Sa

International Resource Information System (IRIS)

sa_participant

SA

OMB: 1840-0759

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SEMINARS ABROAD (SA)
PARTICIPANT

CFDA NUMBER: 84.021

IFLE REPORTING SYSTEM PROPOSED
SCREENS

Paperwork Reduction Notice. According to the Paperwork Reduction Act of 1995, no persons are
required to respond to a collection of information unless it displays a valid OMB control number. The valid
OMB control number for this information collection is 1840-0759. Public reporting burden for this collection
of information is estimated to average 30 minutes per response, including time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the information collection. The obligation to respond to this collection is required to obtain or
retain a benefit. If you have comments or concerns regarding the status of your individual submission of
this form, please contact Sara Starke at 202.453.7681 or at sara.starke@ed.gov.

ATTACHMENT B: IFLE REPORTING SYSTEM PROPOSED SCREENS

Program:
Fulbright-Hays Seminars Abroad
Seminar Title:
U.S. Dept of Education Contact:

Country:
Report Due Date:

Professional
Experience

Orientation
Evaluation

In-Country
Experience
Evaluation

Language
Proficiency

Curriculum Project Outreach Activities

View/Submit
Report

SA Participant
1.
2.
3.
4.
5.
6.
7.

Click on and fill out information for Participant Information and Professional Experience
Click "Save and Continue"
On the Predeparture Orientation Screen, rate each category and click on "Save"
You can continue on to the in-country section or simply "Log Off" to exit and your information will be saved.
Click on "In-Country Experience Evaluation" and answer the questions.
Click "Save and Continue" at the bottom of each screen to continue to the next screen.
On the View/Submit Report Screen:
Verify the information you have entered.
If you need to make changes, click the menu option to return to that screen.
If your report is complete, click the "Submit Report" button at the bottom of the screen.
Once you have submitted your report, you will not be able to make changes.

If you have questions about using the system, click Contact us to send a question to the help desk.

This is a United States Department of Education computer system, which may be accessed and used only for official
Government business by authorized personnel. Unauthorized access or use of this computer system may subject violators
to criminal, civil, and/or administrative action.
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International and Foreign Language Education
U.S. Department of Education
Office of Postsecondary Education
1990 K Street, N.W., Washington, DC 20006-8521
Phone: (202) 502-7700

Program:
Fulbright-Hays Seminars Abroad
Seminar Title:
U.S. Dept of Education Contact:

Country:
Report Due Date:

Professional
Experience

Orientation
Evaluation

In-Country
Experience
Evaluation

Language
Proficiency

Curriculum Project Outreach Activities

Participant Contact Info
* Required fields

Name:
Title/Position:
Street:

Street 2:
City:
State:

*
Select
Selectoneone
Alabama

Postal code:
Phone:

* 123-123-1234
Save

Save and Continue

View/Submit
Report

Program:
Fulbright-Hays Seminars Abroad
Seminar Title:
U.S. Dept of Education Contact:

Country:
Report Due Date:

Professional
Experience

Orientation
Evaluation

In-Country
Experience
Evaluation

Language
Proficiency

Curriculum Project Outreach Activities

View/Submit
Report

Professional Experience
Provide the following information about your professional experience.
* Required fields

Educational level(s) taught or administered: * Select
Select all
allthat
thatapply
apply
2-year
2-year institution
institution
4-year
4-year institution
institution
Chief State
StateSchool
Schoolofficer
officer
Chief
CurriculumSpecialist
Specialist
Curriculum
(for multiple selections, hold down the "ctrl" key and click)

Discipline(s) taught or administered:

* Select
Selectall
allthat
thatapply
apply

Anthropology
Anthropology
Archaeology
Archaeology
Architecture/urbanand
andregional
regionalplanning
planning
Architecture/urban
Areastudies
studies
Area

(for multiple selections, hold down the "ctrl" key and click)

Institution:

Select
Selectone
one
Abilene Christian University

Institution Type:
Institution Designation:

Select
Selectone
one
2-year Public/State Controlled Institution of Higher Education

Eligible to receive assistance under Part A or B of Title III or under Title V of the
Higher Education Act of 1965, as amended (HEA)
Not eligible to receive assistance under Part A or B of Title III or under Title V of the
Higher Education Act of 1965, as amended (HEA)

School:
Select if your school is identified as:

Low-income
The school must be a public or other nonprofit elementary or secondary school.
The school must be in a school district of a Lcal Educational Agency (LEA) that
is elligible each year for assistance under Title I of the Elementary and
Secondary Education Act of 1965 (ESEA).
The number of children enrolled in the school who meet a measure of poverty
under Section 1113(a)(f) of the ESEA must be exceed 30 percent of the total
enrollment of that school.

Rural - The school is designated with a school locale code of 7 or 8 by the
Department's National Center for Education Statistics (For school locale code
definitions, click here: http://nces.ed.gov/ccd/Rural_Locales.asp)
Participant Type:

Select
Selectone
one
Elementary (K-6)

Education level(s) taught or administered:
How many years have you been in that
position?

Select
Selectone
one
K-6

How many years have you been an
educational professional?

Have you previously participated in a Fulbright-Hays Seminar or Group Projects Abroad? *
Yes

If so, for what year(s) and country(ies)?
Save

Save and Continue

Program:
Fulbright-Hays Seminars Abroad
Seminar Title:
U.S. Dept of Education Contact:

Country:
Report Due Date:

Professional
Experience

In-Country
Experience
Evaluation

Orientation
Evaluation

Language
Proficiency

Curriculum Project Outreach Activities

View/Submit
Report

Pre-departure Orientation Evaluation
Rate each question below on a scale of excellent to very poor. You may enter comments below to clarify your ratings.
* Required fields
Rating
Very
Excellent Good Fair Poor Poor NA

Category

1. Balance of lectures, cultural events, cities, and other components of itinerary.

2. Pacing of itinerary.

3. Quality of speakers and academic lectures.

4. Quality of host country faculty and teachers for language instructions.

5. Quality of host country faculty and teachers for area studies instruction.

6. Quality of other host country counterparts.

7. Quality and value of interaction with other program participants.

8. Quality of service provided by host country administering agency (e.g., Fulbright
Commission, host country coordinators).

9. Condition of housing facilities.

10. Meeting special needs of participants.

11. Availability of Project Director and staff.

*
NA = Not Applicable

Comments. Please provide feedback about the in-country experience. For example, discuss: pace of
itinerary, challenges with staff, and/or activities that impacted you professionally: * (limit 5,000 characters
and spaces)

Characters and Spaces: 0

✔

This will be shared with your Project Director anonymously unless you check here.
Save

Save and Continue

International and Foreign Language Education
U.S. Department of Education
Office of Postsecondary Education
1990 K Street, N.W., Washington, DC 20006-8521
Phone: (202) 502-7700

Program:
Fulbright-Hays Seminars Abroad
Seminar Title:
U.S. Dept of Education Contact:

Country:
Report Due Date:

Professional
Experience

In-Country
Experience
Evaluation

Orientation
Evaluation

Language
Proficiency

Curriculum Project Outreach Activities

Foreign Language and Area Studies
Enter information to indicate the impact of the seminar on your language study.

As a result of your seminar experience:

Did you initiate study of a foreign language?

Yes

Select
oneone
Select
Abkhaz

If so, which language:
Do you plan to continue study of a foreign language?

Yes

Select
oneone
Select
Abkhaz

If so, which language:
Do you plan to continue to internationalize your curriculum? *

Yes

If so, how do you plan to do so:
(limit 1,000 characters and spaces)

Characters and Spaces: 0

Save

Save and Continue

View/Submit
Report

Program:
Fulbright-Hays Seminars Abroad
Seminar Title:
U.S. Dept of Education Contact:

Country:
Report Due Date:

Professional
Experience

In-Country
Experience
Evaluation

Orientation
Evaluation

Language
Proficiency

Curriculum Project Outreach Activities

View/Submit
Report

Curriculum Project
As stated in the Fulbright-Hays Seminars Abroad Program Terms and Conditions of the Award,"Participants are required to complete
one curriculum project that is relevant to institutions' use on an individual or small group basis."
Enter information concerning your curriculum project. Note that the project may be available to the general public and that you are
responsible for presenting it in a professional manner so as to appropriately represent the Fulbright-Hays Seminars Abroad program.
* Required fields

Title:

Description:

(limit 1,000 characters and spaces)

Characters and Spaces: 0
Project topic/field:

* Select
Selectall
allthat
thatapply
apply

Anthropology
Anthropology
Archaeology
Archaeology
Architecture/urban
Architecture/urbanand
andregional
regionalplanning
planning
Areastudies
studies
Area

(for multiple selections, hold down the "ctrl" key and click)

Intended audience:

* Select
Selectall
allthat
thatapply
apply

2-year
2-yearinstitution
institution
4-year
4-yearinstitution
institution
ChiefState
StateSchool
Schoolofficer
officer
Chief
CurriculumSpecialist
Specialist
Curriculum

Discussions:

* 1a. Did the project plan change from what you originally proposed in the application?
Yes

1b. If yes, how did it change and why?

Characters and Spaces: 0
2. Did you work on or begin planning (notes, outline, etc.) the project while in country(ies)?
Yes
No
3. How did you feel about the structured time spent discussing curriculum projects during the
seminar?

More time should be allotted for project discussion.
Sufficient time was given for project discussion.
Less time should be allotted for project discussion.
4a. Did you discuss the project (with other participants, host agency, or someone else) while in
country?
Yes
No
4b. Upon return to the U.S.?
Yes

5a. Do you think that attendance in the Seminars Abroad Program has enabled you to build upon
current curriculum in the classroom?
Yes
No
5b. In other classrooms at your school?
Yes
No
5c. Help others in the community (town/city, county, school district) understand another culture?
Yes
No
6. Will you be able to implement the curriculum project within the first year after participating in the
Seminars Abroad program?
Yes
No
If not, please explain why you have not been able to in the box below.
(limit 1,000 characters and spaces)

Characters and Spaces: 0
7. Have your colleagues (teachers in the school or community) used the curriculum project or
mentioned that they had interest in using the curriculum in their classrooms?
Yes
No
If so, how many?
Select
Selectone
one
1-3

8. In your first year after participating in this program, how many students have gained knowledge
from the curriculum developed?
Select
Selectone
one
1-5

9. How do you know the students gained knowledge? Were they assessed?
Yes
No
If they were assessed, how? Briefly describe method below.
(limit 1,000 characters and spaces)

Characters and Spaces: 0
10. Describe the response by students or other attendees to your presentation.
(limit 1,000 characters and spaces)

Characters and Spaces: 0
Curriculum project attachment(s): * The curriculum project file must be in one of the following formats: MS Word, MS PowerPoint or PDF.
Note: If your curriculum project is a Web site, upload a word document with a brief description and the url for your
Web site.
The size of the file may not exceed 5 MB and you are limited to 2 file uploads only. Click here for help in
compressing PowerPoint files.

no file selected
(Click the "Browse..." button to the right to attach an electronic copy of the curriculum project. When prompted, locate
and select the file to upload.)

Upload an additional project file, if any, below:
Save

no file selected

Save and Continue

Program:
Fulbright-Hays Seminars Abroad
Seminar Title:
U.S. Dept of Education Contact:

Country:
Report Due Date:

Professional
Experience

Orientation
Evaluation

In-Country
Experience
Evaluation

Language
Proficiency

Curriculum Project Outreach Activities

Outreach Activity
Below is a list of outreach records.
Enter information for each outreach activity you completed or planned as a result of your
participation in the program. Include activities such as conference presentations, teacher
workshops, media interviews, and articles. This information will be shared with your PD.
To add an outreach activity, click the "Add an Outreach Activity" button.
To view or edit a record, click "Update."
To remove a record, click "Delete."

Add an Outreach Activity

Action

Activity Title

Continue

View/Submit
Report

Program:
Fulbright-Hays Seminars Abroad
Seminar Title:
U.S. Dept of Education Contact:

Country:
Report Due Date:

Professional
Experience

In-Country
Experience
Evaluation

Orientation
Evaluation

Language
Proficiency

Curriculum Project Outreach Activities

Outreach Activities
Enter information for each outreach activity you completed or planned as a result of your participation in
the program. Include activities such as conference presentations, teacher workshops, media interviews,
community events and articles. We strongly encourage you to complete more than one outreach
activity within 12 months of returning from the Seminar Abroad.
* Required fields

Type of activity:

Title of activity:

Target audience:

* Select
Selectall
allthat
thatapply
apply

Select
oneone
Select
Community or other public presentation

<>
Business
Business
Business
Businessexecutives
executives
Community
Communityorganization
organization

(for multiple selections, hold down the "ctrl" key and click)

Web site:

http://

State:

Select
oneone
Select
Alabama

Country:

Select
oneone
Select
United States of America

Is this a completed or planned activity? *
Dates completed or planned:
(limit 300 characters and spaces)

Completed

Planned

Characters and Spaces: 0
Total attendance:
Comments: (limit 1,000 characters and spaces)

Characters and Spaces: 0

Save and New Entry

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View/Submit
Report

U.S. Department of Education
Office of Postsecondary Education
1990 K Street, N.W., Washington, DC 20006-8521
Phone: (202) 502-7700

File Type	application/pdf
Author	Michael Feranda
File Modified	2018-08-21
File Created	2013-02-25