Form 1 NAT TABLE 1

Table 1 - NAT: Enrollment, Traineeship Support, Graduates, Graduates Supported and Projected Data

When completing the application electronically, ensure that you select the correct Current Fiscal Year prior to inputting any data. You must select the correct Current Fiscal Year (20XX) as the dates will dynamically be displayed based on the fiscal year selection.

Complete Table 1 summarizing student enrollment, trainee/ student support, graduates, graduates supported and projected student enrollment. Instructions for completing Table 1 are below.

Students	Total # of Full- time Students Enrolled (As of 10/15/XX)	Total # of Students Supported (07/01/XX - 06/30/XX)	Total # of Graduates (07/01/XX - 06/30/XX)	Total # of Graduates Supported (07/01/XX - 06/30/XX)	Projected Students by 10/15/20XX
# Master’s Students
# Doctoral Students
GRAND TOTAL

OMB Number (0915-0374) and Expiration date (1/31/2017)

RENEWAL

Instructions for Completing Table 1 - NAT:

IMPORTANT NOTES:

• All applicants must complete this table.

• Do not make any changes to this table.

• When completing the application on-line, ensure that you select the correct Current Fiscal Year prior to inputting any data.

• Students - must not be counted as both an Enrollee and a Graduate.

• Enrollees – Students that are enrolled in a Nurse Anesthetist Program and have not graduated or completed the program by 10/15/XX. Enrollees means the total number of students in the Nurse Anesthetist Program (whether supported or not supported with Bureau of Health Workforce Nurse Anesthetist Traineeship funds).

• Students Supported - Students who actually received NAT support from 07/01/XX- 06/30/XX and did not graduate, under "STUDENTS SUPPORTED BY TRAINEESHIPS."

• Graduates – Students who have successfully completed all educational requirements for the Nurse Anesthetist Program between 07/01/XX-06/30/XX. Graduate means the total number of those who graduated from the Nurse Anesthetist Traineeship Program (whether supported or not supported with Bureau of Health Workforce Nurse Anesthetist Traineeship funds).

• Graduates Supported - Students who actually received traineeship support from 07/01/XX- 06/30/XX and graduated, under "TOTAL # OF GRADUATES SUPPORTED".

• For “Total # of Full-time Students Enrolled”, enter the total number of NAT full-time students (Master’s and Doctoral) enrolled as of 10/15/20XX.

• For “Total # of Students Supported”, enter the total number of NAT students (Master’s and Doctoral) enrolled as of 10/15/20XX who received Bureau of Health Workforce NAT support. Of those enrollees The “Total # of Students Supported” must be equal to or less than the “Total Number of Full-time Students Enrolled”.

• For “Total # of Graduates”, enter the total number of NAT graduates (Master’s and Doctoral) who completed degree requirements between 07/01/XX-06/30/XX. If this is a new program, enter “0" in the “Total # of Graduates” column.

• For “Total # of Graduates Supported”, enter the total number of NAT graduates (Master’s and Doctoral) who received NAT support and completed degree requirements between 07/01/XX-06/20/XX. If this is a new program, enter “0" in the “Total # of NAT Graduates” column. The “Total # of Graduates Supported” must be equal to or less than the “Total Number of Graduates”.

• For “Total # of Projected Students”, enter the total number of Master’s and Doctoral students projected to enroll by October 15, 20XX.

• For “Grand Total”, the Grand Totals for each column will be automatically calculated by the electronic system.

OMB Number (0915-0374) and Expiration date (1/31/2017)

RENEWAL