MS TRIO PD Survey Instrument

Study of Upward Bound Implementation

Thank you in advance for the time spent completing this questionnaire-it is vital to the success of this important U.S. Department of Education study. Be assured that your answers will be completely confidential; no information will be reported that identifies you or this Upward Bound (UB) project.

The purpose of this study is to learn more about how Upward Bound projects implement the required service areas. Questions will ask about the specifics of how you provide the services to Upward Bound participants, how many students take up the services, and any details that are critical to understanding what you are providing to participants.

There are questions that are specific to the: 2012-2013 Academic School Year, 2013 Summer Program, and the 2012-2013 Project Year, which includes both the academic year and summer program. The specific service areas we will focus on are:

A4.

•  Academic Tutoring,  which includes services designed to enable students to complete secondary or postsecondary courses, which may include instruction in reading, writing, study skills, mathematics,   science, and other subjects. •  Academic Coursework, which includes courses that are offered as a part of your Upward Bound’s core curriculum. •  Academic Advising, which includes, but is not limited to, providing information and assistance around secondary and postsecondary academic planning (e.g. course selection, high school graduation requirements, college enrollment requirements, etc.), career planning and development, and remediation. •  College Entrance Exam Preparation, which includes assistance in preparing for college entrance examinations. •  College Exposure, which includes activities that give students the opportunity to learn about postsecondary education.

A20.

•  College Application Assistance, which includes assistance with completing college admission applications and searching for schools. •  Financial Aid, which includes improving student and parents financial literacy by providing information on the full range of federal student financial aid programs and benefits (including Federal Pell Grants awards and loan forgiveness); resources for locating public and private scholarships; and assistance in completing financial aid applications, including the Free Application for Federal Student Aid. •  Summer Program, which includes a summer instructional component designed to simulate a college-going experience for participants.

Per the policies and procedures required by the Education Sciences Reform Act of 2002, Title I, Part E, Section 183, responses to this data collection will be used only for statistical purposes. The reports prepared for this study will summarize findings across the sample and will not associate responses with an individual. We will not provide information that identifies you to anyone outside the study team, except as required by law. Any willful disclosure of such information for nonstatistical purposes, without the informed consent of the respondent, is a class E felony.

According to the Paperwork Reduction Act of 1995,no persons are required to respond to a collection of information unless such collection displays a valid OMB control number.  The valid OMB control number for this information collection is xxxx-xxxx.  Public reporting burden for this collection is estimated to average 40 minutes  per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection.  The obligation to respond to this collection is required to obtain or retain benefit (34 CFR § 75.591).  Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to the U.S. Department of Education, 400 Maryland Avenue, S.W., LBJ, Room 2E117, Washington, DC 20210-4537 or send electronically through the Federal eRulemaking  Portal at <http://www.regulations.gov> by selecting the Docket ID number.

Staff

Staff

A1. Please indicate how many people provided UB services during the project year and the way in which they were employed by the project.  Please count all staff that provided UB services—whether they were paid (using grant funds or other sources), volunteering, or also provided support for other programs (e.g., Talent Search, Gear Up).

	2012-2013 School Year Only	2013 Summer Program Only
Full-time permanent staff	    # of Staff	    # of Staff
Part-time permanent staff	    # of Staff	    # of Staff
Volunteers (unpaid)	    # of Volunteers	    # of Volunteers

A2. For the 2012-2013 School Year, please indicate which group of UB staff played the greatest role in delivering services in each UB area this project year. By greatest role, we mean the group that worked with the largest number of students in each service area. Please count all staff that provided UB services-whether they were paid (using grant funds or other sources), volunteering, or also provided support for other programs (e.g., Talent Search, Gear Up).

Select one for each service area. If your response is the same for all service areas, select your answer on

the last row.

	Paid, Full-Time UB Staff	Paid, Part-Time UB Staff	Volunteers (Unpaid)
Academic Tutoring
Academic Coursework
Academic Advising
College Entrance Exam Prep
College Exposure
College Application Assistance
Financial Aid Assistance
All Service Areas

A2a. For the 2013 Summer Program, please indicate which group of UB staff (paid or unpaid), played the greatest role in delivering services to students. By greatest role, we mean the group that worked with the largest number of students during the summer.

Select one for each service area. If your response is the same for all service areas, select your answer on

the last row.

	Paid, Full-Time UB Staff	Paid, Part-Time UB Staff	Volunteers (Unpaid)
Academic Tutoring
Academic Coursework
Academic Advising
College Entrance Exam Prep
College Exposure
College Application Assistance
Financial Aid Assistance
All Service Areas

A3. During the 2012-2013 School Year, please indicate the occupational background ( e.g. other positions held, previous work history) of the staff who played the greatest role in delivering services in each service area. By greatest role, we mean the group that worked with the largest number of students in each service area.

Select one for each service area. If your response is the same for all service areas, select your answers

on the last row.

	UB Project staff (full or part-time)	High School Student	College Student	High School Teacher	Other High School Staff	College Professor	Other Staff Employed by the Host Institution	Other, Specify
Academic Tutoring
Academic Coursework
Academic Advising
College Entrance Exam Prep
College Exposure
College Application Assistance
Financial Aid Assistance
All Service Areas

A3a. During the 2013 Summer Program, please indicate the occupational background ( e.g. other

positions held or previous work history) of the staff who played the greatest role in delivering services. By greatest role, we mean the group that worked with the largest number of students during the summer.

Select one for each service area. If your response is the same for all service areas, select your answers

on the last row.

	UB Project staff (full or part-time)	High School Student	College Student	High School Teacher	Other High School Staff	College Professor	Other Staff Employed by the Host Institution	Other, Specify
Academic Tutoring
Academic Coursework
Academic Advising
College Entrance Exam Prep
College Exposure
College Application Assistance
Financial Aid Assistance
All Service Areas

Thanks for providing those details. Now we will ask about the required service areas offered by Upward

Bound.

Academic Tutoring

Questions in this section are about academic tutoring services provided by your UB project during the

2012-2013 project year.

Academic tutoring services are those designed to enable students to complete secondary or postsecondary courses, which may include instruction in reading, writing, study skills, mathematics, science, and other subjects.

GO TO B2 IF UB=NEW

B1. Was academic tutoring offered during the 2013 summer program?

1. Yes

2. No

PROGRAMMER: SHOW 2013 Summer COLUMN IF B1=1

B2. Select which methods of delivery are/were used when providing academic tutoring to UB participants?

	Tutoring In a Group Setting	One-On-One Tutoring	Online Tutoring	Other, Specify	Which method is used by the largest number of students?
2012-2013 School Year
Methods for delivering tutoring services
2013 Summer Program
Methods for delivering tutoring services

*Online can include: computer-based instructional/advising programs or assessments; participants in web-based seminars, learning communities, or discussion boards; systematic information sharing through email or chat room platforms (e.g., on-line mentoring or counseling).

B2a1. During the school year, how is time in <B2a> most commonly spent?

1. Getting help with homework, school projects, or papers.

2. Getting help with study skills—i.e., how to study and prepare for tests.

3. Getting help in a particular subject for remediation purposes.

4. There is NOT a defined structure.

5. Some other way, Specify.

SHOW IF B1=1

B2b1. During the summer, how is time in <B2a> most commonly spent?

1. Getting help with homework, school projects, or papers

2. Getting help with study skills—i.e., how to study and prepare for tests

3. Getting help in a particular subject for remediation purposes

4. There is NOT a defined structure

5. Some other way, Specify

PROGRAMMER: SHOW 2013 Summer COLUMN IF B1=1

B3. How do you assess students’ academic performance to decide whether they need academic

tutoring?

	Review of Grades	Feedback Requested from Teachers	Formative Assessment Conducted (Pre and Post)	Other, Specify	Not Assessed	Which method is used by the largest number of students?
2012-2013 School Year
Used to assess student progress.
2013 Summer
Used to assess student progress.

• Academic Coursework

Questions in this section ask about the academic courses offered by your Upward Bound project during the 2012-2013 School Year. Academic coursework includes courses that are offered as a part of your Upward Bound’s core curriculum.

C1. Please complete the table below to indicate what subjects are offered, when, the purpose, and the method of delivery—by your Upward Bound project. You should only include courses that are provided by your Upward Bound project, meaning they are funded using grant funds.

	Select courses offered during the school year and/or summer.		Indicate whether students take courses to receive dual credit, college credit, and/or as a UB requirement. Select all that apply				Select the primary method of instruction for each subject.
Subject	School Year	Summer	Receive Dual Credit	Receive College Credit (ONLY)	Receive High School Credit (ONLY)	UB Requirement	Method of Delivery
English/Language Arts	☐	☐	☐	☐	☐	☐
Pre-Algebra	☐	☐	☐	☐	☐	☐
Algebra I	☐	☐	☐	☐	☐	☐
Algebra II	☐	☐	☐	☐	☐	☐
Geometry	☐	☐	☐	☐	☐	☐
Statistics/Probability	☐	☐	☐	☐	☐	☐
Pre-Calculus	☐	☐	☐	☐	☐	☐
Calculus	☐	☐	☐	☐	☐	☐
Physics	☐	☐	☐	☐	☐	☐
Biology	☐	☐	☐	☐	☐	☐
Chemistry	☐	☐	☐	☐	☐	☐
Earth Science	☐	☐	☐	☐	☐	☐
Foreign Language	☐	☐	☐	☐	☐	☐
Other subject, Specify	☐	☐	☐	☐	☐	☐
Other required service area, Specify	☐	☐	☐	☐	☐	☐

PROGRAMMER: Compute SchlYr=Yes if any subject offered during school year) (Compute Summer=Yes if any subject offered during summer)

C2. During the School Year, what are the three most common factors that you consider when determining what UB-offered courses participants should take through the Upward Bound project?

	(Select up to three responses)
High school graduation requirements
Alignment with State/district assessments
College admissions/enrollment requirements
Student report card grades
Student performance on state assessments
Input from Upward Bound project staff from host institution
Input from staff from partner organizations, including target schools
Parent’s input about student needs
Student input about their needs or interests
UB Participants’ plans for future course enrollments
Other, specify

C2a. During the Summer Program, what are the three most common factors that you consider when determining what UB-offered courses participants should take through the Upward Bound project?

	(Select up to three responses)
High school graduation requirements
Alignment with State/district assessments
College admissions/enrollment requirements
Student report card grades
Student performance on state assessments
Input from Upward Bound project staff from host institution
Input from staff from partner organizations, including target schools
Parent’s input about student needs
Student input about their needs or interests
UB Participants’ plans for future course enrollments
Other, specify

Academic Advising

Questions in this section ask about the academic advising services provided by your UB project

during the 2012-2013 project year.

Academic advising includes, but is not limited to, providing information and assistance around secondary

and postsecondary academic planning (e.g. course selection, high school graduation requirements,

college enrollment requirements, etc.), career planning and development, and remediation.

GO TO D2 IF UB=NEW

D1. Was academic advising offered during the 2013 summer program?

1. Yes

2. No

PROGRAMMER: SHOW 2013 SUMMER COLUMN IF D1=1

D2. Select which methods of delivery are/were used when providing academic advising to UB participants?

	Advising in a Group Setting	One-On-One Advising	Online Advising	Workshops focused on course selections	Other, Specify	Which method is used by the largest number of students?
2012-2013 School Year
Methods for delivering advising services
2013 Summer Program
Methods for delivering advising services

*Online can include: computer-based instructional/advising programs or assessments; participants in web-based seminars, learning communities, or discussion boards; systematic information sharing through email or chat room platforms (e.g., on-line mentoring or counseling).

D2a1. During the school year, how is time in <D2a> most commonly spent?

1. Getting help on which courses to take meet high school graduation requirements.

2. Being counseled on which exams and courses to take to meet college entrance requirements.

3. Developing study skills that support college readiness (e.g., time management, note taking skills, etc).

4. Developing and tracking academic goals (i.e., employ an individualized development or academic plan).

5. Planning time spent participating in UB activities, such as academic tutoring and coursework.

6. Getting help with non-academic issues that are affecting school performance (i.e., family issues, health issues).

7. Some other way, Specify

SHOW IF D1=1

D2b1. During the summer, how is time in <D2b> most commonly spent?

1. Getting help on which courses to take meet high school graduation requirements.

2. Being counseled on which exams and courses to take to meet college entrance requirements.

3. Developing study skills that support college readiness (e.g., time management, note taking skills, etc).

4. Developing and tracking academic goals (i.e., employ an individualized development or academic plan).

5. Planning time spent participating in UB activities, such as academic tutoring and coursework.

6. Getting help with non-academic issues that are affecting school performance (i.e., family issues, health issues).

7. Some other way, Specify

College Entrance Exam Prep

Questions in this section ask about the college entrance exam prep services provided by your UB project

during the 2012-2013 project year.

College entrance exam prep includes assistance in preparing for college entrance examinations.

GO TO E2 IF UB=NEW

E2b4. Was college exam prep offered during the 2013 Summer program?

1. Yes

2. No

PROGRAMMER: SHOW 2013 Summer COLUMN IF E1=1

E2. Select which methods of delivery are/were used when providing college exam prep services?

	College Exam Prep In A Group Setting	One-On-One College Exam Prep Services	Online* college exam prep services	Work** independently (i.e., self-directed college exam prep)	Other, Specify	Which method is used by the largest number of students?
2012-2013 School Year
Methods for delivering college exam prep services
2013 Summer Program
Methods for delivering college exam prep services

*Online can include: computer-based instructional/advising programs or assessments; participants in web-based seminars, learning communities, or discussion boards; systematic information sharing through email or chat room platforms (e.g., on-line mentoring or counseling).

** Self –Directed college exam prep that excludes use of computer based programs.

E2a1. During the school year, how is time in <E2a> most commonly spent ?

1. Taking practice tests to improve score

2. Learning test taking skills

3. Managing and coping with test-related stress/anxiety

4. Learning the structure of the tests

5. Learning how tests are scored

6. Learning and reviewing content to prepare to subject specific tests (biology, history, government, English literature and composition, etc.)

7. Some other way, Specify___

SHOW IF E1=1

E2b1. During the summer, how is time <E2a> most commonly spent?

1. Taking practice tests to improve score

2. Learning test taking skills

3. Managing and coping with test-related stress/anxiety

4. Learning the structure of the tests

5. Learning how tests are scored

6. Learning and reviewing content to prepare to subject specific tests (biology, history, government, English literature and composition, etc.)

7. Some other way, Specify___

PROGRAMMER: SHOW 2013 Summer COLUMN IF E1=1

E3. How do you assess students’ college exam prep progress to decide whether they need more or less support? Select all that apply.

	Scores on Practice Tests	Students self-report	Formative Assessment Conducted (Pre and Post)	Other, Specify	Not Assessed	Which method is used by the largest number of students?
2012-2013 School Year
Used to assess student progress in college exam prep
2013 Summer Program
Used to assess student progress in college exam prep

E4. Please indicate what resources are made available to UB participants receiving college exam prep services. Select all that apply.

	2012-2013 School Year	2013 Summer Program SHOW IF E1=1
	Select the resources made available to UB participants receiving college exam prep services.	Select the resources made available to UB participants receiving college exam prep services.
Prep books
Sample tests
Scoring sheets
Online accounts for practice tests
Calculators
Vouchers/reimbursement for test fees
Other, Specify
None of the above.

College Exposure

Questions in this section ask about college exposure services offered by your Upward Bound project during the 2012-2013 project year. College exposure includes activities that give students the opportunity to learn about postsecondary education.

F1. How many college trips were offered during the project year?

	Number of Trips	Number of Schools	Overnight Trip	Day Trip
School Year	    # of trips	    # of schools visited	☐Overnight	☐Day
Summer	    # of trips	    # of schools visited	☐Overnight	☐Day

F2. What are the specific requirements UB participants must meet to be eligible for college visits?

Select all that apply.

1. Achieve a certain level of participation in UB services

2. Complete college applications

3. Complete college entrance exams (e.g., ACT, PSAT, SAT)

4. Student interest

5. Parent request

6. Grade level in school (i.e., only high school juniors or seniors can attend)

7. Some other way, Specify

8. No specific requirements. Available to all UB participants

F3 . What is the main way you determine what colleges to visit?

1. UB participants express their desires

2. You only visit colleges within a set distance from the project office, based on historical patterns of UB graduate enrollment.

3. You visit a select set of colleges each year, based on established relationships with those institutions.

4. Some other way, Specify

F4. What kind of activities do students participate in during the visits?

Select all that apply.

1. Campus tours

2. Dormitory tours

3. Attend/observe college classes/lectures

4. Attend information sessions on applying and financial aid

5. Q&A with current students

6. Overnight stay

7. Something else, Specify

F5. Thinking about college exposure activities, please indicate if you offer any of the following

services to your UB participants. Select all that apply.

	Select if you offer any of the following services to UB participants. (all that apply)	Which of the services is used by the largest number of students for the following services? (select one)
a.. Assistance in researching different colleges
b.. Assistance in researching different college majors
c. Arrange for college/university staff/recruiters to conduct information session or have them make presentations to UB participants
d. Helping students identify the past outcomes (e.g. , graduation or employment rates) of the colleges in which they are interested.
e. Connect participants working Professionals to learn about specific careers and the education needed for them.
f. Other, Specify

College Application Assistance

Questions in this section ask about the college application assistance services provided by your Upward

Bound project during the 2012-2013 project year.

College application assistance includes assistance with completing college admission applications and

searching for schools.

GO TO G2 IF UB=NEW

G1. Was college application assistance offered during the 2013 Summer program?

1. Yes

2. No

G2. What percentage of UB seniors completed at least one college application during the 2012-2013 school year?

1 0-25%

2 26-50%

3 51-75%

4 76-100%

G3. Do you provide guidance on how many schools your students should apply to? 1 Yes, we have a “typical” number of schools we suggest most students apply to

2 Yes, but the number of schools is different for different students (ideally we would have asked what factors they take into account but we don’t want to add questions now)

3. No, our project doesn’t provide guidance on the number of schools.

GO TO G4 IF G3=2

G3a. Approximately how many colleges do you encourage your students to apply to?

	Select appropriate number for each
a. Match colleges (that is, colleges that are aligned with students’ grades and test scores)
b. Safety colleges (that is, colleges that student are very likely to be accepted)
c. Stretch colleges (that is, colleges that students are less certain about acceptance)
d. Total # of colleges students encouraged to apply to

G4. Do you systematically collect students’ college entrance exam (ACT or SAT) scores?

1. Yes

2. No

G5. How do you collect these scores (ACT or SAT)?

1. Students designate host institution as a recipient of their test scores

2. Scores sent directly to the UB program (not through the Host Institution)

3. Students provide paper copies of test scores

4. Students self-report test scores

5. Other, Specify

G6. What institutional factors do you encourage students to consider when selecting colleges to apply to?

Select up to three options.

1. Cost

2. Ranking/selectivity of school

3. Likelihood of acceptance

4. Strength of specific program/department

5. Availability of student support programs/services

6. Opportunity to continue relationship with and support from UB host institution

7. Other, Specify

PROGRAMMER: SHOW 2013 Summer COLUMN IF G1=1

G8. Select which methods of delivery are/were used when providing college application assistance services to UB participants?

	Assistance In A Group Setting	One-On-One Assistance	Online college application assistance	Other, Specify	Which method is used by the largest number of students?
2012-2013 School Year
Methods for delivering college application assistance
2013 Summer Program
Methods for delivering college application assistance

*Online can include: computer-based instructional/advising programs or assessments; participants in web-based seminars, learning communities, or discussion boards; systematic information sharing through email or chat room platforms (e.g., on-line mentoring or counseling).

G8a1. During the school year, how is time in <G8a> most commonly spent?

1. Getting assistance with narrowing college choices based on net costs.

2. Getting assistance with narrowing college choices based on college outcomes. (e.g., graduation or employment rates).

3. Getting help with access to applications (the Common Application Form and others) for colleges in which participants are interested.

4. Receiving guidance and oversight on filling out the application forms.

5. Getting help with writing college essays

6. Getting help with identifying teachers and other adults to write recommendations.

7. Getting assistance with planning and follow up to ensure all the pieces of the application are submitted on time.

8. Some other way, Specify.

SHOW IF G1=1

G8b1. During the summer, how is time in <G8a> most commonly spent?

1. Getting assistance with narrowing college choices based on net costs.

2. Getting assistance with narrowing college choices based on college outcomes. (e.g., graduation or employment rates).

3. Getting help with access to applications (the Common Application Form and others) for colleges in which participants are interested.

4. Receiving guidance and oversight on filling out the application forms.

5. Getting help with writing college essays

6. Getting help with identifying teachers and other adults to write recommendations.

7. Getting assistance with planning and follow up to ensure all the pieces of the application are submitted on time.

8. Some other way, Specify.

Financial Aid

Questions in this section ask about financial aid application assistance services offered by your Upward

Bound project during the 2012-2013 project year. Financial aid assistance includes improving student and parents financial literacy by providing information on the full range of federal student financial aid

programs and benefits (including Federal Pell Grant awards and loan forgiveness); resources for locating

public and private scholarships; and assistance in completing financial aid applications,

including the Free Application for Federal Student Aid.

GO TO H2 IF UB=NEW

H1. Was financial aid application assistance offered during the 2013 Summer program?

1. Yes

2. No

H2. What percentage of UB seniors completed the FAFSA application during the 2012-2013 school year?

1 0-25%

2 26-50%

3 51-75%

4 76-100%

PROGRAMMER: SHOW 2013 Summer COLUMN IF H1=1

H3. Select which methods of delivery are/were used when providing financial aid assistance services to UB participants?

	Assistance In A Group Setting	One-On-One Assistance	Online application assistance	Other, Specify	Which method is used by the largest number of students?
2012-2013 School Year
Methods for delivering financial aid application assistance
2013 Summer Program
Methods for delivering financial aid application assistance

H4a1. During the school year, how is time in <H4a> most commonly spent?

1. Being advised on financial aid requirements.

2. Getting help with determining the information needed for FAFSA forms.

3. Getting help with tracking their progress towards completing FAFSA forms.

4. Getting help with obtaining application fee waivers from colleges.

5. Getting help with using the host institution’s net price calculator to estimate the net cost of attending colleges they are seriously considering.

6. Providing parents with information on financial aid.

7. Some other way, Specify

SHOW IF H1=1

H4b1. During the summer, how is time in <H4a> most commonly spent?

1. Being advised on financial aid requirements.

2. Getting help with determining the information needed for FAFSA forms.

3. Getting help with tracking their progress towards completing FAFSA forms.

4. Getting help with obtaining application fee waivers from colleges.

5. Getting help with using host institution’s net price calculator to estimate the net cost of attending colleges they are seriously considering.

6. Providing parents with information on financial aid.

7. Some other way, Specify

Student Participation

We understand that Upward Bound projects vary in their offerings and requirements. In order to capture this variation, we have a series of questions about student participation across all service areas.

I0. How many Upward Bound students active and/or inactive Upward Bound students did you serve at any time during project year 2012-2103 (including summer 2013)? Please include the maximum number of students served in each grade, including those who became less active or left the program during the year.

______ 9^th grade UB participants

______ 10^th grade UB participants

______ 11^th grade UB participants

______ 12^th grade UB participants

I1. During the 2012-13 project year, did your project require students to attend specific UB activities for a specific amount of time in order to be considered a “participant” in the program? (Examples might include a requirement that students below a certain GPA attend tutoring, that 11^th and 12^th graders attend college application workshops, or that all students participate in at least 10 hours of UB activities each month).

1. Yes, requirements for all or some students (GO TO I1a)

2. No, all participation is optional (GO TO I1c2)

I1a. Did/do the requirement(s) pertain to participation in UB overall or to specific UB service areas such as academic tutoring, academic coursework, academic advising, college entrance exam prep, college exposure, college application assistance, or financial aid assistance?

1. Overall

2. Specific to UB service areas (GO TO I1c)

I1b. Please tell us what the overall participation requirement is in order to be considered as participating in the program.

____________________________________________________________

I1c. Please indicate which service areas had a participation requirement during the 2012-2013 project year and then enter the number of hours required for each and the frequency of the requirement.

	Indicate if participation was mandatory for all students or some students based on specific criteria.	# of Hours/Sessions Required During Mandatory Period	Frequency of Requirement*
Academic Tutoring	Mandatory for all Mandatory for some Not mandatory for any	___# of hours/sessions
Academic Coursework	Mandatory for all Mandatory for some Not mandatory for any	___# of hours/sessions
Academic Advising	Mandatory for all Mandatory for some Not mandatory for any	___# of hours/sessions
College Entrance Exam Prep	Mandatory for all Mandatory for some Not mandatory for any	___# of hours/sessions
College Exposure	Mandatory for all Mandatory for some Not mandatory for any	___# of hours/sessions
College Application Assistance	Mandatory for all Mandatory for some Not mandatory for any	___# of hours/sessions
Financial Aid Assistance	Mandatory for all Mandatory for some Not mandatory for any	___# of hours/sessions

*Some students could mean some grades but not others, or students with particular attributes. **For example of students are expected to attend 1 hour sessions weekly for 40 weeks, and students can have two unexcused absences, please enter 38 hours as # of hours/sessions required and select YEARLY as the frequency.

I1c2. Please indicate how many hours/sessions are made available to a UB participant for each service area. For example, if you offer tutoring 3 days a week for 2 hours, your answer would be 6 hours a week.

	# of Hours/Sessions Available	Frequency*
Academic Tutoring	___# of hours/sessions
Academic Coursework	___# of hours/sessions
Academic Advising	___# of hours/sessions
College Entrance Exam Prep	___# of hours/sessions
College Exposure	N/A	N/A
College Application Assistance	___# of hours/sessions
Financial Aid Assistance	___# of hours/sessions

*For example, if students are expected to attend 1 hour sessions weekly for 40 weeks, and students can have two unexcused absences, please enter 38 hours as # of hours/sessions required and select YEARLY as the frequency.

I1d. SHOW IFI1=1

SHOW ROWS SELECTED AS MANDATORY FOR ALL OR MANDATORY FOR SOME AT I1B

Please indicate how you determine who is required to participate in specific UB services? Select all that apply for each service area.

SHOW IF I1=2

Please indicate whether your UB project uses any of the following to make recommendations for participation in each service area to UB participants. Select all that apply for each service area.

	GPA	Grade Level	State or District Test Scores	UB Assessment Scores	Teacher/Counselor Recommendation	Other, Specify
Academic Tutoring
Academic Coursework
Academic Advising
College Entrance Exam Prep
College Exposure
College Application Assistance
Financial Aid Assistance

I2. Do you track whether students meet the participation requirements?

If I1=2, Show: Do you track students’ participation levels?

1. Yes (GO TO I2a)

2. No (GO TO I3)

I2a. What kinds of outreach activities do you employ for students not meeting the participation requirements?

Select All That Apply

1. Contact students via phone, text, email, or regular mail

2. Contact parents via phone, text, email, or regular mail

3. Contact school counselors or other school staff

4. Other, Specify

I2b. What are the potential consequences of not meeting the participation requirements?

Select All That Apply

1. Probation

2. Loss of opportunity for optional activities (e.g., field trips, cultural activities)

3. Stipend reduction

4. Termination from UB program

5. Other, Specify

I3a. Does your project collect student-level data on your participants or former participants from:

              Select all that apply.

1 National Student Clearinghouse (e.g., data on college enrollment)

2            College Board (e.g., data on PSAT or SAT scores)

3            ACT (e.g., data on ACT scores)

4            State or district (e.g., data on state test scores)

5            Schools (e.g., data on grades in high school courses)

6. Other, SPECIFY

   

   Accessibility

7. Do not collect this information

Now we have questions about where and when UB services are offered.

I4. Please indicate where UB services have been offered during the 2012-2013 project year. In the last column, please indicate where the most students receive services in each service area.

Select all that apply for each service area.

	At The Upward Bound Project Office	At The Host Intuition, Away From The Upward Bound Project Office	At A Local College Or University (Not The Host Institution)	At The Target High Schools	At A Local Community Center (e.g., the YMCA, Boys And Girls Club) Or Library/Auditorium	Virtual (i.e., Online)	Other, Specify	Please select where most students receive services.
Academic Tutoring
Academic Coursework
Academic Advising
College Entrance Exam Prep
College Exposure
College Application Assistance
Financial Aid Assistance
Summer Program								Choose an Item.

I5. During the 2012-2013 school year, for the typical participant in your program, how often could they receive Upward Bound services?”

Weekdays ☐Every week day ☐ Monday ☐Tuesday ☐ Wednesday ☐ Thursday ☐Friday

Weekends ☐Both days     # of weekends per month

☐Saturdays only ☐0 ☐1 ☐2 ☐3 ☐4

☐Sundays only

I5b. Please indicate when the specific UB services were offered during the 2012-2013 school year. In the last column, please indicate when the most students receive services in each service area.

Select all that apply for each service area.

	During The Week, Before School Starts	During The Week, During The School Day	During The Week, After School, Evenings	On Saturdays Or Sundays	On Every Other Saturday Or Sunday (Twice Per Month)	Monthly ONLY	Other, Specify	Please Select When Most Students Receive Services.
Academic Tutoring
Academic Coursework
Academic Advising
College Entrance Exam Prep
College Exposure
College Application Assistance
Financial Aid Assistance

I6. Is transportation provided to the UB activities for any students?

1. Yes, during the summer only

2. Yes, during the school year only

3. Yes, during the school year and summer

4. No, not at all

5. N/A

I7. Does your program serve a rural, urban, or suburban area?

Select all that apply.

1. Rural

2. Urban

3. Suburban

4. Other, specify

2013 Summer Program

This section focuses on what you offered to UB participants during the 2013 Summer program. The summer program includes a summer instructional component designed to simulate a college-going experience for participants.

J1. How long is your summer program?

☐ 6 weeks

☐ 7 weeks

☐ 8 weeks or more

J1a. Is your summer program a residential program?

☐Yes

☐No

J2. We’d like to get details on who is offered the opportunity to participate in the Summer Program, how many slots are available, and what percentage of students participated in the 2013 Summer Program.

First, is participation in the summer program…

1. Mandatory for all UB participants each year (i.e., there is no selection criteria)

2. Mandatory for some UB participants

3. Available, but contingent upon specific selection criteria (i.e., must meet a set list of requirements)

(IF J1=2 OR 3, ASK)

J3. How is participation in the summer program decided?

	All selection criteria. (all that apply)
a. Must be in a certain grade(s). Specify__
b. Must have maintained a certain GPA. Specify___
c. Student expresses interests.
d. Must have completed a certain set of UB activities. Specify.____
e. Other, Specify____

J4. Please select the grades the summer Program is offered to and then indicate how many hours UB students must spend participating in UB activities per week.

2013 Summer Program
	Offered	Hours* On average, how many hours per week are UB participants participating in UB activities during the summer program?*	Percentage What % of the UB participants in each grade participated?
9th		______Hours per week
10th		______ Hours per week
11th		______ Hours per week
12th		______ Hours per week
Graduates	☐

*Please count hours spent in courses, as well as in other activities. If your program is residential, please count all hours spent in activities, including evenings and weekends.

J5. What activities are offered as part of the UB summer program?

	Please indicate how time is spent outside of academic courses during the summer program. (Select Up to Three)
a. Recreational or Cultural activities.
b. Field trips.
c. College visits.
d. Work-study job (provided by the UB program)
e. Arranging non-work study jobs (not provided by the UB program)
f. Meeting with mentors or counselors
g. Participating in other UB required services (i.e., tutoring, academic advising, etc.)
h. Other, Specify

J5. Does your project offer a summer bridge program for UB high school graduates who plan to attend college the following fall?

1. Yes

2. No (SKIP TO J12)

J6. Is the summer bridge program distinct from the regular summer program?

1. Yes—summer bridge participants participate in distinctly different activities from regular summer program participants

2. Somewhat—summer bridge participants participate in many of the regular summer program activities, but some activities are offered specifically for summer bridge participants

3. No—summer bridge participants participate in the same activities as regular summer program participants

J7. How long is your summer bridge program?

☐ 6 weeks

☐ 7 weeks

☐ 8 weeks or more

J8. Which of the following factors are used to determine a student’s eligibility for the UB Summer Bridge program?

Select all that apply.

Needs academic assistance to avoid or reduce need for development/remedial college coursework
Must have been an active UB participant when they graduated from high school
Must have enrolled in some host college or university for the fall term
Must have enrolled in some college or university for the fall term
Other, Specify
All Students are eligible	☐

J9. How many college credit hours can Upward Bound participants receive during the summer bridge program?

_____ Hours

J11. What activities are offered as part of the UB summer bridge program?

Select all that apply.

College coursework
Developing study skills
Mentoring with current undergraduate
Mentoring with career professional
Job shadowing/career awareness
Internship
Working a work-study job (provided by the UB program)
Working a job (not provided by the UB program)
Recreational or cultural activities
Other, Specify

J12. In summer 2013, are you providing Upward Bound participants who have just completed

high school (either formally as in a summer bridge or otherwise) with information on the steps

they need to take to complete enrollment in college in the fall?

1. Yes

2. No (GO TO K1)

J13. Is this information provided upon request or offered systematically to all of these students?

1. Provided to students who request it

2. Offered systematically to all of these students (GO TO J14)

J14. How often is information provided over the summer to help Upward Bound participants take steps toward enrolling in college in the fall?

1. Once

2. 2-5 times

3. 6-10 times

4. More than 10 times

J15. Information on fall college enrollment is provided to…

1. Students who completed the program as seniors

2. All students who participated in the program any time during high school, even those who may have left your project

3. Parents

J16. Is the information provided on fall college enrollment?

1. The same for all students

2. Customized depending on the school that the student plans to attend (GO TO J19)

J17. How was the information provided?

Select all that apply

1. Group meetings

2. One-on-one meetings

3. Telephone calls

4. Mail

5. Email

6. Text message

7. Other, Specify

J18. Who provides the information?

1. Paid UB Staff (full or part time)

2. Volunteers

3. Other, Specify

J19. Please complete the table below to indicate what topics are covered and the method of delivery

by your Upward Bound project to participants who have just completed high school.

Select all that apply.

		Select the primary method of delivery for each topic.
Completing the FAFSA (if not already done)
Deadlines and procedures for submitting tuition payment (if needed)
Understanding financial aid benefits and obligations
Deadlines and procedures for registering for courses
Schedule and procedures for freshman orientation sessions
Deadlines and procedures for course placement tests
Deadlines and procedures for obtaining housing
Understanding health insurance options and waiver policy
Understanding how to access resources through intended school’s web portal
Other, SPECIFY

Technology

Technology

K1. During the 2012-2013 School Year, please select the kinds of technology your UB project used.* Select all that apply for each service area.

	Specialized software (e.g. learning management system, online tutoring software, graphing program for mathematics)	Electronic Content (e.g. learning management system, e-books)	Live online discussion (e.g., chat room)	Online messaging (i.e., instant messaging or IM)	Email	Social media (e.g., twitter, Facebook, etc.)	Text messaging (by phone)	Video-conference	Higher ed data or web portals	Other, Specify
Academic Tutoring
Academic Coursework
Academic Advising
College Entrance Exam Prep
College Exposure
College Application Assistance
Financial Aid Assistance

*For examples, please place your mouse over the column headings.

K1a. For the 2013 Summer Program, please select the kinds of technology your UB project uses. Select all that apply for each service area.

	Specialized software (e.g. learning management system, online tutoring software, graphing program for mathematics)	Electronic Content (e.g. learning management system, e-books)	Live online discussion (e.g., chat room)	Online messaging (i.e., instant messaging or IM)	Email	Social media (e.g., twitter, Facebook, etc.)	Text messaging (by phone)	Video-conference	Higher ed data or web portals	Other, Specify
Academic Tutoring
Academic Coursework
Academic Advising
College Entrance Exam Prep
College Exposure
College Application Assistance
Financial Aid Assistance

Challenges

K2. Please select any challenges you face that affect your ability to provide each of the required services. Select all that apply for each service area. In the last column, please indicate which challenge you consider to be the greatest—by greatest we mean the one that most impacts your ability to meet students need.

	Hiring and retaining capable staff	Getting UB participants to show up	Identifying struggling UB participants who need the service	Obtaining space or facilities to provide service	Having sufficient time with UB participants	Providing transportation for students who need it	Lack of Resources	Other, Specify	Please select where most students receive services.
Academic Tutoring
Academic Coursework
Academic Advising
College Entrance Exam Prep
College Exposure
College Application Assistance
Financial Aid Assistance

K2a. For the Summer Program, please select any challenges you face that affect your ability to provide each of the required services. Select all that apply for each service area. In the last column, please indicate which challenge you consider to be the greatest—by greatest we mean the one that most impacts your ability to meet students need.

	Hiring and retaining capable staff	Getting UB participants to show up	Identifying struggling UB participants who need the service	Obtaining space or facilities to provide service	Having sufficient time with UB participants	Providing transportation for students who need it	Lack of Resources	Other, Specify	Please select where most students receive services.
Academic Tutoring
Academic Coursework
Academic Advising
College Entrance Exam Prep
College Exposure
College Application Assistance
Financial Aid Assistance

Closing

We have a few additional questions that are not specific to any particular service area.

L0. How long have you been the project director?

_____ Number of Years

L1a. Have there been any major changes to your UB project or any service area since the last grant period?

1. Yes (GO TO L1b)

2. No (GO TO L2)

3. Did not have a grant last cycle

L1b. Please indicate the major changes since the last grant period.

	Major changes since the last grant period. (all that apply)
Changed host institution
Changed project director
Other staff changes
Reduced number of students served
Increased number of students served
Added additional target school(s)
Decreased number of target schools
Reduced/eliminated optional services
Other, Specify

L1c. What was the main reason for the change?

1. To improve the program

2. To improve a particular service area

3. To accommodate more UB participants

4. To address student needs

5. To address a competitive priority

6. To cut costs

7. Some other reason(s), Specify

L2. Is there a particular strategy, meaning a practice or approach to implementing a required or optional service area, you believe is especially important in encouraging UB participants to enroll in college? If so, please identify the service area where you implement this strategy, provide a brief description of the strategy, and why you believe it is an especially promising strategy or approach.

Describe the Strategy

Why do you believe it is an especially promising strategy or approach?

L3. Please share any additional insights or information about your UB project that you believe is important for understanding the approaches or outcomes of your project.

Thank you for taking time to complete this important survey. Those are all the questions we have for you.

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