Form 1122-0005 Semi annual Progress Report for Grants to Reduce Domesti

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U.S. Department of Justice
Office on Violence Against Women
SEMI-ANNUAL PROGRESS REPORT FOR
Grants to Reduce Domestic Violence, Dating Violence,
Sexual Assault, and Stalking on Campus Program
Brief Instructions: This form must be completed for each Grants to Reduce Domestic Violence, Dating Violence,
Sexual Assault, and Stalking on Campus Program (Campus Program) grant received. A grant administrator or coordinator must ensure that the form is completed fully with regard to all grant-funded activities. Grant partners,
however, may complete sections relevant to their portion of the grant. Grant administrators or coordinators are
responsible for compiling and submitting a single report that reflects all information collected from grant partners.
All grantees should read each section to determine which questions they must answer, based on the activities engaged in under this grant during the current reporting period. Sections B, E, and F of this form must be completed
by all grantees. In section A, subsection A1 must be answered. In section C, subsection C1 must be answered. In
section D and subsections A2 and C2-C7, grantees must answer an initial question about whether they engaged
in certain activities during the current reporting period. If the response is yes, then the grantee must complete
that section or subsection. If the response is no, the grantee may be asked to explain, and the rest of that section
or subsection is skipped.
For example, 1) if you are a Campus Program grantee providing training and victim services with staff funded under this grant, you should complete A1, A2, B, C1, C3, D, E, and F (and answer “no” in C2 and C4-C7), or 2) if you
are a Campus Program grantee providing training with staff funded under this grant, you should complete A1, A2,
B, C1, C3, E, and F (and answer “no” in C2, C4-C7, and D).
The activities of volunteers or interns should be reported if they were coordinated or supervised by Campus Program-funded staff or if Campus Program funds substantially supported their activities.
For further information on filling out this form, refer to the separate set of instructions, which contains detailed
definitions and examples illustrating how questions should be answered.
Section
Section A:
A1:
A2:
Section B:
Section C:
C1:
C2:
C3:
C4:
C5:
C6:
C7:
Section D:
Section E:
Section F:

General Information
Grant Information
Staff Information
Purpose Areas
Function Areas
Minimum Requirements
Policies
Training
Campus Education
Products
Data Collection and Communication Systems
System and Capital Improvement
Victim Services
Campus and Community Measures
Narrative

Page Number
1
1
3
4
5
5
12
15
19
22
23
24
25
32
34

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A1

GENERAL INFORMATION
Grant Information

All grantees must complete this subsection.

1.

Date of report

2.

Current reporting period

3.

Grantee name

4.

Grant number
(the federal grant number assigned to your Campus Program grant)

(format date with 6 digits, like - 01/31/04)
✔

January 1-June 30

✔

July 1-December 31

(Year)

5a. Type of lead institution
(Check the answer that best describes the institution receiving the Campus Program funds.)
Public school
Private school
5b.

Additional designations of lead instituion
(Check all that apply.)
Tribal college or university
Historically black college or university
Faith-based college or university
Community college
College or university serving primarily Latino or Hispanic populations
University or colleges based in the territories of Guam, Virgin Islands, Puerto Rico,
Northern Mariana Islands, or American Samoa
College or university serving primarily either men or women
Other (specify):

6.

Is this a Higher Education Association Special Initiative to Address Violent Crimes on Campuses
grant?
Yes
No
If yes, identify the association:

7a. Is this a consortium project?
Yes
No
7b. Is this a flagship project?
Yes
No
7c. If you answered yes to either 7a or 7b above, list each participating member and indicate the
number of each type of institution represented in your project in 7d and 7e.
Institution name:
(1)
(2)
(3)
(4)
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7d. Type of institution
(Report the number of each type of institution of your project members.)
Public school

Private school

7e. Additional designation of participating institutions
(Report the number of each type of institution represented in your project, if appropriate.)
Type of institution
Tribal school
Historically black college
Faith-based
Community college
Latino or Hispanic
Territory-based
Single sex
Other (specify):
8.

Number

Point of contact
(person responsible for the day-to-day coordination of the grant)
First name

MI

Last name

Institution name
Address
City

State

Telephone

Zip code
Facsimile

E-mail
9.

Does this grant specifically address tribal populations?
(Check yes if your Campus Program grant focuses on tribal populations, and indicate which tribes or
nations you serve or intend to serve.)
Yes
No
If yes, which tribes/nations:

10. What percentage of your Campus Program funds was directed to each of these areas?
(Report the area(s) addressed by your Campus Program grant during the current reporting period and
estimate the approximate percentage of funds [or resources] used to address each area [consider education, training, victim services, etc.]. The grantee may choose how to make this determination. If the
Campus Program grant funds a consortium or flagship project, responses in this question should reflect
the aggregated responses of project members.)
Throughout this form, the term sexual assault includes both assaults committed by offenders who are
strangers to the victim/survivor and assaults committed by offenders who are known to, related by blood
or marriage to, or in a dating relationship with the victim/survivor. The term domestic violence/dating violence applies to any pattern of coercive behavior that is used by one person to gain power and control over a
current or former intimate partner or dating partner. Stalking is defined as a course of conduct directed at
a specific person that would cause a reasonable person to fear for his or her safety or the safety of others, or
suffer substantial emotional distress. (See separate instructions for more complete definitions.)

Percentage of grant funds
Sexual assault
Domestic violence/dating violence
Stalking
TOTAL (must equal 100 %)

100%0%

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Staff Information

Were Campus Program funds used to fund staff positions during the current reporting period?
Check yes if Campus Program funds were used to pay staff, including part-time staff and contractors. (If
the grant funds a consortium or flagship project, responses in this subsection should reflect the aggregated responses of project members.)
Yes—answer question 11
No—skip to section B
11. Staff
(Report the total number of full-time equivalent [FTE] staff funded by the Campus Program grant during
the current reporting period. Report staff by functions performed, not by title or location. Include employees who are part-time and/or only partially funded with these grant funds as well as consultants/
contractors. If an employee or contractor was employed or utilized for only a portion of the reporting
period, prorate appropriately. For example, if you hired a full-time advocate in October who was 100%
funded with Campus Program funds, you would report that as .50 FTE. Report all FTEs in decimals, not
percentages. One FTE is equal to 1,040 hours—40 hours per week x 26 weeks. See separate instructions for examples of how to calculate and prorate FTEs.)
Staff

FTE(s)

Administrator (director, fiscal manager)
Attorney
Campus police/security officer
Counselor
Evaluator
Information technology staff
Legal advocate (does not include attorney or paralegal)
Paralegal
Program coordinator (training coordinator, victim services coordinator)
Support staff (administrative assistant, bookkeeper, accountant)
Trainer/educator (includes peer educators if paid)
Victim advocate (includes domestic violence, sexual assault, dual)
Other (specify):
TOTAL

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0.00

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B

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PURPOSE AREAS

All grantees must complete this section.
(If the grant funds a consortium or flagship project, responses in this section
should reflect the aggregated responses of project members.)

12. Statutory purpose areas
(Check all purpose areas that apply to activities supported with Campus Program funds during the current reporting period.)
Check ALL
Purpose areas
that apply
To provide personnel, training, technical assistance, data collection, and other equipment
with respect to the increased apprehension, investigation, and adjudication of people
committing domestic violence, dating violence, sexual assault, and stalking on campus.
To develop and implement campus policies, protocols, and services that more effectively
identify and respond to the crimes of domestic violence, dating violence, sexual assault,
and stalking, and to train campus administrators, campus security personnel, and personnel serving on campus disciplinary boards on such policies, protocols, and services.
To implement and operate education programs for the prevention of domestic violence,
dating violence, sexual assault, and stalking.
To develop, enlarge, or strengthen victim services programs on the campuses of institutions involved, including programs providing legal, medical, or psychological counseling,
for victims of domestic violence, dating violence, sexual assault, and stalking, and to improve delivery of victim assistance on campus.
To create, disseminate, or otherwise provide assistance and information about victims’
options on and off campus to bring disciplinary or other legal action, including assistance
to victims in immigration matters.
To develop, install, or expand data collection and communication systems, including computerized systems, linking campus security to local law enforcement for the purpose of
identifying and tracking arrests, protection orders, violations of protection orders, prosecutions, and convictions with respect to the crimes of domestic violence, dating violence,
sexual assault, and stalking on campus.
To provide capital improvements (including improved lighting and communications facilities, but not including the construction of buildings) on campuses to address the crimes
of dating violence, domestic violence, sexual assault, and stalking.
To support improved coordination among campus administrators, campus security personnel, and local law enforcement to reduce domestic violence, dating violence, sexual
assault, and stalking on campus.
13. Program priority areas addressed by your grant
(In addition to the purpose areas identified above, the Campus Program Grant Application and Program
Guidelines may have identified several areas that would receive priority consideration. If your program
addressed any of these priority areas during the current reporting period, list them below.)

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C1

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FUNCTION AREAS
Minimum Requirements

All grantees must complete this subsection.
(If the grant funds a consortium or flagship project, responses in this subsection
should reflect the aggregated responses of project members.)

For purposes of this reporting form, education means providing general information that will increase
public awareness of sexual assault, dating violence, domestic violence, or stalking. Training means
providing information on sexual assault, dating violence, domestic violence, and stalking that enables
professionals to improve their response to victims/survivors as it relates to their role in the system.
14. Prevention and education program events provided for incoming students
(Report the total number of prevention and education program events supported with Campus Program
funds provided for incoming students during the current reporting period. Report the number of prevention and education program events supported with a funding source other than your Campus Program
grant provided to incoming students during the current reporting period.)
Total number of prevention and education program events provided with Campus Program funds
Total number of prevention and education program events provided with other funding sources
Total number of prevention and education program events provided

0

15. Was the mandatory prevention and education program for incoming students developed in
collaboration with campus and community-based victim advocacy organizations?
Yes
No
16a. Prevention and education for incoming students
(In the first column, report the number of incoming students during the current reporting period. In the
second column, report the number of incoming students who received prevention and education supported with Campus Program funds during the current reporting period. In the third column, report the
number of incoming students who received prevention and education supported with a funding source
other than Campus Program funds during the current reporting period.)
Total number
incoming
students

Number educated
with Campus
Program funds

Number educated
with other
funding sources

Number
incoming not
educated

Incoming students
16b. If all incoming students were not provided with prevention education, please explain in the box below.

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17. Topics of prevention and education program events for incoming students
(Indicate all topics addressed in the prevention and education program events provided to incoming
students during the current reporting period. Check all that apply.)
Dating violence prevention
Domestic violence prevention
Sexual assault prevention
Sexual harassment prevention
Stalking prevention
Dating violence overview, dynamics,
and services

Domestic violence overview, dynamics,
and services
Sexual assault overview, dynamics,
and services
Stalking overview, dynamics, and services
Other (specify):

18. Training program events provided for campus police/security officers and judicial/disciplinary
board members
(Report the total number of training program events supported with Campus Program funds provided
for campus police/security officers and judicial/disciplinary board members during the current reporting period. Report the number of training program events supported with a funding source other than
your Campus Program grant provided for campus police/security officers and judicial/disciplinary
board members during the current reporting period. Report total number of events for each group and
each funding source in the total sections.)
Number provided with
Campus Program funds

Number provided with
another funding source

Total events provided

Campus police/security
officers
Judicial/disciplinary
board members
Total events

0

0
0

0

0

19. Were the training programs for campus police/security officers and judicial/disciplinary board
members developed in collaboration with campus and community-based victim advocacy organizations
Yes

No

20. Training for campus police/security officers and judicial/disciplinary board members
(In the first column, report the number of campus police/security officers and judicial/disciplinary
board members who received training supported with Campus Program funds during the current
reporting period. In the second column, report the number of campus police/security officers and judicial/disciplinary board members who received training supported with a funding source other than
Campus Program funds during the current reporting period. In the third column, report the numbers of
those who did not receive training during the current reporting period, and in the last column, report
the total. Report the total of each column in the last row.)
Number trained
with Campus
Program funds
Campus police/security officers
Judicial/disciplinary board
members
Total

Number trained
with another
funding source

Number not
trained

Total
0

0
0

0

0

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0

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21. Training content areas for campus police/security officers and judicial/disciplinary board members
(Indicate all topics covered in training program events provided to campus police/security officers and
judicial/disciplinary board members during the current reporting period. Check all that apply.)
Sexual assault, dating violence, domestic violence,
and stalking
Confidentiality
Dating violence overview, dynamics,
and services
Domestic violence overview, dynamics,
and services
Drug-facilitated sexual assault
Safety planning for victims/survivors
Sexual assault overview, dynamics,
and services
Stalking/cyberstalking overview, dynamics, and
services
Response to victims/survivors who have been
trafficked
Other (specify):
Justice and disciplinary systems
Campus police/security response
Civil court procedures
Criminal court procedures
Disciplinary/judicial board response
Domestic violence/dating violence statutes/
codes
Firearms and domestic violence/dating violence
Identifying predominant aggressor/
decreasing dual arrests
Judicial response
Mandatory reporting requirements
Pro-arrest policies
Protection orders (including full faith and credit)
Sexual assault statutes/codes
Stalking statutes/codes
Other (specify):

Underserved populations
Issues specific to victims/survivors who:
live in rural areas
are American Indian or Alaska Native
are Asian
are black or African American
have disabilities
are elderly
are Hispanic or Latino
are homeless or living in poverty
are immigrants, refugees, or asylum seekers
are lesbian, gay, bisexual, transgender, or
intersex
are Native Hawaiian or other Pacific
Islander
have mental health issues
have substance abuse issues
have limited English proficiency
Other (specify):
Campus and community response
Campus response to sexual assualt
Clery Act reporting
Coordinated community response
Response teams (DART, DVRT, SART)
Technology
Other (specify):

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22. Coordinated campus-based community response activities supported by Campus Program funds during the current reporting period
(Check the appropriate boxes to indicate the campus-based groups or offices, even if they are not
partners with which you have an internal memorandum of understanding [IMOU], that you provided
victim/survivor referrals to, received referrals from, engaged in consultation with, provided technical
assistance to, and/or attended meetings with, according to the usual frequency of those interactions.
If the interactions were not part of a regular schedule, you will need to estimate the frequency with
which these interactions occurred during the current reporting period. In the last column, indicate the
campus-based groups or offices with which you have an IMOU for the purposes of the Campus Program
grant.)
Campus-based group or
office

Academic deans/
directors
Academic departments
Athletics department
Campus police/security
department
Counseling center
Disciplinary/judicial
office or board
Faculty senate
Faith-based services
Greek affairs
Health center
Human resources
Men’s anti-violence
groups
President of the
institution
Residential life
Student affairs
(multicultural center,
career services)
Student groups
Student senate
Victim services
Victim/survivor groups
Women’s center
Women’s anti-violence
groups
Other (specify):

Victim/survivor referrals,
consultations, technical assistance
Daily
Weekly Monthly

Meetings
Weekly

Monthly Quarterly

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IMOU
Partner

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23. (Optional) Additional information
(Use the space below to discuss the effectiveness of coordinated community response [CCR] activities funded or supported by your Campus Program grant and to provide any additional information you
would like to share about your campus-based CCR activities beyond what you have provided in the data
above. Examples might include improved information to victims/survivors regarding available resources
and greater coordination between departments on campus.) (Maximum - 2000 characters)

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24. Coordinated community-based response activities supported by Campus Program funds during the
current reporting period
(Check the appropriate boxes to indicate the community-based agencies, organizations, or groups, even
if they are not partners with which you have an external memorandum of understanding [EMOU], that
you provided victim/survivor referrals to, received referrals from, engaged in consultation with, provided
technical assistance to, and/or attended meetings with, according to the usual frequency of the interactions. If the interactions were not part of a regular schedule, you will need to estimate the frequency
with which these interactions occurred during the current reporting period. If Campus Program-funded
staff participated in a task force or work group, indicate that under “Meetings” by checking the frequency of the meetings and the types of organizations participating. In the last column, indicate the
community-based agencies, organizations, or groups with which you have an EMOU for purposes of the
Campus Program grant.)
Community-based agency/
organization/group

Victim/survivor referrals,
consultations, technical
assistance
Daily

Weekly

Monthly

Meetings

EMOU
partner

Weekly Monthly Quarterly

Advocacy organization (NAACP,
LGBTQ organization)
Batterer intervention
program
Court
Domestic violence
organization
Dual sexual assault and
domestic violence organization
Educational institutions/
organizations
Faith/spiritual-based
organization
Government agency
(vocational rehabilitation, food
stamps, TANF)
Health/mental health
organization
Law enforcement (excluding
campus police/security)
Legal organization (legal
services, bar association, law
school)
Prosecutor’s office
Sexual assault organization
Sex offender treatment
program
Social service organization
Tribal government/Tribal
government agency
Other (specify):
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25. (Optional) Additional information
(Use the space below to discuss the effectiveness of community-based CCR activities funded or supported by your Campus Program grant and to provide any additional information you would like to share
about your community-based CCR activities beyond what you have provided in the data above. Examples might include an improved response to victims/survivors of domestic violence/dating violence following meetings of a regional task force; improved information to victims/survivors regarding resources
and greater coordination between the campus and the local victim services agency as the result of
meetings between campus and community advocates.) (Maximum - 2000 characters)

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C2

Policies

Were your Campus Program funds used to develop, substantially revise, or implement policies or protcols
during the current reporting period?
Check yes if Campus Program-funded staff developed, substantially revised, or implemented policies or
protocols, or if Campus Program funds directly supported the development, revision, or implementation
of policies or protocols.
Yes--answer questions 26-27
No--skip to C3
26. Types of policies or protocols developed, substantially revised, or implemented during the
current reporting period
(Check all that apply.)
Law enforcement

Campus Community
based
based

Appropriate response to underserved populations
Identifying primary aggressor/discouraging dual arrest
Immediate access to protection order information
Mandatory training on sexual assault, domestic violence/dating violence, and stalking
Procedures for anonymous, confidential, or Jane Doe reporting of sexual assault
Sexual assault response and protocols
Policies to protect victims/survivors from internet disclosure of identifying information
No charge to victims/survivors for any costs related to the investigation of sexual assault,
domestic violence/dating violence, and/or stalking offenses
No charge to sexual assault victim/survivor for any costs associated with forensic exam
No victims/survivors polygraphed
Pro-arrest/mandatory arrest
Protection order enforcement (including full faith and credit)
Providing information to victims/survivors about victim services
Other (specify):
Victim services

Campus Community
based
based

Appropriate services for underserved populations
Appropriate response to victims/survivors with substance abuse issues and/or mental health
diagnoses
Confidentiality
Disciplinary policy and procedures
Mandatory training standards for staff and volunteers
Protocols with campus police/security
Staff, board, and/or volunteers represent the diversity of your service area
Procedures for anonymous, confidential, or Jane Doe reporting of sexual assault
Victim/survivor informed about Crime Victims Compensation and victim impact statements
Other (specify):

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Health care

Campus Community
based
based

Advocate response to emergency
room/campus health center
Appropriate response to underserved populations
Forensic evidence collection and
documentation
Mandatory training on sexual assault, domestic violence/dating
violence, and stalking
Routine screening and referrals for
sexual assault, domestic violence/
dating violence, and stalking
Other (specify):

Student conduct code
Dating violence policy
Domestic violence policy
Sexual assault policy
Stalking policy
Other (specify):

Campus response
Clery Act reporting
Data collection
Coordinated campus/community response
Response teams (DART, DVRT, SART)
Sexual assault response and protocols
Other (specify):

Judicial/disciplinary board (campus-based)
Accelerated hearing schedules
Appropriate response to underserved populations
Confidentiality
Mandatory training on sexual assault, domestic
violence/dating violence, and stalking
Discouraging mediation
Procedures for disciplinary hearing security
Sanctions
Victim/survivor notification
Other (specify):

Justice system (community-based)
Civil court procedures
Criminal court procedures
Decreasing dual arrests/identifying predominant
aggressor
Domestic violence/dating violence statutes/
codes
Firearms and domestic violence/dating violence
Judicial response
Law enforcement response
Pro-arrest policies
Prosecution response
Protection orders (including full faith and credit)
Sexual assault response and protocols
Sexual assault statutes/codes
Stalking statutes/codes
Other (specify):

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27. (Optional) Additional information
(Use the space below to discuss the effectiveness of policies funded or supported by your Campus
Program grant that you have developed or implemented and to provide any additional information you
would like to share about your activities relating to the developing, revising, or implementing of policies
beyond what you have provided in the data above.) (Maximum - 2000 characters)

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C3

Training

Were your Campus Program funds used for training during the current reporting period?
Check yes if Campus Program-funded staff provided training or if grant funds directly supported the
training. (If the grant funds a consortium or flagship project, responses in this subsection should reflect
the aggregated responses of project members.)
Yes—answer questions 28-31
No—skip to C4
For the purposes of this reporting form, training is providing information on sexual assault, domestic
violence, dating violence, and stalking that enables professionals to improve their response to victims/
survivors as it relates to their role in the system. Education is providing general information that will
increase public awareness of sexual assault, domestic violence, dating violence, or stalking. In this subsection, report information on training activities. Report education activities in subsection C4.
28. Training events provided
(Report the total number of training events provided with Campus Program funds during the current
reporting period. Exclude those events reported in subsection C1, Minimum Requirements, where you
report on events provided for incoming students and campus police/security and judicial disciplinary
board members. Training provided to Campus Program-funded staff should not be counted.)
Total number of training events provided

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29. Number of people trained
(Report the number of people trained with Campus Program funds during the current reporting period.
Use the category that is most descriptive of the people attending the training event. Exclude those reported in subsection C1. Campus Program-funded staff attending training events should not be counted as people trained. If you do not know how many people to report in specific categories, you may
report the overall number in “Multidisciplinary,” but this category should be used only as a last resort.
Students, community members, and victims/survivors should not be reported as people trained, since
they are not professionals responding to victims/survivors.)
People trained
Advocacy organization staff (NAACP, LGBTQ organization)

Number

Attorneys/law students
Batterer intervention program staff
Educators (teachers, administrators, etc.)
Faith-based organization staff
Health professionals (doctors, nurses, health center staff)
Law enforcement officers
Mental health professionals
Multidisciplinary (various disciplines at same training)
Peer educators
Pre-professional students (students who will serve victims/survivors in a
professional capacity upon completion of their program, e.g., social work,
medical, psychology students)
Sex offender management/sex offender treatment providers
Social service organization staff (non-governmental -- food bank, homeless shelter)
Student affairs staff (residential life, multicultural center, disability organization, LGBTQ)
Victim advocates (includes domestic violence, sexual assault, dual)
Volunteers
Other (specify):
TOTAL

0

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30. Training content areas
(Indicate all topics covered in training events provided by your Campus Program funds during the current reporting period. Do not include training events attended by Campus Program-funded staff. Check
all that apply.)
Sexual assault, domestic violence, dating
violence, and stalking
Confidentiality
Dating violence overview, dynamics,
and services
Domestic violence overview, dynamics,
and services
Drug-facilitated sexual assault
Safety planning for victims/survivors
Sexual assault overview, dynamics,
and services
Stalking overview, dynamics, and services
Response to victims/survivors who are incarcerated
Response to victims/survivors who have
been trafficked
Other (specify):
Justice and disciplinary systems
Campus police/security response
Civil court procedures
Criminal court procedures
Disciplinary/judicial board response
Domestic violence/dating violence statutes/codes
Firearms and domestic violence/dating violence
Identifying predominant aggressor/
decreasing dual arrests
Judicial response
Mandatory reporting requirements
Pro-arrest policies
Protection orders (including full faith
and credit)
Sexual assault statutes/codes
Stalking statutes/codes
Other (specify):

Underserved populations
Issues specific to victims/survivors who:
are American Indian or Alaska Native
are Asian
are black or African American
are elderly
are Hispanic or Latino
are homeless or living in poverty
are immigrants, refugees, or asylum
seekers
are international students
are lesbian, gay, bisexual, transgender,
or intersex
are Native Hawaiian or other Pacific
Islander
are non-traditional or older students
have disabilities
have limiited English proficiency
have mental health issues
have substance abuse issues
live in rural areas
Other (specify):
Campus and community response
Clery Act reporting
Community response to sexual assault
Coordinated community response
Response teams (DART, DVRT, SART)
Technology
Other (specify):

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31. (Optional) Additional information
(Use the space below to discuss the effectiveness of training activities funded or supported by your
Campus Program grant and to provide any additional information you would like to share about your
training activities beyond what you have provided in the data above. Examples might include improved
system response to victims/survivors with disabilities following a multidisciplinary training on issues
specific to victims/survivors with disabilities, or greater awareness and reporting of drug-facilitated
sexual assault.) (Maximum - 2000 characters)

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C4

Campus Education

Were your Campus Program funds used for campus education (outreach events, public awareness, and/
or prevention activities) during the current reporting period?
Check yes if Campus Program-funded staff were used to support campus education or if Campus Program funds directly supported campus education. (If the grant funds a consortium or flagship project,
responses in this subsection should reflect the aggregated responses of project members.)
Yes—answer questions 32-35
No—skip to C5
For purposes of this reporting form, education means providing general information that will increase
public awareness of sexual assault, domestic violence, dating violence, or stalking. In this subsection,
report information on prevention activities and education programs. Training means providing information on sexual assault, domestic violence, dating violence, and stalking that enables professionals to
improve their response to victims/survivors as it relates to their role in the system. In this subsection,
report information on education activities. Report training activities in subsection C3.
32. Education activities
(Indicate the activities supported with Campus Program funds during the current reporting period.
Check all that apply.)

Activities

Sexual
assault

Domestic
violence/
dating
violence

Stalking

Community organizing/community events (rallies, speak
outs, Take Back the Night, vigils)
Educational exhibits (Clothesline Project, silent witness,
information tables)
Media campaigns (press conferences, public service announcements, articles)
Productions for public awareness (video series, theater
productions)
Other (specify):

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33. Education program attendees
(Report the number of people attending education program events provided with Campus Program
funds during the current reporting period. Use the category that is most descriptive of the people attending the education program event. Exclude those reported in subsection C1.)
People attending
Institution administrators (Provost, President)

Number

Academic deans/directors
Athletics (including athletes, coaches, athletics department)
Faculty/staff
Fraternity/sorority members
Parents of students
Residential life staff
Student affairs staff (multicultural center, LGBTQ center, career services)
Students (club sports, intramurals, classroom, non-traditional, international,
etc., excluding those reported in subsection C1)
Victims/survivors
Women’s group participants
Community members/general public
Other (specify):
TOTAL

0

34. Topics of education programs
(Indicate all topics addressed in education programs provided with Campus Program funds during the
current reporting period. Check all that apply.)
Dating violence prevention
Domestic violence prevention
Self-defense
Sexual assault prevention
Stalking prevention
Dating violence overview, dynamics,
and services

Domestic violence overview, dynamics,
and services
Sexual assault overview, dynamics, and
services
Stalking overview, dynamics, and services
Other (specify):

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35. (Optional) Additional information
(Use the space below to discuss the effectiveness of outreach and education activities funded or supported by your Campus Program grant and to provide any additional information you would like to share
about those activities beyond what you have provided in the data above. Examples might include a
marked increase in calls from victims/survivors of sexual violence to your hotline following a Take Back
the Night rally held on the campus commons, or during a Clotheslines Project exhibition.)
(Maximum - 2000 characters)

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C5

Products

Were your Campus Program funds used to develop, substantially revise, or distribute products during the
current reporting period?
Check yes if Campus Program-funded staff developed, substantially revised, or distributed products or if
Campus Program funds directly supported the development, revision, or distribution of products. (If the
grant funds a consortium or flagship project, responses in this subsection should reflect the aggregated
responses of project members.)
Yes—answer question 36
No—skip to C6
36. Use of Campus Program funds for product development, substantial revision, or distribution
(Report the number of products developed, substantially revised, or distributed with Campus Program
funds during the current reporting period. Report the number of new products developed or substantially revised during the current reporting period; the title/topic and intended audience for each product
developed, revised, or distributed; and the number of products used or distributed. If a product was
created in or translated into a language other than English, including Braille, indicate the language.
Report on products that were newly developed or revised during the current reporting period whether
or not they were used or distributed, and on products that were previously developed or revised but
used or distributed during the current reporting period. Do not report the number of products printed
or copied; only report the number developed or revised—in most cases that number will be one for each
product described —and/or the number used or distributed. See separate instructions for examples of
how to report under “developed or revised” and “used or distributed.”)
Products

Number
developed
or revised

Title/topic

Intended
audience

Number
Other
used or
languages
distributed

Brochures

Manuals

Newsletter

Posters

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36. Use of Campus Program funds for product development, substantial revision, or distribution (cont.)
Products

Number
developed
or revised

Title/topic

Intended
audience

Number
Other
used or
languages
distributed

Promotional
products

(wallet cards,
key rings, whistles, etc.)

Training
materials

(power point
presentations,
theatre scripts,
etc.)

Training

curricula

Web site

(indicate the
number of page
views in the
number used
or distributed
column)

Other
(specify):

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C6

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Data Collection and Communication Systems

Were your Campus Program funds used for data collection systems or communication systems or for the
purchase of hardware or other equipment during the current reporting period?
Check yes if Campus Program funds or Campus program-funded staff were used to develop, install, or
expand data collection and/or communication systems. (If the grant funds a consortium or flagship project, responses in this subsection should reflect the aggregated responses of project members.)
Yes—answer questions 37-38
No—skip to C7
37. Use of Campus Program funds for data collection and/or communication systems
(Check all that apply.)
Develop data collection/communication systems
Install data collection/communication systems
Expand existing data collection/communication systems
Link existing data collection/communication systems with local law enforcement
Share information with other community partners
Manage data collection and communication
Purchase computers and other equipment
38. Purpose of data collection and/or communication systems
(Indicate all types of information identified or tracked with this technology by checking all that apply.)
Arrests
Case management
Compliance with judicial/disciplinary board-ordered sanctions
Convictions
Evaluation/outcome measures
Incident reports
Judicial/disciplinary board conditions/violations
Judicial/disciplinary board hearing schedules
Prosecutions
Protection orders
Recidivism
Sentencing
Stalking and harassment orders
Victim notification
Victim service availability
Violations of protection orders
Other (specify):

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C7

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System and Capital Improvement

Were your Campus Program funds used for system and/or capital improvement (but not including construction of buildings) during the current reporting period?
Check yes if Campus Program-funded staff engaged in system and/or capital improvement activities
(not including construction of buildings) or if Campus Program funds directly supported system improvements (e.g., interpreters, evaluations, language lines) and/or capital improvements (e.g., improved
lighting, emergency call boxes). (If the grant funds a consortium or flagship project, responses in this
subsection should reflect the aggregated responses of project members.)
Yes—answer questions 39-40
No—skip to section D
39. Use of Campus Program funds for system improvement
(Indicate the system improvement activities supported with your Campus Program funds during the current reporting period. Check all that apply.)
Victim services

Campus police/
security

Judicial/
disciplinary board

Evaluation
Interpreters
Language lines
Translation of forms and documents
Other (specify):

40. Use of Campus Program funds for capital improvements
(Indicate the capital improvements supported with Campus Program funds during the current reporting
period. Capital improvements do not include the construction of buildings. Check all that apply.)
Capital improvements
Emergency call boxes
Landscape design for security
Lighting
Security cameras
Other (specify):

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D

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VICTIM SERVICES

Were your Campus Program funds used to provide victim services to victims/survivors during the
current reporting period?
Check yes if Campus Program-funded staff provided victim services or if Campus Program funds were
used to support victim services during the current reporting period. (If the grant funds a consortium or
flagship project, responses in this section should reflect the aggregated responses of project members.)
Yes—answer questions 41-48
No—if no, please explain in box below, and then skip to section E

41. Number of victims/survivors served, partially served, and victims/survivors seeking services who
were not served Please do not answer this question without referring to the separate instructions for
further explanation and examples of how to distinguish among these categories.
(Report the following, to the best of your ability, as an unduplicated count for each category during the
current reporting period. This means that each victim/survivor who was seeking or who received services during the current reporting period should be counted only once. For purposes of this question,
victims/survivors are those against whom the sexual assault, domestic violence, dating violence, and/
or stalking was directed. If the victim/survivor presented with more than one victimization, that person
should be counted only once under the primary victimization.)
Domestic
violence/
dating
violence

Sexual
assault
A. Served: Victims/survivors who received the
service(s) they requested, if those services were
funded by your Campus Program grant
B. Partially served: Victims/survivors who received some service(s), but not all of the services
they requested, if those services were funded by
your Campus Program grant
TOTAL SERVED AND PARTIALLY SERVED (41A+B)

Stalking

TOTAL

0

0

0

0

0

C. Victims/survivors seeking services who were
not served: Victims/survivors who sought services and did not receive the service(s) they were
seeking, if those services were funded by your
Campus Program grant

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0

0

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42. Reasons that victims/survivors seeking services were not served or were partially served
(Check all that apply.)
Reasons not served or partially served
Conflict of interest
Did not meet statutory requirements
Hours of operation
Insufficient/lack of culturally appropriate services
Insufficient/lack of language capacity (including sign language)
Insufficient/lack of services for people with disabilities
Lack of child care
Program reached capacity
Program rules not acceptable to victim/survivor
Services inappropriate or inadequate for victims/survivors with mental health issues
Services inappropriate or inadequate for victims/survivors with substance abuse issues
Services not appropriate for victim/survivor
Transportation
Other (specify):

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43. Demographics of victims/survivors served or partially served
(Based on the victims/survivors reported in 41A and 41B, report the total numbers for all that apply. Because victims/survivors may identify in more than one category of race/ethnicity, the total for
“Race/ethnicity” may exceed the total number of victims/survivors reported in 41A and 41B. However,
the total number of victims/survivors reported under “Race/ethnicity” should not be less than the total
number of victims/survivors reported in 41A and 41B. The total number of victims/survivors reported
under “Gender” and the total number reported under “Age” should equal the total number of victims/
survivors reported in 41A and 41B. Those victims/survivors for whom gender, age, and/or race/ethnicity are not known should be reported in the “Unknown” category.)
Race/ethnicity (victims/survivors should not be counted more than once in
either the category “American Indian and Alaska Native” or in the category
“Native Hawaiian and other Pacific Islander.”)
American Indian and Alaska Native

Number of victims/
survivors

Asian
Black or African American
Hispanic or Latino
Native Hawaiian and other Pacific Islander
White
Unknown
TOTAL RACE/ETHNICITY (should not be less than

0)

0

Number of victims/
survivors

Gender
Female
Male
Unknown
TOTAL GENDER (should equal

0)

0

Number of victims/
survivors

Age
0-12
13-17
18-24
25-59
60+
Unknown
TOTAL AGE (should equal

0)

Other demographics

0

Number of victims/
survivors

People with disabilities
People with limited English proficiency
People who are immigrants/refugees/asylum seekers
People who live in rural areas

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44. Victims/survivors’ relationship to offender by victimization
(For those victims/survivors reported as served and partially served in 41A and 41B, report the victim/
survivor’s relationship to the offender, by type of victimization. If a victim/survivor experienced more
than one type of victimization and/or was victimized by more than one perpetrator, count the victim/
survivor in all categories that apply. The total number of relationships in the sexual assault column
0 ; the total number in the
must be at least
0;
domestic violence/dating violence column must be at least
and the total number in the stalking column must be at least
0.

Victims/survivors’ relationship to offender

Number of victim/survivor relationships
by victimization
Sexual
assault

Domestic violence/
dating violence

Stalking

Current or former spouse or intimate partner
Other family or household member
Acquaintance (neighbor, employee, co-worker,
classmate, student, etc.)
Current or former dating relationship
Stranger
Relationship unknown
TOTAL

0

0

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45. Victim services
(Report the number of primary victims/survivors from 41A and 41B who received Campus Program-funded
services. Count each victim/survivor only once for each type of service that the victim/survivor received
during the current reporting period; do not report the number of times that service was provided to the victim/survivor. The total for each type of service should not be higher than
0..
t
Number of
Type of service
victims/
survivors
Academic/education advocacy (Actions designed to help the victim/survivor obtain
needed support, resources, or services including assistance with course scheduling,
academic letter of support, etc.)
Civil legal assistance (Civil legal services provided by an attorney and/or paralegal)
Crisis intervention (Crisis intervention is a process by which a person identifies, assesses, and intervenes with an individual in crisis so as to restore balance and reduce
the effects of the crisis in her/his life. In this category, report crisis intervention that
occurs in person and/or over the telephone.)
Disciplinary board advocacy (Assisting a victim/survivor with issues relating to campus
disciplinary board actions such as preparation of statements, accompanying the victim/survivor to disciplinary board hearings, and all other advocacy relating to campusbased proceedings)
Hospital/clinic/other medical response (Accompanying a victim/survivor to,
or meeting a victim/survivor at a hospital, clinic, or medical office)
Housing assistance (Assisting a victim/survivor with housing issues including finding a room in a different dorm or finding temporary housing either on- or off-campus;
preventing access by the perpetrator to the victim/survivor’s new residence)
Legal advocacy/court accompaniment (Assisting a victim/survivor with legal issues
including preparing paperwork such as victim impact statements, accompanying a
victim/survivor to an administrative hearing, court proceeding, or law enforcement
interview, and all other advocacy within the criminal or civil justice system. Services
provided by an attorney and/or paralegal should be reported in civil legal assistance.)
Support group/counseling services (Individual or group counseling or support provided by a volunteer, peer, or professional)
Transportation
Victim/survivor advocacy (Actions designed to assist the victim/survivor in obtaining
support, resources, or services, including employment, health care, victim’s compensation, etc.)
Other (specify):
45A. Hotline calls
(Report the number of hotline calls received from victims/survivors, and the total number of hotline calls
received, during the current reporting period. Victims/survivors whose calls are reported here should not be
reported as victims served in Question 41 unless they also received at least one of the services described in
Question 45 Victim Services. Victims/survivors who receive services such as crisis intervention or victim advocacy over the telephone, in addition to basic hotline information and/or referrals, should also be reported
in Question 45. Hotline calls that include victim advocacy or crisis intervention services are those that require more time than the average call and involve a more intensive focus on the immediate needs and situation of the victim. For examples of when to report only the hotline call and when to report both the hotline
call and a service or services in Question 45, see separate instructions.)
Number of calls from Total number of
victims/survivors
calls
Hotline calls (Crisis or information and referral calls
received by an agency’s hotline or office telephone)
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46. Number of victims/survivors reporting crimes
(Of the victims/survivors who sought services provided under your Campus Program grant, provide the
number who reported crimes of sexual assault, domestic violence, dating violence, and/or stalking to
campus police/security or community law enforcement during the current reporting period.)
Where crime occurred
On-campus
Off-campus
TOTAL

Campus police/
security

Community law
enforcement

TOTAL
0
0

0

0

0

47. (Optional) Additional information
(Use the space below to discuss the effectiveness of victim services funded or supported by your Campus Program grant and to provide any additional information you would like to share about your victim
services activities beyond what you have provided in the data above. For example, if you have witnessed an increase in the number of victims/survivors who are able to remain in school and continue
their education because of your academic and housing advocacy, you could report that here.)
(Maximum - 2000 characters)

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Expiration Date: 6/30/2011

48. Protection orders
(Report the total number of temporary and/or final protection orders requested and granted for which
Campus Program-funded victim services staff provided assistance to victims/survivors during the current reporting period. These orders may also be referred to as restraining orders, anti-harassment
orders, or no-contact or stay-away orders.)
Sexual assault protection orders

Temporary orders

Final orders

Temporary orders

Final orders

Temporary orders

Final orders

Number requested
Number granted
Domestic violence/dating
violence protection orders
Number requested
Number granted
Stalking protection orders
Number requested
Number granted

Campus Program Semi-annual Progress Report • 32 • Office on Violence Against Women
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SECTION

OMB OMB
Clearance
# 1122-0005
Clearance
# 1121-0258
Expiration
Date: 07/31/2004
Expiration
Date:

E

CAMPUS AND COMMUNITY MEASURES

All grantees must complete this section.
(If the grant funds a consortium or flagship project, responses in this section
should reflect the aggregated responses of project members.)

In this section, use the numbers from your Clery Act report to provide information for the entire campus
or for the campuses represented in your consortium or flagship project, to the extent that the information is available. This applies to all sexual assault, domestic violence, dating violence, and stalking
offenses as defined by question 10, that occurred on campus, or in or on non-campus buildings or
property, and on public property, that were reported to campus security authorities or local law enforcement. Campus security authorities are not restricted to campus police/security officers. See instructions
for question 49 for the definitions of “campus” (to include non-campus buildings or property,
and public property) and “campus security authorities” as defined by the Clery Act.
49. Number of offenses reported
(Report the number of sexual assault, domestic violence, dating violence, and/or stalking offenses reported to campus security authorities, during the current reporting period.)
Type of offense

Number of offenses reported

Sexual assault
Domestic violence/dating violence
Stalking
TOTAL

0

50. Number of criminal offenses charged and campus disciplinary or judicial board actions
(Report the number of offenses in which criminal charges were filed in the local jurisdiction and/or in
which campus disciplinary/judicial board actions were held during the current reporting period.)
a. Number of offenses resulting in criminal charges being filed in the local jurisdiction
b. Number of offenses resulting in campus disciplinary/judicial board actions
51. Dispositions of campus disciplinary or judicial board actions
(Report the dispositions of all campus disciplinary or judicial board actions resolved during the current
reporting period.)
Type of offense

Number dismissed
Request
of victim

Lack of
evidence

Other

Number
acquitted

Sanctions
Reprimand

Suspension Expulsion Counseling Community
service

Other

Sexual assault
Domestic/dating
violence
Stalking

TOTAL

0

0

0

0

0

0

0

0

0

Campus Program Semi-annual Progress Report • 33 • Office on Violence Against Women
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0

THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.
Clearance
1121-0258
OMBOMB
Clearance
# #1122-0005
Expiration
Date:
07/31/2004
Expiration
Date:
6/30/2011

52. (Optional) Additional information
(Use the space below to discuss the effectiveness of law enforcement and/or judicial and disciplinary board activities funded or supported by your Campus Program grant and to provide any additional
information you would like to share about these activities beyond what you have provided in the data
above.) (Maximum - 2000 characters)

53. Dispositions of criminal charges in local jurisdiction
(Report the dispositions of all criminal charges filed in the local jurisdiction that were resolved during
the current reporting period. [Deferred adjudication is a process in which the judge requires the defendant to adhere to certain terms, prior to any adjudication of guilt. If a defendant successfully completes
those terms, the charges are dismissed.])
Number dismissed

Type of offense

Request Lack of
Plea
of victim evidence bargain

Other

Number of
deferred
adjudications

Number convicted
Guilty of
highest

Guilty of
lesser

Plead as
charged

0

0

0

Plead
lesser

Number
acquitted

Sexual assault
Domestic/dating
violence
Stalking

TOTAL

0

0

0

0

0

0

Campus Program Semi-annual Progress Report • 34 • Office on Violence Against Women
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0

SECTION

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OMB Clearance
# 1121-0258
OMB Clearance
# 1122-0005
Expiration
Date:
07/31/2004
Expiration
Date:
6/30/2011

F

NARRATIVE

All grantees must answer question 54. (If the grant funds a consortium or flagship project, responses to
this question should reflect the aggregated responses of project members.)
54. Report on the status of your Campus Program grant goals and objectives as of the end of the current reporting period. Page 37.
(Report succinctly on the status of the goals and objectives for your grant as of the end of the current
reporting period, as they were identified in your grant proposal or as they have been added or revised.
Indicate whether the activities related to your objectives for the current reporting period have been
completed, are in progress, are delayed, or have been revised. Comment briefly on your successes and
challenges, and provide any additional explanation you feel is necessary for us to understand what you
have or have not accomplished relative to your goals and objectives. If you have not accomplished objectives that should have been accomplished during the current reporting period, you must provide an
explanation.)
All grantees must answer questions 55 and 56 on an annual basis. Submit this information on the January to June reporting form only. (If the grant funds a consortium or flagship project, responses to these
questions should reflect the aggregated responses of project members.)
Please limit your response to the space provided (8,000 characters, approximately two pages of continuous single-spaced text) for each question.
o
55. What do you see as the most significant areas of remaining need, with regard to improving services
to victims/survivors of sexual assault, domestic violence, dating violence, and stalking, increasing
victims/survivors safety, and enhancing community response (including offender accountability for
both batterers and sex offenders)? Page 40.
(Consider underserved populations, campus-community collaborations, judicial/disciplinary board response, student safety, challenges implementing prevention and education programs across campus,
and/or challenges and barriers unique to your institution or service area.)
56. What has Campus Program funding allowed you to do that you could not do prior to receiving this
funding? Page 42.
(For example, the money allowed us to make capital improvements; install data collection or communication systems; revise judicial/disciplinary board procedures; create and implement prevention and
education programs; and train campus administrators, judicial/disciplinary board members, and security personnel.)
Questions 57 and 58 are optional.
Please limit your response to the space provided (8,000 characters, approximately two pages of continuous single-spaced text) for each question.
o
57. Provide additional information that you would like us to know about your Campus Program and/or
the effectiveness of your grant. Page 44.
(If you have any other data or information that you have not already reported in answer(s) to previous
questions that demonstrate the effectiveness of your Campus Program grant, please provide it below.
Refer to separate instructions for a more detailed explanation and example. Feel free to discuss any of
the following: institutionalization of staff positions, policies, and/or protocols; systems-level changes;
community collaboration; results of pre-tests and post-tests; the removal or reduction of barriers and
challenges for victims/survivors; utilization of volunteers and/or interns to complete activities; promising practices; and positive or negative unintended consequences.)

Campus Program Semi-annual Progress Report • 35 • Office on Violence Against Women
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OMB Clearance # 1122-0005
Expiration Date: 6/30/2011

58. Provide any additional information that you would like us to know about the data submitted.
(If you have any information that could be helpful in understanding the data you have submitted in this
report, please answer this question. For example, if you submitted two different progress reports for the
same reporting period, you may explain how the data was apportioned to each report; or if you funded
staff—e.g., victim advocates—but did not report any corresponding victim services, you may explain
why; or if you did not use program funds to support either staff or activities during the reporting period,
please explain how program funds were used, if you have not already done so.) Page 46.

Public Reporting Burden
Paperwork Reduction Act Notice. Under the Paperwork Reduction Act, a person is not required to respond to a collection of
information unless it displays a currently valid OMB control number. We try to create forms and instructions that are accurate,
can be easily understood, and which impose the least possible burden on you to provide us with information. The estimated
average time to complete and file this form is 60 minutes per form. If you have comments regarding the accuracy of this estimate, or suggestions for making this form simpler, you can write to the Office on Violence Against Women, U.S. Department of
Justice, 800 K Street, NW, Washington, DC 20531.
Campus Program Semi-annual Progress Report • 36 • Office on Violence Against Women
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APPENDIX A

OMB Clearance # 1122-0005
Expiration Date: 6/30/2011

Describe your goals and objectives, as outlined in your grant proposal, or as revised - Question #54
Goals/Objectives

Back to Instructions

Status

Key Activities

Comments

Goals/Objectives

Back to Instructions

Status

Key Activities

Comments

Grants to Reduce Violent Crimes Against Women on Campus Program Semi-annual Progress Report • 37 • Office on Violence Against Women
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APPENDIX A

OMB Clearance # 1122-0005
Expiration Date: 6/30/2011

Describe your goals and objectives, as outlined in your grant proposal, or as revised - Question #54 (cont. 1)
Back to Instructions

Status

Back to Instructions

Status

Goals/Objectives

Key Activities

Comments

Goals/Objectives

Key Activities

Comments

Grants to Reduce Violent Crimes Against Women on Campus Program Semi-annual Progress Report • 38 • Office on Violence Against Women
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THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

APPENDIX A

OMB Clearance # 1122-0005
Expiration Date: 6/30/2011

Describe your goals and objectives, as outlined in your grant proposal, or as revised - Question #54 (cont. 2)
Back to Instructions

Status

Back to Instructions

Status

Goals/Objectives

Key Activities

Comments

Goals/Objectives

Key Activities

Comments

Grants to Reduce Violent Crimes Against Women on Campus Program Semi-annual Progress Report • 39 • Office on Violence Against Women
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THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

Back to Instructions

OMB Clearance
# 1122-0005
OMB Clearance
# 1121-0258
Expiration
Date:
6/30/2011
Expiration
Date:
07/31/2004

What do you see as the most significant areas of remaining need, with regard to improving services to victims/survivors
of sexual assault, domestic violence, dating violence, and stalking, increasing victims/survivors safety, and enhancing
community response (including offender accountability for both batterers and sex offenders)?
Question #55

Campus Program Semi-annual Progress Report • 40 • Office on Violence Against Women
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THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

Back to Instructions

Clearance
1121-0258
OMB OMB
Clearance
# #1122-0005
Expiration
Date:
07/31/2004
Expiration
Date:
6/30/2011

What do you see as the most significant areas of remaining need, with regard to improving services to victims/survivors
of sexual assault, domestic violence, dating violence, and stalking, increasing victims/survivors safety, and enhancing
community response (including offender accountability for both batterers and sex offenders)?
Question #55 (cont.)

Campus Program Semi-annual Progress Report • 41 • Office on Violence Against Women
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THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

Back to Instructions

OMB Clearance
# 1121-0258
OMB Clearance
# 1122-0005
Expiration
Date:
07/31/2004
Expiration
Date:
6/30/2011

What has Campus Program funding allowed you to do that you could not do prior to receiving this funding?
Question #56

Campus Program Semi-annual Progress Report • 42 • Office on Violence Against Women
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Back to Instructions

OMB Clearance
# 1121-0258
OMB Clearance
# 1122-0005
Expiration
07/31/2004
Expiration
Date:Date:
6/30/2011

What has Campus Program funding allowed you to do that you could not do prior to receiving this funding?
Question #56 (cont.)

Campus Program Semi-annual Progress Report • 43 • Office on Violence Against Women
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THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

Back to Instructions

OMB Clearance
# 1121-0258
OMB Clearance
# 1122-0005
Expiration
Date:
07/31/2004
Expiration
Date:
6/30/2011

Provide additional information that you would like us to know about your Campus Program and/or the effectiveness of
your grant.
Question #57

Campus Program Semi-annual Progress Report • 44 • Office on Violence Against Women
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Back to Instructions

OMB Clearance
# 1121-0258
OMB Clearance
# 1122-0005
Expiration
Date:
07/31/2004
Expiration
Date:
6/30/2011

Provide additional information that you would like us to know about your Campus Program and/or the effectiveness of
your grant.
Question #57 (cont.)

Campus Program Semi-annual Progress Report • 45 • Office on Violence Against Women
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OMB Clearance # 1122-0005
Expiration Date: 6/30/2011
Provide any additional information that you would like us to know about the data submitted.
Question #58
Back to Instructions

Campus Program Semi-annual Progress Report • 46 • Office on Violence Against Women
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THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.
OMB Clearance # 1122-0005
Expiration Date: 6/30/2011

Provide any additional information that you would like us to know about the data submitted.
Question #58 (cont.)
Back to Instructions

Campus Program Semi-annual Progress Report • 47 • Office on Violence Against Women
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OMB Clearance # 1122-0005
Expiration Date: 6/30/2011

Validate

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