| OMB Approval #: 2502-0567 | ||||||||||||||||
| Exp Date: 05/31/2020 | ||||||||||||||||
| I certify that the information provided on this form and in any accompanying documentation is true and accurate. I acknowledge that making, presenting, or submitting a false, fictitious, or fraudulent statement, representation, or certification may result in criminal, civil, and/or administrative sanctions, including fines, penalties, and imprisonment. | ||||||||||||||||
| “The Public Reporting Burden for this collection of information is estimated to average 102 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Reports Management Officer, Office of Information Policies and Systems, U.S. Department of Housing and Urban Development, Washington, DC 20410-3600 and to the Office of Management and Budget, Paperwork Reduction Project (2502-0567), Washington, DC 20503. Do not send this completed form to either of the above addresses. “HUD’s Office of Housing Counseling will use the information collected to evaluate and rank applications. The housing counseling training grant program provides training for housing counselors on a nation-wide basis. This information is required to be eligible for the grant award as authorized by Section 106 of the Housing and Urban Development Act of 1968 (12 U.S.C. 1701x) and Section 4 of the Department of Housing and Urban Development Act (42 U.S.C. 3533) as amended by Subtitle D – Office of Housing Counseling of Dodd-Frank Wall Street Reform and Consumer Protection Act. There are no assurances of confidentiality. HUD may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.” |
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| HUD-92910 All prior versions of this form are obsolete | ||||||||||||||||
| General Instructions for HUD-92910 |
| Applicants must provide completed Housing Counseling Training Charts as a required part of their application submission. There are six charts in this spreadsheet that must be completed in their entirety in order for applicants to receive full points. The completed charts and exhibits along with the narratives will constitute the basis for evaluating the application. |
| HUD-92910 All prior versions of this form are obsolete |
| Chart A - Past Performance | |||||||||||||
| Applicant Name: | |||||||||||||
| Instructions: List the number of training courses by delivery method that you and your applicant partners intend to provide during the period of performance stated in this Training NOFA. Use the following definitions for the three delivery methods: 1. In-Person: The course is provided to counselors in a face-to-face classroom setting. This includes place based training and national institute training. 2. Web-based: Online Non-Interactive: The course is provided to counselors electronically and does NOT allow for realtime instructor-counselor interaction. 3. Web-based: Online / Interactive: The course is provided to counselors electronically and allows for realtime instructor-counselor interaction. Column G - Performance Learning Checks Including an Examination: Indicate the number of courses with learning checks and examinations that will be required to pass the course NOTE: ALL DATA ENTERED BELOW IS NUMERIC. DO NOT ENTER X FOR ANY RESPONSE. Refer to NOFA for definition of Scholarships |
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| Delivery Method: In-Person Web-Based - •Online Non-Interactive • Online / Interactive |
Number of courses provided during the period of performance described in the TNOFA | Number of counselors trained during the period of performance described in the TNOFA | Number of courses that addressed Departmental Priorities (Example: Disaster, HECM Default) | Number of courses in which student satisfaction was measured | Number of courses in which learning checks were included in examination | Number of counselors by Delivery Method that include rural, lower income, persons of disabilities and other under-served and underrepresented | Number of courses provided in multiple languages | Average numbe of hours per Delivery Method | Number of scholarships provided to individuals with limited English proficiency, rural, lower income, persons with disabilities and other under-served and underrepresented | Total # of scholarships (all types with all funding) | Average cost per student by Delivery Method | ||
| In-Person | 5 | 125 | 15 | 5 | 4 | 25 | 5 | 8 | 3 | 75 | $750 | ||
| Online / Interactive | 7 | 60 | 5 | 3 | 3 | 15 | 3 | 6 | 7 | 20 | $150 | ||
| Online Non-Interactive | 15 | 240 | 4 | 7 | 7 | 10 | 7 | 3 | 10 | 40 | $75 | ||
| Chart B - Proposed Performance | ||||||||||||
| Applicant Name: | ||||||||||||
| Instructions: List the number of training courses by delivery method that you and your applicant partners intend to provide during the period of performance stated in this Training NOFA. Use the following definitions for the three delivery methods: 1. In-Person: The course is provided to counselors in a face-to-face classroom setting. This includes place based training and national institute training. 2. Web-based: Online Non-Interactive: The course is provided to counselors electronically and does NOT allow for realtime instructor-counselor interaction. 3. Web-based: Online / Interactive: The course is provided to counselors electronically and allows for realtime instructor-counselor interaction. Column G - Performance Learning Checks Including an Examination: Indicate the number of courses with learning checks and examinations that will be required to pass the course NOTE: ALL DATA ENTERED BELOW IS NUMERIC. DO NOT ENTER X FOR ANY RESPONSE. Refer to NOFA for definition of Scholarships |
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| Delivery Method: In-Person Web-Based - •Online Non-Interactive • Online / Interactive |
Number of courses proposed as described in the TNOFA | Number of counselors to be trained as described in the TNOFA | Number of courses that address Departmental Priorities (Example: Disaster, HECM Default) | Number of courses in which student satisfactiwill be measured | Number of courses in which learning checks are included in examination | Number of counselors projected by Delivery Method that include rural, lower income, persons of disabilities and other under served and underrepresented | Number of courses provided in multiple languages | Average number of hours per Delivery Method | Number of scholarships provided to individuals with limited English proficiency, rural, lower income, persons with disabilities and other under served and underrepresented |
Total # of scholarships (all types with all funding) | Average cost per student by Delivery Method | |
| In-Person | 5 | 125 | 15 | 5 | 4 | 25 | 5 | 8 | 15 | 75 | $750 | |
| Online / Interactive | 3 | 60 | 5 | 3 | 3 | 15 | 3 | 6 | 5 | 20 | $150 | |
| Online Non-Interactive | 7 | 240 | 4 | 7 | 7 | 10 | 7 | 3 | 30 | 40 | $75 | |
| Chart C - Budget | |||
| Applicant Name: | |||
| Instructions: Complete all applicable sections below with your actual expenditures | |||
| Actual Expenditures for the period of performance stated in this Training NOFA* | |||
| Expense Items | Actual Expenditures - grant funds | Actual Expenditures - all sources | |
| Staff Salaries | |||
| Staff Fringe Benefits | |||
| Consultant/Trainer Fees | |||
| Rent/Office | |||
| Rent/Training Venues | |||
| Travel/Consultant/Trainer | |||
| Travel/Staff | |||
| Total Amount of Scholarships | |||
| Equipment | |||
| Telephone/internet/Website | |||
| Delivery Services | |||
| Printing / Production of Class Materials | |||
| Other Expenses (describe)** or add lines if needed | |||
| Training Partners | |||
| Sub-grantee disbursments | |||
| Indirect Costs (indirect cost rate: ) | |||
| TOTAL EXPENDITURES | 0 | 0 | |
| Percent of HUD Grant Spent on Scholarships: | #DIV/0! | ||
| Notes: | |||
| *Applicants who did not receive a training grant should provide expendidtures from all other sources. | |||
| **Add budget items not listed in the "Other Expenses" line and describe in detail in the comments box. | |||
| HUD-92910 | |||
| All prior versions of this form are obsolete | |||
| Chart D - Leveraging | ||||||
| Applicant Name: | ||||||
| Instructions: Identify all non-federal leveraged resources available during the period of performance stated in the Training NOFA for the proposed work plan including subgrantee resources, if applicable. | ||||||
| Organization Providing Leveraged Funds/In-kind Contributions (include fees/program income) and Point of Contact | Type of Contribution (Cash, In-kind, fees) | Time Period Funds are Available | Commitment Letter in Hand (Not Pending) | Use of Funds | Amount of Funds | |
| EXAMPLES | ||||||
| ABC Intermediary | Fees | 10/1/XX - 9/30/XX | Pre-purchase education/certification class | $50,000 | ||
| Jane Dough Foundation/ John Dough (123) 456-7891 | Cash | 1/1/XX - 1/1/XX | on-line testing development | $10,000 | ||
| Chase Bank Foundation/ Penny Money (456) 789-1011 | Cash | 10/1/XX - 9/30/XX | x | Hsg Counselor Education Program | $7,500 | |
| City of Love/ Happy Giver (345) 678-9123 | In-Kind | 1/1/XX - 8/31/XX | x | Space for in-person classes | $12,000 | |
| HUD-92910 | ||||||
| All prior versions of this form are obsolete | ||||||
| Chart E - Training Partners | |||||||
| Applicant Name: | |||||||
| Instructions: In this section, identify training partners you worked with to provide place based training during the past period of performance and will work with during this period of performance stated in the Training NOFA. The amount of training partner contribution should be added to your agency leveraging (Chart D). See TNOFA details for definition of Training Partners | |||||||
| Partner Name | Type of Entity | Name of Contact at Entity | Contact Phone Number | Number of Events | Proposed amount of Training Partner contribution for upcoming period of performance | Past amount of Training Partner contribution for past performance period | |
| Example | |||||||
| City of Love | City Government | Happy Giver | (345) 678-9123 | 1 | $5,000.00 | $2,000.00 | |
| ABC Org | Local NP | Betty Boop | (234) 567-8901 | 2 | $10,000.00 | $0.00 | |
| HUD-92910 | |||||||
| All prior versions of this form are obsolete | |||||||
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |