award(s) in this collaboration? -Yes -No			X
	Online Resources
	1	Online resource name			X
	2	Resource type: (Select all that apply.) -Web site -Wiki -Blog -E-mail list -Social networking community -Virtual environment, please describe:			X
	3	Current URL or other location			X
	4	What was the number of "hits" this resource received during the 2010 - 2011 reporting period?			X
	5	If you have a unique login system, enter the number of unique logins. If this is an e-mail list, please enter the number of subscribers. Enter “0” if not applicable:			X
	6	Was this resource created with personnel from the other award(s) in this collaboration? -Yes -No			X
Additional Proposals
	1	Proposal title			X
	2	Funding organization: Federal government organization -Department of Education -Department of Energy -National Institutes of Health -National Science Foundation -National Oceanic and Atmospheric Administration -Other federal government organization, please specify Non-federal government organization -State government organization, please specify -Local government organization, please specify -Non-profit organization, please specify -Industry, please specify			X
	3	Funding organization program			X
	4	Proposal number			X
	Project Highlight
		Enter a short title for this project highlight			X
	Highlight Description
		Upload an Adobe PDF document containing the detailed highlight description. Limit: One			X
	Highlight Photo(s)
		Upload at least one highlight photo (.jpg, .jpeg, or .gif file).			X
	Photo Release Form(s)
		Upload at least one Adobe PDF document of the signed photo release form for each of the photos submitted above.			X
	Data Collection Feedback
	1	Approximately how many hours were spent collating and entering data for this project in preparation for submission?		X
	2	Enter any comments regarding the project data collection process:		X	X

RDE: Number of Respondents, Frequency of Response, and Annual Hour Burden

The estimated average number of annual respondents is 31, with an estimated average annual response burden of 1,439 hours. The Web-based collection is an annual activity of the RDE program. Respondents are PIs; one PI per award completes the survey. The estimated average annual hour burden per respondent was determined using the burden information reported by respondents in the past two collection cycles.

The estimated annual burden is calculated below.

Respondent Type	Estimated Average Annual No. of Respondents	Estimated Average Annual Burden Hours Per Respondent	Estimated Annual Burden Hour Total
PIs of RDE Alliance & Enrichment Awards	14	87	1,218
PIs of Other RDE Awards	17	13	221
Total	31		1,439

RDE: Hour Burden Estimates by Each Form and Aggregate Hour Burdens

As mentioned above respondents are award PIs. All RDE awards provide data in the Award Details, Funding Sources, Institutions, Project Personnel, Dissemination Activities, Additional Proposals, Project Highlights, and Data Collection Feedback sections of the system. In addition, Alliance and Enrichment awards also provide data in the Project Participations section, and Research and Demonstration awards provide data in the Research Studies section. Alliance and Enrichment awards, as the largest and most active of the RDE awards, have the most data to compile and submit. The other types of awards provide very similar amounts of data through the system, so their burden is the same.

Form Type	Respondent Type	No. of Respondents	Burden Hours Per Respondent	Total Burden Hours
Alliance & Enrichment awards	PIs	14	87	1,218
Other RDE awards	PIs	17	13	221
Total		31		1,439

RDE: Estimates of Annualized Cost to Respondents for the Burden Hours

The overall annualized cost to the respondents is estimated to be $58,999. The following table shows the annualized estimates of costs to PI respondents, who are generally university professors. This estimated hourly rate is based on a report from the American Association of University Professors, “Annual Report on the Economic Status of the Profession, 2011-12,” Academe, March–April 2012, Survey Report Table 4. According to this report, the average salary of an associate professor across all types of doctoral-granting institutions (public, private-independent, religiously affiliated) was $86,319. When divided by the number of standard annual work hours (2,080), this calculates to approximately $41 per hour.

Respondent Type	No. of Respondents	Burden Hours Per Respondent	Average Hourly Rate	Estimated Annual Cost
PIs of RDE Alliance & Enrichment awards	14	87	$41	$49,938
PIs of Other RDE awards	17	13	$41	$9,061
Total	31			$58,999

RDE: Estimates of Costs to the Federal Government

Computing the annualized cost to NSF for the RDE data collection was done by taking the budgets for three years and calculating the costs for each of the following operational activities involved in producing, maintaining, and conducting the RDE data collection:

Operational Activities	Cost Over Three Years
System Development (includes initial development of the database and Web-based application, and later changes requested by the program, e.g., increased reporting tools, additional validations)	$531,917
System Maintenance, Updates, and Technical Support (system requires updates each year before opening the collection; maintenance is required to keep the system current with technology, e.g., database servers, operating systems)	$229,454
Data Collection Opening and Support (e.g., online and telephone support to respondents and contacting respondents to encourage completion of the questions), Reporting (as defined by HRD), and Followup Activities (e.g., providing data to other consultants)	$281,603
Three-Year Total for All Operational Activities	$1,042,974

The annualized cost was computed as one-third of the total three-year costs; thus, the annualized cost to NSF for the RDE collection is $347,658.

RDE: Questions – Alliance Track

		Sections/Questions		Data Elements
		Alliance Award
		Award Details
		1. Verify Award Details - NSF Award Data
		1		Awards are asked to verify: Award Track NSF Award Number Award Title Principal Investigator Primary Institution Award Start Date Previous Award Number Collaborative Award? (Yes/No) (If part of a collaborative award, awards are also asked to verify the NSF Award Number, Award Institution, Award Title, and Principal Investigator for all collaborating awards.) Are the above data correct and complete for your institution's award and any collaborative awards? -Yes -No Was the current award preceded by another NSF RDE award? -Yes -No
		2. Previous NSF RDE Award
		2a		Was the current award preceded by another NSF RDE award? -Yes -No
		2b		Previous NSF Award Number
		2c		Previous NSF Award Title
		2d		Previous RDE Award Track: <dropdown list> -Alliance -Research -Enrichment -Demonstration -Dissemination
		Funding Sources
		1		Full name of funding source
		2		Name of funding program
		3		Amount of funding
		4a		Type of funding: <dropdown list> -Federal -State -Local -Business/industry -University
		4b		If funding type is "Federal," specify Grant or Award ID
		Data Corrections
		Institution Data Corrections: Higher Education Institutions
		1. Student Data
		1		What is the source of your student data? (Select all that apply.) -Disability services office -Registrar -Office of Institutional Research
		2		Complete the following tables for the reporting year and the baseline year.
		General Data
				Total number of students
				Students receiving disability services via this institution
		Full/Part Time
				Students enrolled full time
				Students enrolled part time
		Candidates
				Enrolled degree candidates
				Enrolled certificate candidates
				Students taking classes (not for degree or certificate)
		Academic Level Data
				Freshmen
				Sophomores
				Juniors
				Seniors
				Master's students
				Doctoral students
				Other students
		Gender
				Total female students
				Total male students
				Institution declined to report
				Project declined to report
		Ethnicity
				Hispanic or Latino
				Not Hispanic or Latino
				Institution declined to report
				Project declined to report
		Race
				American Indian or Alaska Native
				Asian
				Black or African American
				Native Hawaiian or Other Pacific Islander
				White
				Institution declined to report
				Project declined to report
		Condition
				None
				Asperger’s syndrome/autism spectrum disorder
				Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD)
				Deaf or hard-of-hearing (D/HoH)
				Physical impairment/orthopedic/mobility impairment
				Systemic health/medical condition
				Psychological/psychiatric condition
				Learning disorder
				Blind or visual impairment
				Speech impairment
				Acquired/traumatic brain injury
				Other condition
				Institution declined to report
				Project declined to report
		U.S. Military Service Status
				Active duty
				Reserve or National Guard
				Previous military service
				No military service
				Institution declined to report
				Project declined to report
		2. Students Enrolled in RDE-Defined STEM Majors
		2-1		Complete the following tables for the reporting year and baseline year.
		Degree Types for All RDE-Defined STEM Majors
				All students in RDE-defined STEM majors—A.A./A.S./A.A.S.
				All students in RDE-defined STEM majors—B.A./B.S.
				All students in RDE-defined STEM majors—M.A./M.S.
				All students in RDE-defined STEM majors—Ph.D.
		Enrollment, RDE- Defined STEM Majors with Conditions
				Total number of RDE-defined STEM majors with conditions
		Degree Types for RDE-Defined STEM Majors with Conditions
				Students with conditions in RDE-defined STEM majors--A.A./A.S./A.A.S.
				Students with conditions in RDE-defined STEM majors--B.A./B.S.
				Students with conditions in RDE-defined STEM majors--M.A./M.S.
				Students with conditions in RDE-defined STEM majors--Ph.D.
		Gender
				Total female students
				Total male students
				Institution declined to report
				Project declined to report
		Ethnicity
				Hispanic or Latino
				Not Hispanic or Latino
				Institution declined to report
				Project declined to report
		Race
				American Indian or Alaska Native
				Asian
				Black or African American
				Native Hawaiian or Other Pacific Islander
				White
				Institution declined to report
				Project declined to report
		Condition
				Asperger’s syndrome/autism spectrum disorder
				Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD)
				Deaf or hard-of-hearing (D/HoH)
				Physical impairment/orthopedic/mobility impairment
				Systemic health/medical condition
				Psychological/psychiatric condition
				Learning disorder
				Blind or visual impairment
				Speech impairment
				Acquired/traumatic brain injury
				Other condition
				Institution declined to report
				Project declined to report
		U.S. Military Service Status
				Active duty
				Reserve or National Guard
				Previous military service
				No military service
				Institution declined to report
				Project declined to report
		3. Students Who Graduated From RDE‑ Defined STEM Majors
		3-1		Complete the following tables for the reporting year and baseline year.
		Degree Types for All RDE-Defined STEM Graduates
				All RDE-defined STEM graduates—A.A./A.S./A.A.S.
				All RDE-defined STEM graduates—B.A./B.S.
				All RDE-defined STEM graduates—M.A./M.S.
				All RDE-defined STEM graduates—Ph.D.
		RDE-Defined STEM Graduates with Conditions
				Total number of RDE-defined STEM graduates with conditions
		Degree Types for RDE-Defined STEM Graduates with Conditions
				RDE-defined STEM graduates with conditions—A.A./A.S./A.A.S.
				RDE-defined STEM graduates with conditions—B.A./B.S.
				RDE-defined STEM graduates with conditions—M.A./M.S.
				RDE-defined STEM graduates with conditions—Ph.D.
		Gender
				Total female students
				Total male students
				Institution declined to report
				Project declined to report
		Ethnicity
				Hispanic or Latino
				Not Hispanic or Latino
				Institution declined to report
				Project declined to report
		Race
				American Indian or Alaska Native
				Asian
				Black or African American
				Native Hawaiian or Other Pacific Islander
				White
				Institution declined to report
				Project declined to report
		Condition
				Asperger’s syndrome/autism spectrum disorder
				Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD)
				Deaf or hard-of-hearing (D/HoH)
				Physical impairment/orthopedic/mobility impairment
				Systemic health/medical condition
				Psychological/psychiatric condition
				Learning disorder
				Blind or visual impairment
				Speech impairment
				Acquired/traumatic brain injury
				Other condition
				Institution declined to report
				Project declined to report
		U.S. Military Service Status
				Active duty
				Reserve or National Guard
				Previous military service
				No military service
				Institution declined to report
				Project declined to report
		K-12 Schools
		1. Student Data
		1		What is the source of your student data? (Select all that apply.) -State Department of Education -School district office -National Center for Education Statistics -High school administrator
		2		Complete the following tables for the reporting year and the baseline year.
		General Data
				Total number of students
		Academic Level
				Freshmen
				Sophomores
				Juniors
				Seniors
		Gender
				Total female students
				Total male students
				Institution declined to report
				Project declined to report
		Ethnicity
				Hispanic or Latino
				Not Hispanic or Latino
				Institution declined to report
				Project declined to report
		Race
				American Indian or Alaska Native
				Asian
				Black or African American
				Native Hawaiian or Other Pacific Islander
				White
				Institution declined to report
				Project declined to report
		Condition
				None
				Asperger's syndrome/autism spectrum disorder
				Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADH D)
				Deaf or hard-of-hearing (D/HoH)
				Physical impairment/orthopedic/mobility impairment
				Systemic health/medical condition
				Psychological/psychiatric condition
				Learning disorder
				Blind or visual impairment
				Speech impairment
				Acquired/traumatic brain injury
				Other condition
				School declined to report
				Project declined to report
		School Districts
		1. Student Data
		1		What is the source of your student data? (Select all that apply.) -State Department of Education -School district office -National Center for Education Statistics
		2		Complete the following tables for the reporting year and the baseline year.
		General Data
				Total number of students
		Academic Level
				Freshmen
				Sophomores
				Juniors
				Seniors
		Gender
				Total female students
				Total male students
				Institution declined to report
				Project declined to report
		Ethnicity
				Hispanic or Latino
				Not Hispanic or Latino
				Institution declined to report
				Project declined to report
		Race
				American Indian or Alaska Native
				Asian
				Black or African American
				Native Hawaiian or Other Pacific Islander
				White
				School district declined to report
				Project declined to report
		Condition
				None
				Asperger's syndrome/autism spectrum disorder
				Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADH D)
				Deaf or hard-of-hearing (D/HoH)
				Physical impairment/orthopedic/mobility impairment
				Systemic health/medical condition
				Psychological/psychiatric condition
				Learning disorder
				Blind or visual impairment
				Speech impairment
				Acquired/traumatic brain injury
				Other condition
				School declined to report
				Project declined to report
		School Groups
		1. Student Data
		1		What is the source of your student data? (Select all that apply.) -State Department of Education -School district offices -National Center for Education Statistics -High school administrators
		2		Complete the following tables for the reporting year and the baseline year.
		General Data
				Total number of students
		Academic Level
				Freshmen
				Sophomores
				Juniors
				Seniors
		Gender
				Total female students
				Total male students
				Institution declined to report
				Project declined to report
		Ethnicity
				Hispanic or Latino
				Not Hispanic or Latino
				Institution declined to report
				Project declined to report
		Race
				American Indian or Alaska Native
				Asian
				Black or African American
				Native Hawaiian or Other Pacific Islander
				White
				School group declined to report
				Project declined to report
		Condition
				None
				Asperger's syndrome/autism spectrum disorder
				Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADH D)
				Deaf or hard-of-hearing (D/HoH)
				Physical impairment/orthopedic/mobility impairment
				Systemic health/medical condition
				Psychological/psychiatric condition
				Learning disorder
				Blind or visual impairment
				Speech impairment
				Acquired/traumatic brain injury
				Other condition
				School declined to report
				Project declined to report
		Institutions
		Higher Education Institutions
		1. Institution Data
		1-1a		Institution State: <dropdown list> -Standard 50 States plus -Outside U.S. (Foreign) -Armed Forces America -Armed Forces Europe -Armed Forces Pacific -American Samoa -District of Columbia -DoDEA -Guam -Northern Mariana Islands -Puerto Rico -US Territories -Virgin Islands
		1-1b		Institution name: <dropdown list>
		1-1c		Address line 1
		1-1d		Address line 2
		1-1e		Address line 3
		1-1f		City
		1-1g		ZIP Code
		1-2		Institution type: -Public institution -Private institution
		1-3		Carnegie Basic Classification: <dropdown list>
		1-4		Ethnicity characteristics: (Select all that apply.) -Historically Black College or University (HBCU) -Tribal College or University (TCU) -Hispanic-Serving Institution (HSI) -Minority-Serving Institution (MSI) -None of the above
		1-5		Gender characteristics: -Single gender—male -Single gender—female -Coed
		1-6		Campus characteristics: -Virtual campus -Traditional campus -Virtual and traditional campus
		1-7		Project role: -Primary awardee institution or organization -Subawardee -Non-award partner -Consultant
		2. Project Impacts
		2-1		Has this project affected policies at this institution regarding educating students with conditions during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, what changed? If yes, what changed?
		2-2		Has this project affected practices at this institution regarding educating students with conditions during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, what changed? If yes, what changed?
		2-3		Has this project affected services provided by this institution's office for students with conditions during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, what changed?
		2-4		Were any courses at this institution retrofitted for Universal Design for Learning (UDL) during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?
		2-5		Were any new courses at this institution created using UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?
		2-6		Were any student laboratory facilities or experiments at this institution retrofitted for UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?
		2-7		Were any new student laboratory facilities or experiments at this institution created using UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?
		2-8		Were any fieldwork experiences at this institution changed because of UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?
		2-9		Were any new fieldwork experiences created at this institution using UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?
		3. Student Data
		3-1		What is the source of your student data? (Select all that apply.) -Disability services office -Registrar -Office of Institutional Research
		3-2		Complete the following tables for the reporting year:
		General Data
				Total number of students
				Students receiving disability services via this institution
		Full/Part Time
				Students enrolled full time
				Students enrolled part time
		Candidates
				Enrolled degree candidates
				Enrolled certificate candidates
				Students taking classes (not for degree or certificate)
		Academic Level
				Freshmen
				Sophomores
				Juniors
				Seniors
				Master's students
				Doctoral students
				Other students
		Gender
				Total female students
				Total male students
				Institution declined to report
				Project declined to report
		Ethnicity
				Hispanic or Latino
				Not Hispanic or Latino
				Institution declined to report
				Project declined to report
		Race
				American Indian or Alaska Native
				Asian
				Black or African American
				Native Hawaiian or Other Pacific Islander
				White
				Institution declined to report
				Project declined to report
		Condition
				None
				Asperger's syndrome/autism spectrum disorder
				Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADH D)
				Deaf or hard-of-hearing (D/HoH)
				Physical impairment/orthopedic/mobility impairment
				Systemic health/medical condition
				Psychological/psychiatric condition
				Learning disorder
				Blind or visual impairment
				Speech impairment
				Acquired/traumatic brain injury
				Other condition
				Institution declined to report
				Project declined to report
		U.S. Military Service Status
				Active duty
				Reserve or National Guard
				Previous military Service
				No military service
				Institution declined to report
				Project declined to report
		4. Students Enrolled in RDE-Defined STEM Majors
		4-1		Complete the following tables for the reporting year:
		Degree Types for All RDE-Defined STEM Majors
				All students in RDE-defined STEM majors—A.A./A.S./A.A.S.
				All students in RDE-defined STEM majors—B.A./B.S.
				All students in RDE-defined STEM majors—M.A./M.S.
				All students in RDE-defined STEM majors—Ph.D.
		Enrollment, RDE- Defined STEM Majors with Conditions
				Total number of RDE-defined STEM majors with conditions
		Degree Types for All RDE-Defined STEM Majors with Conditions
				Students with conditions in RDE-defined STEM majors—A.A.
				Students with conditions in RDE-defined STEM majors—B.A./B.S.
				Students with conditions in RDE-defined STEM majors—M.A./M.S.
				Students with conditions in RDE-defined STEM majors—Ph.D.
		Gender
				Total female students
				Total male students
				Institution declined to report
				Project declined to report
		Ethnicity
				Hispanic or Latino
				Not Hispanic or Latino
				Institution declined to report
				Project declined to report
		Race
				American Indian or Alaska Native
				Asian
				Black or African American
				Native Hawaiian or Other Pacific Islander
				White
				Institution declined to report
				Project declined to report
		Condition
				None
				Asperger's syndrome/autism spectrum disorder
				Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADH D)
				Deaf or hard-of-hearing (D/HoH)
				Physical impairment/orthopedic/mobility impairment
				Systemic health/medical condition
				Psychological/psychiatric condition
				Learning disorder
				Blind or visual impairment
				Speech impairment
				Acquired/traumatic brain injury
				Other condition
				Institution declined to report
				Project declined to report
		U.S. Military Service Status
				Active duty
				Reserve or National Guard
				Previous military service
				No military service
				Institution declined to report
				Project declined to report
		5. Students Who Graduated From RDE-Defined STEM Majors
		5-1		Complete the following tables for the reporting year.
		Degree Types for All RDE-Defined STEM Graduates
				All RDE-defined STEM graduates—A.A./A.S./A.A.S.
				All RDE-defined STEM graduates—B.A./B.S.
				All RDE-defined STEM graduates—M.A./M.S.
				All RDE-defined STEM graduates—Ph.D.
		RDE-Defined STEM Graduates with Conditions
				Total number of RDE-defined STEM graduates with conditions
		Degree Types for RDE-Defined STEM Graduates with Conditions
				RDE-defined STEM graduates with conditions—A.A./A.S./A.A.S.
				RDE-defined STEM graduates with conditions—B.A./B.S.
				RDE-defined STEM graduates with conditions—M.A./M.S.
				RDE-defined STEM graduates with conditions—Ph.D.
		Gender
				Total female students
				Total male students
				Institution declined to report
				Project declined to report
		Ethnicity
				Hispanic or Latino
				Not Hispanic or Latino
				Institution declined to report
				Project declined to report
		Race
				American Indian or Alaska Native
				Asian
				Black or African American
				Native Hawaiian or Other Pacific Islander
				White
				Institution declined to report
				Project declined to report
		Condition
				None
				Asperger's syndrome/autism spectrum disorder
				Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADH D)
				Deaf or hard-of-hearing (D/HoH)
				Physical impairment/orthopedic/mobility impairment
				Systemic health/medical condition
				Psychological/psychiatric condition
				Learning disorder
				Blind or visual impairment
				Speech impairment
				Acquired/traumatic brain injury
				Other condition
				Institution declined to report
				Project declined to report
		U.S. Military Service Status
				Active duty
				Reserve or National Guard
				Previous military Service
				No military service
				Institution declined to report
				Project declined to report
		K-12 Schools
		1. School Data
		1-1a		Full school name
		1-1b		School type: -Public institution -Private institution
		1-1c		If "Public institution" was selected, specify district
		1-1d		Address line 1
		1-1e		Address line 2
		1-1f		Address line 3
		1-1g		City
		1-1h		School State: <dropdown list>
		1-1i		ZIP Code
		1-2		School characteristic: -High school -Middle school/junior high school -Elementary school -Multi-age school for students with conditions -Multi-age school
		1-3		Project role: -Primary awardee institution or organization -Subawardee -Non-award partner -Consultant
		2. Project Impacts
		2-1		Has this project affected policies at this school regarding educating students with conditions during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, what changed?
		2-2		Has this project affected services and/or practices at this school regarding educating students with conditions during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, what changed?
		2-3		Were any courses at this school retrofitted for Universal Design for Learning (UDL) during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?
		2-4		Were any new courses at this school created using UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?
		2-5		Were any student laboratory facilities or experiments at this school retrofitted for UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?
		2-6		Were any new student laboratory facilities or experiments at this school created using UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?
		2-7		Were any fieldwork experiences at this school changed because of UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?
		2-8		Were any new fieldwork experiences created at this school using UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?
		3. Student Data
		3-1		What is the source of your student data? (Select all that apply.) -State Department of Education -School district office -National Center for Education Statistics -High school administrator
		3-2		Complete the following tables for the reporting period.
		General Data
				Total number of students
		Academic Level
				Freshmen
				Sophomores
				Juniors
				Seniors
		Gender
				Total female students
				Total male students
				Institution declined to report
				Project declined to report
		Ethnicity
				Hispanic or Latino
				Not Hispanic or Latino
				Institution declined to report
				Project declined to report
		Race
				American Indian or Alaska Native
				Asian
				Black or African American
				Native Hawaiian or Other Pacific Islander
				White
				Institution declined to report
				Project declined to report
		Condition
				None
				Asperger's syndrome/autism spectrum disorder
				Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADH D)
				Deaf or hard-of-hearing (D/HoH)
				Physical impairment/orthopedic/mobility impairment
				Systemic health/medical condition
				Psychological/psychiatric condition
				Learning disorder
				Blind or visual impairment
				Speech impairment
				Acquired/traumatic brain injury
				Other condition
				Institution declined to report
				Project declined to report
		School Districts
		1. School District Data
		1-1a		School district name
		1-1c		School district office address line 1
		1-1d		School district office address line 2
		1-1e		School district office address line 3
		1-1f		City
		1-1g		School district State: <drop down list>
		1-1h		ZIP Code
		1-2		Project role: -Primary awardee institution or organization -Subawardee -Non-award partner -Consultant
		1-3		Schools in the school district: List each school in the school district on a separate line in the following format: School Name, City, State School Name, City, State ͙
		1-4		How many high schools are in this school district?
		1-5		How many middle/junior high schools are in this school district?
		1-6		How many elementary schools are in this school district?
		1-7		How many multi-age schools for students with conditions are in this school district?
		1-8		How many multi-age schools are in this school district?
		2. Project Impacts
		2-1		Has this project affected policies in this school district regarding educating students with conditions during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, what changed?
		2-2		Has this project affected services and/or practices in this school district regarding educating students with conditions during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, what changed?
		2-3		Were any courses in this school district retrofitted for Universal Design for Learning (UDL) during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?
		2-4		Were any new courses created in this school district using UDL during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?
		2-5		Were any student laboratory facilities or experiments in this school district retrofitted for UDL during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?
		2-6		Were any new student laboratory facilities or experiments created in this school district using UDL during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?
		2-7		Were any fieldwork experiences in this school district changed because of UDL during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?
		2-8		Were any new fieldwork experiences created in this school district using UDL during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?
		General Student Data (Enter data for high school students only)
				Total number of students
		Academic Level
				Freshman
				Sophomores
				Juniors
				Seniors
		Gender
				Total female students
				Total male students
				Institution declined to report
				Project declined to report
		Ethnicity
				Hispanic or Latino
				Not Hispanic or Latino
				Institution declined to report
				Project declined to report
		Race
				American Indian or Alaska Native
				Asian
				Black or African American
				Native Hawaiian or Other Pacific Islander
				White
				School district declined to report
				Project declined to report
		Condition
				None
				Asperger's syndrome/autism spectrum disorder
				Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADH D)
				Deaf or hard-of-hearing (D/HoH)
				Physical impairment/orthopedic/mobility impairment
				Systemic health/medical condition
				Psychological/psychiatric condition
				Learning disorder
				Blind or visual impairment
				Speech impairment
				Acquired/traumatic brain injury
				Other condition
				Institution declined to report
				Project declined to report
		School Groups
		1. School Group Data
		1-1		School group name
		1-2		Schools in the school group: List each school in the school group on a separate line in the following format: School Name, City, State School Name, City, State ...
		1-3		Project role: -Primary awardee institution or organization -Subawardee -Non-award partner -Consultant
		1-4		How many public schools are in this school group?
		1-5		How many private schools are in this school group?
		1-6		How many high schools are in this school group?
		1-7		How many middle/junior high schools are in this school group?
		1-8		How many elementary schools are in this school group?
		1-9		How many multi-age schools for students with conditions are in this school group?
		1-10		How many multi-age schools are in this school group?
		2. Project Impacts
		2-1		Has this project affected policies in this school group regarding educating students with conditions during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, what changed?
		2-2		Has this project affected services and/or practices in this school group regarding educating students with conditions during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, what changed?
		2-3		Were any courses in this school group retrofitted for Universal Design for Learning (UDL) during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?
		2-4		Were any new courses created in this school group using UDL during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?
		2-5		Were any student laboratory facilities or experiments in this school group retrofitted for UDL during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?
		2-6		Were any new student laboratory facilities or experiments created in this school group using UDL during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?
		2-7		Were any fieldwork experiences in this school group changed because of UDL during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?
		2-8		Were any new fieldwork experiences created in this school group using UDL during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?
		Non-Academic Organizations
		1. Organization Data
		1-1		Full organization name
		1-2a		Address line 1
		1-2b		Address line 2
		1-2c		Address line 3
		1-2d		City
		1-2e		State: <dropdown list>
		1-2f		ZIP Code
		1-3		Organization characteristics: -Industry -Non-profit organization -Local government organization -State government organization -Federal government organization -Non-university/non-industry lab
		1-4		Project role: -Primary awardee institution or organization -Subawardee -Non-award partner -Consultant
		2. Project Impacts
		2-1		Has this project affected policies at this organization regarding people with conditions during the reporting period? -Yes -No -Organization declined to report -Project declined to report If yes, what changed?
		2-2		Has this project affected practices at this organization regarding people with conditions during the reporting period? -Yes -No -Organization declined to report -Project declined to report If yes, what changed?
		2-3		Were any laboratories/offices/workspaces at this organization retrofitted for Universal Design for Learning (UDL) during the reporting period? -Yes -No -Organization declined to report -Project declined to report If yes, how many?
		2-4		Were any new laboratories/offices/workspaces at this organization created using UDL during the reporting period? -Yes -No -Organization declined to report -Project declined to report If yes, how many?
		Project Personnel
		1. Contact Information
		1-1a		Title
		1-1b		First name
		1-1c		Middle name
		1-1d		Last name
		1-1e		Suffix
		Institutional Affiliation
		1-2a		Institution State: <dropdown list>
		1-2b		Choose a type of institution for this person, and then select or enter a name: -This person is affiliated with a higher education institution. -Higher education institution name: <dropdown list> -This person is affiliated with another type of organization that is not a higher education institution -School or organization name:
		Office Address
		1-3a		Office address line 1
		1-3b		Office address line 2
		1-3c		Office address line 3
		1-3d		City
		1-3e		State: <dropdown list>
		1-3f		ZIP Code
		1-3g		Country: <dropdown list>
		1-4a		E-mail address
		1-4b		Office phone number & Extension
		1-4c		Office fax number
		1-4d		Cell phone number
		2. Academic Fields
		2		-Select this project personnel member's academic field(s): <extensive list>
Select at least one project roe for this person:		3. Project Roles
		3-1		Employment title
				Select at least one project role for this person
				Principal Investigator
				Co-Principal Investigator (Co-PI)
				Project Director
				Associate/Assistant Project Director
				Project Manager
				Associate/Assistant Project Manager
				Coordinator; please specify area of coordination
				Internal Project Evaluator
				External Project Evaluator
				College/University Administrator
				Staff—Full Professor
				Staff—Associate Professor
				Staff—Assistant Professor
				Staff—Instructor
			Staff—Senior Researcher
			Staff—Associate Researcher
			Staff—Assistant Researcher
			Staff—Research Assistant
			Staff—Admin Assistant/Secretary
			Staff—Technology Support
			Post-Doctoral Fellow
			Student—Doctoral
			Student—Master’s
			Student—Baccalaureate
			Student—Associate’s
			Student—High School
			Consultant
			Mentor
			None
	4. Demographic
	Information
	4-1		Birth year
	4-2		Gender: -Male -Female -Project declined to report-Institution declined to report Personnel declined to report
	4-3		Ethnicity: -Hispanic or Latino -Not Hispanic or Latino -Project declined to report -Institution declined to report -Personnel declined to report
	4-4		Race: (Mark one or more.) -American Indian or Alaska Native -Asian -Black or African American -Native Hawaiian or Other Pacific Islander -White -Project declined to report -Institution declined to report -Personnel declined to report
	4-5		Citizenship: -U.S. citizen -Permanent resident -U.S. national (born in American Samoa or Swains Island, or descendent of U.S. national) -Non-U.S. citizen -Project declined to report -Institution declined to report -Personnel declined to report
	4-6		U.S. military service status: -Active duty -Reserve or National Guard -Previous military service -No military service -Project declined to report -Institution declined to report -Personnel declined to report
	Conditions and Support
	5-1		Does this person have a condition? -Yes -No -Project declined to report -Institution declined to report -Personnel declined to report Select condition(s) & Select Primary: -Asperger's syndrome/autism spectrum disorder -Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD) -Deaf or hard-of-hearing (D/HoH) -Physical impairment/orthopedic/mobility impairment -Systemic health/medical condition -Psychological/psychiatric condition -Learning disorder -Blind or visual impairment -Speech impairment -Acquired/traumatic brain injury -Other condition
	5-2		During the 2010-2011 reporting period, was this person registered with the campus disability services office? -Yes -No -Project declined to report -Institution declined to report -Personnel declined to report
	5-3		During the 2010-2011 reporting period, did this person receive services from the campus disability services office? -Yes -No -Project declined to report -Institution declined to report -Personnel declined to report
	6. Mentoring and Tutoring
	Activity as a Mentor
	6-1a		Did this person serve as a mentor? -Yes -No
	6-1b		If yes, whom did this person mentor? (Select all that apply.) -Elementary school students -Middle/junior high school students -High school students -Non-credit post-secondary students -Undergraduate students (2-year) -Undergraduate students (4-year) -Graduate students -Faculty/staff members -Industry/business members -Parents
	6-1c		Approximately how many mentoring sessions did this person have during this reporting period?
	6-1d		Of those sessions, indicate the number of each type: Face-to Face: Phone: Virtual:
	Activity as a Mentee
	6-2a		Was this person a mentee? -Yes -No
	6-2b		If yes, what kind of mentor(s) did they have? (Select all that apply.) -Faculty/staff members -Industry/business members
	6-2c		Approximately how many mentoring sessions did this person receive during this reporting period?
	6-2d		Of those sessions, indicate the number of each type: Face-to Face: Phone: Virtual:
	Activity as a Tutor
	6-3a		Did this person serve as a tutor? -Yes -No
	6-3b		If yes, whom did this person tutor? (Select all that apply.) -Elementary school students -Middle/junior high school students -High school students -Non-credit post-secondary students -Undergraduate students (2-year) -Undergraduate students (4-year) -Graduate students
	6-3c		Approximately how many tutoring sessions did this person have during this reporting period?
	7. Learning Experiences
	Learning Community Experiences
	7-1a		Did this person participate in a student learning community sponsored by this project? -Yes -No
	7-1b		If yes, was this community: (Select all that apply.) -Related to a course -A virtual community -A living learning community
	7-1c		Did this person participate in a faculty/staff learning community sponsored by this project? -Yes -No
	7-1d		If yes, was this community: (Select all that apply.) -Related to a course -A virtual community -A living learning community
	Universal Design for Learning (UDL) Experiences
	7-2a		Did this person provide UDL trainings? -Yes -No
	7-2b		If yes, how many trainings were provided?
	7-2c		Did this person receive UDL trainings? -Yes -No
	7-2d		If yes, how many trainings were received?
	8. International Experiences
	8-1		City
	8-2		Country: <dropdown list>
	8-3		Organization
	8-4		Program name
	8-5		What kind of activity was this experience? (Select all that apply.) -Teaching elementary school students -Teaching middle/junior high school students -Teaching high school students -Teaching undergraduate students -Teaching graduate students -Research: data gathering -Research: data analysis
	8-6		How many weeks did the experience last?
	8-7		What was the average number of hours worked each week?
	Project Participants
	Students
	1. Contact Information
	1-1a		Title
	1-1b		First name
	1-1c		Middle name
	1-1d		Last name
	1-1e		Suffix
	1-2		Other ID
	Institutional Affiliation
	1-3a		Institution State: <dropdown list>
	1-3b		Choose a type of institution for this person, and then select or enter a name: -This person is affiliated with a higher education institution. -Higher education institution name: <dropdown list> -This person is affiliated with another type of organization that is not a higher education institution -School or organization name:
	Current Contact Information
	1-4a		Current address line 1
	1-4b		Current address line 2
	1-4c		Current address line 3
	1-4d		Current city
	1-4e		Current State: <dropdown list>
	1-4f		Current ZIP Code
	1-4g		Current country: <dropdown list>
	1-5a		Current phone number & Extension
	1-5b		Current e-mail address
	Permanent Contact Information
			The current contact information is the same as the student's permanent contact information.
	1-6a		Permanent address line 1
	1-6b		Permanent address line 2
	1-6c		Permanent address line 3
	1-6d		Permanent city
	1-6e		Permanent State: <dropdown list>
	1-6f		Permanent ZIP Code
	1-6g		Permanent country: <dropdown list>
	1-7a		Permanent phone number & Extension
	1-7b		Permanent e-mail address
	1-7c		Cell phone number
	2. Student Information
	2-1		Student type: -Graduate student -Undergraduate student (4-year school) -Undergraduate student (2-year school) -Non-credit post-secondary student -High school student (Senior-12th Grade) -High school student (Junior-11th Grade) -High school student (Sophomore-10th Grade) -High school student (Freshman-9th Grade) -Middle/junior high school student -Elementary school student
	2-2		If this participant is a graduate or undergraduate student, indicate the student's major: <extensive list> This student has not declared an academic major.
			Questions 2-3 through 2-4 are required for high school, undergraduate, and graduate students.
	2-3a		What degree or certification is this student pursuing? -None -Certificate of completion -High school diploma -Associate's degree -Baccalaureate degree -Master's degree -Ph.D.
	2-3b		How many years has the student been pursuing this degree or certification? (Enter a number between 1 and 10.)
	2-4a		During the current reporting period, did this student receive a degree or certification? -Yes -No
	2-4b		If yes, what degree or certification did the student receive? -Certificate of completion -High school diploma -Associate's degree -Baccalaureate degree -Masters degree -Ph.D.
	2-4c		If yes, what does the student plan to do during the next academic year? -Pursue associate's degree -Pursue baccalaureate degree in an RDE-defined STEM field -Pursue graduate degree in an RDE-defined STEM field -Pursue non-STEM degree -Enter the workforce -Pursue certificate/other training in an RDE-defined STEM field -Pursue non-STEM certificate/training -Unknown/undecided
	3. Demographic Information
	3-1		Birth year
	3-2		Gender: -Male -Female -Project declined to report -Institution declined to report -Participant declined to report
	3-3		Ethnicity: -Hispanic or Latino -Not Hispanic or Latino -Project declined to report -Institution declined to report -Participant declined to report
	3-4		Race: (Mark one or more.) -American Indian or Alaska Native -Asian -Black or African American -Native Hawaiian or Other Pacific Islander -White -Project declined to report -Institution declined to report -Participant declined to report
	3-5		Citizenship: -U.S. citizen -Permanent resident -U.S. national (born in American Samoa or Swains Island, or descendent of U.S. national) -Non-U.S. citizen -Project declined to report -Institution declined to report -Participant declined to report
	3-6		U.S. military service status: -Active duty -Reserve or National Guard -Previous military service -No military service -Project declined to report -Institution declined to report -Personnel declined to report
	Conditions and Support
	4-1		Does this person have a condition? -Yes -No -Project declined to report -Institution declined to report -Personnel declined to report Select condition(s) & Select Primary: -Asperger's syndrome/autism spectrum disorder -Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD) -Deaf or hard-of-hearing (D/HoH) -Physical impairment/orthopedic/mobility impairment -Systemic health/medical condition -Psychological/psychiatric condition -Learning disorder -Blind or visual impairment -Speech impairment -Acquired/traumatic brain injury -Other condition
	4-2		During the 2010-2011 reporting period, was this student registered with the campus disability services office or did this student have an IEP or 504 Plan? -Yes -No -Project declined to report -Institution declined to report -Participant declined to report
	4-3		During the 2010-2011 reporting period, did this student receive services from the campus disability services office or did this student receive services as specified in an IEP or 504 Plan? -Yes -No -Project declined to report -Institution declined to report -Participant declined to report
	4-4a		Did this person participate in any of the following transition activities? (Select all that apply.) -Individualized Education Program (IEP) - Individual transition counseling services - Group transition counseling services - For-credit course dealing with transition - Single transition workshop - Transition workshop series - None of the above
	4-4b		If "transition workshop series" was selected, how many sessions were held in the series?
	5. Mentoring and Tutoring
	Activity as a Mentor
	5-1a		Did this person serve as a mentor? -Yes -No
	5-1b		If yes, whom did this person mentor? (Select all that apply.) - Elementary school students - Middle/junior high school students - High school students - Non-credit post-secondary students - Undergraduate students (2-year) - Undergraduate students (4-year) - Graduate students
	5-1c		Approximately how many mentoring sessions did this person have during this reporting period?
	5-1d		Of those sessions, indicate the number of each type: Face-to Face: Phone: Virtual:
	Activity as a Mentee
	5-2a		Was this person a mentee? -Yes -No
	5-2b		If yes, what kind of mentor(s) did they have? (Select all that apply.) - Non-credit post-secondary students - Undergraduate students (2-year) - Undergraduate students (4-year) - Graduate students - Faculty/staff members -Industry/business members
	5-2c		Approximately how many mentoring sessions did this person receive during this reporting period?
	5-2d		Of those sessions, indicate the number of each type: Face-to Face: Phone: Virtual:
	Activity as a Tutor
	5-3a		Did this person serve as a tutor? -Yes -No
	5-3b		If yes, whom did this person tutor? (Select all that apply.) -Elementary school students -Middle/junior high school students -High school students -Non-credit post-secondary students -Undergraduate students (2-year) -Undergraduate students (4-year) -Graduate students
	5-3c		Approximately how many tutoring sessions did this person have during this reporting period?
	Activity for Receiving Tutoring
	5-4a		Did this person receive tutoring? -Yes -No
	5-4b		If yes, what kind of tutor(s) did this person have? (Select all that apply.) -Non-credit post-secondary students -Undergraduate students (2-year) -Undergraduate students (4-year) -Graduate students -Faculty/staff members -Industry/business members
	5-4c		Approximately how many tutoring sessions did this person receive during this reporting period?
	6. Learning Experiences
	Learning Community Experiences
	6-1a		Did this person participate in a student learning community sponsored by this project? -Yes -No
	6-1b		If yes, was this community: (Select all that apply.) -Related to a course -A virtual community -A living learning community
	Universal Design for Learning (UDL) Experiences
	6-2a		Did this person provide UDL trainings? -Yes -No
	6-2b		If yes, how many trainings were provided?
	6-2c		Did this person receive UDL trainings? -Yes -No
	6-2d		If yes, how many trainings were received?
	7. International Experiences
	7-1		City
	7-2		Country: <dropdown list>
	7-3		Organization
	7-4		Program name
	7-5		What kind of activity was this experience? (Select all that apply.) -Teaching elementary school students -Teaching middle/junior high school students -Teaching high school students -Teaching undergraduate students -Teaching graduate students -Research: data gathering -Research: data analysis
	7-6		How many weeks did the experience last?
	7-7		What was the average number of hours worked each week?
	8. Stipend Information
	8-1a		Did this person receive a stipend during the2010-2011 reporting period? -Yes -No
	8-1b		Was the stipend based on participation in project activities? -Yes -No
	8-1c		Was the stipend based on academic performance? -Yes -No
	8-1d		Award stipend amount provided to this person from the award during the 2010 – 2011 reporting period:
	8-1e		Non-award stipend amount provided to this person during the 2010 - 2011 reporting period (i.e., funding from sources other than the award):
	9. Academic Achievements
	9-1		Student's grade point average as of August 31, 2010: ___ out of ___
	New Academic Achievement Record
	9-1		Title
	9-2		Type: -Monetary award -Non-monetary award
	9-3		Awarding organization or institution
	10. Internships, Externships, and Fieldwork
	Internship
	10-1		Program/laboratory name
	10-2		Duration: -Summer -Academic quarter/semester -Full academic year
	Externship
	10-1		Institution/business name
	10-2		Institution/business city
	10-3		Institution/business State: <dropdown list>
	10-4		Duration: -Summer -Academic quarter/semester -Full academic year
	Fieldwork
	10-1		Fieldwork program name
	10-2		Fieldwork program city
	10-3		Fieldwork program State: <dropdown list>
	10-4		Duration: -Summer -Academic quarter/semester -Full academic year
	Higher Education Faculty and Staff
	1. Contact Information
	1-1a		Title
	1-1b		First name
	1-1c		Middle name
	1-1d		Last name
	1-1e		Suffix
	1-2		Other ID (if applicable)
	Institutional Affiliation
	1-3a		Institution State: <dropdown list>
	1-3b		Higher education institution name: <dropdown list>
	Current Contact Information
	1-4a		Current address line 1
	1-4b		Current address line 2
	1-4c		Current address line 3
	1-4d		Current city
	1-4e		Current State: <dropdown list>
	1-4f		Current ZIP Code
	1-4g		Current country: <dropdown list>
	1-5a		Current phone number & Extension
	1-5b		Current e-mail address
	2. Participant Information
	2-1		Faculty and staff type: -College/university faculty -College/university administrator -College/university staff
	2-2		Select this higher education faculty and staff member's academic field(s): <extensive list> Does not apply: this person does not work in any academic field.
	3. Demographic Information
	3-1		Birth year
	3-2		Gender: -Male -Female -Project declined to report -Institution declined to report -Participant declined to report
	3-3		Ethnicity: -Hispanic or Latino -Not Hispanic or Latino -Project declined to report -Institution declined to report -Participant declined to report
	3-4		Race: (Mark one or more.) -American Indian or Alaska Native -Asian -Black or African American -Native Hawaiian or Other Pacific Islander -White -Project declined to report -Institution declined to report -Participant declined to report
	3-5		Citizenship: -U.S. citizen -Permanent resident -U.S. national (born in American Samoa or Swains Island, or descendent of U.S. national) -Non-U.S. citizen -Project declined to report -Institution declined to report -Participant declined to report
	3-6		U.S. military service status: -Active duty -Reserve or National Guard -Previous military service -No military service -Project declined to report -Institution declined to report -Participant declined to report
	Conditions and Support		Does this person have a condition? -Yes -No -Project declined to report -Institution declined to report -Participant declined to report Select condition(s) & Select Primary: -Asperger's syndrome/autism spectrum disorder -Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD) -Deaf or hard-of-hearing (D/HoH) -Physical impairment/orthopedic/mobility impairment -Systemic health/medical condition -Psychological/psychiatric condition -Learning disorder -Blind or visual impairment -Speech impairment -Acquired/traumatic brain injury -Other condition
	4-1
	4-2		During the 2010-2011 reporting period, was this person registered with the campus disability services office? -Yes -No -Project declined to report -Institution declined to report -Participant declined to report
	4-3		During the 2010-2011 reporting period, did this person receive services from the campus disability services office? -Yes -No -Project declined to report -Institution declined to report -Participant declined to report
	5. Mentoring and Tutoring
	Activity as a Mentor
	5-1a		Did this person serve as a mentor? -Yes -No
	5-1b		If yes, whom did this person mentor? (Select all that apply.) -Elementary school students - Middle/junior high school students - High school students - Non-credit post-secondary students - Undergraduate students (2-year) - Undergraduate students (4-year) - Graduate students - Faculty/staff members -Industry/business members -Parents
	5-1c		Approximately how many mentoring sessions did this person have during this reporting period?
	5-1d		Of those sessions, indicate the number of each type: Face-to Face: Phone: Virtual:
	Activity as a Mentee
	5-2a		Was this person a mentee? -Yes -No
	5-2b		If yes, what kind of mentor(s) did they have? (Select all that apply.) -Faculty/staff members -Industry/business members
	5-2c		Approximately how many mentoring sessions did this person receive during this reporting period?
	5-2d		Of those sessions, indicate the number of each type: Face-to Face: Phone: Virtual:
	Activity as a Tutor
	5-3a		Did this person serve as a tutor? -Yes -No
	5-3b		If yes, whom did this person tutor? (Select all that apply.) -Elementary school students -Middle/junior high school students -High school students -Non-credit post-secondary students -Undergraduate students (2-year) -Undergraduate students (4-year) -Graduate students -Other
	5-3c		Approximately how many tutoring sessions did this person have during this reporting period?
	6. Learning Experiences
	Learning Experiences
	6-1a		Did this person participate in a student learning community sponsored by this project? -Yes -No
	6-1b		If yes, was this community: (Select all that apply.) -Related to a course -A virtual community -A living learning community
	6-1c		Did this person participate in a faculty/staff learning community sponsored by this project? -Yes -No
	6-1d		If yes, was this community: (Select all that apply.) -Related to a course -A virtual community -A living learning community
	Universal Design for Learning (UDL) Experiences
	6-2a		Did this person provide UDL trainings? -Yes -No
	6-2b		If yes, how many trainings were provided?
	6-2c		Did this person receive UDL trainings? -Yes -No
	6-2d		If yes, how many trainings were received?
	7. International Experiences
	7-1		City
	7-2		Country: <dropdown list>
	7-3		Organization
	7-4		Program name
	7-5		What kind of activity was this experience? (Select all that apply.) -Teaching elementary school students -Teaching middle/junior high school students -Teaching high school students -Teaching undergraduate students -Teaching graduate students -Research: data gathering -Research: data analysis
	7-6		How many weeks did the experience last?
	7-7		What was the average number of hours worked each week?
	8. Stipend Information
	Stipends
	8-1a		Did this person receive a stipend during the 2010-2011 reporting period? -Yes -No
	8-1b		Was the stipend based on participation in project activities? -Yes -No
	8-1c		Award stipend amount provided to this person from the award during the 2010-2011 reporting period
	8-1d		Non-award stipend amount provided to this person during the 2010 - 2011 reporting period (i.e., funding from sources other than the award):
	K-12 Teachers and Staff
	1. Contact Information
	1-1a		Title
	1-1b		First name
	1-1c		Middle name
	1-1d		Last name
	1-1e		Suffix
	1-2		Other ID (if applicable)
	Institutional Affiliation
	1-3a		Institution State: <dropdown list>
	1-3b		Higher education institution name: <dropdown list>
	Current Contact Information
	1-4a		Current address line 1
	1-4b		Current address line 2
	1-4c		Current address line 3
	1-4d		Current city
	1-4e		Current State: <dropdown list>
	1-4f		Current ZIP Code
	1-4g		Current country: <dropdown list>
	1-5a		Current phone number & Extension
	1-5b		Current e-mail address
	2. Participant Information
	2-1		Participant type: -High school teacher -Middle/junior high school teacher -Elementary school teacher -Pre–K teacher -Administrator -Guidance counselor -Teaching assistant
	2-2		Teaching Specialty: (Not applicable to administrators or guidance counselors) -General -Mathematics -Science -Technology -Special Education
	3. Demographic Information
	3-1		Birth year
	3-2		Gender: -Male -Female -Project declined to report -Institution declined to report -Participant declined to report
	3-3		Ethnicity: -Hispanic or Latino -Not Hispanic or Latino -Project declined to report -Institution declined to report -Participant declined to report
	3-4		Race: (Mark one or more.) -American Indian or Alaska Native -Asian -Black or African American -Native Hawaiian or Other Pacific Islander -White -Project declined to report -Institution declined to report -Participant declined to report
	3-5		Citizenship: -U.S. citizen -Permanent resident -U.S. national (born in American Samoa or Swains Island, or descendent of U.S. national) -Non-U.S. citizen -Project declined to report -Institution declined to report -Participant declined to report
	3-6		U.S. military service status: -Active duty -Reserve or National Guard -Previous military service -No military service -Project declined to report -Institution declined to report -Participant declined to report
	Conditions and Support
	4-1		Does this person have a condition? -Yes -No -Project declined to report -Institution declined to report -Participant declined to report Select condition(s) & Select Primary: -Asperger's syndrome/autism spectrum disorder -Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD) -Deaf or hard-of-hearing (D/HoH) -Physical impairment/orthopedic/mobility impairment -Systemic health/medical condition -Psychological/psychiatric condition -Learning disorder -Blind or visual impairment -Speech impairment -Acquired/traumatic brain injury -Other condition
	4-2		During the 2010-2011 reporting period, was this person registered with the campus disability services office? -Yes -No -Project declined to report -Institution declined to report -Participant declined to report
	4-3		During the 2010-2011 reporting period, did this person receive services from the campus disability services office? -Yes -No -Project declined to report -Institution declined to report -Participant declined to report
	5. Mentoring and Tutoring
	Activity as a Mentor
	5-1a		Did this person serve as a mentor? -Yes -No
	5-1b		If yes, whom did this person mentor? (Select all that apply.) -Elementary school students - Middle/junior high school students - High school students - Non-credit post-secondary students - Undergraduate students (2-year) - Undergraduate students (4-year) - Graduate students - Faculty/staff members -Industry/business members - Parents
	5-1c		Approximately how many mentoring sessions did this person have during this reporting period?
	5-1d		Of those sessions, indicate the number of each type: Face-to Face: Phone: Virtual:
	Activity as a Mentee
	5-2a		Was this person a mentee? -Yes -No
	5-2b		If yes, what kind of mentor(s) did they have? (Select all that apply.) -Faculty/staff members -Industry/business members
	5-2c		Approximately how many mentoring sessions did this person receive during this reporting period?
	5-2d		Of those sessions, indicate the number of each type: Face-to Face: Phone: Virtual:
	Activity as a Tutor
	5-3a		Did this person serve as a tutor? -Yes -No
	5-3b		If yes, whom did this person tutor? (Select all that apply.) -Elementary school students -Middle/junior high school students -High school students -Non-credit post-secondary students -Undergraduate students (2-year) -Undergraduate students (4-year) -Graduate students
	5-3c		Approximately how many tutoring sessions did this person have during this reporting period?
	6. Learning Experiences
	Learning Community Experiences
	6-1a		Did this person participate in a student learning community sponsored by this project? -Yes -No
	6-1b		If yes, was this community: (Select all that apply.) -Related to a course -A virtual community -A living learning community
	6-1c		Did this person participate in a faculty/staff learning community sponsored by this project? -Yes -No
	6-1d		If yes, was this community: (Select all that apply.) -Related to a course -A virtual community -A living learning community
	Universal Design for Learning (UDL) Experiences
	6-2a		Did this person provide UDL trainings? -Yes -No
	6-2b		If yes, how many trainings were provided?
	6-2c		Did this person receive UDL trainings? -Yes -No
	6-2d		If yes, how many trainings were received?
	7. International Experiences
	7-1		City
	7-2		Country: <dropdown list>
	7-3		Organization
	7-4		Program name
	7-5		What kind of activity was this experience? (Select all that apply.) -Teaching elementary school students -Teaching middle/junior high school students -Teaching high school students -Teaching undergraduate students -Teaching graduate students -Research: data gathering -Research: data analysis
	7-6		How many weeks did the experience last?
	7-7		What was the average number of hours worked each week?
	8. Stipend Information
	Stipends
	8-1a		Did this person receive a stipend during the 2010-2011 reporting period? -Yes -No
	8-1b		Was the stipend based on participation in project activities? -Yes -No
	8-1c		Award stipend amount provided to this person from the award during the 2010 - 2011 reporting period:
	8-1d		Non-award stipend amount provided to this person during the 2010 - 2011 reporting period (i.e., funding from sources other than the award)
	Other Participants
	1. Contact Information
	1-1a		Title
	1-1b		First name
	1-1c		Middle name
	1-1d		Last name
	1-1e		Suffix
	1-2		Other ID (if applicable)
	Organization Affiliation
	1-3a		Organization State: <dropdown list>
	1-3b		Choose a type of organization for this person, and then select or enter a name: -This person is affiliated with a higher education institution. Higher education institution name: <dropdown list> -This person is affiliated with another type of organization that is not a higher education institution. School or organization name:
	Current Contact Information
	1-4a		Current address line 1
	1-4b		Current address line 2
	1-4c		Current address line 3
	1-4d		Current city
	1-4e		Current State: <dropdown list>
	1-4f		Current ZIP Code
	1-4g		Current country: <dropdown list>
	1-5a		Current phone number & Extension
	1-5b		Current e-mail address
	2. Participant Information
	2-1		Participant type: -Community organization representative -Externship/internship mentor -Industry representative
	Academic Fields
	2-2		-Does not apply: this person does not work in any academic field. Select this participant's academic field(s): <extensive list>
	3. Demographic Information
	3-1		Birth year
	3-2		Gender: -Male -Female -Project declined to report -Institution declined to report -Participant declined to report
	3-3		Ethnicity: -Hispanic or Latino -Not Hispanic or Latino -Project declined to report -Institution declined to report -Participant declined to report
	3-4		Race: (Mark one or more.) -American Indian or Alaska Native -Asian -Black or African American -Native Hawaiian or Other Pacific Islander -White -Project declined to report -Institution declined to report -Participant declined to report
	3-5		Citizenship: -U.S. citizen -Permanent resident -U.S. national (born in American Samoa or Swains Island, or descendent of U.S. national) -Project declined to report -Institution declined to report -Participant declined to report
	3-6		U.S. military service status: -Active duty -Reserve or National Guard - Previous military service -No military service -Project declined to report -Institution declined to report -Participant declined to report
	Conditions
	4-1		Does this person have a condition? -Yes -No -Project declined to report -Institution declined to report -Participant declined to report Select condition(s) & Select Primary: -Asperger's syndrome/autism spectrum disorder -Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD) -Deaf or hard-of-hearing (D/HoH) -Physical impairment/orthopedic/mobility impairment -Systemic health/medical condition -Psychological/psychiatric condition -Learning disorder -Blind or visual impairment -Speech impairment -Acquired/traumatic brain injury -Other condition
	5. Mentoring and Tutoring
	Activity as a Mentor
	5-1a		Did this person serve as a mentor? -Yes -No
	5-1b		If yes, whom did this person mentor? (Select all that apply.) - Elementary school students - Middle/junior high school students - High school students - Non-credit post-secondary students - Undergraduate students (2-year) - Undergraduate students (4-year) - Graduate students - Faculty/staff members -Industry/business members - Parents
	5-1c		Approximately how many mentoring sessions did this person have during this reporting period?
	5-1d		Of those sessions, indicate the number of each type: Face-to Face: Phone: Virtual:
	Activity as a Tutor
	5-2a		Did this person serve as a tutor? -Yes -No
	5-2b		If yes, whom did this person tutor? (Select all that apply.) -Elementary school students -Middle/junior high school students -High school students -Non-credit post-secondary students -Undergraduate students (2-year) -Undergraduate students (4-year) -Graduate students
	5-2c		Approximately how many tutoring sessions did this person have during this reporting period?
	6. Learning Experiences
	Learning Community Experiences
	6-1a		Did this person participate in a student learning community sponsored by this project? -Yes -No
	6-1b		If yes, was this community: (Select all that apply.) -Related to a course -A virtual community -A living learning community
	6-1c		Did this person participate in a faculty/staff learning community sponsored by this project? -Yes -No
	6-1d		If yes, was this community: (Select all that apply.) -Related to a course -A virtual community -A living learning community
	Universal Design for Learning (UDL) Experiences
	6-2a		Did this person provide UDL trainings? -Yes -No
	6-2b		If yes, how many trainings were provided?
	6-2c		Did this person receive UDL trainings? -Yes -No
	6-2d		If yes, how many trainings were received?
	7. International Experiences
	7-1		City
	7-2		Country: <dropdown list>
	7-3		Organization
	7-4		Program name
	7-5		What kind of activity was this experience? (Select all that apply.) -Teaching elementary school students -Teaching middle/junior high school students -Teaching high school students -Teaching undergraduate students -Teaching graduate students -Research: data gathering -Research: data analysis
	7-6		How many weeks did the experience last?
	7-7		What was the average number of hours worked each week?
	8. Stipend Information
	Stipends
	8-1a		Did this person receive one of the following types of stipends during the 2010-2011 reporting period?
	8-1b		Was the stipend based on participation in project activities? -Yes -No
	8-1c		Award stipend amount provided to this person from the award during the 2010 - 2011 reporting period:
	8-1d		Non-award stipend amount provided to this person during the 2010 - 2011 reporting period (i.e., funding from sources other than the award):
	Dissemination Activities
	Professional Publications
	1		Publication citation
	2		Publication file (Upload an Adobe PDF document containing the publication. Limit: One)
	3		URL of publication [ ] Publication is not yet available online.
	4		Publication type: (Select all that apply.) -Peer reviewed -Invited -Non-peer reviewed
	5		Was this publication created with personnel from the other award(s) in this collaboration? -Yes -No
	Professional Presentations
	1		Presentation title
	2		Presentation type: (Select all that apply.) -Conference -Media -Classroom -College/university/department event
	3		Professional organization
	4		Enter URL of presentation
	5		Estimate the number of people in the audience
	6		Was this presentation created with personnel from the other award(s) in this collaboration? -Yes -No
	New Tools, Measurement Methods, and Other Materials
	1		Tool name
	2		Tool type: (Select all that apply.) -Survey -Questionnaire -Assessment tool -Instruction material -Replication manual -Other guide/manual -Brochure/newsletter -Software
	3a		How many people was this tool distributed to this year?
	3b		Who were the primary users of this material? (Select all that apply.) -STEM faculty -Educators, general -Educators, special education -STEM careers -General public -K-12 students -Post-secondary students
	4		Was this tool, measurement method, or other material created with personnel from the other award(s) in this collaboration? -Yes -No
	Online Resources
	1		Online resource name
	2		Resource type: (Select all that apply.) -Web site -Wiki -Blog -E-mail list -Social networking community -Virtual environment, please describe:
	3		Current URL or other location
	4		What was the number of "hits" this resource received during the 2010 - 2011 reporting period?
	5		If you have a unique login system, enter the number of unique logins. If this is an e-mail list, please enter the number of subscribers. Enter “0” if not applicable:
	6		Was this resource created with personnel from the other award(s) in this collaboration? -Yes -No
	Additional Proposals
	1		Proposal title
	2		Funding organization: Federal government organization -Department of Education -Department of Energy -National Institutes of Health -National Science Foundation -National Oceanic and Atmospheric Administration -Other federal government organization, please specify Non-federal government organization -State government organization, please specify -Local government organization, please specify -Non-profit organization, please specify -Industry, please specify
	3		Funding organization program
	4		Proposal number
	Project Highlight
			Enter a short title for this project highlight:
	Highlight Description
			Upload an Adobe PDF document containing the detailed highlight description. Limit: One
	Highlight Photo(s)
			Upload at least one highlight photo (.jpg, .jpeg, or .gif file).
	Photo Release Form(s)
			Upload at least one Adobe PDF document of the signed photo release form for each of the photos submitted above.
	Data Collection Feedback
	1		Approximately how many hours were spent collating and entering data for this project in preparation for submission?
	2		Enter any comments regarding the project data collection process:

RDE: Questions – Research Track

	Section/Question	Data Element
	Research Award
	Award Details
	1. Verify Award Details - NSF Award
	1	Awards are asked to verify: Award Track NSF Award Number Award Title Principal Investigator Primary Institution Award Start Date Previous Award Number Collaborative Award? (Yes/No) (If part of a collaborative award, awards are also asked to verify the NSF Award Number, Award Institution, Award Title, and Principal Investigator for all collaborating awards.) Award Institution, Award Title, and Principal Investigator for all collaborating awards.) Are the above data correct and complete for your institution's award and any collaborative awards? -Yes -No Was the current award preceded by another NSF RDE award? -Yes -No
	2. Previous NSF RDE Award
	2a	Was the current award preceded by another NSF RDE award? -Yes -No
	2b	Previous NSF Award Number
	2c	Previous NSF Award Title
	2d	RDE Award Track: <dropdown list> -Alliance -Research -Enrichment -Demonstration -Dissemination
	Funding Sources
	1	Full name of funding source
	2	Name of funding program
	3	Amount of funding
	4a	Type of funding: <dropdown list> -Federal -State -Local -Business/industry -University
	4b	If funding type is "Federal," specify Grant or Award ID
	Institutions
	Higher Education Institutions
	1. Institution Data
	1-1a	Institution State: <dropdown list> -Standard 50 States plus -Outside U.S. (Foreign) -Armed Forces America -Armed Forces Europe -Armed Forces Pacific -American Samoa -District of Columbia -DoDEA -Guam -Northern Mariana Islands -Puerto Rico -US Territories -Virgin Islands
	1-1b	Institution name: <dropdown list>
	1-1c	Address line 1
	1-1d	Address line 2
	1-1e	Address line 3
	1-1f	City
	1-1g	ZIP Code
	1-2	Institution type: -Public institution -Private institution
	1-3	Carnegie Basic Classification :<dropdown list>
	1-4	Ethnicity characteristics: (Select all that apply.) -Historically Black College or University (HBCU) -Tribal College or University (TCU) -Hispanic-Serving Institution (HSI) -Minority-Serving Institution (MSI) -None of the above
	1-5	Gender characteristics: -Single gender—male -Single gender—female -Coed
	1-6	Campus characteristics: -Virtual campus -Traditional campus -Virtual and traditional campus
	1-7	Project role: -Primary awardee institution or organization -Subawardee -Non-award partner -Consultant
	2. Project Impacts
	2-1	Has this project affected policies at this institution regarding educating students with conditions during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, what changed? If yes, what changed?
	2-2	Has this project affected practices at this institution regarding educating students with conditions during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, what changed?
	2-3	Has this project affected services provided by this institution's office for students with conditions during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, what changed?
	2-4	Were any courses at this institution retrofitted for Universal Design for Learning (UDL) during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?
	2-5	Were any new courses at this institution created using UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?
	2-6	Were any student laboratory facilities or experiments at this institution retrofitted for UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?
	2-7	Were any new student laboratory facilities or experiments at this institution created using UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?
	2-8	Were any fieldwork experiences at this institution changed because of UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?
	2-9	Were any new fieldwork experiences created at this institution using UDL during the reporting period? -Yes -No -Institution declined to report -Project declined to report If yes, how many?
	K-12 Schools
	School Data
	1-1a	Full school name
	1-1b	School type: -Public institution -Private institution
	1-1c	If "Public institution" was selected, specify district
	1-1d	Address line 1
	1-1e	Address line 2
	1-1f	Address line 3
	1-1g	City
	1-1h	School State :<dropdown list>
	1-1i	ZIP Code
	1-2	School characteristic: -High School -Middle school/junior high -Elementary school -Multi-age school for students with conditions -Multi-age school
	1-3	Project role: -Primary awardee institution or organization -Subawardee -Non-award partner -Consultant
	2. Project Impacts
	2-1	Has this project affected policies at this school regarding educating students with conditions during the reporting period? -Yes -No -School declined to report -Project declined to report If yes, what changed?
	2-2	Has this project affected services and/or practices at this school regarding educating students with conditions during the reporting period? -Yes -No -School declined to report -Project declined to report If yes, what changed?
	2-3	Were any courses at this school retrofitted for Universal Design for Learning (UDL) during the reporting period? -Yes -No -School declined to report -Project declined to report If yes, how many?
	2-4	Were any new courses at this school created using UDL during the reporting period? -Yes -No -School declined to report -Project declined to report If yes, how many?
	2-5	Were any student laboratory facilities or experiments at this school retrofitted for UDL during the reporting period? -Yes -No -School declined to report -Project declined to report If yes, how many?
	2-6	Were any new student laboratory facilities or experiments at this school created using UDL during the reporting period? -Yes -No -School declined to report -Project declined to report If yes, how many?
	2-7	Were any fieldwork experiences at this school changed because of UDL during the reporting period? -Yes -No -School declined to report -Project declined to report If yes, how many?
	2-8	Were any new fieldwork experiences created at this school using UDL during the reporting period? -Yes -No -School declined to report -Project declined to report If yes, how many?
	School Districts
	1. School District Data
	1-1a	School district name
	1-1b	School district office address line 1
	1-1c	School district office address line 2
	1-1d	School district office address line 3
	1-1e	City
	1-1f	School district State :<dropdown list>
	1-1g	ZIP Code
	1-2	Project Role: -Primary awardee institution or organization -Subawardee -Non-award partner -Consultant
	1-3	Schools in the school district: List each school in the school district on a separate line in the following format: School Name, City, State School Name, City, State
	1-4	How many high schools are in this school district?
	1-5	How many middle/junior high schools are in this school district?
	1-6	How many elementary schools are in this school district?
	1-7	How many multi-age schools for students with conditions are in this school district?
	1-8	How many multi-age schools are in this school district?
	2. Project Impacts
	2-1	Has this project affected policies at this school district regarding educating students with conditions during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, what changed?
	2-2	Has this project affected services and/or practices at this school district regarding educating students with conditions during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, what changed?
	2-3	Were any courses at this school district retrofitted for Universal Design for Learning (UDL) during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?
	2-4	Were any new courses created in this school district using UDL during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?
	2-5	Were any student laboratory facilities or experiments in this school district retrofitted for UDL during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?
	2-6	Were any new student laboratory facilities or experiments in this school district created using UDL during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?
	2-7	Were any fieldwork experiences in this school district changed because of UDL during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?
	2-8	Were any new fieldwork experiences created in this school district using UDL during the reporting period? -Yes -No -School district declined to report -Project declined to report If yes, how many?
	School Groups
	1.School Group Data
	1-1	School group name
	1-2	Schools in the school group List each school in the school group on a separate line in the following format: School Name, City, State School Name, City, State …
	1-3	Project role: -Primary awardee institution or organization -Subawardee -Non-award partner -Consultant
	1-4	How many public schools are in this school group?
	1-5	How many private schools are in this school group?
	1-6	How many high schools are in this school group?
	1-7	How many middle/junior high schools are in this school group?
	1-8	How many elementary schools are in this school group?
	1-9	How many multi-age schools for students with conditions are in this school group?
	1-10	How many multi-age schools are in this school group?
	2. Project Impacts
	2-1	Has this project affected policies in this school group regarding educating students with conditions during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, what changed?
	2-2	Has this project affected services and/or practices in this school group regarding educating students with conditions during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, what changed?
	2-3	Were any courses in this school group retrofitted for Universal Design for Learning (UDL) during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?
	2-4	Were any new courses created in this school group using UDL during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?
	2-5	Were any student laboratory facilities or experiments in this school group retrofitted for UDL during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?
	2-6	Were any new student laboratory facilities or experiments created in this school group using UDL during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?
	2-7	Were any fieldwork experiences in this school group changed because of UDL during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?
	2-8	Were any new fieldwork experiences created in this school group using UDL during the reporting period? -Yes -No -School group declined to report -Project declined to report If yes, how many?
	Non-Academic Organizations
	Organization Data
	1-1	Full Organization Name
	1-2a	Address line 1
	1-2b	Address line 2
	1-2c	Address line 3
	1-2d	City
	1-2e	State: <dropdown list>
	1-2f	ZIP code
	1-3	Organization Characteristics: -Industry -Non-profit organization -Local government organization -State government organization -Federal government organization -Non-university/non-industry lab
	1-4	Project role: -Primary awardee institution or organization -Subawardee -Non-award partner -Consultant
	Project Impacts
	2-1	Has this project affected policies at this organization regarding people with conditions during the reporting period? -Yes -No -Organization declined to report -Project declined to report If yes, what changed?
	2-2	Has this project affected practices at this organization regarding people with conditions during the reporting period? -Yes -No -Organization declined to report -Project declined to report If yes, what changed?
	2-3	Were any laboratories/offices/workspaces at this organization retrofitted for Universal Design for Learning (UDL) during the reporting period? -Yes -No -Organization declined to report -Project declined to report If yes, how many?
	2-4	Were any new laboratories/offices/workspaces at this organization created using UDL during the reporting period? -Yes -No -Organization declined to report -Project declined to report If yes, how many?
	Project Personnel
	1.Contact Information
	1-1a	Title
	1-1b	First Name
	1-1c	Middle Name
	1-1d	Last Name
	1-1e	Suffix
	2.Institutional Affiliation
	1-2a	Institution State: <dropdown list>
	1-2b	Choose a type of institution for this person, and then select or enter a name: -This person is affiliated with a higher education institution. -Higher education institution name: <dropdown list> -This person is affiliated with another type of organization that is not a higher education institution -School or organization name
	Office Address
	1-3a	Office address line 1
	1-3b	Office address line 2
	1-3c	Office address line 3
	1-3d	City
	1-3e	State: <dropdown list>
	1-3f	ZIP Code
	1-3g	Country: <dropdown list>
	1-4a	E-mail address
	1-4b	Office phone number & Extension
	1-4c	Office fax number
	1-4d	Cell phone number
	2. Academic Fields
	2	-Select this project personnel member's academic field(s): <extensive list>
	Project Roles
	3-1	Employment title
	3-2	Select at least one project role for this person: -Principal Investigator -Co-Primary Investigator (Co-PI) -Project Director -Associate/Assistant Project Director -Project Manager -Associate/Assistant Project Manager -Coordinator; please specify area of coordination: -Internal Project Evaluator -External Project Evaluator -College/University Administrator -Staff--Full Professor -Staff--Associate Professor -Staff--Assistant Professor -Staff--Instructor -Staff--Senior Researcher -Staff--Associate Researcher -Staff--Assistant Researcher -Staff—Research Assistant -Staff—Admin Assistant/Secretary -Staff—Technology Support -Post-Doctoral Fellow -Student—Doctoral -Student--Master's -Student—Baccalaureate -Student—Associate -Student--High School -Consultant -Mentor -None
	Conditions and Support
	4-1	Does this person have a condition? -Yes -No -Project declined to report -Institution declined to report -Personnel declined to report Select condition(s) & Select Primary: -Asperger's syndrome/autism spectrum disorder -Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD) -Deaf or hard-of-hearing (D/HoH) -Physical impairment/orthopedic/mobility impairment -Systemic health/medical condition -Psychological/psychiatric condition -Learning disorder -Blind or visual impairment -Speech impairment -Acquired/traumatic brain injury -Other condition
	4-2	During the 2010-2011 reporting period, was this person registered with the campus disability services office? -Yes -No -Project declined to report -Institution declined to report -Personnel declined to report
	4-3	During the 2010-2011 reporting period, did this person receive services from the campus disability services office? -Yes -No -Project declined to report -Institution declined to report -Personnel declined to report
	Demographic Information
	5-1	Birth year
	5-2	Gender: -Male -Female -Project declined to report -Institution declined to report -Personnel declined to report
	5-3	Ethnicity: -Hispanic or Latino -Not Hispanic or Latino -Project declined to report -Institution declined to report -Personnel declined to report
	5-4	Race: (Mark one or more.) -American Indian or Alaska Native -Asian -Black or African American -Native Hawaiian or Other Pacific Islander -White -Project declined to report -Institution declined to report -Personnel declined to report
	5-5	Citizenship: -U.S. citizen -Permanent resident -U.S. national (born in American Samoa or Swains Island, or descendent of U.S. national) -Non-U.S. Citizen -Project declined to report -Institution declined to report -Personnel declined to report
	5-6	U.S. military service status: -Active duty -Reserve or National Guard -Previous military service -No military service -Project declined to report -Institution declined to report -Personnel declined to report
	6. International Experiences
	6-1	City
	6-2	Country: <dropdown list>
	6-3	Organization
	6-4	Program name
	6-5	What kind of activity was this experience? (Select all that apply.) -Teaching elementary school students -Teaching middle/junior high school students -Teaching high school students -Teaching undergraduate students -Teaching graduate students -Research: data gathering -Research: data analysis
	6-6	How many weeks did the experience last?
	6-7	What was the average number of hours worked each week?
	Research Studies
	1. Study Design
	1-1	Enter a name to identify this research study record
	1-2	List the hypotheses that this study tests
	1-3	What research methodologies were used in this research study?
	2. Subject Groups
	2-1a	Enter a name to identify this subject group
	2-1b	Enter the total number of subjects in this subject group
	2-1c	Subject group type: -Control group -Descriptive group -Experimental group -Extant dataset
	2-1d	How many participants in this subject group received monetary and/or non-monetary compensation?
	Subject Gender
		Total female subjects
		Total male subjects
		Institution declined to report
		Project declined to report
	Subject Ethnicity
		Hispanic or Latino
		Not Hispanic or Latino
		Institution declined to report
		Project declined to report
	Subject Race
		American Indian or Alaska Native
		Asian
		Black or African American
		Native Hawaiian or Other Pacific Islander
		White
		Institution declined to report
		Project declined to report
	Subject Age Level
		0-5
		6-12
		13-16
		17-18
		19-21
		22-25
		26-35
		36-45
		46 and over
		Institution declined to report
		Project declined to report
	Subject Academic Level
		Pre-K
		Grades K-6
		Grades 7-8
		High school
		Associate's degree candidate
		Baccalaureate candidate
		Master's degree candidate
		Ph.D. candidate
		Not applicable
		Institution declined to report
		Project declined to report
	Subject U.S. Military Service Status
		Active duty
		Reserve or National Guard
		Previous military service
		No military service
		Institution declined to report
		Project declined to report
	Subject Condition Status
		None
		Asperger's syndrome/autism spectrum disorder
		Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADH D)
		Deaf or hard-of-hearing (D/HoH)
		Physical impairment/orthopedic/mobility impairment
		Systemic health/medical condition
		Psychological/psychiatric condition
		Learning disorder
		Blind or visual impairment
		Speech impairment
		Acquired/traumatic brain injury
		Other condition
		Institution declined to report
		Project declined to report
	3. Study Inputs
	3-1a	Did your study use data from any NSF-RDE Alliance projects? -Yes -No <List of awards>
	4. Study Outputs
	4-1a	Did your study produce a replication manual? -Yes -No
	4-1b	If yes, provide the URL to access the manual, if available
	4-2a	Did your study disseminate findings directly to NSF-RDE Alliance projects? -Yes -No <List of awards>
	Dissemination Activities
	Professional Publications
	1	Publication citation
	2	Publication file (Upload an Adobe PDF document containing the publication. Limit: One)
	3	URL of publication [ ] Publication is not yet available online.
	4	Publication type: (Select all that apply.) -Peer reviewed -Invited -Non-peer reviewed
	5	Was this publication created with personnel from the other award(s) in this collaboration? -Yes -No
	Professional Presentations
	1	Presentation title
	2a	Presentation type: (Select all that apply.) -Conference -Media -Classroom -College/university/department event
	3	Professional organization
	4	URL of presentation
	5	Estimate the number of people in the audience
	6	Was this presentation created with personnel from the other award(s) in this collaboration? -Yes -No
	New Tools, Measurement Methods, and Other Materials
	1	Tool name
	2	Tool type: (Select all that apply.) -Survey -Questionnaire -Assessment tool -Instructional material -Replication manual -Other guide/manual -Brochure/newsletter -Software
	3a	How many people was this tool distributed to this year?
	3b	Who were the primary users of this material? (Select all that apply.) -STEM faculty -Educators, general -Educators, special education -STEM careers -General public -K-12 students -Post-secondary students
	4	Was this tool, measurement method, or other material created with personnel from the other award(s) in this collaboration? -Yes -No
	Online Resources
	1	Online resource name
	2	Resource type: (Select all that apply.) -Web site -Wiki -Blog -E-mail list -Social networking community -Virtual environment, please describe:
	3	Current URL or other location
	4	What was the number of "hits" this resource received during the 2010 - 2011 reporting period?
	5	If you have a unique login system, enter the number of unique logins. If this is an e-mail list, please enter the number of subscribers. Enter “0” if not applicable:
	6	Was this resource created with personnel from the other award(s) in this collaboration? -Yes -No
Additional Proposals
	1	Proposal title
	2	Funding organization: Federal government organization -Department of Education -Department of Energy -National Institutes of Health -National Science Foundation -National Oceanic and Atmospheric Administration -Other federal government organization, please specify Non-federal government organization -State government organization, please specify -Local government organization, please specify -Non-profit organization, please specify -Industry, please specify
	3	Funding organization program
	4	Proposal number
	Project Highlight
		Enter a short title for this project highlight
	Highlight Description
		Upload an Adobe PDF document containing the detailed highlight description. Limit: One
	Highlight Photo(s)
		Upload at least one highlight photo (.jpg, .jpeg, or .gif file).
	Photo Release Form(s)
		Upload at least one Adobe PDF document of the signed photo release form for each of the photos submitted above.
	Data Collection Feedback
	1	Approximately how many hours were spent collating and entering data for this project in preparation for submission?
	2	Enter any comments regarding the project data collection process:

1 Elements of these characteristics include: Name, address, date of birth, gender, ethnicity, race, disability status, class, major, grade point average, yearly fellowship or stipend amount, or project role.

2 Elements of these characteristics include: Sources and amount of funds, fellowships, scholarships, traineeships, partnerships, training, and research methods.

3 Elements of these characteristics include: Research findings, publications, presentations, degrees granted, and educational materials.

4 Elements of these characteristics include: Name, address, date of birth, gender, ethnicity, race, disability status, class, major, grade point average, yearly fellowship or stipend amount, or project role.

5 Elements of these characteristics include: Sources and amount of funds, fellowships, scholarships, traineeships, partnerships, training, and research methods.

6 Elements of these characteristics include: Research findings, publications, presentations, degrees granted, and educational materials.

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