1.1 Poll Worker Progress Report- Revised

U.S. ELECTION ASSISTANCE COMMISSION 633 3rd St. NW, Suite 200

Washington, DC 20001

HAVCP Poll Worker Program Progress Report

Instructions: Reports due for the period ending March 31 should describe the activities of the previous six-month period and reports due for the period ending September 30 should cover the previous 12- month period. Final reports should cover the entire performance period from the start of the grant.

Additional guidance can be found on our website: https://www.eac.gov/grants/help-america-vote-college-program

EAC grants reports will be made publicly available. Therefore, your report narrative should:

* Be written in clear, concise, and in plain language

* Not include sensitive confidential information

Section I: Cover Page

Grant Information

1. Entity Name:

2. Award Number:

3. Grant Type: Poll Worker Program

4. Report Type: □Semi-Annual, □Annual, □Final

5. Reporting Period:

Section II: Progress Narrative

1. Program Activities

Describe in detail what happened during this reporting period and explain how you implemented the approved grant activities in accordance with your Program Narrative. (Note: Your activities should align with your expenditures in Section IV and you may use those categories as headings in your response as applicable.)

□ Check if no activity during this reporting period.

2. Training

Provide a description of any training conducted.

□ Check if no training was conducted during this reporting period.

3. Partnerships

Describe the partnerships built or fostered during the reporting period. Include collaboration with local election offices.

□ Check if no activity during this reporting period.

4. Historically Underrepresented Communities

Describe how your program activities served historically underrepresented groups or locally underserved communities.

□ Check if no activity during this reporting period.

5. College Students Served

Provide the total number of unique college students served in the following categories. Enter ‘0’ if no students were served in a category or if the category does not apply to your program.

Metric	Reporting Period Total	Cumulative Total for Grant
Enrolled in Poll Worker Training
Completed Poll Worker Training
Enrolled in Election Day Participation
Completed Election Day Poll Worker Duties
Participated in National Poll Worker Day Activities
Community Volunteers Engaged in Poll Worker Activities

6. Additional Performance Measures

Input data for your selected Performance Measures. The same measures should be reported on for each reporting period.

Measure	Reporting Period Total	Cumulative Total for Grant
Total number of partnerships developed
Number of outreach plans developed and executed
Social media engagement (Include unit of measurement i.e. impressions, reach, referrals, and conversions.)
Workshops, Presentations, Trainings, Conferences - number of college students served (in-person or virtual audience)
Total number of college students reached via print methods (magazine, college newspaper, print ads, etc.)
Number of college students reached via digital platforms (e.g. Social Media, Websites, Blogs, etc.):
Number of listeners or viewers (podcast, radio, TV, Public Service Announcements, ads)

7. Performance Measure Narrative

Describe in detail how performance measures were achieved during the reporting period. Consider the following questions: What activities took place to engage college students? What challenges and successes did the program face? What is the relationship between college students/colleges and your local election office? How is the College Poll-Worker Program meeting a need in your community?

8. Matching Requirement

Describe how you are meeting or have met the 10% matching requirement.

Section III: Challenges and Changes

9. Issues Encountered

Describe how and whether the issues were resolved. Also, briefly discuss the implications of any unresolved issues or concerns.

□ Check if no major issues were encountered during this reporting period.

10. Significant Changes

Describe any significant changes to your program during the reporting period, including changes to your original Program Narrative or favorable developments that improved program efficiency and/or service delivery.

□ Check is no significant changes were made during this reporting period.

Section IV: Expenditures

11. Fill out the table below with both the Federal and Program Match expenditures for the current reporting period. Include federal and state interest expenditures and write-in any cost areas that do not fit into the predefined program categories. If you do not have expenses for a particular category, please populate the field with $0.00. Total expenses will be automatically calculated. Please verify totals prior to submission.

Expenditures should be consistent with the activities described in your narrative and with the amounts in your financial reports. (EAC uses the difference between your current and previous period FFR to calculate current period expenditures).

Category	Federal	Program Match
Personnel
Fringe
Equipment
Training
Contractual/Consultants
Supplies
Other
Indirect Costs
TOTAL

Section V: Final Assessment (Final Report Only)

Instructions: The final progress report is your opportunity to share the significant successes of your project and present information about the results your project achieved. The report should cover the entire period of performance.

12. Self-Assessment

Assess whether the goals set out in your Narrative were met as intended during the grant program. Highlight any needs that were not met or ongoing/under resourced areas for future consideration.

13. Impact and Achievements

Describe how this grant program impacted college student participation in elections in your area. Highlight your accomplishments and successes.

14. Lessons Learned

Describe any lessons learned during the grant that may be replicated, expanded and/or help others.

Section V: Certification

15. Name and Contact of the authorized certifying official.

First and Last Name:

Title:

Phone Number:

Email Address:

Signature:

Privacy Act Statement: EAC–4

SYSTEM NAME: Election Assistance Commission Federal Financial Assistance and HAVA Grantee Files.

SYSTEM LOCATION: Located in hard copy files at 1201 New York Avenue, NW., Suite 300, Washington, DC 20005; in electronic format on secured servers, data disks, and encrypted thumb drives with controlled access.

CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM: Individuals with whom EAC does business for purposes of providing Federal financial assistance and awarding grants.

CATEGORIES OF RECORDS IN THE SYSTEM: Grantee, federal financial assistance, and peer reviewer applications, financial and banking information, correspondence, and legal memoranda.

AUTHORITY FOR MAINTENANCE OF THE SYSTEM: The Budget and Accounting Procedures Act of 1950, as amended. 31 U.S.C. 3511, et seq.

PURPOSE: The information in this system is used to issue grant solicitations, analyze grant applications, make award decisions, and manage and oversee grantees. Information in this system is also used to perform all administrative functions related to EAC's other Federal financial assistance programs.

ROUTINE USES OF RECORDS MAINTAINED IN THE SYSTEM, INCLUDING CATEGORIES OF USERS AND THE PURPOSES OF SUCH USES: Data in this system is used to administer all aspects of EAC's federal financial assistance and grant-making programs; and to conduct statistical research or analyze trends associated with these activities. Data may also be used to assist with Congressional oversight of Federal funds administered by EAC. Data may be shared with the Department of Health and Human Services (HHS) to enable HHS to service EAC grant recipients. Data may be disclosed to the Department of Justice, the U.S. Department of the Treasury, or the Government Accountability Office (GAO) in connection with payment and debt collection activities. Information may also be disclosed to GAO in connection with grant administration and audit activities within GAO's jurisdiction; and to the National Institute of Standards and Technology (NIST) in conjunction with joint EAC/NIST grant activities. Access to records in the system is limited to authorized personnel whose official duties require such access. Permission level assignments allow users access only to those functions for which they are authorized.

POLICIES AND PRACTICES FOR STORING, RETRIEVING, ACCESSING, RETAINING, AND DISPOSTING OF RECORDS IN THE SYSTEM:

STORAGE: Records are maintained in file folders in locked file cabinets in financial management, grants, testing and certification, and research policies and programs staff offices. Electronic records are maintained in a secure password protected environment and maintained with safeguards meeting the security requirements of the Federal Information Security Management Act (FISMA) of 2002.

SAFEGUARDS: EAC staff maintain hard copy files in locked file cabinets in controlled access offices by Grants; Research, Policy, and Programs; Testing and Certification; and financial management staff. Electronic data is stored on magnetic media in a computer system with controlled access that requires passwords and identity authentication for users. EAC staff maintain electronic files in a controlled access environment. System managers determine user permission levels based on staff duties and responsibilities. Only those staff authorized to perform tasks associated with information contained in this system of records have permission to access and maintain these files. Network users are also notified when they login to EAC systems that improper use of EAC electronic systems may violate applicable law and subject employees to disciplinary action. EAC staff who access electronic files remotely may only do so by connecting to EAC's servers via a secure remote password-protected connection.

RETRIEVABILITY: Records are retrieved by name and by Tax Identification Number.

RETENTION AND DISPOSAL: Records in this system are maintained in accordance with the applicable National Archives and Records Administration Records Schedule.

SYSTEM MANAGER(S) AND ADDRESS: Executive Director, U.S. Election Assistance Commission, 1201 New York Avenue, NW., Suite 300, Washington, DC 20005. After receipt, the Executive Director will direct records requests to the appropriate division staff with responsibility for the specific Federal financial management or grants records that are the subject of the request.

NOTIFICATION PROCEDURE: See Preliminary Statement.

RECORD ACCESS PROCEDURES: See Preliminary Statement.

CONTESTING RECORD PROCEDURES: See Preliminary Statement.

RECORD SOURCE CATEGORIES: Information in this system is obtained from documents submitted by individuals covered by the system as well as documents issued by EAC financial management staff.

EXEMPTIONS CLAIMED FOR THE SYSTEM: None.

Paperwork Reduction Act. In accordance with the Paperwork Reduction Act of 1995 (44 U.S.C. chapter 35), the information collection requirements associated with the programs, as covered in this Notice, have been approved by the Office of Management and Budget (OMB) under OMB Control Number 3265-0025. Public burden reporting for this collection of information is estimated to average 1 hour per response for individuals completing all parts of this form, including time for reviewing instructions, searching existing data sources, gathering, and maintaining the data needed, and completing and reviewing the collection of information. You are not required to answer these questions unless this number is displayed. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, U.S. Election Assistance Commission, 633 3rd Street NW, Suite 200, Washington, DC 20001.

Tel: (301) 563-3919

www.eac.gov

Fax: (301) 734-3108

Toll free: 1 (866) 747-1471