Form 1122-0005 Semiannual PRogress Report for the Campus Program

^{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

OMB Clearance # 1121-0258

Expiration Date: 07/31/2004

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 en- gaged 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 un- der 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 Pro- gram-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	Page Number
Section A:	General Information	1
A1:	Grant Information	1
A2:	Staff Information	3
Section B:	Purpose Areas	4
Section C:	Function Areas	5
C1:	Minimum Requirements	5
C2:	Policies	12
C3:	Training	15
C4:	Campus Education	19
C5:	Products	22
C6:	Data Collection and Communication Systems	23
C7:	System and Capital Improvement	24
Section D:	Victim Services	25
Section E:	Campus and Community Measures	32
Section F:	Narrative	34

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

OMB Clearance # 1121-0258

Expiration Date: 07/31/2004

SECTION

_A1

GENERAL INFORMATION Grant Information

^{All grantees must complete this subsection.}

1. Date of report (format date with 6 digits, like - 01/31/04)

2. Current reporting period January 1-June 30 July 1-December 31 (Year) 3. Grantee name 4. Grant number

^{(the federal grant number assigned to your Campus Program grant)}

^{5a. Type of lead institution}

(Check the one answer that best describes the institution receiving the Campus Program funds.)

Public school

Private school

^{5b. Additional designations of lead institution}

^{(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 an OVW Special Initiative to address violent crimes on campuses grant?

Yes No If yes, identify:

7a. Is this a consortium project?

Yes No

7b.

7b. If you answered yes to 6 or 7aabove, 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)

^{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)}

Type of institution			Number
Tribal school
Historically Black college
Faith-based
Community college
Latino or Hispanic
Territory-based
Single sex
Other (specify):

^{8. Point of contact}

^{(Program Coordinator or person responsible for the day-to-day coordination of the grant)}

First name MI Last name Institution name Address City State Zip code

Telephone 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 edu- cation, training, victim services, etc.]. The grantee may choose how to make this determination. If the Campus Program grant funds a consortium project, responses in this question should reflect the aggregated responses of project members.)

Throughout this form, the term sexual assault any nonconsensual sexual act proscribed by Federal, tribal, or State law, including when the victim lacks capacity to consent.

The term domestic violence/dating vio- lence 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}

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Sexual assault

Domestic violence/dating violence

Stalking

TOTAL (must equal 100 %)

100%

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SECTION

_A2 ^{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 project, responses in this subsection should reflect the aggre-

gated 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 em-

ployees 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 instruc-

tions 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

SECTION

_B

_{PURPOSE AREAS}

All grantees must complete this section.

(If the grant funds a consortium 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 cur-

rent reporting period.)

_{Check ALL}

that apply

Purpose areas

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, strengthen 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, to include the use of technology to commit these crimes, 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, and population specific services on the campuses of institu tions involved, including programs providing legal, medical, or psychological counseling, for victims of domestic violence, dating violence, sexual assault, and stalking, and to im- prove 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 com- puterized systems, linking campus security to local law enforcement for the purpose of identifying and tracking arrests, protection orders, violations of protection orders, prosecu- tions, 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 facili- ties, 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 per- sonnel, and local law enforcement to reduce domestic violence, dating violence, sexual assault, and stalking on campus.

To develop or adapt and provide developmental, culturally appropriate, and linguistically accessible print or electronic materials to address both prevention and intervention in domestic violence, dating violence, sexual violence and stalking.

To develop or adapt population specific strategies and projects for victims of domestic violence, dating violence, sexual assault, and stalking from underserved populations on campus.

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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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SECTION

_C1

FUNCTION AREAS Program Requirements

All grantees must complete this subsection.

(If the grant funds a consortium 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 all 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 preven-

tion 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

15. Was the mandatory prevention and education events held during the reporting period for all incoming students developed in collaboration with campus and community-based victim advocacy organizations?

Yes No

^{16a. Prevention and education for all 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 sup-

ported 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 during this reporting period, please explain in the box below. (For example, provide the time of year (fall, spring, summer) that the prevention education is provided.

17. Topics of prevention and education program events for all 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 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

Bystander Intervention

Other (specify):

18. Traini events provided for all campus police/security officers and campus disciplinary board members

(Report the total number of training events supported with Campus Program funds provided for campus police/security officers and campus disciplinary board members during the current report-ing 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 campus 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 of training events heldwith Campus Program funds

Number of training events held with another funding source

Total events held

Campus police/security officers

Campus disciplinary board members
Total events

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

Yes No

_{20. Training for all campus police/security officers andcampus disciplinary board members}

(In the first column, report the number of campus police/security officers and campus 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 ju-

dicial/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.)

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Campus police/security officers

Campus disciplinary board members

Total

Number trained with Campus Program funds

Number trained with another funding source

_{Number not}

_trained ^Total

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.)

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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

□ Trauma Informed Response

□ Victim Accommodations

Bystander Intervention

Other (specify):

Justice and disciplinary systems Campus police/security response Civil court procedures

Criminal court procedures

Disciplinary response

Domestic violence/dating violence statutes/

codes

Firearms and domestic violence/dating violence

Identifying predominant aggressor/

decreasing dual arrests

Mandatory reporting requirements

Protection orders (including full faith and credit)

Sexual assault statutes/codes

Stalking statutes/codes

Victims Accommodations

Investigations

Student Code of Conduct

Sanctions and/or Dispositions

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

Deaf and/or hard of hearing

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

International students

Students abroad

Other (specify):

Campus and community response Campus response to sexual assalt Clery Act reporting

Coordinated community response Response teams (DART, DVRT, SART) Use and misuse of technology

Other (specify):

• Title IX 

• Retaliation  

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Expiration Date: 6/30/2011

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.)

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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

Office of the President/Chancellor

Residential life

Student affairs (multicultural center, career services)

Student groups (students of color; LGTBQ, etc.)

Student senate

Title IX Office

Victim/survivor groups

Women’s center

Other (specify):

_{Victim/survivor referrals,}

_{consultations, technical assistance} ^Meetings

^{Daily Weekly Monthly} Weekly Monthly Quarterly

IMOU Partner

_{OC 23. (Optional) Additional information}

OMB Clearance# 1122-0005

Expiration Date: 6/30/2011

(Use the space below to discuss the effectiveness of coordinated community response [CCR] activi-

ties 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)

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 inter- actions. 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

Meetings

EMOU

partner

Advocacy organization (NAACP, LGBTQ organization)

Daily Weekly Monthly Weekly Monthly Quarterly

Community Based Organization

Court

Domestic violence organization

Dual sexual assault and domestic violence organiza

Faith-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}

Social service organization

Tribal government/Tribal government agency

Other (specify):

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)

SECTION

_C2 ^Policies

OMB Clearance # 1122-0005

Expiration Date: 6/30/2011

Were your Campus Program funds used to develop, substantially revise, or implement policies or protocols 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 incidents

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

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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):

Health care

Campus Community

Student conduct code

_{Dating violence policy}

based

based

Advocate response to emergency room/campus health center

Appropriate response to under- served populations

Forensic evidence collection and documentation

Mandatory training on sexual as- sault, domestic violence/dating violence, and stalking

Routine screening and referrals for sexual assault, domestic violence/ dating violence, and stalking

Other (specify):

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):}

Campus 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):

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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SECTION

_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 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 sub- section, 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 re-

ported in subsection C1. Campus Program-funded staff attending training events should not be count-

ed 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	Number
Advocacy organization staff (NAACP, LGBTQ organization)
Administrators and Campus Leadership
Attorneys/law students
Faculty and Staff )(i.e. Clery Reporters/ Title IX Coordinators and Residential Life, Athletic Department))
Faith-based organization staff
Health professionals (doctors, nurses, health center staff)
Local Law enforcement officers
Mental health professionals
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)

Victim advocates (includes domestic violence sexual assault ordual)
Volunteers
Other (specify):
TOTAL

30. Training content areas

(Indicate all topics covered in training events provided by your Campus Program funds during the cur-

rent reporting period. Do not include training events attended by Campus Program-funded staff. Check

all that apply.)

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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 in- carcerated

Bystander Intervention

Other (specify):

Justice and disciplinary systems Campus police/security response Civil court procedures

Criminal court procedures

Disciplinary response

Domestic violence/dating violence stat- utes/codes

Firearms and domestic violence/dating violence

Identifying predominant aggressor/

decreasing dual arrests

Mandatory reporting requirements

Protection orders (including full faith and credit)

Sexual assault statutes/codes

Stalking statutes/codes

Victims’ Accommodations

Investigations

Student Code of Conduct

Sanctions and/or Dispositions

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

Deaf and/or Hard of Hearing

have limited English proficiency

have mental health issues

have substance abuse issues live in rural areas

International Students

Students Abroad

Other (specify):

Campus and community response

Clery Act reporting

Campus response to sexual assault

Coordinated community response Response teams (DART, DVRT, SART) Use and misuse of technology

Other (specify):

_{OC 31. (Optional) Additional information}

OMB Clearance# 1122-0005

Expiration Date: 6/30/2011

(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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SECTION

_C4 ^{Campus Prevention}

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 Pro-

gram funds directly supported campus education. (If the grant funds a consortium 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.

Prevention 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)
Classroom Activities (i.e., “Don’t Cancel that Class”)
Theatre performances

Other (specify):

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Campus Program Semi-annual Progress Report • 20 • Office on Violence Against Women

_{oc 35. (Optional) Additional information}

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Expiration Date: 6/30/2011

(Use the space below to discuss the effectiveness of outreach and education activities funded or sur:r

ported 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)}

Campus Program Semi-annual Progress Re ort • 21• Office on Violence Against Women

SECTION

_C5 ^Products

OMB Clearance # 1122-0005

Expiration Date:

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 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 substan- tially 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

Other languages

OMB Clearance # 1121-0258

Expiration Date: 07/31/2004

Training Materials and Training Curricula

Manuals

_Newsletter

_Posters

Campus Program Semi-annual Progress Report • 22 • Office on Violence Against Women

OMB Clearance # 1122-0005

Expiration Date:

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

Products

Number developed or revised

Title/topic ^Intended audience

Number used or distributed

Other languages

OMB Clearance # 1121-0258

Expiration Date: 07/31/2004

Promo- tional products (wallet cards, key rings, whis- tles, etc.)

Training materials (power point presentations, theatre scripts, etc.)

Training

curricula

Social Media (Twitter; Instagram, etc.)

Other

(specify):

Campus Program Semi-annual Progress Report • 23 • Office on Violence Against Women

OMB Clearance # 1121-0258

Expiration Date: 07/31/2004

SECTION

_C6 ^{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 proj-

ect, 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 campus disciplinary board-ordered sanctions

Evaluation/outcome measures Incident reports

Campus disciplinary boardconditions/violations

campus disciplinary board hearing schedules

Protection orders

Stalking and harassment orders

Victim notification

Victim service availability

Other (specify):

OMB Clearance # 1121-0258

Expiration Date: 07/31/2004

SECTION

_C7 ^{System and Capital Improvement}

Were your Campus Program funds used for system and/or capital improvement (but not including con- struction 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 improve-

ments (e.g., interpreters, evaluations, language lines) and/or capital improvements (e.g., improved

lighting, emergency call boxes). (If the grant funds a consortium 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 cur-

rent reporting period. Check all that apply.)

_{Victim services Campus police/ Judicial/}

security disciplinary board

Evaluation

Assessment or Climate Survey

Homicide Prevention (i.e. Lethality Assessment)

Fatality Review

Interpreters Language lines

Language Access Plans

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):

OMB Clearance # 1121-0258

Expiration Date: 07/31/2004

SECTION

_D ^{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 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 ser- vices 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.)

	Sexual assault	Domestic violence/ dating violence	Stalking	TOTAL
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 re- ceived 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)
C. Victims/survivors seeking services who were not served: Victims/survivors who sought ser- vices and did not receive the service(s) they were seeking, if those services were funded by your Campus Program grant

42. Reasons that victims/survivors seeking services were not served or were partially served

(Check all that apply.)

_{Conflict of interest}

Reasons not served or partially served

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
	Safety/security risk (due to offender’s behavior)
	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
	Services not available for party(ies) based on family composition

Transportation

Other (specify):

_{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 ap-

ply. 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/ethnic-

ity are not known should be reported in the “Unknown” category.)

Race (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 or Alaska Native

Asian

Black or African American

Native Hawaiian and other Pacific Islander

White

Unknown

_{TOTAL RACE (should not be less than )}

Number of victims/

survivors

OMB Clearance # 1121-0258

Expiration Date: 07/31/2004

_Gender ^{Number of victims/}

^survivors

Female Male

Gender Non-Conforming

Unknown

TOTAL GENDER (should equal )

_Age ^{Number of victims/}

^survivors

0-6

7-10

11-17

18-24

25-59

60+ Unknown

^{TOTAL AGE (should equal )}

_{Other demographics} ^{Number of victims/}

^survivors

People with disabilities

People with limited English proficiency

People who are immigrants/refugees/asylum seekers

People who are LGTBQ

People who live in rural areas

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 must be at least ; the total number in the

domestic violence/dating violence column must be at least ;

and the total number in the stalking column must be at least .

_{Victims/survivors’ relationship to offender}

Number of victim/survivor relationships by victimization

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

Sexual assault

_{Domestic violence/}

_{dating violence} ^Stalking

Campus Program Semi-annual Progress Report • 29• Office on Violence Against Women

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 vic- tim/survivor. The total for each type of service should not be higher than .

Type of service

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.)

Number of victims/ survivors

Civil legal assistance (Civil legal services provided by an attorney and/or paralegal)

OMB Clearance # 1121-0258

Expiration Date: 07/31/2004

Crisis intervention (Crisis intervention is a process by which a person identifies, as- sesses, 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 vic- tim/survivor to disciplinary board hearings, and all other advocacy relating to campus- based 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 find- ing 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 provid- ed 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 compen- sation, etc.)
Other (specify):

45A. Hotline Support, Information and Referral calls

(Report the number of hotline support, information or referral 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 ad- vocacy 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 re- quire more time than the average call and involve a more intensive focus on the immediate needs and situ- ation 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 victims/survivors	Total number of calls
Hotline support, information and referral calls (Crisis or information and referral calls received by an agency’s hotline or office telephone)

Campus Program Semi-annual Progress Report • 30 • Office on Violence Against Women

_{46. Number of victims/survivors reporting crimes}

OMB Clearance # 1122-0005

Expiration Date: 6/30/2011

(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.)

TOTAL

Where crime occurred	Campus police/ security			local law enforcement			TOTAL
On-campus
Off-campus

47. (Optional) Additional information

(Use the space below to discuss the effectiveness of victim services funded or supported by your Cam- pus 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 wit- nessed 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)

Campus Program Semi-annual Progress Report • 31• Office on Violence Against Women

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 cur- rent 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
Number requested
Number granted

Domestic violence/dating violence protection orders	Temporary orders			Final orders
Number requested
Number granted

Stalking protection orders	Temporary orders			Final orders
Number requested
Number granted

Expiration Date:

SECTION

_E

_{CAMPUS AND COMMUNITY MEASURES}

All grantees must complete this section.

(If the grant funds a consortium 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 project, to the extent that the informa- tion is available. This applies to all sexual assault, domestic violence, dating violence, and stalking incidents 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 enforce- ment. 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 incidents reported}

(Report the number of sexual assault, domestic violence, dating violence, and/or stalking Iincidents re

ported to campus security authorities, during the current reporting period.)

Type of incident Number reported

Sexual assault

Domestic violence/dating violence

Stalking

TOTAL

50. Number of incidents, criminal charges or referred for campus disciplinary action

(Report the number of incidents in which criminal charges were filed in the local jurisdiction and/or in

which an incident was referred for campus disciplinary action during the current 6 month reporting period.)

a. Number of incidents resulting in criminal charges being filed in the local jurisdiction

b. Number of incidents resulting in a referral for campus disciplinary action

^{51. Outcomescampus disciplinary actions}

^{(Report the outcomes of all campus disciplinary actions resolved during the current}

reporting period.)

_{Type of incident} ^{Number Number}

Found REsponsibile

OMB Clearance # 1121-0258

Expiration Date: 07/31/2004

Sexual assault

Domestic/dating violence

Stalking

TOTAL

Request of victim

^Other

acquitted

^Suspension Expulsion ^Counseling

Community _Other service

52. Additional information

(Use the space below to discuss the effectiveness of law enforcement and/or judicial and disciplin- ary 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. If your numbers appear to be low, please provide an explanation. ) (Maximum - 2000 characters)

OMB Clearance # 1121-0258

Expiration Date: 07/31/2004

SECTION

_F ^NARRATIVE

All grantees must answer question 54. (If the grant funds a consortium 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 cur- rent reporting period.

(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 ob-

jectives 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 Janu- ary to June reporting form only. (If the grant funds a consortium 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 continu- ous single-spaced text) for each question.

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)?

(Consider underserved populations, campus-community collaborations, campus disciplinary board re-

sponse, 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?

(For example, the money allowed us to make capital improvements; install data collection or commu- nication systems; revise campus disciplinary board procedures; create and implement prevention and education programs; and train campus administrators, campus disciplinary board members, and secu-rity personnel.)

Questions 57 and 58 are optional.

Please limit your response to the space provided (8,000 characters, approximately two pages of continu- ous single-spaced text) for each question.

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

(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; promis-

ing practices; and positive or negative unintended consequences.)

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.)

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 esti- mate, or suggestions for making this form simpler, you can write to the Office on Violence Against Women, U.S. Department of Justice, 145 N Street, NE, Washington, DC 20530..

Campus Program Semi-annual Progress Report • 36 • Office on Violence Against Women

_{Describe your goals and objectives, as outlined in your grant proposal, or as revised - Question #54}

Goals/Objectives

_{Key Activities}

Status

_Comments

_{Goals/Objectives}

Status

_{Key Activities}

Comments

Goals/Objectives

_{Key Activities}

Status

_Comments

_{Goals/Objectives}

Status

_{Key Activities}

Comments

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)}

Goals/Objectives

_{Key Activities}

Status

_Comments

_{Goals/Objectives}

Status

_{Key Activities}

_Comments

Grants to Reduce Violent Crimes Against Women on Campus Program Semi-annual Progress Report • 39 • Office on Violence Against Women

Question #55

Campus Program Semi-annual Progress Report • 40 • Office on Violence Against Women

Question #55 (cont.)

Question #58

^{THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DAT 8Ya nce #}

_{_}

1122 0005

_{Expiration Date: 6130/2011}

Provide any additional information that you would like us to know about the data submitted.

Question #58 (cont.)

Campus Pro am Semi-annual Progress Report • 47 • Office on Violence Against Women

_{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

^{THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.}