School Data Collection

OMB Package for Pell Grant Experiments Random Assignment Data Collection Form

Data Collection Form: PGE Student Random Assignment Data Collection Form

Instructions: Please provide the following data elements for all students at your institution who are qualified for and have agreed to participate in the Pell Grant Experiments Study. The data matrix below can be completed electronically and uploaded to the secure website upon completion (insert web submission instructions here).

List of Data Elements for Entry into Random Assignment Database

Data Element	Entry Field Instructions
Student’s First Name
Student’s Middle Name
Student’s Last Name
Social Security Number	(xxx-xx-xxxx)
Date of Birth	(yyyy, mm, dd)
Name of PGE Program	(Insert name)