RESOURCE REPORT

Complete Only One RR Form for the Entire State. Do Not Submit Sponsoring-Agency-Level or Within-State-Regional Resource Reports.
All Person Counts Should Reflect Active Counselors,Coordinators,Other Staff as of the End of Each Grant Year (31March).
The Unique Count of Counselors Attending Any Update Training During the Grant Year Cannot Exceed the Grand Total Number of Counselors.
12 Month Period for This Report 	IState Code IState Grantee  Name
From: 04/01/	ITo:	03/31/	  	I
Person Completing Report 	Title 	Telephone Number
(	) 	-

Section 1	All Other	Section 2
Number of  Active Counselors	State	Local and	Number of LocalCoordinators I Sponsors and Hours
And Hours As of 31March	Office 	Field Sites	Total 	As of 31March 	Total
A. Number of Volunteer Counselors	A.Number of Volunteer (Unpaid) Coordinators
B.Number of SHIP-Paid Counselors	B. Number of SHIP-Paid Coordinators
C. Number of In-Kind-Paid Counselors	C. Number  of In-Kind-Paid Coordinators
TotalNumber of Counselors  - A+B+C	Total Number of Coordinators-  A+B+C
D. Volunteer Counselor Hours	D. Volunteer (Unpaid) Coordinator Hours
E.SHIP-Paid Counselor Hours	 E. SHIP-Paid Coordinator Hours F.In-Kind-Paid Counselor Hours	F. In-Kind-Paid Coordinator Hours TotalCounselor Hours - D+E+F	Total Coordinator Hours - D+E+F
Section 3	All Other	:;,ection 4- Counselor Trainings 	 		Total
Number of Other Paid and Volunteer 	State	Localand	A. Number of InitialTrainings for New SHIP Counselors
Staff And Hours As of 31March 	Office	Field Sites	Total	B.Number of New SHIP Counselors Attending Initial Trainings
A. Number of Volunteer Other Staff 	C. Total Number of Counselor Hours in Initial Trainings
B. Number of SHIP-Paid Other Staff	D. Number of UpdateTrainings for SHIP Counselors
C. Number of In-Kind-Paid Other Staff	E.Number of SHIP Counselors Attending Update Trainings
TotalNumber of Other Staff-  A+B+C	F.Total Number of Counselor Hours in Update Trainings
D. Volunteer Other Staff Hours	NoteItem E should representthe number (unduplicated) of counselors who
E.SHIP-Paid Other Staff Hours	attended atIeast oneupdate training during the full12 month period. F.In-Kind-Paid Other Staff Hours	Please do not count a counselor more than once,even if he/she attended TotalOther Staff Hours - D+E+F	 multiple updatetrainings.

Counselor Race- Ethnicity	
1	Hispanic  Latino  or Spanish Origin	
2	White Non-Hispanic	
3	Black  African  American	
4	American Indian or Alaska Native	
5	Asian Indian	
6	Chinese	
7	Filipino	
8	Japanese	
9	Korean	
10	Vietnamese	
11	Native  Hawaiian	
12	Guamanian  or Chamorro	
13	Samoan	
14	Other  Asian	
15	Other  Pacific Islander	
16	Some Other  Race-Ethnicitv	
17	More Than One Race-Ethnicitv	
99	Not Collected	

Counselor Disability	
1	Disabled	
2	Not Disabled	
9	Not Collected	

Counselor Speaks Another language	
1	Language Other Than English		
2	English Speaker Only		
9	Not Collected		

Section 5- Number of TotalActive Counselors (SHIP-Paid,In-Kind-Paid,and Volunteer Counselors) with the Following Characteristics

Years of SHIP Service		
1	Less Than 1Year		
2	1Year Up to 3 Years		
3	3 Years Up to 5 Years		
4	More Than 5 Years		
9	Not Collected		

Counselor Age			
1	Less Than 65 Years of Age			
2	65 Years or Older			
9	Not Collected			

Counselor Gender	
1	Female		
2	Male		
9	Not Collected		

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