SLP Annual Performance Report Form

Appendix D: Data Collection Instrument

U.S. Department of Education, Office of Innovation and Improvement

School Leadership Program (SLP) Annual Performance Report Form, OMB # XXX, exp. x/x

Cover Sheet

Select One: [ ] Annual Performance Report [ ] Annual Performance Report Update [ ] Final Performance Report

General Information

1. PR/Award #:

2. Grantee NCEA ID#:

(Block 5 of the Grant Award Notification – 11 characters.)

3. Project Title:

(Enter the same title as on the approved application.)

4. Grantee Name (Block 1 of the Grant Award Notification.):

5. Grantee Address (See instructions.)

6. Project Director (See instructions.)

Name:

Title:

Phone #:

( )

-

Ext.:

( )

Fax #:

( )

-

Email Address:

Reporting Period Information (See instructions.)

7. Reporting Period:

From:

/ /

To:

/ /

(mm/dd/yyyy)

Budget Expenditures (To be completed by your Business Office. See instructions. Also see Budget Information.)

8. Budget Expenditures

	Federal Grant Funds	Non-Federal Funds (Match/Cost Share)
a. Previous Budget Period
b. Current Budget Period
c. Entire Project Period (For Final Performance Reports only)

Indirect Cost Information (To be completed by your Business Office. See instructions.)

9. Indirect Costs

a. Are you claiming indirect costs under this grant?

Yes

No

b. If yes, do you have an Indirect Cost Rate Agreement approved by the Federal Government?

Yes

No

c. If yes, provide the following information:

Period Covered by the Indirect Cost Rate Agreement:

From:

/ /

To:

/ /

(mm/dd//yyyy)

Approving Federal agency:

ED

Other (please specify):

Type of Rate (For Final Performance Reports Only):

Provisional

Final

Other (Please specify):

d. For Restricted Rate Programs (check one) – Are you using a restricted cost rate that:

Is included in your approved Indirect Cost Rate Agreement?

Complies with 34 CFR 76.564(c)(2)?

Human Subjects (See instructions.)

10. Is there Annual Certification of Institutional Review Board (IRB) approval attached?

Yes

No

N/A

Performance Measures Status and Certification (See instructions.)

11. Performance Measures Status

a. Are complete data on performance measures for the current budget period included in the Project Narrative?				Yes			No
b. If no, when will data be available and submitted to the ED?	/ /	(mm/dd/yyyy)

12. To the best of my knowledge and belief, all data in this performance report are true and correct, and the report fully discloses all known weaknesses concerning the accuracy, reliability, and completeness of the data.

Name of Authorized Representative		Title
Signature of Authorized Representative		Date

Paperwork Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is xxxx-xxxx. The time required to complete information for the data collection is estimated to average 40 hours, including the time to review instructions, search existing data resources, gather the data needed, complete and review the information collection. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Education, Washington, D.C. 20202-4651. If you have comments or concerns regarding the status of your individual submission of this form, write directly to: U.S. Department of Education, Office of Innovation and Improvement, Teacher Quality Programs, 400 Maryland Avenue, SW, Washington, DC 20202-6140.

U.S. Department of Education, Office of Innovation and Improvement

School Leadership Program (SLP) Annual Performance Report Form XXXX-XX

Executive Summary

(See instructions.)

U.S. Department of Education, Office of Innovation and Improvement

School Leadership Program (SLP) Annual Performance Report Form XXXX-XX

Project Narrative

Section A. Project Information (See instructions.)

1. Please indicate the project year on which you are reporting:

	Year 1
	Year 2
	Year 3
	Year 4
	Year 5
	Year 6 (1-year, no cost extension)

2. Please provide the following information on the participants who were NEW to your project this year.

a. The total number of NEW project participants:
b. The number of NEW project participants who are…
Black:
White (non-Hispanic):
Hispanic:
Asian or Pacific Islander:
American Indian or Alaska Native:
Multi-Racial:
Other:
c. The number of NEW project participants who are employed…
As principals:
As assistant principals:
As teachers:
In other school or district staff positions:
In other positions within the field of education:
In positions outside of the field of education:

3. Did any participants drop out of your project this year?			Yes			No
a. If yes, how many participants dropped out?
b. If yes, what were the reasons participants gave for dropping out (use space below)?

Section B. GPRA Measures (See instructions.)

Objective 1: To recruit, prepare, and support individuals from education or other fields to become principals or assistant principals of schools in high-need local educational agencies (LEAs).

1. Does your project recruit and prepare individuals to become principals or assistant principals (please mark one)?

	Yes. If yes, proceed to Performance Measure 1.1.
	No. If no, proceed to Objective 2, Question 1.

2. Performance Measure 1.1: The percentage of School Leadership Program participants seeking certification who meet certification requirements to become a principal or assistant principal.

In the table below, enter the information requested for the current project year by group. A group is defined as all participants who started your project in a given year. Please see the instructions for more detailed information on reporting data for Performance Measure 1.1.

Group	COLUMN A Enter the # of SLP participants seeking certification to become an assistant principal or principal	COLUMN B Enter the # of SLP participants who met certification requirements for assistant principals or principals	COLUMN C Divide Column B by Column A, multiply by 100, and enter the percentage
Group 1: All participants who started the project in year 1
Group 2: All participants who started the project in year 2
Group 3: All participants who started the project in year 3
Group 4: All participants who started the project in year 4
Group 5: Participants who started the project in year 5

Explanation of Progress for Performance Measure 1.1. (Use as many pages as necessary)

In your explanation of progress for the current project year include:

• Information about how data were collected

• Explanation for any missing data

• An explanation for why progress was not made, if applicable, and steps for addressing the issue

• Explanation of participants who received certification prior to entering the program, but were not yet serving in administrative positions.

3. Performance Measure 1.2: The percentage of School Leadership Program participants certified through the funded project who are hired as an assistant principal of a school in a high-need LEA.

In the table below, please complete the information for the current project year by group. A group is defined as all participants who started your project in a given year. Please see the instructions for more detailed information on reporting data for Performance Measure 1.2.

Group	COLUMN A Enter the # of SLP participants certified through the project to become an assistant principal or principal	COLUMN B Enter the # of SLP participants who have been hired as an assistant principal in a high-need LEA	COLUMN C Divide Column B by Column A, multiply by 100, and enter the percentage
Group 1: All participants who started the project in year 1
Group 2: All participants who started the project in year 2
Group 3: All participants who started the project in year 3
Group 4: All participants who started the project in year 4
Group 5: Participants who started the project in year 5

Explanation of Progress for Performance Measure 1.2. (Use as many pages as necessary)

In your explanation of progress for the current project year include:

• Information about how data were collected

• Explanations for any missing data

• An explanation for why progress was not made, if applicable, and steps for addressing the issue

• Explanation of participants who received certification prior to entering the program, but were not yet serving in administrative positions (number of participants and number who were hired as an assistant principal in a high-need LEA after participating in the SLP funded program.)

4. Performance Measure 1.3: The percentage of School Leadership Program participants certified through the funded project who are hired as a principal of a school in a high-need LEA.

In the table below, please complete the information for the current project year by group. A group is defined as all participants who started your project in a given year. Please see the instructions for more detailed information on reporting data for Performance Measure 1.3.

Group	COLUMN A Enter the # of SLP participants certified through the project to become an assistant principal or principal	COLUMN B Enter the # of SLP participants who have been hired as a principal in a high-need LEA	COLUMN C Divide Column B by Column A, multiply by 100, and enter the percentage
Group 1: All participants who started the project in year 1
Group 2: All participants who started the project in year 2
Group 3: All participants who started the project in year 3
Group 4: All participants who started the project in year 4
Group 5: Participants who started the project in year 5

Explanation of Progress for Performance Measure 1.3. (Use as many pages as necessary)

In your explanation of progress for the current project year include:

• Information about how data were collected

• Explanations for any missing data

• An explanation for why progress was not made, if applicable, and steps for addressing the issue

• Explanation of participants who received certification prior to entering the program, but were not yet serving in administrative positions (number of participants and number who were hired as a principal in a high-need LEA after participating in the SLP funded program)

5. Performance Measure 1.4: The percentage of School Leadership Program participants who are hired as a principal or assistant principal of a school in a high-need LEA and remain in that position for at least 2 years.

Reporting on this performance measure starts in year 3. In the table below, please complete the information for the current project year (starting in year 3) by group. A group is defined as all participants who started your project in a given year. Please see the instructions for more detailed information on reporting data for Performance Measure 1.4.

Group	COLUMN A Enter the # of SLP participants certified through the project and hired as an assistant principal or principal 2 years ago	COLUMN B Enter the # of SLP participants still in an assistant principal or principal position in the same high-need LEA	COLUMN C Divide Column B by Column A, multiply by 100, and enter the percentage
Group 1: All participants who started the project in year 1
Group 2: All participants who started the project in year 2
Group 3: All participants who started the project in year 3
Group 4: All participants who started the project in year 4
Group 5: Participants who started the project in year 5

Explanation of Progress for Performance Measure 1.4. (Use as many pages as necessary)

In your explanation of progress for the current project year include:

• Information about how data were collected

• Explanations for any missing data

• An explanation for why progress was not made, if applicable, and steps for addressing the issue

• Explanation of participants who received certification prior to entering the program, but were not yet serving in administrative positions (number of participants hired as an assistant principal or principal in a high-need LEA after participating 2 years ago and number still in an assistant principal or principal position in the same high-need LEA)

Objective 2: To train and support principals and assistant principals from schools in high-need local educational agencies (LEAs) in order to improve their skills and increase retention.

1. Does your project train and support currently practicing principals or assistant principals who did not seek and/or obtain their certification through your project (please mark one)?

	Yes. If yes, proceed to Performance Measure 2.1.
	No. If no, proceed to Section C: Project Measures.

2. Performance Measure 2.1: The percentage of principals and assistant principals from schools in high-need LEAs who participated in the School Leadership Program-funded professional development activities who showed an increase in their pre-post scores on a standardized measure of principal skills.

Note: participants participating in one-time professional development activities should not be included in this measure.

In the table below, please complete the information for the current project year by group. A group is defined as all participants who started your project in a given year. Please use the spreadsheet provided by SLP to determine the number of participants who showed an increase from their pre- to post-test scores. For more detailed information, see the instructions for Performance Measure 2.1.

Group	COLUMN A Enter the # who completed project activities	COLUMN B Enter the # of SLP participants with pre-and post-test scores	COLUMN C Enter the # of SLP participants who showed an increase in their pre-post scores	COLUMN D Divide Column C by Column B, multiply by 100, and enter the percentage
Group 1: All participants who started the project in year 1
Group 2: All participants who started the project in year 2
Group 3: All participants who started the project in year 3
Group 4: All participants who started the project in year 4
Group 5: Participants who started the project in year 5

Explanation of Progress for Performance Measure 2.1. (Use as many pages as necessary)

In your explanation of progress for the current project year include:

• Information about how data were collected including what, when, and how pre- and post-tests were administered

• Explanations for any missing data

• An explanation for why progress was not made, if applicable, and steps for addressing the issue

• A description of what is considered as completion of the program (e.g., length of program and expected level of participation)

3. Performance Measure 2.2: The percentage of principals and assistant principals from schools in high-need LEAs who participated in the School Leadership Program-funded professional development activities who remained in their administrative position for at least 2 years.

Reporting on this performance measure starts in year 3. In the table below, please complete the information for the current project year (starting in year 3) by group. A group is defined as all participants who started your project in a given year. The 2 years should be counted starting the day after a participants completes the project. Please see the instructions for more detailed information on reporting data for Performance Measure 2.2.

Group	COLUMN A Enter the # of SLP participants who completed the project 2 years ago	COLUMN B Enter the # of SLP participants still in an assistant principal or principal position in the same high-need LEA	COLUMN C Divide Column B by Column C, multiply by 100, and enter the percentage
Group 1: All participants who started the project in year 1
Group 2: All participants who started the project in year 2
Group 3: All participants who started the project in year 3
Group 4: All participants who started the project in year 4
Group 5: Participants who started the project in year 5

Explanation of Progress for Performance Measure 2.2. (Use as many pages as necessary)

In your explanation of progress for the current project year include:

• Information about how data were collected

• Explanations for any missing data

• An explanation for why progress was not made, if applicable, and steps for addressing the issue

• A description of what is considered as completion of the program (e.g., length of program and expected level of participation)

• For program activities that are conducted with the same group of participants over a 4 or 5-year period, report the number of these participants and the number remaining in their position in the final year of the grant

Section C. Project Measures (See instructions.)

Use the tables in Section C to report on any project measures included in your application. Please see the instructions for more detailed information on reporting data for Project Measures.

Project Objective 1:

1.a. Performance Measure:
Target			Actual Performance Data
Raw Number	Ratio	%	Raw Number	Ratio	%
	/			/

Explanation of Progress. (Use as many pages as necessary)

In your explanation of progress for the current project year include:

• Information about how data were collected

• Explanations for any missing data

• An explanation for why progress was not made, if applicable, and steps for addressing the issue

• Information about how data have been used to inform project improvements

1.b. Performance Measure:
Target			Actual Performance Data
Raw Number	Ratio	%	Raw Number	Ratio	%
	/			/

Explanation of Progress. (Use as many pages as necessary)

In your explanation of progress for the current project year include:

• Information about how data were collected

• Explanations for any missing data

• An explanation for why progress was not made, if applicable, and steps for addressing the issue

• Information about how data have been used to inform project improvements

U.S. Department of Education, Office of Innovation and Improvement

School Leadership Program Grant Performance Report

Budget Information

Section A. Budget Summary (See instructions.)

Please use the table below to report on the Federal and non-Federal funds (e.g., in-kind contributions) expended during the current budget period.

Budget Categories	COLUMN A Federal Funds (SLP Funds)	COLUMN B Non-Federal Funds	COLUMN C Total (Column A+B)
1. Personnel
2. Fringe Benefits
3. Travel
4. Equipment
5. Supplies
6. Contractual
7. Construction
8. Other
9. Total Direct Costs (lines 1-8)
10. Indirect Costs
11. Training Stipends
12. Total Costs (lines 9-11)

Section B. Budget Narrative (See instructions.)

U.S. Department of Education, Office of Innovation and Improvement

School Leadership Program Grant Performance Report

Additional Information

(See instructions.)

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