Form 1122-0011 Semiannual Progress Report for the Tribal Coalitions Pro

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U.S. Department of Justice
Office on Violence Against Women
SEMI-ANNUAL PROGRESS REPORT FOR
Grants to Support Tribal Domestic Violence
and Sexual Assault Coalitions
Brief Instructions: This form must be completed for each Grant to Support Tribal Domestic Violence and Sexu-

al Assault Coalition (Tribal Coalitions) grant received. The grant administrator or coordinator must ensure that
the form is completed fully with regard to all grant activities.
All grantees should read through each section to determine which questions they must answer based on the
activities engaged in under this grant during the current reporting period. Sections B, D and subsection A1 of
this form must be completed by all grantees. In subsection A2 and section C, grantees must answer an initial
question in each subsection about whether they engaged in certain activities during the current reporting
period. If the response is yes, then the grantee must complete that subsection. If the response is no, the rest
of that subsection is skipped.
For example, 1) if staff funded under this grant only provided training and technical assistance during the
current reporting period, you would complete A1, A2, B, C1, C6, and D (and answer ‘no’ in C2-C5 and C7); or,
2) if staff funded under this grant provided training and technical assistance and developed products during the current reporting period, you would complete A, B, C1, C4, C5, C6, and D (and answer ‘no’ in C2, C3,
and, C7).
The activities of volunteers or interns should be reported if they were coordinated or supervised by Tribal Coalitions Program-funded staff or if Tribal Coalitions Program funds substantially support their activities.

For further information on filling out this form, refer to the separate set of instructions, which contains detailed definitions and examples, illustrating how questions should be answered.

Section
Section A:
A1:
A2:
Section B:
Section C:
C1:
C2:
C3:
C4:
C5:
C6:
C7:
Section D:

General Information
Grant Information
Staff Information
Purpose Areas
Function Areas
Training
Education
System Advocacy
Policies
Products
Topics of Technical Assistance
Organizational Development and Capacity Building
Narrative

Page Number
1
1
3
4
6
6
10
13
17
20
21
24
25

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A1

GENERAL INFORMATION
Grant information

All grantees must complete this section.

1.

Date of report

2.

Current reporting period

3.

Grantee name

4.

Grant number
(the federal grant number assigned to your Tribal Coalitions Program grant)

5.

Type of grantee organization
(Check one.)
Established tribal coalition
Individual
Other non-profit

6.

Type of Coalition (Check one.)
Sexual assault coalition
Domestic violence coalition
Dual sexual assault/domestic violence coalition

7.

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

January 1- June 30

MI

July 1-December 31

(Year)

Last name

Agency/organization name (if different from grantee name)
Address
City
Telephone

State

Zip code

Facsimile

E-mail
8.

What percentage of your tribal coalition operating budget is funded by this Tribal Coalitions Program grant?

9.

What tribal population(s) is(are) served by your Tribal Coalitions Program grant?

10. Did this tribal coalition exist prior to receiving Tribal Coalitions grant funds?
Yes
No
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11. Coalition members
(Report the total number of organizational members, including sexual assault programs, domestic violence programs, other victim services agencies, and other organizational members. Report the total
number of individual members of your tribal coalitions, if any. Individual members are individual persons, not programs.)
Coalition members

Number

Sexual assault programs/rape crisis centers
Domestic violence programs
Dual sexual assault and domestic violence programs
Tribal victim services agencies
Other organizational members
Total number of organizational members

0

Total number of individual members

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A2

Staff Information

Were Tribal Coalitions funds used to fund staff positions during the current reporting period?
Check yes if Tribal Coalitions funds were used to pay staff, including part-time staff and contractors.
Yes—answer question 12
No—skip to section B
12. Staff
(Report the total number of full-time equivalent [FTE] staff funded by your Tribal Coalitions Program
grant during the current reporting period. Report staff by the function(s) performed, not by title or location. Include employees who are part-time and/or only partially funded with these grant funds as well
as consultants/contractors. If an employee or contractor was employed or utilized for only a portion of
the reporting period, prorate appropriately. For example, if you hired a full-time administrator in October
who was 100% funded with Tribal Coalition Program funds, you would report that as .5 FTEs. Report all
FTEs in decimals, not percentages. One FTE is equal to 1,040 hours—40 hours per week x 26 weeks.
See separate instructions for examples of how to calculate FTEs.)
Staff
Administrator (executive director, fiscal manager)

FTE(s)

Attorney
Communication specialist (public awareness, media relations)
Information technology staff
Program coordinator (training coordinator, outreach coordinator)
Support staff (administrative assistant, accountant, bookkeeper)
System advocate
Technical assistance provider
Trainer/educator
Tribal cultural specialist
Other (specify):
Total

0.00

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B

PURPOSE AREAS

All grantees must complete this section.

13. Purpose Areas
(Check all purpose areas that apply to activities supported with Tribal Coalitions Program funds during
the current reporting period.)
Check ALL
Purpose areas
that apply
Increasing awareness of domestic violence/dating violence and sexual assault against
American Indian and Alaska Native women
Enhancing the response to violence against American Indian and Alaska Native women at
the tribal, Federal, and State levels
Identifying and providing technical assistance to coalition membership and tribal communities to enhance access to essential services to American Indian women victimized by
domestic/dating and sexual violence
13a. Program priority areas addressed by your grant
(In addition to the purpose areas identified above, the Tribal Coalition Grant Program Application and
Program Guidelines may have identified several program priorities that would receive priority consideration. If your project addressed any of these priority areas during the current reporting period, list
them below.)

14. Culturally specific activities
(List all culturally-specific activities that your tribal coalition engaged in during the current reporting period in the community(ies) you serve. Check the box in the first column if the activity was funded with
Tribal Coalitions Program funds.)
Tribal Coalitions
funded

Activity
a.
b.
c.
d.
e.
f.

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15. (OPTIONAL) Additional information
(Use the space below to discuss the effectiveness of your culturally-specific activities funded or supported by your Tribal Coalitions Program grant and to provide further explanation on how these activities increase the safety of American Indian/Alaska Native women.) (Maximum - 2000 characters)

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C1

FUNCTION AREAS
Training

Were your Tribal Coalitions Program funds used for training during the current reporting period?
Check yes if Tribal Coalitions Program-funded staff provided training or if Tribal Coalitions Program
funds were used to directly support the training.
Yes—answer questions 16-19
No—skip to subsection C2
For the purposes of this reporting form, 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. Education means providing general information
that will increase public awareness of sexual assault, domestic violence, dating violence, and stalking.
In this subsection, report information on training activities. Education should be reported in subsection
C2
16. Type and number of training events provided
(Report the number of statewide, regional, and tribal-based training events by the type of training that
were either provided by Tribal Coalitions Program-funded staff or directly supported with Tribal Coalitions Program funds. Staff development training provided to Tribal Coalitions Program-funded staff
should not be counted. Use the Sexual assault/Domestic violence columns if training events focused
on both sexual assault and domestic violence.)
Statewide
Type of training

Sexual
assault

Total number of training events
Intra-state regions

Tribal

Sexual
Sexual
Sexual
Domestic assault/ Sexual Domestic assault/ Sexual Domestic assault/
violence domestic assault violence domestic assault violence domestic
violence
violence
violence

Computerbased training
Conferences
Teleconferences
Videoconferences
Workshops/
seminars
Other (specify):

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17. Number of people trained
Type of training
training period
events by Tribal Coalitions Program(Report
the number of people trained duringTotal
the number
current of
reporting
funded staff or training supported by Tribal Coalitions Program funds. Use the category that is most
descriptive of the people attending the training event. Tribal Coalitions Program-funded staff attending
Statewide
Intra-state regions
Tribal
staff development training should not be counted. If you do not know how many people to report in specific categories, you may report the overall number in “Multidisciplinary.”)
People trained
Number
Attorneys/law students (does not include prosecutors)
Batterer intervention program/offender accountability staff
Child protective service workers
Children’s advocates (not affiliated with CPS)
Correction personnel (probation, parole, and correctional facility staff)
Court personnel (tribal—judges, clerks)
Court personnel (non-tribal—judges, clerks)
Domestic violence program staff (tribal)
Domestic violence program staff (non-tribal)
Educators (teachers, administrators, etc.)
Faith-based organization staff
Federal agency staff (BIA, IHS, FBI)
Health professionals (doctors, nurses; does not include forensic examiners)
Law enforcement officers (tribal)
Law enforcement officers (non-tribal)
Legal services staff (does not include attorneys)
Mental health professionals
Military command staff
Multidisciplinary (various disciplines at same training)
Other government agency staff (vocational rehabilitation, food stamps, TANF)
Prosecutors (tribal)
Prosecutors (non-tribal)
Sexual assault forensic examiners/sexual assault nurse examiners (SAFE/SANE)
Sexual assault program staff (tribal)
Sexual assault program staff (non-tribal)
Social service organization staff (non-government—food bank, homeless shelter, etc.)
Tribal community groups
Tribal elders
Tribal government/tribal government agency staff
Victim assistants (governmental, includes victim-witness specialist/coordinator)
Volunteers
Other (specify):
Total

0
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18. Training content areas

(Indicate all topics covered in training events provided with your Tribal Coalitions Program-funds during the current reporting period. Check all that apply.)
Other underserved populations
Sexual assault, domestic violence/dating violence
and stalking
Issues specific to American Indian and Alaska
Native victims/survivors who
Advocacy for American Indian and/or Alaska Native women
are elderly
Child custody in the context of violence against
are homeless or living in poverty
women
are isolated or institutionalized
Child witnesses in the context of domestic
are lesbian, gay, bisexual, transgender, or
violence/dating violence
intersex
Confidentiality
have disabilities
Cultural issues specific to American Indians
have mental health issues
and/or Alaska Natives
live in rural areas
Dating violence overview, dynamics, and
live in urban areas
services
Other (specify):
Domestic violence overview, dynamics, and services
Drug facilitated sexual assault
Dynamics and history of violence against American Indian and/or Alaska Native women
Historical trauma
Indian Child Welfare Act
Safety planning for victims/survivors
Sexual assault overview, dynamics, and
services
Stalking overview, dynamics, and services
Supervised visitation and exchange
Other (specify):
Organizational community response
Coalition development
Collaboration
Coordinated community response
Discrimination and oppression issues
Evaluation
Federal agency response to sexual assault and
domestic violence/dating violence (IHS, BIA,
FBI, USAO)
Outreach
Program accessibility
Program rules
Public benefits (TANF, disability, food stamps,
unemployment, etc.)
Response teams (DART, DVRT, SART)
Strategic planning
Technology
Tribal strategies to address sexual assault or domestic violence/dating violence, or stalking
Victim service administration and operations
Other (specify):

Justice system
Court procedures
Decreasing dual arrests/identifying predominant aggressor
Domestic violence statues/code development
Evidence analysis, collection, and preservation
Evidence-based prosecution
Firearms and domestic violence/dating violence
Judicial response
Law enforcement response (including protocols,
arrest policies, and evidence collection)
Mandatory reporting requirements
Pro-arrest policies
Prosecution response
Protection orders (including full faith and credit)
Sex offender registry(ies)
Sexual assault forensic examinations
Sexual assault statutes/codes
Stalking statutes/codes
Tribal jurisdiction and Public Law 280
Other (specify):

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19. (OPTIONAL) Additional information
(Use the space below to discuss the effectiveness of your training activities funded or supported by
your Tribal Coalitions Program grant and to provide further explanation on how these activities increase
the safety of American Indian/Alaska Native women.) (Maximum - 2000 characters)

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C2

Education

Were your Tribal Coalitions Program funds used for education activities during the current reporting period?
Check yes if Tribal Coalitions Program-funded staff engaged in education activities or if Tribal Coalitions
Program were used to directly support education activities.
Yes—answer questions 20-23
No—skip to C3
For the purposes of this reporting form, education means providing general information that will increase
public awareness of sexual assault, domestic violence, dating violence, and stalking. Training means providing information on sexual assault, domestic violence, dating violence, and stalking that enables a professional to improve her/his response to victims/survivors of sexual assault, domestic violence, dating violence,
and stalking. In this subsection, report information on education activities. Training should be reported in
subsection C1.
20. Education events
(Report the total number of education events provided during the current reporting period.)
Total number of education events provided
21. People educated with Tribal Coalitions Program funds
(Report the number of people attending education events during the current reporting period. Use the
category that is most descriptive of the people who attended the educational event.)

People attending event

Number
Tribal

Non-tribal

Child care providers
Community businesses (retail stores, pharmacies)
Community groups (service or social groups)
Community members
Employers
Faith-based groups
Men’s groups
Parents/guardians
Students
Tribal elders
Tribal government/tribal government agency staff
Victims/survivors (do not count psychoeducational support
groups)
Women’s groups
Other (specify):
Total

0

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22. Topics of education events provided with Tribal Coalitions Program funds
(Indicate all topics covered in education provided with your Tribal Coalitions Program funds during the
current reporting period. Check all that apply.)
Sexual assault, domestic violence, dating vioHow to help American Indian or Alaska Nalence, and stalking
tive victims/survivors who:
Dating violence overview, dynamics and serare elderly
vices
are homeless or living in poverty
Domestic violence overview, dynamics and
are isolated or institutionalized
services
are lesbian, gay, bisexual, transgender,
Historical trauma
or intersex
Indigenous awareness programs
have disabilities
Mandated reporting of child victimization
have mental health issues
Safety planning
have substance abuse issues
Sex offender registry(ies)
live in rural areas
Sexual assault overview, dynamics, and serlive in urban areas
vices
Other (specify):
Stalking overview, dynamics, and services
VAWA
Youth awareness of sexual assault, domestic
violence/dating violence, and stalking
Workplace violence
Other (specify):

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23. (OPTIONAL) Additional information
(Use the space below to discuss the effectiveness of your education activities funded or supported by
your Tribal Coalitions Program grant and to provide further explanation on how these activities increase
the safety of American Indian/Alaska Native women.) (Maximum - 2000 characters)

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C3

System Advocacy

Were your Tribal Coalitions Program funds used for system advocacy during the current reporting period?
Check yes if Tribal Coalitions Program-funded staff engaged in system advocacy or if Tribal Coalitions
Program funds were used to directly support system advocacy. (System advocacy is an activity intended
to effect policy and/or procedural change in order to improve institutional response to sexual assault
and/or domestic violence.)
Yes—answer questions 24-27
No—skip to C4
24. System advocacy activities
(Indicate the system advocacy activities convened or participated in with Tribal Coalitions Program
funds during the current reporting period. Check all that apply.)
Systems advocacy

Sexual assault

Domestic violence

Appointed tribal and state commissions
Community, regional, statewide task force/caucus
Multidisciplinary working groups
Project-specific interagency working groups
Tribal systems advocacy
Other (specify):

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25. Improved system response
(Report the total number of statewide, regional, and local meetings convened and/or attended by Tribal Coalitions
Program--funded staff during the current reporting period. Report based on the primary group in attendance. If
there were multiple agencies or organizations at the meeting, count the meeting as a multidisciplinary meeting.
Each meeting should be counted only once.)
Number of meetings
Number of meetings
convened
attended
Agency/organization/people
Sexual
Domestic
Sexual
Domestic
assault
violence
assault
violence
American Indian or Alaska Native women
Batterer intervention program/offender accountability staff
Child advocacy organization (not affiliated with CPS)
Child welfare agency
Corrections (probation, parole, correctional facility)
Court (tribal)
Court (non-tribal)
Crime victim compensation
Domestic violence program (tribal)
Domestic violence program (non-tribal)
Dual sexual assault and domestic violence program (tribal)
Dual sexual assault and domestic violence program (non-tribal)
Educational institution/university/school
Faith-based organization
Federal agency staff (IHS, BIA, FBI)
Government agency staff (state and local)
Health/mental health organization
Law enforcement agency (tribal)
Law enforcement agency (non-tribal)
Legal services organization (legal services, bar association, law
school)
Multi-disciplinary group/task force
People representing other underserved populations
Prosecutor’s office (tribal)
Prosecutor’s office (non-tribal)
Sexual assault nurse examiner/sexual assault forensic examiner
program (SANE/SAFE)
Sexual assault program (tribal)
Sexual assault program (non-tribal)
Social services organization (food bank, homeless shelter)
Substance abuse services
Tribal community groups
Tribal elders
Tribal government/tribal government agency
Victims/survivors
Other (specify):
Total

0

0

0

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26. Coordination activities
(Indicate other methods used during the current reporting period to coordinate tribal victim services activities and/or to collaborate and coordinate with federal, state, and local entities engaged in activities
to reduce or end violence against women. Check all that apply.)
E-mail
E-mail listserv
Fax
Newsletter
Telephone/conference call
Toll-free telephone number
Tracking availability of victim services
U.S. Mail
Web site
Other (specify):

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27. (OPTIONAL) Additional information
(Use the space below to discuss the effectiveness of system advocacy activities funded or supported by
your Tribal Coalitions Program grant and to provide further explanation on how these activities increase
the safety of American Indian/Alaska Native women.) (Maximum - 2000 characters)

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C4

Policies

Were your Tribal Coalitions Program funds used to develop, or substantially revise policies or
protocols during the current reporting period?
Check yes if Tribal Coalitions Program-funded staff developed, or substantially revised policies or protocols or if Tribal Coalitions Program funds were used to directly support the development, or substantial
revision of policies or protocols.
Yes—answer questions 28-29
No—skip to C5
28. Types of policies and/or protocols developed, or substantially revised during the current reporting
period.
(Check all the policies or protocols developed, or substantially revised with Tribal Coalitions Program
funds during the current reporting period. Use the SA column for policies and/or protocols addressing
sexual assault and the DV column for those addressing domestic violence.)
Victim services
SA DV
Appropriate response to underserved populations
Confidentiality
Procedures for anonymous, confidential, or
Jane Doe reporting of sexual assault
Training standards for staff and volunteers
Staff, board, and/or volunteers represent the
diversity of your service area
Standards of service
Victim/survivor informed about Crime Victims
Compensation and Victim Impact Statements
Other (specify):

Prosecution
SA DV
Appropriate response to underserved populations
Mandatory training on sexual assault, domestic violence/dating violence, and/or stalking
No charge to victims/survivors for any costs
related to the prosecution of sexual assault,
domestic violence/dating violence and/or
stalking
No victims/survivors polygraphed
Protection order enforcement (including full
faith and credit)
Sexual assault response and protocols
Stalking response and protocols
Vertical prosecution
Victim witness notification
Other (specify):

Law enforcement
SA DV
Appropriate response to underserved populations
Identifying primary aggressor/discouraging dual Court
arrest
SA DV
Immediate access to protection order informaAccelerated trial schedules
tion
Appropriate response to underserved populaMandatory training on sexual assault, domestic
tions
violence/dating violence, and/or stalking
Dedicated sexual assault or domestic vioNo charge to sexual assault victims/survivors
lence/dating violence docket
for any cost associated with forensic exam
Full faith and credit for protection orders
No victims/survivors polygraphed
Immediate access to obtain protection orders
Pro-arrest/mandatory arrest
Judicial monitoring of sexual assault, domesProcedures for anonymous, confidential, or
tic violence/dating violence, and/or stalking
Jane Doe reporting of sexual assault
offenders
Protection order enforcement (including full
Mandatory training on sexual assault, domesfaith and credit)
tic violence/dating violence, and/or stalking
Providing information to victims/survivors about
No charge to sexual assault victims/survivors
victim services
for any cost associated with forensic exam
Sexual assault response and protocols
Policy against mutual restraining orders
Stalking response and protocols
Procedures for courtroom security
Other (specify):
Other (specify):

Tribal Coalitions Program Semi-annual Progress Report • 17 • Office on Violence Against Women

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1121-02
OMB Clearance # 1122-0011
Expiration
Date: 06/30/2011
10/31/2007

Probation
SA DV
Mandatory training on sexual assault, domestic
violence/dating violence, and/or stalking
Strategies to assist and protect victims/survivors
during probation
Perform checks on police logs, criminal and civil
databases
Special procedures for cases involving diverse,
underserved populations
Offender monitoring
Other (specify):
Health care
SA DV
Advocate response in emergency room
Appropriate response to underserved populations
Forensic evidence collection and documentation
Forensic exams not billed to victim/survivor
Mandatory training on sexual assault, domestic
violence, and/or stalking
Routine screening and referrals for sexual assault, domestic violence/dating violence, and/or
stalking
Other (specify):

Tribal Coalitions Program Semi-annual Progress Report • 18 • Office on Violence Against Women

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THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.
OMB
OMBClearance
Clearance##1121-028
1122-0011
10/31/2007
Expiration Date: 06/30/2011

29. (OPTIONAL) Additional information
(Use the space below to discuss the effectiveness of policies you have developed or implemented that
were funded or supported by your Tribal Coalitions Program grant and to provide further explanation on
how these policies increase the safety of American Indian/Alaska Native women.) (Maximum - 2000 characters)

Tribal Coalitions Program Semi-annual Progress Report • 19 • Office on Violence Against Women

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SECTION

1121-0284
OMB Clearance # 1122-0011
Expiration Date: 06/30/2011
10/31/2007

C5

Products

Were your Tribal Coalitions Program funds used to develop, substantially revise, or distribute products
during the current reporting period?
Check yes if Tribal Coalitions Program-funded staff developed products or if Tribal Coalitions Program
funds were used to directly supported the development, revision, or distribution of products.
Yes—answer question 30
No—skip to section C6
30. Use of Tribal Coalitions Program funds for product development, substantial revision, or distribution
(Report the number of products developed, substantially revised, or distributed with Tribal Coalitions
Program funds during the current reporting period. Report the number of new products developed
or substantially revised during the current reporting period; the title/topic; the 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 substantially revised during the current
reporting period whether or not they were used or distributed, and on products that were previously developed or revised but were used or distributed during the current reporting period. Do not report the
number of products printed or copied; only report the number developed or revised—in most cases that
number will be one for each product described—and/or the number used or distributed. See separate
instructions for examples of how to report under “developed or revised” and “used or distributed.”)
Products

Number
developed
or revised

Title/topic

Intended
audience

Number
Other
used or
languages
distributed

Brochures
Manuals
Newsletter
Training curricula
Training materials
Reports
Web site
(report number of
page views in the
used or distributed column)

Videos

Other (specify):

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

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SECTION

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OMB
OMBClearance
Clearance##1121-02
1122-0011
Expiration Date: 06/30/2011
10/31/2007

C6

Technical Assistance

Were your Tribal Coalitions Program funds used to provide technical assistance during the current reporting period?
Check yes if Tribal Coalitions Program-funded staff provided technical assistance or if Tribal Coalitions
Program funds were used to directly support the provision of technical assistance.
Yes—answer questions 31-33
No—skip to C7
31. Number of technical assistance activities
(Report the total number of technical assistance activities provided to programs during the current
reporting period, indicating whether they were site visits or other types of consultations. Consultations
may include in-person, telephonic, electronic, or other types of contact. Each contact should be counted as one activity.)
Number of Number of other technical
Recipients of technical assistance
site visits assistance consultations
Batterer intervention program /offender monitoring
Child welfare agency (Child Protective Services)
Corrections (probation, parole, correctional facility)
Court (tribal)
Court (non-tribal)
Disability organization
Domestic violence program (tribal)
Domestic violence program (non-tribal)
Dual sexual assault and domestic violence program
Elder organization
Faith-based organization
Federal agencies (BIA,CIA,FBI,IHS)
Health/mental health organization
Law enforcement (tribal)
Law enforcement agency (non-tribal)
Legal services organization (legal services, bar association, law
school)
Military command staff
Order tribal coalition
Prosecutor’s office (tribal)
Prosecutor’s office (non-tribal)
Sexual assault forensic examiners/sexual assault nurse examiner
Sexual assault program (tribal)
Sexual assault program (non-tribal)
Tribal community groups
Tribal government/Tribal government agency
University/school
Youth program
Other (specify):
Total

0
Tribal Coalitions Program Semi-annual Progress Report • 21 • Office on Violence Against Women

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0

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OMB
OMBCle
Clearance # 1122-0011
0/31/2007
Expiration Date: 06/30/2011

32. Topics of technical assistance
(Check the topics that apply to technical assistance provided with Tribal Coalitions Program funds during the current reporting period. The technical assistance provided may be categorized by more than
one topic. Check all that apply.)
Topics of technical assistance
Sexual assault Domestic violence
Coordinated community response
Court response
Curricula and training issues
Developing or enhancing culturally appropriate services for underserved populations
Developing or enhancing appropriate services for elder victims/
survivors
Developing or enhancing appropriate services for victims/survivors who have disabilities
Forensic evidence collection and documentation
Law enforcement response
Probation response
Program development
Program evaluation
Prosecution response
Response to dating violence victims/survivors
Response to domestic violence victims/survivors
Response to sexual assault victims/survivors
Response to stalking victims/survivors
Safety planning
Sex offender registry(ies)
Standards of service
Technology and technology capacity (data collection systems
and confidentiality)
Technology safety and security
Tribal codes
University/school
Victim service administration and operations
Other (specify):

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

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OMB
OMB Clearance # 1122-0011
10/31/2007
Expiration Date: 06/30/2011

33. (OPTIONAL) Additional information
(Use the space below to discuss the effectiveness of technical assistance activities funded or supported by your Tribal Coalitions Program grant and to provide further explanation on how these activities
increase the safety of American Indian/Alaska Native women.) (Maximum - 2000 characters)

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

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SECTION

OMB Clearance # 1122-0011
Expiration Date: 06/30/2011
10/31/2007

C7

Organizational Development and
Capacity Building

Were your Tribal Coalitions Program grant funds used for organizational development and/or capacity
building during the current reporting period?
Check yes if Tribal Coalitions Program funded staff engaged in organizational development and/or
capacity building activities, or if Tribal Coalitions Program funds were used to directly support organizational development and/or capacity building.
Yes—answer questions 34-35
No—skip to section D
34. Coalition development and capacity building
(Check all activities that were engaged in with Tribal Coalitions Program funds during the current reporting period.)
Activity

Board member development
Communication (TTY, language lines, etc.)
Develop personnel policies
Emergency preparedness
Equipment purchase (computers, printers, faxes, telephones, cell phones, etc.)
Evaluation/outcome measures, development or tracking
Identify gaps in service
Internet/e-mail/listserv development
Office space (opening/maintaining)
Outreach to underserved populations
Software purchase or development
Staff development
Strategic planning
Technology security and safety
Toll-free telephone line operation
Web site development or enhancement
Other (specify):
35. Do you consider system privacy and/or security when purchasing or developing software?
Yes
No

Tribal Coalitions Program Semi-annual Progress Report • 24 • Office on Violence Against Women

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SECTION

OMB
OMBClearance
Clearance##1121-0284
1122-0011
ExpirationDate:
Date:10/31/2007
06/30/2011
Expiration

D

NARRATIVE

All grantees must answer question 36.
Please limit your response to the space provided.
36. Report on the status of the goals and objectives for the tribal coalitions (Report 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 on your successes and challenges, and provide any additional explanation you feel is necessary for us to understand what you have or have not accomplished relative to your
goals and objectives. If you have not accomplished objectives that should have been accomplished
during the current reporting period, you must provide an explanation.) Page 26.
All grantees must answer questions 37 and 38 on an annual basis. Please submit this information on
the January to June reporting form only.
PLEASE LIMIT YOUR RESPONSE TO TWO PAGES FOR EACH QUESTION.
37. 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 geographic area served, service delivery systems, types
of victimization, jurisdictional issues, and challenges and barriers unique to the tribal communities
served by your tribal coalitions.) Page 29.
38. What has the Tribal Coalitions Program funding allowed you to do or maintain that you could not do
without receiving this funding? (For example, has the funding enabled you to identify and eliminate
gaps in services; improve services to tribal populations; or, improve criminal justice response to American Indian and/or Alaska Native women? Provide specific examples in your answer [e.g., opened an
office with two full-time staff].) Page 31.
Questions 39 and 40 are optional.
PLEASE LIMIT YOUR RESPONSE TO TWO PAGES FOR EACH QUESTION.
39. Provide additional information regarding the effectiveness of your grant-funded program. (If you have
other data or information that you have not already reported in answers to previous questions that
demonstrate the effectiveness of your Tribal Coalitions Program grant, please provide it below. Refer
to the separate instructions for a fuller explanation and examples.) Page 33.
40. Provide any additional information that may provide explanation about the data submitted. (If you
have any information that could be helpful in understanding the data submitted, please answer this
question. For example, if two grant reports were submitted, you may explain how the data was apportioned to each report; if you funded staff but did not report any activities, you may explain why; or if
you did not use program funds to support either staff or activities during the reporting period, please
explain how program funds were used, if you have not already done so.) Page 35.
Public Reporting Burden
Paperwork Reduction Act Notice. Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. We try to
create forms and instructions that are accurate, can be easily understood, and which impose the least
possible burden on you to provide us with information. The estimated average time to complete and
file this form is 60 minutes per form. If you have comments regarding the accuracy of this estimate, or
suggestions for making this form simpler, you can write to the Office on Violence Against Women, U.S.
Department of Justice, 800 K Street, NW, Washington, DC 20531.
Tribal Coalitions Program Semi-annual Progress Report • 25 • Office on Violence Against Women

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OMBClearance
Clearance##1122-0011
1121-0284
OMB
Expiration
ExpirationDate:
Date:06/30/2011
10/31/2007

Report on the status of the goals and objectives for the tribal coalitions - Question #36
Back to Instructions

Status

Goals/Objectives

Key Activities

Comments

Goals/Objectives

Status

Key Activities

Comments

Tribal Coalitions Program Semi-annual Progress Report • 26 • Office on Violence Against Women

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THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.
OMB
OMBClearance
Clearance##1121-0284
1122-0011
ExpirationDate:
Date:10/31/2007
06/30/2011
Expiration

Report on the status of the goals and objectives for the tribal coalitions - Question #36 (cont. 1)

Back to Instructions

Status

Goals/Objectives

Key Activities

Comments

Goals/Objectives

Status

Key Activities

Comments

Tribal Coalitions Program Semi-annual Progress Report • 27 • Office on Violence Against Women

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THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.
OMB Clearance
Clearance ## 1122-0011
OMB
Expiration
31/2007 Date: 06/30/2011

Report on the status of the goals and objectives for the tribal coalitions - Question #36 (cont. 2)
Back to Instructions

Status

Goals/Objectives

Key Activities

Comments

Goals/Objectives

Status

Key Activities

Comments

Tribal Coalitions Program Semi-annual Progress Report • 28 • Office on Violence Against Women

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

Back to Instructions

OMB
OMB Clearance
Clearance ## 1122-0011
1121-0284
Expiration
Expiration Date:
Date: 06/30/2011
10/31/2007

What do you see as the most significant areas of remaining need, with regard to improving services to victims/survivors of sexual assault, domestic violence/dating violence; and stalking; increasing victims/survivors safety; and enhancing community response (including offender accountability for both batterers and sex
offenders? - Question #37

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

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

Back to Instructions

OMB Clearance
Clearance #
# 1122-0011
1121-0284
OMB
E
Expiration Date: 06/30/2011

What do you see as the most significant areas of remaining need, with regard to improving services to victims/survivors of sexual assault, domestic violence/dating violence, and stalking; increasing victims/survivors safety; and enhancing community response (including offender accountability for both batterers and sex
offenders? - Question #37 (cont.)

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

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

Back to Instructions

OMB
OMBClearance
Clearance##11211122-0011
0/31/2007
Expiration Date: 06/30/2011

What has the Tribal Coalitions funding allowed you to do or maintain that you could not do without receiving
this funding? - Question #38

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

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Back to Instructions

Clearanc # 1122-0011
OMB Clearance
Expiration
Date: 06/30'/2011
10/31/2007

What has the Tribal Coalitions funding allowed you to do or maintain that you could not do without receiving
this funding? - Question #38 (cont.)

Tribal Coalitions Program Semi-annual Progress Report • 32 • Office on Violence Against Women

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Back to Instructions

OMB Clearance # 1122-0011
1121-02
Expiration
Date: 06/30/2011
10/31/2007

Provide additional information regarding the effectiveness of your grant-funded program. - Question #39

Tribal Coalitions Program Semi-annual Progress Report • 33 • Office on Violence Against Women

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

Back to Instructions

OMB Clearance
Clearance #
# 1122-0011
OMB
10/31/2007
Expiration
Date: 06/30/2011

Provide additional information regarding the effectiveness of your grant-funded program. - Question #39
(cont.)

Tribal Coalitions Program Semi-annual Progress Report • 34 • Office on Violence Against Women

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Back to Instructions

OMB
OMBCClearance # 1122-0011
0/31/2007
Expiration Date: 06/30/2011

Provide any additional information that may provide explanation about the data submitted. - Question #40

Tribal Coalitions Program Semi-annual Progress Report • 35 • Office on Violence Against Women

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Back to Instructions

OMB Clearance
Cl
OMB
# 1122-0011
10/31/2007
Expiration
Date: 06/30/2011

Provide any additional information that may provide explanation about the data submitted. - Question #40
(cont.)

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

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OMB Clearance
Clearance #
# 1122-0011
OMB
2007
Expiration
Date: 06/30/2011

Validate

Tribal Coalitions Program Semi-annual Progress Report • 37 • Office on Violence Against Women

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