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 | Grantee Name: | Write here | 
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 | Grant Year: | 
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 | PR Number: | Write here | 
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 | Reporting Period: | 
	
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		| High School Equivalency Program | 
	
		| U.S. Department of Education | 
	
		| Annual Performance Report and Final Performance Report | 
	
		| Data Form | 
	
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		| A. | HEP Project Statistics and Reporting for GPRA | 
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		| Reporting Block, Item A1 | 
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		| A1. | Number of students served during the reporting period. | 
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		| a. | Number funded to be served | 
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		| b. | Number served in HEP HSE instruction (note: A1b1 + A1b2 should sum to equal A1b) | 
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		| 1 | Number served who were new participants (first year in HEP) (subset of A1b) | 
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		| 2 | Number served who were returning participants  (subset of A1b) | 
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		| Reporting Block, Item A2 | 
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		| A2. | Status at the end of the reporting period. | 
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 | (Note: A2a-c should sum to equal the number reported in A1b(no. served)). | 
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		| a. | Number of HSE attainers. (Obj. 1 National Target: 69%) (GPRA 1) | 
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 | *Supporting documentation required.  See instructions for Item A2.   Ensure that you include the  attainers in A1b3 in this count. | 
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		| 1 | Number of HSE attainers who were new participants. | 
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		| 2 | Number of HSE attainers who were returning participants. | 
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		| 3 | Number of HSE attainers who passed the HSE assessment in  the English Language. | 
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		| 4 | Number of HSE attainers who passed the HSE assessment in  the Spanish Language. | 
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		| 5 | Number of HSE attainers who passed the HSE assessment in a language other than English or Spanish. | 
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		| b. | Number of withdrawals | 
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		| 1 | Number of withdrawals who were new participants. | 
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		| 2 | Number of withdrawals who were returning participants. | 
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		| c. | Number of persisters (came back to continue in the subsequent budget period; persisters | 
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 | were enrolled in instructional services in the current reporting period  but did not yet achieve | 
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 | a HSE and have returned by APR due date of the subsequent budget period to continue | 
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 | instructional services) | 
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 | Your data input accuracy result | Good Job | Good Job | Good Job | Good Job | Good Job | 
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		| Reporting Block, Item A3 | 
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		| A3. | Placement of HSE attainers (from question A2a above) from the current reporting period by | 
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 | APR due date | 
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		| a. | Unduplicated number of HSE attainers who entered postsecondary education or training | 
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 | 0 | 0 | 0 | 0 | 0 | 
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 | programs, upgraded employment, or the military (count each participant only once for this | 
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 | in A2a above, and should equal the sum of A3a 1-3) (Obj. 2 National Target: 80%) (GPRA 2) | 
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		| 1 | Number of HSE attainers who entered postsecondary education or training programs | 
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		| 2 | Number of HSE attainers who obtained upgraded employment | 
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		| 3 | Number of HSE attainers who entered the military | 
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		| Reporting Block, Item A4 | 
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		| A4. | Follow-up on HSE attainers from the reporting period. | 
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		| a. | Number of HSE attainers you were able to track for follow-up data | 
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		| Reporting Block, Item A5 | 
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		| A5. | Time to completion for HSE attainers from question A2a above.  (Note: A5a-c should sum to | 
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 | equal the number reported in A2a.) | 
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		| a. | Number of HSE attainers who got their HSE within one reporting period of your project | 
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		| b. | Number of HSE attainers who got their HSE after more than one, but within two reporting | 
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 | periods of your project | 
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		| c. | Number of HSE attainers who got their HSE after more than two reporting periods                               of your project | 
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 | Your data input accuracy result | Good Job | Good Job | Good Job | Good Job | Good Job | 
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		| Reporting Block, Item A6 | 
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 | Performance Calculation Table | 
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 | Current Performance Period | 
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		| Annual Award Amount | 
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		| GPRA Measure 1 | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 
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		| GPRA Measure 2 | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 
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		| Success efficiency ratio | $0 | $0 | $0 | $0 | $0 | 
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 | Grantee Name: | Write here | 
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 | Grant Year: | 
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 | PR Number: | Write here | 
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 | Reporting Period: | 
	
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		| B. | HEP Project Student Participant Information | 
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		| Reporting Block, Item B1 | 
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		| B1 | Instruction and services received by HEP HSE enrolled students during the reporting period. | Y1 | Y2 | Y3 | Y4 | Y5 | 
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		| a. | Total HSE instruction hours received by all HEP HSE enrolled students.₁ | 
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		| b. | Total HSE instruction hours received by HSE attainers. | 
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		| c. | Total number of students receiving the following types of services: ₂ | 
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		| Instructional Support Services | 
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		| Please indicate the number of students receiving instructional support services. | 
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		| 1 | Tutoring | 
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		| 2 | Mentoring or coaching | 
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		| 3 | College transition services | 
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		| 4 | Work training services | 
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		| 5 | Job placement services | 
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		| 6 | Counseling or guidance services | 
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		| 7 | Transportation services/ financial support for transportation | 
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		| 8 | Child care | 
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		| 9 | Financial support | 
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 | a. Tuition | 
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 | b. Books and materials | 
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 | c. Room and board | 
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 | d. Stipends | 
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		| 10 | Other support services: ______________________ | 
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		| Reporting Block, Item B2 | 
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		| B2 | Characteristics of the HEP HSE enrolled students during the reporting period. | 
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 | (Note: [B2a +  B2b should equal the number reported in A1b] and | 
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 | [B2c + B2d should  equal the number reported in A1b]). | 
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		| a. | Number of students who are male | 
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		| b. | Number of students who are female | 
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		| c. | Number of students who are 21 years old or younger | 
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		| d. | Number of students who are over 21 years old | 
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 | 0 | 0 | 0 | 0 | 0 | 
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		| ₁ The program office will take aggregated information and determine mean and median values for instructional hours within and | 
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		| across program models.  These data will be used to determine the most positive outcomes of program models.  Proficiency level | 
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		| will be established, if it is measured, through item C4a. | 
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		| ₂ Item B1c requires grantees to report whether or not a student has received a service in any quantity. The total hours received or | 
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		| total number should not be reported here. | 
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 | Grantee Name: | Write here | 
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 | Grant Year: | 
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 | PR Number: | Write here | 
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 | Reporting Period: | 
	
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		| C. | HEP Project Services Information | 
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		| Reporting Block, Item C1 | 
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		| C1. | Project Model Characteristics during the Reporting Period | 
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		| a. | Report the number of commuter students. (A commuter student is a student | 
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		| who does not live in IHE-funded housing.) | 
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		| b. | Report the number of residential students. (A residential student is a student | 
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		| who lives in IHE-funded housing.) | 
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		| c. | Does this project provide open enrollment or structured enrollment? | 
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		| d. | In what languages are project services provided? (Check all that apply.) | 
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		| e. | Is this project in a four-year or two-year educational institution, or in a non-profit organization? | 
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		| f. | Is the project in an institution that uses a semester, quarter, or trimester academic calendar? | 
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		| Reporting Block, Item C2 | 
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		| C2. | Project Personnel Characteristics during the Reporting Period | 
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		| a. | Number of FTE teaching staff funded by the HEP grant to provide HSE instruction | 
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		| b. | Number of FTE teaching staff contributing to the project, not funded by the HEP grant | 
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		| c. | Number of FTE instructional support staff (tutors, coaches, mentors) funded by the HEP grant | 
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 | to provide HSE instruction | 
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		| d. | Number of FTE instructional support staff contributing to the project, not funded by the | 
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 | HEP grant | 
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		| Reporting Block, Item C3 | 
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		| C3. | Project HEP HSE Instructional Services Offered during the Reporting Period | 
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		| a. | How frequently are HSE instructional services provided? Check the option that best describes | 
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		| the frequency of instructional services.  If your program has both part time and full time | 
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		| options, please check the box that best describes the majority of your program students. | 
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		| b. | Average length of instructional service per individual instructional session, in | 
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 | hours. (Provide the average length of instructional service that the majority of | 
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 | students participate in). | 
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		| c. | Average length of instructional service per semester, in days.  (Provide the average length | 
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		| Reporting Block, Item C4 | 
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		| C4. | Project Student Assessment Information Related to this Reporting Period | 
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		| a. | Does your project screen students prior to enrollment in HEP HSE instructional services | 
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 | services to establish whether they are above or below a proficiency threshold? (Check one)₃ | 
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		| 
 | If “No,” skip to Section D. | 
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		| 1 | If your project uses a screening or intake assessment to establish a proficiency threshold, | 
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		| 
 | what is your project proficiency threshold for accepting students into HEP HSE instructional | 
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 | Scale/Standard Score _________ | 
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		| 
 | services? (Only check “no assessment” if proficiency is determined without the use of a | 
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 | _______ | 
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		| 
 | formal assessment). | 
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		| 2 | What kind of screening or intake assessment is used?  (If not a published assessment, | 
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 | please check “Other,” provide the title and the program office with a copy of the assessment | 
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 | used). | 
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		| 3 | What was the average screening or intake MATH scale/standard score for this reporting | 
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 | period? | 
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		| 4 | What was the average screening or intake READING scale/standard score for this reporting | 
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 | period? | 
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		| b. | Which HSE assessment(s) does your project use? | 
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		| ₃ | The program office is asking if the project currently collects intake screening data; | 
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 | projects that do not collect intake data will not be required to do so. | 
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 | Grantee Name: | Write here | 
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 | PR Number: | Write here | 
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		| E. | HEP Project Budget Information (see instructions) | 
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		| E1 | Report section E1 (narratives) in MS Word | 
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		| E2 | Report section E2 in the following Table and in the space below | 
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		| 2 | Report in column (a) carryover funds in their correct category amounts from the previous budget period, | 
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 | in column (b) the recommended funds, by budget category, for the current budget period, | 
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 | in column (c), the total revised budget amounts (using  your approved, revised budget as in your ED524 Form), | 
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 | and by adding the previous year's carryover in column (a) with the recommended amount in column (b), in each budget category, and | 
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 | in column (d), your project’s actual expenditures for this reporting period. | 
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		| 
 | Budget Categories | Proposed Expenditures | Actual  Expenditures | 
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 | (a) Carryover from Previous Budget Period | (b) Recommended Amount | (c) Total Approved, Revised Budget Amounts | (d) Actual Expenditure Amounts | 
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 | 1 | Personnel | 
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 | $0.00 | 
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 | 2 | Fringe Benefit | 
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 | $0.00 | 
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 | 3 | Travel | 
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 | $0.00 | 
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 | 4 | Equipment | 
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 | 5 | Supplies | 
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 | 6 | Contractual | 
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 | $0.00 | 
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 | 7 | Construction | 
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 | 8 | Other | 
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		| 
 | 9 | Total Direct Costs (lines 1-8) | 
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 | $0.00 | $0.00 | $0.00 | $0.00 | 
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 | Your data input accuracy result | 
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 | Good Job | 
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		| 
 | 10 | Indirect Costs | 
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 | $0.00 | 
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 | Your data input accuracy result | 
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 | Good Job | 
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		| 
 | 11 | Training Stipends | 
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 | $0.00 | 
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 | 12 | Total Amounts (lines 9-11) | 
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 | $0.00 | $0.00 | $0.00 | $0.00 | 
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 | Your data input accuracy result | Good Job | 
 | Good Job | 
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		| 
 | Note: Remember to keep budget line items consistent.  For example, if you categorized student textbooks in | 
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 | the Stipend line item in your revised budget, payments for student textbooks must be categorized in the | 
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 | Stipend line item in the Actual Expenditures column. | 
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		| 1) | If the Revised Budget Amounts (Recommended + Carryover) and the Actual Expenditure Amounts are different, | 
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 | explain this difference. | 
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 | Write Here…. | 
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