RDE Explanation

Attachment H1

Research in Disabilities Education (RDE)

Monitoring System

Table of Contents

RDE: Crosswalk – Alliance Track 3

RDE: Number of Respondents, Frequency of Response, and Annual Hour Burden 91

RDE: Hour Burden Estimates by Each Form and Aggregate Hour Burdens 92

RDE: Estimates of Annualized Cost to Respondents for the Burden Hours 93

RDE: Estimates of Costs to the Federal Government 94

RDE: Questions – Alliance Track 95

RDE: Crosswalk – Alliance Track

New Element	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	Award Track NSF Award Number Award Title Principal Investigator Primary Institution Award Start Date Award End 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	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
	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 - 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
	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
		School declined to report	X
		Project declined to report	X
	Ethnicity
		Hispanic or Latino	X
		Not Hispanic or Latino	X
		School 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 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. 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
		School district declined to report	X
		Project declined to report	X
	Ethnicity
		Hispanic or Latino	X
		Not Hispanic or Latino	X
		School district 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 district 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	Maiden name	X
	1-1f	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. Fields
	2	-Indicate the field(s) in which this person worked during the reporting period: <extensive list>	X
Select at least one project roe for this person:	3. Project Roles
	3-1	Employment title (during the reporting period)	X
		Select at least one project role for this person for the reporting period:	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 (as of the reporting period): -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 (as of the reporting period): -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	Did this person have a condition during the reporting period? -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 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 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 during the reporting period? -Yes -No		X
	6-1b	If yes, whom did this person mentor during the reporting period? (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 the 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 during the reporting period? -Yes -No		X
	6-2b	If yes, what kind of mentor(s) did they have during the reporting period? (Select all that apply.) -Faculty/staff members -Industry/business members		X
	6-2c	Approximately how many mentoring sessions did this person receive during the 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 during the reporting period? -Yes –No		X
	6-3b	If yes, whom did this person tutor during the reporting period? (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 the reporting period?		X
	7. Learning Experiences
	Learning Community Experiences
	7-1a	Did this person participate in a student learning community sponsored by this project during the reporting period? -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 during the reporting period? -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 during the reporting period? -Yes -No		X
	7-2b	If yes, how many trainings were provided?		X
	7-2c	Did this person receive UDL trainings during the reporting period? -Yes -No		X
	7-2d	If yes, how many trainings were received during the reporting period?		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	Maiden name
	1-1f	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
	Permanent Contact Information
	1-4a	Permanent address line 1	X
	1-4b	Permanent address line 2	X
	1-4c	Permanent address line 3	X
	1-4d	Permanent city	X
	1-4e	Permanent State: <dropdown list>	X
	1-4f	Permanent ZIP Code	X
	1-4g	Permanent country: <dropdown list>	X
	1-5a	Permanent phone number & Extension	X
	1-5b	Permanent e-mail address	X
	1-5c	Cell phone number	X
	Current Contact Information
		The current contact information is the same as the student's permanent contact information.	X
	1-6a	Current address line 1	X
	1-6b	Current address line 2	X
	1-6c	Current address line 3	X
	1-6d	Current city	X
	1-6e	Current State: <dropdown list>	X
	1-6f	Current ZIP Code	X
	1-6g	Current country: <dropdown list>	X
	1-7a	Current phone number & Extension	X
	1-7b	Current e-mail address	X
	2. Student Information
	2-1	Student type (during the reporting period): -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 was a graduate or undergraduate student during the reporting period, indicate the student's major: <extensive list> This student has not declared an academic major as of the reporting period. (Undergraduate students only.)	X
		Questions 2-3 through 2-4 are required for high school, undergraduate, and graduate students.
	2-3a	What degree or certification was this student pursuing during the reporting period? -None -Certificate of completion -High school diploma -Associate's degree -Baccalaureate degree -Master's degree -Ph.D.	X
	2-3b	As of August 31, 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 -Master’s 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 (as of the reporting period): -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 (as of the reporting period): -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	Did this person have a condition during the reporting period? -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 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 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 during the reporting period? (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 during the reporting period?		X
	5. Mentoring and Tutoring
	Activity as a Mentor
	5-1a	Did this person serve as a mentor during the reporting period? -Yes -No		X
	5-1b	If yes, whom did this person mentor during the reporting period? (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 the 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 during the reporting period? -Yes -No		X
	5-2b	If yes, what kind of mentor(s) did they have during the reporting period? (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 the 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 during the reporting period? -Yes -No		X
	5-3b	If yes, whom did this person tutor during the reporting period? (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 the reporting period?		X
	Activity for Receiving Tutoring
	5-4a	Did this person receive tutoring during the reporting period? -Yes -No		X
	5-4b	If yes, what kind of tutor(s) did this person have during the reporting period? (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 the reporting period?		X
	6. Learning Experiences
	Learning Community Experiences
	6-1a	Did this person participate in a student learning community sponsored by this project during the reporting period? -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 during the reporting period? -Yes -No		X
	6-2b	If yes, how many trainings were provided during the reporting period?		X
	6-2c	Did this person receive UDL trainings during the reporting period? -Yes -No		X
	6-2d	If yes, how many trainings were received during the reporting period?		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 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 reporting period.		X
	8-1e	Non-award stipend amount provided to this person during the 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,: ___ 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	Maiden Name
	1-1f	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	Indicate the field(s) in which this person worked during the reporting period: <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 (as of the reporting period): -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 (as of the reporting period): -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	Did this person have a condition during the reporting period? -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 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 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 during the reporting period? -Yes -No		X
	5-1b	If yes, whom did this person mentor during the reporting period? (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 the 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 during the reporting period? -Yes -No		X
	5-2b	If yes, what kind of mentor(s) did they have during the reporting period? (Select all that apply.) -Faculty/staff members -Industry/business members		X
	5-2c	Approximately how many mentoring sessions did this person receive during the 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 during the reporting period? -Yes -No		X
	5-3b	If yes, whom did this person tutor during the reporting period? (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 the reporting period?		X
	6. Learning Experiences
	Learning Experiences
	6-1a	Did this person participate in a student learning community sponsored by this project during the reporting period? -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 during the reporting period? -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 during the reporting period? -Yes -No		X
	6-2b	If yes, how many trainings were provided during the reporting period?		X
	6-2c	Did this person receive UDL trainings during the reporting period? -Yes -No		X
	6-2d	If yes, how many trainings were received during the reporting period?		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 the 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 reporting period		X
	8-1d	Non-award stipend amount provided to this person during the 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	Maiden Name	X
	1-1f	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 during the reporting period: -High school teacher -Middle/junior high school teacher -Elementary school teacher -Pre–K teacher -K-12 administrator -K-12 guidance counselor -K-12 teaching assistant	X
	2-2	Teaching Specialty during the reporting period: (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 (as of the reporting period): -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 (as of the reporting period): -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	Did this person have a condition during the reporting period? -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 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 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 during the reporting period? -Yes -No		X
	5-1b	If yes, whom did this person mentor during the reporting period? (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 the 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 during the reporting period? -Yes -No		X
	5-2b	If yes, what kind of mentor(s) did they have during the reporting period? (Select all that apply.) -Faculty/staff members -Industry/business members		X
	5-2c	Approximately how many mentoring sessions did this person receive during the 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 during the reporting period? -Yes -No		X
	5-3b	If yes, whom did this person tutor during the reporting period? (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 the reporting period?		X
	6. Learning Experiences
	Learning Community Experiences
	6-1a	Did this person participate in a student learning community sponsored by this project during the reporting period? -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 during the reporting period? -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 during the reporting period? -Yes -No		X
	6-2b	If yes, how many trainings were provided during the reporting period?		X
	6-2c	Did this person receive UDL trainings during the reporting period? -Yes -No		X
	6-2d	If yes, how many trainings were received during the reporting period?		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 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 reporting period:		X
	8-1d	Non-award stipend amount provided to this person during the 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	Maiden Name	X
	1-1f	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 during the reporting period: -Community organization representative -Externship/internship mentor -Industry representative	X
	2-2	-Indicate the field(s) in which this person worked during the reporting period: <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 (as of the reporting period): -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 (as of the reporting period): -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	Did this person have a condition during the reporting period? -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 during the reporting period? -Yes -No		X
	5-1b	If yes, whom did this person mentor during the reporting period? (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 the 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 during the reporting period? -Yes -No		X
	5-2b	If yes, whom did this person tutor during the reporting period? (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 the reporting period?		X
	6. Learning Experiences
	Learning Community Experiences
	6-1a	Did this person participate in a student learning community sponsored by this project during the reporting period? -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 during the reporting period? -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 during the reporting period? -Yes -No		X
	6-2b	If yes, how many trainings were provided during the reporting period?		X
	6-2c	Did this person receive UDL trainings during the reporting period? -Yes -No		X
	6-2d	If yes, how many trainings were received during the reporting period?		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 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 reporting period:		X
	8-1d	Non-award stipend amount provided to this person during the 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
X	5	Was this publication created with personnel from other NSF RDE award(s)? -Yes -No			X
X	6	Other NSF RDE award(s) that collaborated in creating this publication			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
X	6	Presentation date			X
X	7	Location of presentation			X
X	8	Was this presentation created with personnel from other NSF RDE award(s)? -Yes -No			X
X	9	Other NSF RDE award(s) that collaborated in creating this presentation			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 during the reporting period?			X
	3b	Who were the primary users of this tool? (Select all that apply.) -STEM faculty -Educators, general -Educators, special education -STEM professionals -General public -K-12 students -Post-secondary students			X
X	4	Was this tool or method created in collaboration with personnel from other NSF RDE award(s)? -Yes -No			X
X	5	Other NSF RDE award(s) that collaborated in creating this new tool or method.			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 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
X	6	Was this online resource created in collaboration with personnel from other NSF RDE award(s)?			X
X	7	Other NSF RDE award(s) that collaborated in creating this online resource.			X
	Additional Proposals
	1	Proposal title			X
	2	Funding organization: Federal Government organization -National Institutes of Health -National Oceanic and Atmospheric Administration -National Science Foundation -U.S. Department of Education -U.S. Department of Energy -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
X	5	Was this proposal created in collaboration with personnel from other NSF RDE award(s)?			X
X	6	Other NSF RDE award(s) that collaborated in creating this proposal			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
X		Was this highlight created in collaboration with personnel from other NSF RDE award(s)?			X
X		Other NSF RDE award(s) that collaborated in creating this highlight			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 data collection instrument or process and any notes about your data		X	X

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

The estimated average number of annual respondents is 12, with an estimated average annual response burden of 1,368 hours. The Web-based collection is an annual activity of the RDE program. Respondents are PIs; one PI per award completes the survey. There are currently 12 RDE Alliance awards. Moving forward, data will only be collected from Alliance awards. No new Alliance awards will be added, thus, the number of respondents will decline over time. The estimated average annual hour burden per respondent was determined using the burden information reported by respondents in the past three 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	12	114	1,368
Total	12		1,368

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

As mentioned above, respondents are award PIs and only Alliance awards are reporting data. There is now only one form. The annual burden by form was calculated as follows:

Form Type	Respondent Type	No. of Respondents	Burden Hours Per Respondent	Total Burden Hours
RDE data collection form	PIs	12	114	1,368
Total		12		1,368

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

The overall annualized cost to the respondents is estimated to be $57,456. The following table shows the annualized estimates of costs to PI respondents, who are generally university professors. The estimated hourly rate is based on a report from the American Association of University Professors, “Annual Report on the Economic Status of the Profession, 2014-15,” Academe, March–April 2015, Survey Report Table 4. According to this report, the average salary across all academic ranks and across all types of doctoral-granting institutions (public, private-independent, religiously affiliated) was $87,838. When divided by the number of standard annual work hours (2,080), this calculates to approximately $42 per hour.

Respondent Type	No. of Respondents	Burden Hours Per Respondent	Average Hourly Rate	Estimated Annual Cost
PIs	12	114	$42	$57,456
Total	12			$57,456

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 the most recent year and calculating the costs for each of the following operational activities involved in producing, maintaining, and conducting the 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)	$441,298
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)	$190,364
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)	$233,628
Three-Year Total for All Operational Activities	$865,291

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 $288,430.

RDE: Questions – Alliance Track

		Sections/Questions		Data Elements
		Alliance Award
		Award Details
		1. Verify Award Details - NSF Award Data
		1		Award Track NSF Award Number Award Title Principal Investigator Primary Institution Award Start Date Award End 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
		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
		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 -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?
		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
				School declined to report
				Project declined to report
		Ethnicity
				Hispanic or Latino
				Not Hispanic or Latino
				School 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 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. 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
				School district declined to report
				Project declined to report
		Ethnicity
				Hispanic or Latino
				Not Hispanic or Latino
				School district 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 district 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		Maiden Name
		1-1f		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. Fields
		2		- Indicate the field(s) in which this person worked during the reporting period: <extensive list>
Select at least one project roe for this person:		3. Project Roles
		3-1		Employment title (during the reporting period)
				Select at least one project role for this person for the reporting period:
				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 (as of the reporting period): -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 (as of the reporting period): -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		Did this person have a condition during the reporting period? -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 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 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 during the reporting period? -Yes -No
	6-1b		If yes, whom did this person mentor during the reporting period? (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 the 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 during the reporting period? -Yes -No
	6-2b		If yes, what kind of mentor(s) did they have during the reporting period? (Select all that apply.) -Faculty/staff members -Industry/business members
	6-2c		Approximately how many mentoring sessions did this person receive during the 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 during the reporting period? -Yes -No
	6-3b		If yes, whom did this person tutor during the reporting period? (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 the reporting period during the reporting period?
	7. Learning Experiences
	Learning Community Experiences
	7-1a		Did this person participate in a student learning community sponsored by this project during the reporting period? -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 during the reporting period? -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 during the reporting period? -Yes -No
	7-2b		If yes, how many trainings were provided during the reporting period?
	7-2c		Did this person receive UDL trainings during the reporting period? -Yes -No
	7-2d		If yes, how many trainings were received during the reporting period?
	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		Maiden Name
	1-1f		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:
	Permanent Contact Information
	1-4a		Permanent address line 1
	1-4b		Permanent address line 2
	1-4c		Permanent address line 3
	1-4d		Permanent city
	1-4e		Permanent State: <dropdown list>
	1-4f		Permanent ZIP Code
	1-4g		Permanent country: <dropdown list>
	1-5a		Permanent phone number & Extension
	1-5b		Permanent e-mail address
	1-5c		Cell phone number
	Current Contact Information
			The current contact information is the same as the student's permanent contact information.
	1-6a		Current address line 1
	1-6b		Current address line 2
	1-6c		Current address line 3
	1-6d		Current city
	1-6e		Current State: <dropdown list>
	1-6f		Current ZIP Code
	1-6g		Current country: <dropdown list>
	1-7a		Current phone number & Extension
	1-7b		Current e-mail address
	2. Student Information
	2-1		Student type during the reporting period: -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 was a graduate or undergraduate student during the reporting period, indicate the student's major: <extensive list> This student had not declared an academic major as of the reporting period. (Undergraduate students only.)
			Questions 2-3 through 2-4 are required for high school, undergraduate, and graduate students.
	2-3a		What degree or certification was this student pursuing during the reporting period? -None -Certificate of completion -High school diploma -Associate's degree -Baccalaureate degree -Master's degree -Ph.D.
	2-3b		As of August 31, 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 during the reporting period? -Certificate of completion -High school diploma -Associate's degree -Baccalaureate degree -Master’s 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 (as of the reporting period): -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 (as of the reporting period): -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		Did this person have a condition during the reporting period? -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 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 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 during the reporting period? (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 during the reporting period?
	5. Mentoring and Tutoring
	Activity as a Mentor
	5-1a		Did this person serve as a mentor during the reporting period? -Yes -No
	5-1b		If yes, whom did this person mentor during the reporting period? (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 the 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 during the reporting period? -Yes -No
	5-2b		If yes, what kind of mentor(s) did they have during the reporting period? (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 the 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 during the reporting period? -Yes -No
	5-3b		If yes, whom did this person tutor during the reporting period? (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 the reporting period?
	Activity for Receiving Tutoring
	5-4a		Did this person receive tutoring during the reporting period? -Yes -No
	5-4b		If yes, what kind of tutor(s) did this person have during the reporting period? (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 the reporting period?
	6. Learning Experiences
	Learning Community Experiences
	6-1a		Did this person participate in a student learning community sponsored by this project during the reporting period? -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 during the reporting period? -Yes -No
	6-2b		If yes, how many trainings were provided during the reporting period?
	6-2c		Did this person receive UDL trainings during the reporting period? -Yes -No
	6-2d		If yes, how many trainings were received during the reporting period?
	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 the 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 reporting period:
	8-1e		Non-award stipend amount provided to this person during the 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,: ___ 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		Maiden Name
	1-1f		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 during the reporting period: -College/university faculty -College/university administrator -College/university staff
	2-2		Indicate the field(s) in which this person worked during the reporting period: <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 (as of the reporting period): -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 (as of the reporting period): -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		Did this person have a condition during the reporting period? -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 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 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 during the reporting period? -Yes -No
	5-1b		If yes, whom did this person mentor during the reporting period? (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 the 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 during the reporting period? -Yes -No
	5-2b		If yes, what kind of mentor(s) did they have during the reporting period? (Select all that apply.) -Faculty/staff members -Industry/business members
	5-2c		Approximately how many mentoring sessions did this person receive during the 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 during the reporting period? -Yes -No
	5-3b		If yes, whom did this person tutor during the reporting period? (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 the reporting period?
	6. Learning Experiences
	Learning Experiences
	6-1a		Did this person participate in a student learning community sponsored by this project during the reporting period? -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 during the reporting period? -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 during the reporting period? -Yes -No
	6-2b		If yes, how many trainings were provided?
	6-2c		Did this person receive UDL trainings during the reporting period? -Yes -No
	6-2d		If yes, how many trainings were received during the reporting period?
	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 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 reporting period
	8-1d		Non-award stipend amount provided to this person during the 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		Maiden Name
	1-1f		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 during the reporting period: -High school teacher -Middle/junior high school teacher -Elementary school teacher -Pre–K teacher -K-12 administrator -K-12 guidance counselor -K-12 teaching assistant
	2-2		Teaching Specialty during the reporting period: (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 (as of the reporting period): -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 (as of the reporting period): -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		Did this person have a condition during the reporting period? -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 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 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 during the reporting period? -Yes -No
	5-1b		If yes, whom did this person mentor during the reporting period? (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 the 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 during the reporting period? -Yes -No
	5-2b		If yes, what kind of mentor(s) did they have during the reporting period? (Select all that apply.) -Faculty/staff members -Industry/business members
	5-2c		Approximately how many mentoring sessions did this person receive during the 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 during the reporting period? -Yes -No
	5-3b		If yes, whom did this person tutor during the reporting period? (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 the reporting period?
	6. Learning Experiences
	Learning Community Experiences
	6-1a		Did this person participate in a student learning community sponsored by this project during the reporting period? -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 during the reporting period? -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 during the reporting period? -Yes -No
	6-2b		If yes, how many trainings were provided during the reporting period?
	6-2c		Did this person receive UDL trainings during the reporting period? -Yes -No
	6-2d		If yes, how many trainings were received during the reporting period?
	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 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 reporting period:
	8-1d		Non-award stipend amount provided to this person during the 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		Maiden Name
	1-1f		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 during the reporting period: -Community organization representative -Externship/internship mentor -Industry representative
	2-2		Indicate the field(s) in which this person worked during the reporting period: <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 (as of the reporting period): -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 (as of the reporting period): -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		Did this person have a condition during the reporting period? -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 during the reporting period? -Yes -No
	5-1b		If yes, whom did this person mentor during the reporting period? (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 the 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 during the reporting period? -Yes -No
	5-2b		If yes, whom did this person tutor during the reporting period? (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 the reporting period?
	6. Learning Experiences
	Learning Community Experiences
	6-1a		Did this person participate in a student learning community sponsored by this project during the reporting period? -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 during the reporting period? -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 during the reporting period? -Yes -No
	6-2b		If yes, how many trainings were provided during the reporting period?
	6-2c		Did this person receive UDL trainings during the reporting period? -Yes -No
	6-2d		If yes, how many trainings were received during the reporting period?
	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 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 reporting period:
	8-1d		Non-award stipend amount provided to this person during the 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
X	5		Was this publication created in collaboration with personnel from other NSF RDE award(s)? -Yes -No
X	6		Other NSF RDE award(s) that collaborated in creating this publication
	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
X	6		Presentation date
X	7		Location of presentation
X	6		Was this presentation created in collaboration with personnel from other NSF RDE award(s)? -Yes -No
X	7		Other NSF RDE award(s) that collaborated in creating this presentation
	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 during the reporting period?
	3b		Who were the primary users of this tool? (Select all that apply.) -STEM faculty -Educators, general -Educators, special education -STEM professionals -General public -K-12 students -Post-secondary students
X	4		Was this tool or method created in collaboration with personnel from the other NSF RDE award(s)? -Yes -No
X	5		Other NSF RDE award(s) that collaborated in creating this new tool or method
	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 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:
X	6		Was this online resource created in collaboration with personnel from other NSF RDE award(s)? -Yes -No
X	7		Other NSF RDE award(s) that collaborated in creating this online resource
	Additional Proposals
	1		Proposal title
	2		Funding organization: Federal Government organization -National Institutes of Health -National Oceanic and Atmospheric Administration -National Science Foundation -U.S. Department of Education -U.S. Department of Energy -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
X	5		Was this proposal created in collaboration with personnel from other NSF RDE award(s)? -Yes -No
X	6		Other NSF RDE award(s) that collaborated in creating this proposal
	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.
X			Was this highlight created in collaboration with personnel from other NSF RDE award(s)? -Yes -No
X			Other NSF RDE award(s) that collaborated in creating this highlight
	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 data collection instrument or process and any notes about your data

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, and 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.

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