Research in Disabilities Education Program On-Line Project Data Management System (Completed by PIs/Program Coordinators of RDE Alliance Awards)

The Federal Government has a continuing commitment to monitor its awards to identify and address any inequities based on gender, race, ethnicity, or disability of the principal investigators, co-principal investigators, trainees, or other participants. Submission of the requested information is not mandatory. If you do not wish to submit the information, please mark the checkboxes provided for this purpose on the Web pages that follow.

Information from this data collection system will be retained by the National Science Foundation (NSF), a Federal agency, and will be an integral part of its Privacy Act System of Records in accordance with the Privacy Act of 1974 and maintained in the Education and Training System of Records 63 Fed. Reg. 264, 272 (January 5, 1998). These are confidential files accessible only to appropriate NSF officials, their staffs, and their contractors responsible for monitoring, assessing, and evaluating NSF programs. Only data in highly aggregated form, or data explicitly requested as "for general use," will be made available to anyone outside of NSF for research purposes. Data submitted will be used in accordance with criteria established by NSF for monitoring research and education grants, and in response to Public Law 99-383 and 42 USC 1885c.

[Link to] NSF Privacy Policy

Public Burden

Submission of the requested information is voluntary. Failure to provide full and complete information, however, may reduce the possibility for continuing support through the award/project subject to this survey. Pursuant to 5 CFR 1320.5(b), an agency may not conduct or sponsor, and a person is not required to respond to an information collection unless it displays a valid Office of Management and Budget (OMB) control number. The OMB control number for this collection is 3145-0164. The public reporting burden for the entire collection of information is estimated to average 80 hours per award for Alliance awards and 12 hours per award for other RDE awards, including the time for reviewing instructions. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Suzanne Plimpton, Reports Clearance Officer for OMB Collection 3145-0164, Facilities and Operations Branch, Division of Administrative Services, National Science Foundation, 4201 Wilson Blvd., Suite 295, Arlington, VA 22230.

OMB# 3145-0164
Expires XXXXX

Instructions for Project PIs/Coordinators

The Research in Disabilities Education (RDE) Project Data Management System is an on-line system that collects information required for effective administration, communication, program and project monitoring and evaluation, and for measuring attainment of NSF's program, project and strategic goals, as required by the President's Management agenda as represented by the Office of Management and Budget's (OMB) Program Assessment Rating Tool (PART), by the Government Performance and Results Act (GPRA) of 1993, and by the NSF’s Strategic Plan. Data collected will also be used when responding to queries from Committees of Visitors, Congress, and scientific experts. The data can also be used as a preliminary step in more detailed future evaluation efforts, such as the sort of rigorous evaluations described in the May 2007 Report of the Academic Competitiveness Council (ACC), which was established by the Deficit Reduction Act of 2005 (P.L. 109-171) to serve as a multi-agency effort to identify Federal STEM education programs and establish their effectiveness.

All information, including project participant data, that you submit to this system comes from existing project data sources that are maintained by your project and/or institution. The reporting period for this collection is September 1, 20XX to August 31, 20XX, and the PDMS will be open for data collection from January 10 to March 10, 20XX. You can complete the required sections in any order. Icons beside each link will help you track your progress and alert you to potential problems as you move through the sections. Some questions will be marked as required, and the other questions are optional.

NSF has contracted ICF Macro to conduct this data collection. If you have any questions about the system or need any technical assistance, you can email ICF Macro staff at rde@macrointernational.com, or you can speak to an ICF Macro staffer by calling 877-492-5913.

Award

Please review the following data for your award. This section was prepopulated.^¹ If you need to make changes, please contact ICF Macro to make the necessary adjustments. Asterisks indicate required fields; you must complete such fields in order to submit your data. For help with unfamiliar terms, please consult the glossary.

^ Award Status ___________________________________

^ Program Track^² ___________________________________

^ NSF Award Number ___________________________________

^ Award Title

______________________________________________________________________

_____________________________________________________________________

^ Award Institution ___________________________________

^Award Start Date Month _____ Day _____ Year _____

^Award End Date Month _____ Day _____ Year _____

^Collaborative Award(s)

NSF Award Number Institution Award Title Award PI

_______________ ___________ ____________ ____________

…

_______________ ___________ ____________ ____________

All data above will be prepopulated. If respondents have questions, they can contact ICF Macro.

In the past year, did this project receive any funding in addition to the NSF RDE funding?

If yes, Funding Agency:

Funding Program:

Amount of Funding:

Type of Funding

Federal

State

Local

Business/Industry

University

Other (provide text box)

If this award was preceded by an NSF RDE award, what was the:

NSF Award Number: ____________________

Award Title: ___________________________

What was its RDE award track?

__ Alliance award

__ Research award

__ Enrichment award

__ Demonstration award

__ Dissemination award

__ Other

Institutions

Please provide information about your project’s primary, partnering, and associate institutions and organizations for the current reporting period. There are three types: academic institutions of higher education, K-12 education organizations, and non-academic institutions.

Only submit data for those institutions that do not have collaborating awards and are not supported by a collaborating award.

Academic Institution (college, university, or other institute of higher education)^³

* Institution Name ___________________________________________

Postal Address ___________________________________________

___________________________________________

* Institution Type (select one)

___Public ___Private

What is this institution’s Carnegie classification?

Research Universities (RU/VH) (very high research activity)
Research Universities (RU/H) (high research activity)
Doctoral/Research Universities (DRU)
Master’s Colleges and Universities (Master’s/L) (larger programs)
Master’s Colleges and Universities (Master’s/M) (medium programs)
Master’s Colleges and Universities (Master’s/S) (smaller programs)
Baccalaureate Colleges—Arts & Sciences (Bac/A&S)
Baccalaureate Colleges—Diverse Fields (Bac/Diverse)
Baccalaureate/Associate’s Colleges (Bac/Assoc)
Associate’s—Public Rural-serving Small (Assoc/PubRS)
Associate’s—Public Rural-serving Medium (Assoc/PubRM)
Associate’s—Public Rural-serving Large (Assoc/PubRL)
Associate’s—Public Suburban-serving Single Campus (Assoc/PubSSC)
Associate’s—Public Suburban-serving Multicampus (Assoc/PubSMC)
Associate’s—Public Urban-serving Single Campus (Assoc/PubUSC)
Associate’s—Public Urban-serving Multicampus (Assoc/PubUMC)
Associate’s—Public Special Use (Assoc/PubSpec)
Associate’s—Private Not-for-profit (Assoc/PrivNFP)
Associate’s—Private For-profit (Assoc/PrivFP)
Associate’s—Public 2-year Colleges under Universities (Assoc/Pub2in4)
Associate’s—Public 4-year, Primarily Associate’s (Assoc/Pub4)
Associate’s—Private Not-for-profit 4-year, Primarily Associate’s (Assoc/PrivNFP4)
Associate’s—Private For-profit 4-year, Primarily Associate’s (Assoc/PrivFP4)
Theological seminaries, Bible colleges, and other faith-related institutions (Spec/Faith)
Medical schools and medical centers (Spec/Medical)
Other health profession schools (Spec/Health)
Schools of engineering (Spec/Engg)
Other technology-related schools (Spec/Tech)
Schools of business and management (Spec/Bus)
Schools of art, music, and design (Spec/Arts)
Schools of law (Spec/Law)
Other special-focus institutions (Spec/Oth)
Tribal colleges and universities

* Institutional 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)

* Institutional Gender Characteristics (select one)

___Single Gender – Male

___Single Gender – Female

___Coed

* Institutional Campus Characteristics (select one)

___Virtual Campus

___Traditional Campus

___Virtual and Traditional

* Project Role (select one)

___Primary Awardee^⁴

___Subawardee (as defined by NSF on the award budget)

___Non-award partner

___Consultant (as defined by NSF on the award budget)

___Other, please specify ___________________________________________

Has this project affected policies at this institution regarding educating students with disabilities during the current reporting period?

___Yes ___ No

If yes, what changed?

________________________________________

Has this project affected practices at this institution regarding educating students with disabilities during the current reporting period?

___Yes ___ No

If yes, what changed?

________________________________________

Has this project affected services provided by this institution’s office for students with disabilities during the current reporting period?

___Yes ___ No

If yes, what changed?

________________________________________

Were any courses at this institution retrofitted for Universal Design for Learning (UDL) during the current reporting period?

___Yes ___ No

If yes, how many?

Were any new courses created using Universal Design for Learning (UDL) during the current reporting period?

___Yes ___ No

If yes, how many?

Were any student labs retrofitted for Universal Design for Learning (UDL) during the current reporting period?

___Yes ___ No

If yes, how many?

Were any new student labs created using Universal Design for Learning (UDL) during the current reporting period?

___Yes ___ No

If yes, how many?

Were any fieldwork experiences at this institution changed because of Universal Design for Learning (UDL) during the current reporting period?

___Yes ___ No

If yes, how many?

Were any new fieldwork experiences created at this institution using Universal Design for Learning (UDL) during the current reporting period?

___Yes ___ No

If yes, how many?

K-12 Academic Organization^⁵

* School Name___________________________________________

District ___________________________________________

*Postal Address ___________________________________________

___________________________________________

* Institution Type (select one)

___Public ___Private

* Institutional Characteristics (select one)

___High School

___Middle School/Junior High

___Elementary School

___Other, please specify ___________________________________________

* Project Role (select one)

___ Primary Awardee

___ Subawardee (as defined by NSF on the award budget)

___Non-award partner

___Consultant (as defined by NSF on the award budget)

___Other, please specify ___________________________________________

Has this project affected policies at this institution regarding educating students with disabilities during the current reporting period?

___Yes ___ No

If yes, what changed?

________________________________________

Has this project affected services and/or practices at this institution regarding educating students with disabilities during the current reporting period?

___Yes ___ No

If yes, what changed?

________________________________________

Were any courses at this institution retrofitted for Universal Design for Learning (UDL) during the current reporting period?

___Yes ___ No

If yes, how many?

Were any new courses created using Universal Design for Learning (UDL) during the current reporting period?

___Yes ___ No

If yes, how many?

Were any student labs retrofitted for Universal Design for Learning (UDL) during the current reporting period?

___Yes ___ No

If yes, how many?

Were any new student labs created using Universal Design for Learning (UDL) during the current reporting period?

___Yes ___ No

If yes, how many?

Were any fieldwork experiences at this institution changed because of Universal Design for Learning (UDL) during the current reporting period?

___Yes ___ No

If yes, how many?

Were any new fieldwork experiences created at this institution using Universal Design for Learning (UDL) during the current reporting period?

___Yes ___ No

If yes, how many?

Non-Academic Organizations^⁶

* Institution Name ___________________________________________

Postal Address ___________________________________________

___________________________________________

* Institutional Characteristics (select one)

___Industry Partner

___Non-Profit Organization

___Local Government Organization

___State Government Organization

___Federal Government Organization

___Non-university/non-industry Lab

___Other, please specify ___________________________________________

* Project Role (select one)

___Primary Awardee

___Subawardee (as defined by NSF on the award budget)

___Non-award partner

___Consultant (as defined by NSF on the award budget)

___Other, please specify ___________________________________________

Has this project affected policies at this organization regarding people with disabilities during the current reporting period?

___Yes ___ No

If yes, what changed?

________________________________________

Has this project affected practices at this organization regarding people with disabilities during the current reporting period?

___Yes ___ No

If yes, what changed?

________________________________________

Were any labs/offices/workspaces retrofitted for Universal Design for Learning (UDL) during the current reporting period?

___Yes ___ No

If yes, how many?

Were any new labs/offices/workspaces created using Universal Design for Learning (UDL) during the current reporting period?

___Yes ___ No

If yes, how many?

Project Personnel^⁷

Enter the information about your project personnel in the spaces below. Asterisks indicate required fields; you must complete them in order to submit your data. For help with unfamiliar terms, please consult the glossary.

Contact Information

Name

Title ___________________________________________

*First Name ___________________________________________

Middle Name ___________________________________________

*Last Name ___________________________________________

Suffix ___________________________________________

Office Mailing Address

*Street ___________________________________________

___________________________________________

*City _________________ *State _____ *Zip/Postal Code__________ Country __________

* Institutional Affiliation

Name: ___________________________________________ State: _____

* E-mail Address: _______________@______________

Office Phone Number ____________________ ext. ____

Office Fax Number ____________________ ext. ____

Cell Phone Number ____________________

*Academic Field

[Drop down list of fields]

[Include Does Not Apply option]

Project Roles

* Employment Title ___________________________________________

* Project Administration Position (select all that apply)

___Primary Investigator (PI)

___ Co-Primary Investigator (Co-PI)

___Project Director

___Associate/Assistant Project Director

___Project Manager

___ Associate/Assistant Project Manager

___Coordinator, please specify area of coordination ____________________

___Other, please specify ___________________________________________

* Internal Project Evaluation Position (select all that apply)

___Evaluation Team – Lead

___Evaluation Team – Data Collector

___Evaluation Team – Statistician/Analyst

___Other, please specify ___________________________________________

* External Project Evaluation Position (select all that apply)

___Evaluation Team – Lead

___Evaluation Team – Data Collector

___Evaluation Team – Statistician/Analyst

___Other, please specify ___________________________________________

* Project Research Position (select all that apply)

___Primary Investigator (PI)

___ Co-Primary Investigator (Co-PI)

___Staff – Full Professor

___Staff – Associate Professor

___Staff – Assistant Professor

___Staff – Instructor

___Staff – Senior Researcher

___Staff – Associate Researcher

___Staff – Assistant Researcher

___Staff – Research Assistant

___Post-Doctoral Fellow

___Student – Doctoral

___Student – Masters

___Student – Baccalaureate

___Student – Associate

___Student – High School

___Other, please specify ___________________________________________

Demographic Information

Year of birth^⁸ __________

(Enter “9999” for “not reported.)

* Gender (select one)

___Male ___Female ___Not reported

* Ethnicity (select one)

___Hispanic or Latino

___Not Hispanic or Latino

* Race (mark one or more)

___American Indian or Alaska Native

___Asian

___Black or African American

___Native Hawaiian or Other Pacific Islander

___White

* Condition (select all that apply)

___None

___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, please specify: ___________________________________________

___Not reported

*If more than one disability is reported, offer respondents an opportunity to rank their selections as primary, secondary, etc.

Was this person registered with the campus disability services office?

Yes/No

Did this person receive services?

Yes/No

* Citizenship (select one)

___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

* United States Military Service Status (select one)

___Active Duty

___Active Reserve

___Veteran

___No Military Service

___Not Reported

Mentoring

Did this person serve as a mentor?

___Yes ___ No

If yes, who did they mentor?

__ High School Students

__ Community College Student

__ Undergraduate students

__ Graduate Students

__ Faculty/Staff

__ Industry/Business

__ Other, please explain (provide text box)

Approximately how mentoring sessions did they have during the last year?

___

Of those, how many were

___ Face to Face

___ Phone

___ Virtual

Was this person a mentee?

___Yes ___ No

If yes, what kind of mentor did they have?

__ High School Student

__ Community College Student

__ Undergraduate Student

__ Graduate Student

__ Faculty/Staff Member

__ Industry/Business Partner

__ Other, please explain (provide text box)

Approximately how mentoring sessions did they have during the last year?

___

Of those, how many were

___ Face to Face

___ Phone

___ Virtual

Tutoring

Did this person receive tutoring during this year as a part of this project?

___Yes ___ No

If yes, who did they receive tutoring from?

__ High School Student

__ Community College Student

__ Undergraduate Student

__ Graduate Student

__ Faculty/Staff

__ Industry/Business

__ Other, please explain (provide text box)

Did this person serve as a tutor?

___Yes ___ No

If yes, who did they tutor?

__ High School Student

__ Community College Student

__ Undergraduate Student

__ Graduate Student

__ Faculty/Staff

__ Industry/Business

__ Other, please explain (provide text box)

Approximately how tutoring sessions did this person participate in?

___ As a tutor

___ Receiving tutoring

Learning Communities

Did this person participate in a student learning community sponsored by this project?

Yes/No

If yes, was this community (select all that apply)

__ related to a course

__ a virtual community

__ a living/learning community

Did this person participate in a faculty learning community sponsored by this project?

Yes/No

If yes, was this community (select all that apply)

__ related to a course

__ a virtual community

__ a living/learning community

Project Experiences - International

*Did this project personnel member have any international experiences as a result of this project during the current reporting period?

___Yes ___No

If yes, where was this experience?

Country __________________

City _______________

Organization ___________________

Program Name ________________________

What kind of activity was this experience? (select all that apply)

__ Teaching students

___ Elementary School

___ High School

___ Undergraduate Students

___ Graduate Students

___ Doing research

___ Data gathering

___ Data analysis

___ Other, please specify _____________________________

How many weeks did the experience last? ____________

What was the average number of hours worked each week? __________

Universal Design for Learning (UDL) Experiences

Did this person provide Universal Design for Learning (UDL) trainings?

___Yes ___ No

If yes, how many?

Did this person receive Universal Design for Learning (UDL) trainings?

___Yes ___ No

If yes, how many?

Project Participant^⁹

Enter the information about your project participant in the spaces below. Asterisks indicate required fields; you must complete them in order to submit your data. For help with unfamiliar terms, please consult the glossary.^¹⁰

[Instructions for how to enter number instead of names for privacy reasons will be provided.]

Contact Information

Name

Title ___________________________________________

*First Name ___________________________________________

Middle Name ___________________________________________

*Last Name ___________________________________________

Suffix ___________________________________________

Other ID (if applicable) __________________

Current Mailing Address

*Street ___________________________________________

___________________________________________

*City _________________ *State _____ *Zip/Postal Code__________ Country __________

* Institutional Affiliation

Name: ___________________________________________ State: _____

* Current Phone Number ____________________ ext. ____

* E-mail Address: _______________@______________

Participation Information

* Participant Type

___College/University Administrator

___ College/University Faculty

___ College/University Staff

___High School Teacher

___Middle School Teacher

___K-5 Teacher___Pre-K Teacher

___Graduate Student

___Undergraduate Student (4-Year)

___Undergraduate Student (2-Year)

___High School Student (Freshman)

___High School Student (Sophomore)

___High School Student (Junior)

___High School Student (Senior)

___Other, please specify ___________________________________________

If Administrator/Staff/Faculty:

Academic Field(IPDES drop-down menu)

If K-12 Teacher:

Teaching Specialty (select one)

___General

___Math

___Science

___Technology

___Other, please specify ___________________________________________

If Graduate/Undergraduate Student:

Major (IPDES drop-down menu)

Student Demographics (only asked about students)

What degree is this student pursuing?

___ High School

___ Associates

___ Undergraduate

___ Masters

___ Doctorate

___ Other, please specific ___________________

What year of school is this student currently in? [Enter numerical value] _____

During the currect reporting period, did this sudent receive any of the following types of degree/certifications?

___ Certficate of Completion

___ High school diploma

___ Associates degree

___ Undergraduate degree

___ Masters degree

___ Ph.D.

___ Other, please specific ___________________

If the student received a degree or certificate during the reporting period, what did the student plan to do during the next academic year?

___ Pursue associates degree

___ Pursue undergraduate degree in a STEM field

___ Pursue graduate degree in a STEM field

___ Pursue non-STEM degree

___ Enter the workforce

___ Unknown

Student’s Permanent Contact Information (only asked about students)

Permanent Mailing Address

*Street ___________________________________________

___________________________________________

*City _________________ State _____ *Zip/Postal Code__________ Country __________

*Permanent E-mail Address: _______________@______________

Permanent Home Phone Number ____________________ ext. ____

Cell Phone Number ____________________

Demographic Information

* Year of birth^¹¹ __________

* Gender (select one)

___Male ___Female ___Not reported

* Ethnicity (select one)

___Hispanic or Latino

___Not Hispanic or Latino

* Race (mark one or more)

___American Indian or Alaska Native

___Asian

___Black or African American

___Native Hawaiian or Other Pacific Islander

___White

* Condition (select all that apply)

___None

___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, please specify: ___________________________________________

___Not reported

Was this person registered with the campus disability services office?

Yes/No

Did this person receive services?

Yes/No

* Citizenship (select one)

___U.S. Citizen

___Permanent Resident (“Green Card”)

___U.S. National (Born in American Samoa or Swains Island or descendent of U.S. National)^¹²

___Non-U.S. Citizen

* Veteran Status re US Military Service (select one)

___Active Duty

___Active Reserve

___Veteran

___No Military Service

___Not Reported

Mentoring

Did this person serve as a mentor?

___Yes ___ No

If yes, who did they mentor?

__ High School Students

__ Community College Student

__ Undergraduate students

__ Graduate Students

__ Faculty/Staff

__ Industry/Business

__ Other, please explain (provide text box)

Approximately how mentoring sessions did they have during the last year?

___

Of those, how many were

___ Face to Face

___ Phone

___ Virtual

Was this person a mentee?

___Yes ___ No

If yes, who was their mentor?

__ High School Student

__ Community College Student

__ Undergraduate Student

__ Graduate Student

__ Faculty/Staff Member

__ Industry/Business Partner

__ Other, please explain (provide text box)

Approximately how mentoring sessions did they have during the last year?

___

Of those, how many were

___ Face to Face

___ Phone

___ Virtual

Tutoring

Did this person receive tutoring during this year as a part of this project?

___Yes ___ No

If yes, who did they receive tutoring from?

__ High School Student

__ Community College Student

__ Undergraduate Student

__ Graduate Student

__ Faculty/Staff

__ Industry/Business

__ Other, please explain (provide text box)

Did this person serve as a tutor?

___Yes ___ No

If yes, who did they tutor?

__ High School Student

__ Community College Student

__ Undergraduate Student

__ Graduate Student

__ Faculty/Staff

__ Industry/Business

__ Other, please explain (provide text box)

Approximately how tutoring sessions did this person participate in?

___ As a tutor

___ Receiving tutoring

Stipends

Did this person receive one of the following types of stipends?

___None

___No Performance or Participation Restrictions

___Restricted to Students Participating in Project Activities

___Restricted to Students Providing Mentoring and/or Tutoring to Post-Secondary Students

___Restricted to Students Providing Mentoring and/or Tutoring to Secondary Students

___Restricted to Student Academic Performance

___Other Restrictions, please specify ________________________________

RDE Stipend Amount^¹³ provided to this person from NSF-RDE funding during the current reporting period $ ______

Non-RDE Stipend Amount^¹⁴ provided to this person during the current reporting period (includes stipends, scholarships, and funding from sources other than the NSF RDE program) $ ______

Please list the stipend sources _______________________________________________

Learning Communities

Did this person participate in a student learning community sponsored by this project?

___Yes ___ No

If yes, was this community (select all that apply)

__ related to a course

__ a virtual community

__ a living/learning community

Did this person participate in a faculty learning community sponsored by this project?

___Yes ___ No

If yes, was this community (select all that apply)

__ related to a course

__ a virtual community

__ a living/learning community

Internship/Fieldwork Experiences (only asked for students)

Did this person participate in a university research internship?

___Yes ___ No

If yes, Program/Lab Name ____________________

Did this person participate in a research externship?

___Yes ___ No

If yes, Institution/Business Name _________________

City ______________

State _____________

Did this person participate in a fieldwork experience?

___Yes ___ No

If yes, Program Name ____________________

City ______________

State _____________

Project Experiences - International

*Did this project participant have any international experiences as a result of this project during the current reporting period?

___Yes ___No

If yes, where was this experience?

Country __________________

City _______________

Organization ___________________

Program Name ________________________

What kind of activity was this experience? (select all that apply)

__ Teaching students

___ Elementary School

___ High School

___ Undergraduate Students

___ Graduate Students

___ Doing research

___ Data gathering

___ Data analysis

___ Other, please specify _____________________________

How many weeks did the experience last? ____________

What was the average number of hours worked each week? __________

Transition Support (only asked for students)

Did this person participate in any of the following transition actives?

___ IEP

___ Individual transition counseling services

___ Group transition counseling services

___ For-credit course dealing with transition

___ Single transition workshop

___ Transition workshop series

__How many sessions were there in the series?

Universal Design for Learning (UDL) Experiences

Did this person provide Universal Design for Learning (UDL) trainings?

___Yes ___ No

If yes, how many?

Did this person receive Universal Design for Learning (UDL) trainings?

___Yes ___ No

If yes, how many?

Academic Achievement (only asked for students)

Participant’s GPA as of mm/dd/yy^¹⁵ ___.___ out of ___.___.

Did this participant receive and Honors/Awards during the current reporting period?

___Yes __No

Student Award/Honor^¹⁶

Title ___________________________________________

Type (select all that apply)

___Monetary Award

___Non-monetary Award

___Other, please describe___________________________________________

Organization _________________________________________

ALLIANCE DATA

Institutional Data (Collected for Each Institution of Higher Education Submitted Earlier)

What is the source of your institutional data? (select all that apply)

___Disability Services

___Registrar

___Other, please describe___________________________________________

General Institutional Data--In this table, enter overall data for this institution^¹⁷

	This Year	Last Year^¹⁸ (read only)	Baseline^¹⁹ (enter year)
Total Students
Students Enrolled Full Time
Students Enrolled Part Time
Enrolled Degree Candidates
Enrolled Certificate Candidates
Students taking classes (not for degree or certificate)
Students receiving disability services via this institution
Academic Level
Freshman
Sophomores
Juniors
Seniors
Masters Students
Doctoral Students
Other
Gender
Total Female Students
Total Male Students
Not reported
Ethnicity
Hispanic or Latino
Not Hispanic or Latino
Race
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White






Condition
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 Conditions
Not reported
U.S. Military Service Status
Active Duty
Active Reserve
Veteran
Not reported

Data on Students Enrolled in STEM Majors—In this table enter data only for students at this organization that are currently enrolled as STEM Majors

	This Year	Last Year (read only)	Baseline (enter year)
Enrolled in STEM majors
Students with disabilities in STEM majors - AA
Students with disabilities in STEM majors – BA/BS
Students with disabilities in STEM majors – MA/MS
Students with disabilities in STEM majors – PhD
Gender
Total Female Students
Total Male Students
Not reported
Ethnicity
Hispanic or Latino
Not Hispanic or Latino
Race
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White






Condition
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 Conditions
Not reported
U.S. Military Service Status
Active Duty
Active Reserve
Veteran
Not reported

Data on Students Who Graduated from STEM Majors—In this table, enter only data on STEM Majors that graduated during the reporting period.

	This Year	Last Year (read only)	Baseline (enter year)
Graduated STEM majors - AA
Graduated STEM majors – BA/BS
Graduated STEM majors – MA/MS
Graduated STEM majors - PhD
Students with disabilities who graduated in STEM majors - AA
Students with disabilities who graduated in STEM majors – BA/BS
Students with disabilities who graduated in STEM majors – MA/MS
Students with disabilities who graduated in STEM majors - PhD
Gender
Total Female Graduates
Total Male Graduates
Not reported
Ethnicity
Hispanic or Latino
Not Hispanic or Latino
Race
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White






Condition
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 Conditions
Not reported
U.S. Military Service Status
Active Duty
Active Reserve
Veteran
Not reported

Institutional Data (Collected for Each High School Submitted Earlier)

General Institutional Data--In this table, enter overall data for this institution

	This Year	Last Year	Baseline
Total Students
Freshman
Sophomores
Juniors
Seniors
Gender
Total Female Students
Total Male Students
Not reported
Ethnicity
Hispanic or Latino
Not Hispanic or Latino
Race
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White






Condition
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 Conditions
Not reported

*Field in the tables cannot be left blank—an “Unknown” option should be included.

Additional proposal data

Did your work on this award lead to you writing any proposals? If so, list all the proposals that you submitted this year as a result of the award:

Funding Agency:

Program:

Proposal Title:

Proposal Number:

Research

How many research studies were conducted under this award during the current collection period?^²⁰

Research Study Data^²¹

* List the hypotheses that this study tests: (500 character limit)

1) ____________________________________________________________

2) ____________________________________________________________

3)___________________________________________________________

4)____________________________________________________________

Research Study Design

What were the research methodologies used in this research study?

[Provide text box for data entry]

Subject Group Data

Enter subject group data for the research study. If your project did not have an experimental group, enter data only in the Control Group row.

Subject Gender and Ethnicity Data

	Total Subjects	Gender			Ethnicity
		Male	Female	Not reported	Hispanic/Latino	Not Hispanic /Latino
Control Group^²²
Experimental Group^²³

Subject Race Data

Control Group^²⁴	American Indian/Alaska Native	Asian	Black or African American	Native Hawaiian or other Pacific Islander	White
Experimental Group^²⁵

Subject Age Level Data

	Ages
	0-5	6-12	13-16	17-18	19-21	22-25	26-35	36-45	46 and Over	Not reported
Control Group
Experimental Group

Subject Academic Level Data

	Academic Level
	Pre-K	K-6	7-8	High School	Associate Degree Candidate	Baccalaureate Candidate	Masters Candidate	PhD candidate	Not Applicable	Not reported
Control Group
Experimental Group

Subject Military Service Status

	US Military Service Status
	Active Duty	Active Reserve	Veteran
Control Group
Experimental Group

Subject Condition

Condition

None

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 Conditions

Not reported

Control Group

Experimental Group

* Did your study produce a replication manual? (select one)

___Yes ___No

* If yes, provide the URL to access the manual

____________________________________________________________

* Did your study disseminate findings directly to NSF-RDE Alliance projects?

___Yes ___No

* If yes, provide the NSF award numbers of the RDE Alliance projects.

____________________________________________________________

* Did your study use data from any NSF-RDE Alliance projects?

___Yes ___No

* If yes, provide the NSF award numbers of the RDE Alliance projects.

____________________________________________________________

____________________________________________________________

Dissemination

Professional Publications^²⁶

Did any project personnel or participants contribute to any professional publications during this reporting year as a result of the project?

If so, provide citation:

URL, if available on-line ________________________________

*Type (select all that apply)

___Peer Reviewed

___Invited

___Non-Peer Reviewed

Professional Presentations^²⁷

Did any project personnel or participants give any professional presentations during this reporting year as a result of the project?

*Title ___________________________________________

*Type (select all that apply)

___Conference Presentation

___Media Presentation

___Class Presentation

___Other, please describe___________________________________________

*Professional Organization _________________________________________

URL of presentation, if available ______________________________________

Estimate the number of people in the audience _____

New Tools, Measurement Methods, and Other Materials^²⁸

Did the project develop any new tools, measurement methods, or other materials not already submitted for individual participants and personnel?

* Name ___________________________________________

* Type (select all that apply)

___Survey

___Questionnaire

___Assessment Tool

___Instructional Material

___Replication Manual

___Other Guides/Manuals

___Brochures

___Other, please describe___________________________________________

How many people was this distributed to this year? _________

Who were the primary users of this material?

___ STEM Faculty

___ Educators, General

___ Educators, Special Education

___ STEM Careers

___ General Public

___ Other, please describe ________________

Online Resources Provided^²⁹

* Name ___________________________________________

* Type (select all that apply)

___Website

___Wiki

___Blog

___E-mail List

___Virtual Environment, please describe___________________________________________

___Other, please describe___________________________________________

Current URL or other location _________________________________________

Usage Record

* Number of “hits”

This Year _____ Last year _____ Baseline_____ % Change ______

* If you have a unique login system, number of unique logins

This year _____ Last year _____ Baseline_____ % Change ______

If the project has a unique login system, please indicate how many users of each type the system had this year:

___ Students

___ University faculty/staff/administrators

___ K-12 Teachers

___ Parents

___ Industry/Business users

___ General Public

___ Other

NSF Highlights

(Highlights are optional)

Each year, NSF program officers are asked to write "Highlights" (formerly known as "Nuggets") on the results of NSF research and education awards. These Highlights are used to help assess the Foundation's performance in attaining the strategic outcome goals outlined in the NSF 2006-2011 Strategic Plan and to share successes with various groups.

Do you have a highlight to submit for the currect reporting period?

Yes/No

If yes, a template for the NSF highlight will be provided.

When writing your highlight, please:

Provide a descriptive title for this Highlight
Describe the achievement/result that is the Highlight
Provide photo and phote release form

[Examples of past highlights with be provided, and users will upload text, photo, and photo release into the system.]

1 In the online system, ^ items are prepopulated.

2 At this point, the value will be one of these five: Alliance, Research, Enrichment, Demonstration, Dissemination

3 Questions for each degree-granting institution.

4 Primary awardee institution will be partially preloaded

5 Questions repeat for each K-12 organization.

6 Questions repeat for each non-academic institution.

7 Questions repeat for each member of the project staff. The primary PI’s information must be preloaded with enough information to permit the initial access to the system.

8 Enter 4 digits or select from a dropdown list?

9 Questions repeat for each project participant.

10 Particpant Questions apply to ONLY Alliance and Enrichment track awards.

11 Enter 4 digits or select from a dropdown list?

12 According to 8 U.S.C. § 1408, it is possible to be a U.S. national without being a U.S. citizen. A person whose only connection to the U.S. is through birth in an outlying possession (which as of 2005 is limited to American Samoa and Swains Island), or through descent from a person so born acquires U.S. nationality but not U.S. citizenship.

13 This question applies only if a stipend other than “None” was selected.

14 This question applies only if a stipend other than “None” was selected.

15 Date of the end of the academic year – example 8/31/yy (set as a system parameter)

16 Questions repeat for each honor or award.

17 PIs will enter baseline data during their first year of data entry.

18 Display if available in system.

19 Display if available in the system.

20 May be multiple entries

21 Questions repeat for each study.

22 Allow for multiple control groups in all tables

23 Allow for multiple experimental groups in all tables

24 Allow for multiple control groups in all tables

25 Allow for multiple experimental groups in all tables

26 May be multiple entries

27 May be multiple entries

28 May be multiple entries

29 May be multiple entries

File Type	application/msword
File Title	GK-12 ONLINE SURVEY 2006–2007 FORMS
Last Modified By	nsfuser
File Modified	2009-10-27
File Created	2009-10-27

Research in Disabilities Education Program On-Line Project Data Management System (Completed by PIs/Program Coordinators of RDE Alliance Awards)

The National Science Foundation's Study of Persons with Disabilities Majoring in Science, Engineering, Mathematics, and Technology

OfflineForms_Draft_Revised_10_27_09