Form No Form No. No Form No. Citizenship and Integration Direct Services Grant Progra

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Overview

Part I. Narrative
Part II. Individuals Served
Part III. Class Table

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Sheet 1: Part I. Narrative

Citizenship and Integration Grant Program

Quarterly Report

OMB Control Number: 1615-0140 Expiration Date: 01/31/2021 An agency may not conduct or sponsor an information collection, and a person is not required to respondto a collection of information, unless it displays a valid OMB Control Number. The public reporting burden for this after award report collection of information is 28 hours. This includes the time required for reviewing instructions and completing the form. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to U.S. Citizenship and Immigration Services, Regulatory Coordination Division, Office of Policy and Strategy, 20 Massachusetts Ave, NW, Washington, DC 20529-2140, OMB No. 1615-NEW. Do not mail your completed form to this address. Obligation to Respond: Required to Obtain Benefits.

I. Grant Information

Organization:

Sub-Awardee Organization:

Name of Person Completing Report:

Quarter:

Date:

II. Goals

Have you met your quarterly target for your core goals? (You can find your goals in your Program Goals Chart.)

Yes

No

Core Goals

1. Number of newly enrolled non-duplicated LPRs to enroll in citizenship instruction classes

2. Number of LPRs for whom you provide naturalization eligilbity screening

3. Number of LPRS for whom you prepare and submit Form N-400 with Form G-28

If you did not meet one or more of your goals, describe actions you have taken to improve performance and how you plan to meet your goals in the future:

III. Accomplishments and Challenges

Identify specific accomplishments and challenges during the quarter. Place a checkmark in the appropriate column and then provide an explanation of the accomplishment or challenge. You do not need a checkmark for each topic; choose the most relevant topics for this quarter.

Topics

Accomplishments

Challenges

Explanation

Citizenship Instruction

Student recruitment

Student retention

Student assessment

Student improvement

Curriculum development

Managing different student levels

Citizenship instruction

Development of citizenship materials (Please attach any new resources)

Following up with students on naturalization outcomes

Special events (field trips, USCIS visit, celebrations, etc.)

Other citizenship instruction topic

Naturalization Application Services

Client recruitment

Client intake

Client eligibility for naturalization

Naturalization application preparation and filing

Complex naturalization cases

BIA recognition and accreditation

Following up with clients on naturalization outcomes

Special events (info sessions, workshops, etc.)

Other naturalization application services topic

Personnel

Hiring new staff

Staff turnover

Staff training/development

Volunteer recruitment, retention, placement

Other personnel topic

Program Administration

Outreach and advertising

Partnerships

Budget

Data management and reporting

Library initiatives

Press about the grant program

Other topics

IV. Staff Changes

Have you made any staff changes during the quarter?

Yes

No

If yes, please explain:

V. BIA Recognition and Accreditation

Indicate your progress towards BIA recognition and/or accreditation. Place a checkmark next to the appropriate response, and provide additional detail if requested.

Received BIA recognition/accreditation during the quarter. Provide employee name, title, and date accreditation expires:

Renewed BIA accreditation during the quarter. Provide employee name, title, and date accreditation expires:

Pursuing BIA recognition/accreditation. Describe progress made during the quarter:

Already BIA recognized and accredited. No changes to report.

N/A, only attorneys provide naturalization application services.

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Sheet 2: Part II. Individuals Served

GranteeOrgName

Quarter

AlienNumber

CountryofBirth

DateEnrolled

ClassNumber

ClassLevel

HoursInClass

PrePostTestUsed

PreTestScore

PostTestScore

DateScreenedbyGrantee

PreviouslyFiledN400

DateN400FiledByGrantee

DateG28FiledbyGrantee

N648FiledbyGrantee

FeeWaiverFiledbyGrantee

DateRFERespFiledbyGrantee

GranteeLegalRepatInterview

Date1stNatzTestPassed

Date1stNatzTestFailed

Date2ndNatzTestPassed

Date2ndNatzTestFailed

DateOathTaken

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Sheet 3: Part III. Class Table

Grantee Org Name	Class Name	Class Number	Class Level	Name of Instructor(s)	# of Aids/ Tutors	Date Class Started	Date Class Ended	Schedule (Days/Hrs)	# of Class Hours per Week	# of Weeks per Class Cycle	Total Instructional Hours Offered	Total Enrolled Students
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TOTALS											0	0