Louis Stokes Alliances for Minority Participation (LSAMP) Monitoring System

Attachment B1

Louis Stokes Alliances for Minority Participation (LSAMP)

Monitoring System

Table of Contents

LSAMP: Crosswalk 3

LSAMP: Number of Respondents, Frequency of Response, and Annual Hour Burden 26

LSAMP: Hour Burden Estimates by Each Form and Aggregate Hour Burdens 27

LSAMP: Estimates of Annualized Cost to Respondents for the Hour Burdens 28

LSAMP: Estimates of Costs to the Federal Government 29

LSAMP: Questions 30

LSAMP: Crosswalk by:

Highlighted in blue are items which will be discontinued during the period of the renewal.

Highlighted in yellow are proposed new items.

Highlighted in grey are item wordings which NSF proposes, with OMB approval, to change. Previous text is marked with strikethrough.

Common Collection Categories Questions	Staff and Project Participant Characteristics1	Project Implementation Characteristics2	Project Outputs3
Respondent’s Contact Information: Name: First, Last Phone Email	X
1. Student Enrollment
Count of Physics/Astronomy student enrollment (report Freshmen, Sophomores, Juniors, Seniors, and unknown class students separately, and part-time and full-time students separately) by: Race Black or African American Native American Alaska Native Native Hawaiian or Other Pacific Islander Asian White More Than One Race Reported: Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander. More Than One Race Reported: Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian. Race Not Reported or Unknown Ethnicity Hispanic or Latino Not Hispanic or Latino Not Reported Gender Male Female Not Reported			X
Count of Mathematics student enrollment (report Freshmen, Sophomores, Juniors, Seniors, and unknown class students separately, and part-time and full-time students separately) Race Black or African American Native American Alaska Native Native Hawaiian or Other Pacific Islander Asian White More Than One Race Reported: Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander. More Than One Race Reported: Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian. Race Not Reported or Unknown Ethnicity Hispanic or Latino Not Hispanic or Latino Not Reported Gender Male Female Not Reported			X
Count of Computer science student enrollment (report Freshmen, Sophomores, Juniors, Seniors, and unknown class students separately, and part-time and full-time students separately) by: Race Black or African American Native American Alaska Native Native Hawaiian or Other Pacific Islander Asian White More Than One Race Reported: Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander. More Than One Race Reported: Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian. Race Not Reported or Unknown Ethnicity Hispanic or Latino Not Hispanic or Latino Not Reported Gender Male Female Not Reported			X
Count of Geosciences student enrollment (report Freshmen, Sophomores, Juniors, Seniors, and unknown class students separately, and part-time and full-time students separately) by: Race Black or African American Native American Alaska Native Native Hawaiian or Other Pacific Islander Asian White More Than One Race Reported: Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander. More Than One Race Reported: Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian. Race Not Reported or Unknown Ethnicity Hispanic or Latino Not Hispanic or Latino Not Reported Gender Male Female Not Reported			X
Count of Engineering student enrollment (report Freshmen, Sophomores, Juniors, Seniors, and unknown class students separately, and part-time and full-time students separately) by: Race Black or African American Native American Alaska Native Native Hawaiian or Other Pacific Islander Asian White More Than One Race Reported: Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander. More Than One Race Reported: Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian. Race Not Reported or Unknown Ethnicity Hispanic or Latino Not Hispanic or Latino Not Reported Gender Male Female Not Reported			X
Count of Life/Biological Sciences student enrollment (report Freshmen, Sophomores, Juniors, Seniors, and unknown class students separately, and part-time and full-time students separately) by: Race Black or African American Native American Alaska Native Native Hawaiian or Other Pacific Islander Asian White More Than One Race Reported: Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander. More Than One Race Reported: Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian. Race Not Reported or Unknown Ethnicity Hispanic or Latino Not Hispanic or Latino Not Reported Gender Male Female Not Reported			X
Count of Agricultural Sciences student enrollment (report Freshmen, Sophomores, Juniors, Seniors, and unknown class students separately, and part-time and full-time students separately) by: Race Black or African American Native American Alaska Native Native Hawaiian or Other Pacific Islander Asian White More Than One Race Reported: Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander. More Than One Race Reported: Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian. Race Not Reported or Unknown Ethnicity Hispanic or Latino Not Hispanic or Latino Not Reported Gender Male Female Not Reported			X
Count of Environmental Sciences student enrollment (report Freshmen, Sophomores, Juniors, Seniors, and unknown class students separately, and part-time and full-time students separately) by: Race Black or African American Native American Alaska Native Native Hawaiian or Other Pacific Islander Asian White More Than One Race Reported: Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander. More Than One Race Reported: Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian. Race Not Reported or Unknown Ethnicity Hispanic or Latino Not Hispanic or Latino Not Reported Gender Male Female Not Reported			X
Count of Non-STEM student enrollment (report Freshmen, Sophomores, Juniors, Seniors, and unknown class students separately, and part-time and full-time students separately) by: Race Black or African American Native American Alaska Native Native Hawaiian or Other Pacific Islander Asian White More Than One Race Reported: Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander. More Than One Race Reported: Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian. Race Not Reported or Unknown Ethnicity Hispanic or Latino Not Hispanic or Latino Not Reported Gender Male Female Not Reported			X
2. Degree Awards
Count of Chemistry degrees (report Bachelor’s, Master’s, and Doctoral degrees separately) by: Race Black or African American Native American Alaska Native Native Hawaiian or Other Pacific Islander Asian White More Than One Race Reported: Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander. More Than One Race Reported: Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian. Race Not Reported or Unknown Ethnicity Hispanic or Latino Not Hispanic or Latino Not Reported Gender Male Female Not Reported			X
Count of Physics/Astro degrees (report Bachelor’s, Master’s, and Doctoral degrees separately) by: Race Black or African American Native American Alaska Native Native Hawaiian or Other Pacific Islander Asian White More Than One Race Reported: Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander. More Than One Race Reported: Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian. Race Not Reported or Unknown Ethnicity Hispanic or Latino Not Hispanic or Latino Not Reported Gender Male Female Not Reported			X
Count of Mathematics degrees (report Bachelor’s, Master’s, and Doctoral degrees separately) by: Race Black or African American Native American Alaska Native Native Hawaiian or Other Pacific Islander Asian White More Than One Race Reported: Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander. More Than One Race Reported: Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian. Race Not Reported or Unknown Ethnicity Hispanic or Latino Not Hispanic or Latino Not Reported Gender Male Female Not Reported			X
Count of Computer science degrees (report Bachelor’s, Master’s, and Doctoral degrees separately) by: Race Black or African American Native American Alaska Native Native Hawaiian or Other Pacific Islander Asian White More Than One Race Reported: Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander. More Than One Race Reported: Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian. Race Not Reported or Unknown Ethnicity Hispanic or Latino Not Hispanic or Latino Not Reported Gender Male Female Not Reported			X
Count of Geosciences degrees (report Bachelor’s, Master’s, and Doctoral degrees separately) by: Race Black or African American Native American Alaska Native Native Hawaiian or Other Pacific Islander Asian White More Than One Race Reported: Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander. More Than One Race Reported: Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian. Race Not Reported or Unknown Ethnicity Hispanic or Latino Not Hispanic or Latino Not Reported Gender Male Female Not Reported			X
Count of Engineering degrees (report Bachelor’s, Master’s, and Doctoral degrees separately) by: Race Black or African American Native American Alaska Native Native Hawaiian or Other Pacific Islander Asian White More Than One Race Reported: Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander. More Than One Race Reported: Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian. Race Not Reported or Unknown Ethnicity Hispanic or Latino Not Hispanic or Latino Not Reported Gender Male Female Not Reported			X
Count of Life/Biological Sciences degrees (report Bachelor’s, Master’s, and Doctoral degrees separately) by: Race Black or African American Native American Alaska Native Native Hawaiian or Other Pacific Islander Asian White More Than One Race Reported: Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander. More Than One Race Reported: Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian. Race Not Reported or Unknown Ethnicity Hispanic or Latino Not Hispanic or Latino Not Reported Gender Male Female Not Reported			X
Count of Agricultural Sciences degrees (report Bachelor’s, Master’s, and Doctoral degrees separately) by: Race Black or African American Native American Alaska Native Native Hawaiian or Other Pacific Islander Asian White More Than One Race Reported: Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander. More Than One Race Reported: Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian. Race Not Reported or Unknown Ethnicity Hispanic or Latino Not Hispanic or Latino Not Reported Gender Male Female Not Reported			X
Count of Environmental Sciences degrees (report Bachelor’s, Master’s, and Doctoral degrees separately) by: Race Black or African American Native American Alaska Native Native Hawaiian or Other Pacific Islander Asian White More Than One Race Reported: Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander. More Than One Race Reported: Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian. Race Not Reported or Unknown Ethnicity Hispanic or Latino Not Hispanic or Latino Not Reported Gender Male Female Not Reported			X
Count of Non-STEM degrees (report Bachelor’s, Master’s, and Doctoral degrees separately) by: Race Black or African American Native American Alaska Native Native Hawaiian or Other Pacific Islander Asian White More Than One Race Reported: Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander. More Than One Race Reported: Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian. Race Not Reported or Unknown Ethnicity Hispanic or Latino Not Hispanic or Latino Not Reported Gender Male Female Not Reported			X
3. Activity Data (Complete an activity information screen for each activity conducting during reporting period.)
Activity Title			X
Target (select one) Student Faculty Student and Faculty			X
Time Period (select one) Academic Year Only Summer Year Only Calendar Year			X
Coordinators (choose one to three)			X
Category (select one) Teaching Research Service			X
Subcategory (select one) Curriculum Reform Faculty Enrichment Other Assistantships Research Pedagogy Courses Research Seminars Special Techniques Training Mentoring Recruitment Environmental Improvement Peer-Group Learning Academic Counseling Special Acad Supp			X
Field (select one) All Clubs Courses Faculty Field Trips Industry Material Development Mod of Degree Requirements Off-Site On-Site Other Peer Recruiters Seminars Short-Courses Social Events Tutoring Visiting Appointments Workshops			X
Activity Description (text box)			X
Activity Goals and Objectives (text box)			X
Activity Outcome (text box)			X
Count of students participating in the activity by: Race Black or African American Native American Alaska Native Native Hawaiian or Other Pacific Islander Asian White More Than One Race Reported: Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander. More Than One Race Reported: Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian. Race Not Reported or Unknown Ethnicity Hispanic or Latino Not Hispanic or Latino Not Reported Gender Male Female Not Reported			X
Count of faculty and Graduate Students participating in the activity by: Race Black or African American Native American Alaska Native Native Hawaiian or Other Pacific Islander Asian White More Than One Race Reported: Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander. More Than One Race Reported: Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian. Race Not Reported or Unknown Ethnicity Hispanic or Latino Not Hispanic or Latino Not Reported Gender Male Female Not Reported			X
4. Individual Data
Student Participants (complete a screen for each student)
Name: Last, First, Middle Initial	X
Social Security Number (optional)	X
Gender (select one) Male Female Not Reported	X
Ethnicity (select one) Hispanic or Latino Not Hispanic or Latino Not Reported	X
Race (Choose one or more responses): Native American Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Not Reported	X
Disability Status (Choose one): Yes (check Yes if any of the following apply): Deaf or serious difficulty hearing Blind or serious difficulty seeing even when wearing glasses Serious difficulty walking or climbing stairs Other serious disability related to a physical, mental, or emotional condition No Do not wish to provide	X
Discipline (choose 1 from list)	X
Class (choose 1 from list)	X
GPA (data box)	X		X
Graduated this Year? Yes/No/Dropped Out	X		X
Mentor (choose 1 from list)	X
Academic Year Financial Support? Yes/No		X
Summer Financial Support? Yes/No		X
Activities in which the individual participated (select all that apply from list generated in section 3)		X
Partner activities in which the individual participated (select all that apply from list generated in section 3)		X
Faculty Participants (complete a screen for each faculty member)
Name: Last, First, Middle Initial	X
Social Security Number (optional)	X
Gender (select one) Male Female Not Reported	X
Ethnicity (select one) Hispanic or Latino Not Hispanic or Latino Not Reported	X
Race (Choose one or more responses): Native American Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Not Reported	X
Disability Status (Choose one): Yes (check Yes if any of the following apply): Deaf or serious difficulty hearing Blind or serious difficulty seeing even when wearing glasses Serious difficulty walking or climbing stairs Other serious disability related to a physical, mental, or emotional condition No Do not wish to provide	X
Discipline (select 1 from list)	X
Faculty Rank (select 1 from list)	X
5. Two Year Institution’s Transfer Student Data
To what school did the student transfer? (choose 1 from list)	X
If known, what is the student’s major? (choose 1 from list)	X
6. Students Entering Graduate School Information
Count of students who received Direct Support by: Race Black or African American Native American Alaska Native Native Hawaiian or Other Pacific Islander Asian White More Than One Race Reported: Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander. More Than One Race Reported: Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian. Race Not Reported or Unknown Ethnicity Hispanic or Latino Not Hispanic or Latino Not Reported Gender Male Female Not Reported		X	X
Count of students who did not receive direct support by: Race Black or African American Native American Alaska Native Native Hawaiian or Other Pacific Islander Asian White More Than One Race Reported: Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander. More Than One Race Reported: Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian. Race Not Reported or Unknown Ethnicity Hispanic or Latino Not Hispanic or Latino Not Reported Gender Male Female Not Reported			X
7. Abstract and Budget Information
LSAMP Alliance Abstract, Goals and Systemic Changes (summaries) Alliance Abstract (text box) Alliance Goals and Objectives (text box) Impact and Systemic Changes (text box)X		X	X
LSAMP Alliance-Supported Activities (summaries) AMP-Supported Student Activities (text box) AMP-Supported Faculty Development Activities (text box) AMP-Supported Curriculum Development and Related Activities (text box) AMP-Supported Summer Bridge and Related Outreach Activities (text box) Other AMP-Supported Activities (text box)		X
LSAMP Alliance Results: Accomplishments and Obstacles (summaries) Alliance Highlights (include top three) (text box) Alliance Accomplishments (text box) Alliance Obstacles (text box)			X
Alliance Budget: For each of the Senior Personnel provide: Number of Personnel (1) Number of Person Months Number of Person Months: Academic Year Number of Person Months: Summer NSF Dollar Amount Matching Dollar Amount For each category of Other Personnel provide: Number of Personnel (1) Number of Person Months Number of Person Months: Academic Year Number of Person Months: Summer NSF Dollar Amount Matching Dollar Amount Categories of Other Personnel are: Post Doctoral Associates Other Professionals Graduate Students Undergraduate Students Secretarial/Clerical Other staff For Fringe Benefits provide: NSF Dollar Amount Matching Dollar Amount For each Permanent Equipment provide: Cost NSF Dollar Amount Matching Dollar Amount Travel: For Domestic Travel provide: NSF Dollar Amount Matching Dollar Amount For Foreign Travel provide: NSF Dollar Amount Matching Dollar Amount For each category of Participant Supplemental Costs provide: Cost Count Participant Supplemental Categories are: Stipends Travel Subsistence Other For Residual Funds provide: NSF Dollar Amount Matching Dollar Amount (All other amounts shown on the budget screen are calculated by the system.)		X
LSAMP Alliance Budget-Text (summaries) FY [yyyy] Budget Explanation (textbox) FY [yyyy] Budget Explanation of Matching Funds (textbox) FY [yyyy] Subcontractors and Amounts of Contracts (textbox)		X
For each Non-Academic Partner provide: Name Type of Partner (select one) National Science Foundation Institution State of Local Government Federal Agency Federal Lab Foreign Government Corporation Foundation and Other Non-Profit Project Generated Other Description		X	X

LSAMP: Number of Respondents, Frequency of Response, and Annual Hour Burden

The estimated average number of annual respondents is 643 (112 project PIs/co-PIs and 531 LSAMP institution personnel), with an estimated annual response burden of 10,288 hours. The Web-based collection is an annual activity of the LSAMP program. Respondents are PIs/co-PIs and institution personnel; generally, two or more co-PIs per award and one project personnel member per alliance institution completes the questionnaire. The estimated annual hour burden per respondent was determined using the burden information reported by respondents from the last two collection cycles.

The burden estimates for each type of respondent are outlined below:

Respondent Type	Estimated Average Annual No. of Respondents	Estimated Average Annual Burden Hours Per Respondent	Estimated Annual Burden Hour Total
PIs/co-PIs	112	16	1,792
Institution personnel	531	16	8,496
Total	643		10,288

LSAMP: Hour Burden Estimates by Each Form and Aggregate Hour Burdens

There is only one form. This form accounts for the entire annual response burden of 10,288 hours. The annual burden by form was calculated as follows:

Form Type	Respondent Type	No. of Respondents	Burden Hours Per Respondent	Total Burden Hours
LSAMP data collection form	PIs, co-PIs, institution personnel	643	16	10,288
Total		643		10,288

LSAMP: Estimates of Annualized Cost to Respondents for the Hour Burdens

The overall annualized cost to the respondents is estimated to be $349,856. The estimated hourly rate for PIs/co-PIs, who are generally university professors, is based on a report from the American Association of University Professors, “The Annual Report on the Economic Status of the Profession, 2020-2021,” Survey Report Table 1. According to this report, the average salary across all academic ranks and across all types of doctoral-granting institutions (public, private-independent, religiously affiliated) was $109,428. The rate for institution personnel was established by using the Bureau of Labor Statistics’ May 2017 National Occupational Employment and Wage Estimates, which estimates the mean annual wage for those in Education, Training, and Library Occupations to be $62,140. Each of these figures was then divided by the number of standard annual work hours (2,080) to determine an average hourly rate for each respondent type. Those rates and the corresponding total annual cost are indicated in the table below:

Respondent Type	No. of Respondents	Burden Hours Per Respondent	Average Hourly Rate	Estimated Annual Cost
Project PIs/co-PIs	112	16	$53	$94,976
Institution personnel	531	16	$30	$254,880
Total	643			$349,856

LSAMP: Estimates of Costs to the Federal Government

Computing the annualized cost to NSF for the LSAMP data collection was done by taking the projected budget for the next three years and calculating the cost for each of the following operational activities involved in producing, maintaining, and conducting the data collection:

Operational Activities	Cost Over Three Years
System Development (includes initial development of the database and Web-based application, and later changes requested by the program, e.g., increased reporting tools, additional validations)	$165,183
System Maintenance, Updates, and Technical Support (system requires updates each year before opening the collection; maintenance is required to keep the system current with technology, e.g., database servers, operating systems)	$297,330
Data Collection Opening and Support (e.g., online and telephone support to respondents and contacting respondents to encourage completion of the questions), Reporting (as defined by HRD), and Follow-up Activities (e.g., providing data to other consultants)	$198,220
Three-Year Total for All Operational Activities	$660,733

The annualized cost was computed as one-third of the total three-year cost; thus, the annualized cost to NSF for the LSAMP data collection is $220,244.

LSAMP: Questions

Highlighted in blue are items which will be discontinued during the period of the renewal.

Highlighted in yellow are proposed new items.

Highlighted in grey are item wordings which NSF proposes, with OMB approval, to change. Previous text is marked with strikethrough.

Respondent’s Contact Information:

Name: First, Last

Phone

Email

1. Student Enrollment

Count of Chemistry student enrollment (report Freshmen, Sophomores, Juniors, Seniors, and unknown class students separately, and part-time and full-time students separately) by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

Count of Physics/Astronomy student enrollment (report Freshmen, Sophomores, Juniors, Seniors, and unknown class students separately, and part-time and full-time students separately) by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

Count of Mathematics student enrollment (report Freshmen, Sophomores, Juniors, Seniors, and unknown class students separately, and part-time and full-time students separately) by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

Count of Computer science student enrollment (report Freshmen, Sophomores, Juniors, Seniors, and unknown class students separately, and part-time and full-time students separately) by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

Count of Geosciences student enrollment (report Freshmen, Sophomores, Juniors, Seniors, and unknown class students separately, and part-time and full-time students separately) by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

Count of Engineering student enrollment (report Freshmen, Sophomores, Juniors, Seniors, and unknown class students separately, and part-time and full-time students separately) by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

Count of Life/Biological Sciences student enrollment (report Freshmen, Sophomores, Juniors, Seniors, and unknown class students separately, and part-time and full-time students separately) by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

Count of Agricultural Sciences student enrollment (report Freshmen, Sophomores, Juniors, Seniors, and unknown class students separately, and part-time and full-time students separately) by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

Count of Environmental Sciences student enrollment (report Freshmen, Sophomores, Juniors, Seniors, and unknown class students separately, and part-time and full-time students separately) by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

Count of Non-STEM student enrollment (report Freshmen, Sophomores, Juniors, Seniors, and unknown class students separately, and part-time and full-time students separately) by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

2. Degree Awards

Count of Chemistry degrees (report Bachelor’s, Master’s, and Doctoral degrees separately) by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

Count of Physics/Astro degrees (report Bachelor’s, Master’s, and Doctoral degrees separately) by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

Count of Mathematics degrees (report Bachelor’s, Master’s, and Doctoral degrees separately) by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

Count of Computer science degrees (report Bachelor’s, Master’s, and Doctoral degrees separately) by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

Count of Geosciences degrees (report Bachelor’s, Master’s, and Doctoral degrees separately) by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

Count of Engineering degrees (report Bachelor’s, Master’s, and Doctoral degrees separately) by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

Count of Life/Biological Sciences degrees (report Bachelor’s, Master’s, and Doctoral degrees separately) by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

Count of Agricultural Sciences degrees (report Bachelor’s, Master’s, and Doctoral degrees separately) by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

Count of Environmental Sciences degrees (report Bachelor’s, Master’s, and Doctoral degrees separately) by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

Count of Non-STEM degrees (report Bachelor’s, Master’s, and Doctoral degrees separately) by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

3. Activity Data (Complete an activity information screen for each activity conducting during reporting period.)

Activity Title

Target (select one)

• Student

• Faculty

• Student and Faculty

Time Period (select one)

• Academic Year Only

• Summer Year Only

• Calendar Year

Coordinators (choose one to three)

Category (select one)

• Teaching

• Research

• Service

Subcategory (select one)

• Curriculum Reform

• Faculty Enrichment

• Other

• Assistantships

• Research Pedagogy Courses

• Research Seminars

• Special Techniques Training

• Mentoring

• Recruitment

• Environmental Improvement

• Peer-Group Learning

• Academic Counseling

• Special Acad Supp

Field (select one)

• All

• Clubs

• Courses

• Faculty

• Field Trips

• Industry

• Material Development

• Mod of Degree Requirements

• Off-Site

• On-Site

• Other

• Peer

• Recruiters

• Seminars

• Short-Courses

• Social Events

• Tutoring

• Visiting Appointments

• Workshops

Activity Description (text box)

Activity Goals and Objectives (text box)

Activity Outcome (text box)

Count of students participating in the activity by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

Count of faculty and Graduate Students participating in the activity by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

4. Individual Data

Student Participants (complete a screen for each student)

Name: Last, First, Middle Initial

Social Security Number (optional)

Gender (select one)

• Male

• Female

• Not Reported

Ethnicity (select one)

• Hispanic or Latino

• Not Hispanic or Latino

• Not Reported

Race (Choose one or more responses):

• Native American

• Alaska Native

• Asian

• Black or African American

• Native Hawaiian or Other Pacific Islander

• White

• Not Reported

Disability Status (Choose one):

• Yes (check Yes if any of the following apply):

• Deaf or serious difficulty hearing

• Blind or serious difficulty seeing even when wearing glasses

• Serious difficulty walking or climbing stairs

• Other serious disability related to a physical, mental, or emotional condition

• No

• Do not wish to provide

Discipline (choose 1 from list)

Class (choose 1 from list)

GPA (data box)

Graduated this Year?

Yes/No/Dropped Out

Mentor (choose 1 from list)

Academic Year Financial Support?

Yes/No

Summer Financial Support?

Yes/No

Activities in which the individual participated (select all that apply from list generated in section 3)

Partner activities in which the individual participated (select all that apply from list generated in section 3)

Faculty Participants (complete a screen for each faculty member)

Name: Last, First, Middle Initial

Social Security Number (optional)

Gender (select one)

• Male

• Female

• Not Reported

Ethnicity (select one)

• Hispanic or Latino

• Not Hispanic or Latino

• Not Reported

Race (Choose one or more responses):

• Native American

• Alaska Native

• Asian

• Black or African American

• Native Hawaiian or Other Pacific Islander

• White

• Not Reported

Disability Status (Choose one):

• Yes (check Yes if any of the following apply):

• Deaf or serious difficulty hearing

• Blind or serious difficulty seeing even when wearing glasses

• Serious difficulty walking or climbing stairs

• Other serious disability related to a physical, mental, or emotional condition

• No

• Do not wish to provide

Discipline (select 1 from list)

Faculty Rank (select 1 from list)

5. Two Year Institution’s Transfer Student Data

To what school did the student transfer? (choose 1 from list)

If known, what is the student’s major? (choose 1 from list)

6. Students Entering Graduate School Information

Count of students who received Direct Support by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

Count of students who did not receive direct support by:

Race

Black or African American

Native American

Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

More Than One Race Reported:

Students reporting a) two or more race categories and b) one or more of the reported categories include: Native American, Alaska Native, Black or African American, Native Hawaiian or Other Pacific Islander.

More Than One Race Reported:

Students reporting a) both White and Asian, and b) no other categories in addition to White and Asian.

Race Not Reported or Unknown

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Not Reported

Gender

Male

Female

Not Reported

7. Abstract and Budget Information

LSAMP Alliance Abstract, Goals and Systemic Changes (summaries)

Alliance Abstract (text box)

Alliance Goals and Objectives (text box)

Impact and Systemic Changes (text box)X

LSAMP Alliance-Supported Activities (summaries)

AMP-Supported Student Activities (text box)

AMP-Supported Faculty Development Activities (text box)

AMP-Supported Curriculum Development and Related Activities (text box)

AMP-Supported Summer Bridge and Related Outreach Activities (text box)

Other AMP-Supported Activities (text box)

LSAMP Alliance Results: Accomplishments and Obstacles (summaries)

Alliance Highlights (include top three) (text box)

Alliance Accomplishments (text box)

Alliance Obstacles (text box)

Alliance Budget:

For each of the Senior Personnel provide:

Number of Personnel (1)

Number of Person Months

Number of Person Months: Academic Year

Number of Person Months: Summer

NSF Dollar Amount

Matching Dollar Amount

For each category of Other Personnel provide:

Number of Personnel (1)

Number of Person Months

Number of Person Months: Academic Year

Number of Person Months: Summer

NSF Dollar Amount

Matching Dollar Amount

Categories of Other Personnel are:

Post Doctoral Associates

Other Professionals

Graduate Students

Undergraduate Students

Secretarial/Clerical

Other staff

For Fringe Benefits provide:

NSF Dollar Amount

Matching Dollar Amount

For each Permanent Equipment provide:

Cost

NSF Dollar Amount

Matching Dollar Amount

Travel:

For Domestic Travel provide:

NSF Dollar Amount

Matching Dollar Amount

For Foreign Travel provide:

NSF Dollar Amount

Matching Dollar Amount

For each category of Participant Supplemental Costs provide:

Cost

Count

Participant Supplemental Categories are:

Stipends

Travel

Subsistence

Other

For Residual Funds provide:

NSF Dollar Amount

Matching Dollar Amount

(All other amounts shown on the budget screen are calculated by the system.)

LSAMP Alliance Budget-Text (summaries)

FY [yyyy] Budget Explanation (textbox)

FY [yyyy] Budget Explanation of Matching Funds (textbox)

FY [yyyy] Subcontractors and Amounts of Contracts (textbox)

For each Non-Academic Partner provide:

Name

Type of Partner (select one)

• National Science Foundation

• Institution

• State of Local Government

• Federal Agency

• Federal Lab

• Foreign Government

• Corporation

• Foundation and Other Non-Profit

• Project Generated Other

Description

1 Elements of these characteristics include name, address, date of birth, gender, ethnicity, race, disability status, class, major, grade point average, and project role.

2 Elements of these characteristics include sources and amount of funds, fellowships, scholarships, traineeships, partnerships, training, and research methods.

3 Elements of these characteristics include research findings, publications, presentations, degrees granted, and educational materials.