Public 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 1855-0031. Public reporting burden for this collection of information is estimated to average 40 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The obligation to respond to this collection is required to obtain or retain a benefit under Title IV, Part F, Subpart 4 of the Elementary and Secondary Education Act, as amended by the Every Student Succeeds Act. If you have any comments or concerns regarding the status of your individual submission of this form, please contact Bonnie Carter at Bonnie.Carter@ed.gov or (202) 401-3576 or Asheley McBride at Asheley.McBride@ed.gov or 202-453-6398.
U.S. Department of Education OMB No: 1855-0031
Check only one box per Program Office instructions. Exp: xx/xx/xxxx
☐ Annual Performance Report ☐ Final Performance Report
Check only one box per Program Office instructions.
☐ Planning Year ☐ Implementation Year
General Information
1. PR/Award #: Click here to enter text. 2. Grantee NCES ID#: Click here to enter text.
(Block 5 of the Grant Award Notification - 11 characters.) (See instructions. Up to 12 characters.)
3 Project Title: Click here to enter text.
(Enter the same title as on the approved application.)
4. Grantee Name (Block 1 of the Grant Award Notification.):Click here to enter text.
5. Grantee Address (See instructions.)Click here to enter text.
6. Project Director (See instructions.) Name: Click here to enter text. Title:Click here to enter text.
Phone #: Click here to enter text. Ext: (Click here to enter text.) Fax #: Click here to enter text.
Email Address: Click here to enter text.
Reporting Period Information (See instructions.)
7. Reporting Period: From: Click here to enter a date. To: Click here to enter a date.
Budget Expenditures (To be completed by your Business Office. See instructions.)
8. Budget Expenditures
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Federal Grant Funds |
Non-Federal Funds (Match/Cost Share) |
a. Previous Budget Period |
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b. Current Budget Period |
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c. Entire Project Period (For Final Performance Reports only) |
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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: Click here to enter a date. To: Click here to enter a date.
Approving Federal agency: ☐ED ☐other (Please specify): Click here to enter text.
Type of Rate (For Final Performance Reports Only): ☐ Provisional ☐ Final ☐ Other (Please specify): Click here to enter text.
d. For Restricted Rate Programs (check one) -- Are you using a restricted indirect cost rate that:
☐ Is included in your approved Indirect Cost Rate Agreement?
☐ Complies with 34 CFR 76.564(c)(2)?
Human Subjects (Annual Institutional Review Board (IRB) Certification) (See instructions.)
10. Is the 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 Status Chart? ☐Yes ☐ No
b. If no, when will the data be available and submitted to the Department? Click here to enter a date.
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.
Click here to enter text. Click here to enter text.
Name of Authorized Representative Title
_______________________________ Click here to enter a date.
Signature Date
Please keep this brief and do not exceed two pages
Project highlights:
Extent to which the expected outcomes and performance measures were achieved:
Briefly summarize contributions the project has made to research, knowledge, practice, and/or policy in providing arts education and integration on a national level:
What evidence do you have that demonstrates that your project has served to improve or expand arts education and arts integration that addresses the needs of children and youth, with special emphasis on serving children from low-income families?
What evidence do you have that demonstrates that your project has served to improve or expand arts education and arts integration that addresses the needs of children and youth, with special emphasis on serving children with disabilities?
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SECTION A – Population Served (Use as many pages as necessary.)
Instructions: Complete the table below for each outreach activity.
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# Students |
# Teachers |
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Program/Activity Name |
Activity Type |
Invited |
Participated |
Invited |
Participated |
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SECTION B - Performance Objectives Information and Related Performance Measures Data (Use as many pages as necessary.)
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Target |
GPRA Measure 1: The total number of students who participate in standards-based arts education sponsored by the grantee. |
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GPRA Measure 3: The total number of students from low-income families who participate in standards-based arts education sponsored by the grantee. |
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GPRA Measure 4: The total number of students with disabilities who participate in standards-based education sponsored by the grantee. |
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Program/Activity |
Standard on which Program/Activity is Based |
GPRA 1: # of Participating Students |
GPRA 3: # of Students from Low-Income Families |
GPRA 4: # Students with Disabilities |
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Status of progress:
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Note: The “In Progress” status is only applicable to measures with completion dates that fall after the end of the reporting period. In Progress measures must be updated in the Ad Hoc Report
Description of progress (include challenges faced, if any)
For each measure “Not Met,” describe how and when the measure will be met, and any lessons learned.
SECTION B - Performance Objectives Information and Related Performance Measures Data (Use as many pages as necessary.)
GPRA Measure 2: The number of teachers participating in the grantee’s program who receive professional development that is sustained and intensive.
Program GPRA Measure 2 Target (established with your program officer): Click here to enter text.
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Professional Development…… |
Criteria 1: Participating teachers who completed 40 hours or more of the professional development hours offered by the project during the current reporting period |
Criteria 2: Participating teachers who completed 75% of the total number of professional development hours offered by the project during the current reporting period |
Criteria 3: Participating teachers who completed professional development hours over at least a 6 month period during the current reporting period |
# Participating teachers who met Criteria 1, 2, AND, 3 |
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Start date |
End date |
# hours offered |
# Participating Teachers |
Total # of Participating Teachers Meeting Criteria |
% of Participating Teachers Meeting Criteria |
Total # of Participating Teachers Meeting Criteria |
% of Participating Teachers Meeting Criteria |
Total # of Participating Teachers Meeting Criteria |
% of Participating Teachers Meeting Criteria |
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Status of progress:
☐ Met |
☐ Not Met |
☐ In Progress (only applicable to measures with completion dates that fall after the end of the reporting period. In Progress measures must be updated in the Ad Hoc Report ) |
Description of progress (include challenges faced, if any)
If Measure was “Not Met,” describe how and when the measure will be met, and any lessons learned.
SECTION B - Performance Objectives Information and Related Performance Measures Data
Project Objective: Click here to enter text.
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Project Performance Measure |
Target |
Actual |
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Click here to enter text. |
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Explanation of Progress:
Status of progress:
☐ Met |
☐ Not Met |
☐ In Progress (only applicable to measures with completion dates that fall after the end of the reporting period. In Progress measures must be updated in the Ad Hoc Report ) |
Description of progress (include challenges faced, if any)
If Measure was “Not Met,” describe how and when the measure will be met, and any lessons learned.
SECTION B - Performance Objectives Information and Related Performance Measures Data
Project Objective: Click here to enter text.
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Project Performance Measure |
Target |
Actual |
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Ratio |
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Click here to enter text. |
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Explanation of Progress:
Status of progress:
☐ Met |
☐ Not Met |
☐ In Progress (only applicable to measures with completion dates that fall after the end of the reporting period. In Progress measures must be updated in the Ad Hoc Report ) |
Description of progress (include challenges faced, if any)
If Measure was “Not Met,” describe how and when the measure will be met, and any lessons learned.
SECTION B - Performance Objectives Information and Related Performance Measures Data
Project Objective: Click here to enter text.
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Project Performance Measure |
Target |
Actual |
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Raw Number |
Ratio |
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Raw Number |
Ratio |
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Click here to enter text. |
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Explanation of Progress:
Status of progress:
☐ Met |
☐ Not Met |
☐ In Progress (only applicable to measures with completion dates that fall after the end of the reporting period. In Progress measures must be updated in the Ad Hoc Report ) |
Description of progress (include challenges faced, if any)
If Measure was “Not Met,” describe how and when the measure will be met, and any lessons learned.
SECTION B - Performance Objectives Information and Related Performance Measures Data
Project Objective: Click here to enter text.
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Project Performance Measure |
Target |
Actual |
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Ratio |
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Raw Number |
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Explanation of Progress:
Status of progress:
☐ Met |
☐ Not Met |
☐ In Progress (only applicable to measures with completion dates that fall after the end of the reporting period. In Progress measures must be updated in the Ad Hoc Report ) |
Description of progress (include challenges faced, if any)
If Measure was “Not Met,” describe how and when the measure will be met, and any lessons learned.
SECTION B - Performance Objectives Information and Related Performance Measures Data
Project Objective: Click here to enter text.
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Project Performance Measure |
Target |
Actual |
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Raw Number |
Ratio |
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Raw Number |
Ratio |
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Click here to enter text. |
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Explanation of Progress:
Status of progress:
☐ Met |
☐ Not Met |
☐ In Progress (only applicable to measures with completion dates that fall after the end of the reporting period. In Progress measures must be updated in the Ad Hoc Report ) |
Description of progress (include challenges faced, if any)
If Measure was “Not Met,” describe how and when the measure will be met, and any lessons learned.
SECTION B - Performance Objectives Information and Related Performance Measures Data
Project Objective: Click here to enter text.
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Project Performance Measure |
Target |
Actual |
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Raw Number |
Ratio |
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Raw Number |
Ratio |
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Click here to enter text. |
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Explanation of Progress:
Status of progress:
☐ Met |
☐ Not Met |
☐ In Progress (only applicable to measures with completion dates that fall after the end of the reporting period. In Progress measures must be updated in the Ad Hoc Report ) |
Description of progress (include challenges faced, if any)
If Measure was “Not Met,” describe how and when the measure will be met, and any lessons learned.
SECTION C – Non-Construction Programs: Budget Summary
Instructions
Approved Budget: Enter the amount awarded for the current reporting year in each budget category. Enter the start date of the grant budget year (e.g., 10/1/14) and the end date of the budget year (e.g., 9/30/15). If you are not sure of the start and end dates of the budget year for your grant, contact your project officer.
Carryover from Prior Year: Enter the amount of any funds carried over from the prior budget year.
Expenditures to Date: Enter the amount of funds expended to date in each budget category. Enter the period that the expenditures cover. The start date will be the start of the grant budget year (e.g., 10/1/14). The end date will be the end of the current reporting period (e.g., 5/30/15). If you are not sure of the start of the budget year or the end of the current reporting period, contact your project officer.
Anticipated Costs: Enter the amount of funds encumbered that will be expended prior to the end of the grant budget year. If this report covers the end of the budget year, this column should be empty.
Carryover to Following Year: Enter the amount of funds you propose to carry over to the next budget period.
SECTION C – Non-Construction Programs: Budget Summary
BUDGET SUMMARY U.S. DEPARTMENT OF EDUCATION FUNDS |
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Budget Categories |
Approved Budget
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Carryover from Prior Year |
Expenditures
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Anticipated Costs
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Carryover to Following Year |
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Reporting Period |
Start: mm/dd/yy End: mm/dd/yy |
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Start: mm/dd/yy End: mm/dd/yy |
Start: mm/dd/yy End: mm/dd/yy |
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Start: mm/dd/yy End: mm/dd/yy |
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1. Personnel |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
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Enter $ Amount |
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2. Fringe Benefits |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
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Enter $ Amount |
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3. Travel |
Enter $ Amount |
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Enter $ Amount |
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4. Equipment |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
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5. Supplies |
Enter $ Amount |
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6. Contractual |
Enter $ Amount |
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7. Construction |
Enter $ Amount |
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8. Other |
Enter $ Amount |
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Enter $ Amount |
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9. Total Direct Costs (lines 1-8) |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
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Enter $ Amount |
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10. Indirect Costs |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
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Enter $ Amount |
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11. Training Stipends |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
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12. Total Costs (lines 9-11) |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
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Enter $ Amount |
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SECTION C – Non-Construction Programs: Budget Summary
BUDGET SUMMARY NON-FEDERAL FUNDS |
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Budget Categories |
Approved Budget
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Carryover from Prior Year |
Expenditures
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Anticipated Costs
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Carryover to Following Year
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Reporting Period |
Start: mm/dd/yy End: mm/dd/yy |
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Start: mm/dd/yy End: mm/dd/yy |
Start: mm/dd/yy End: mm/dd/yy |
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Start: mm/dd/yy End: mm/dd/yy |
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1. Personnel |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
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Enter $ Amount |
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2. Fringe Benefits |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
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Enter $ Amount |
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3. Travel |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
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Enter $ Amount |
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4. Equipment |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
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Enter $ Amount |
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5. Supplies |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
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Enter $ Amount |
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6. Contractual |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
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Enter $ Amount |
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7. Construction |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
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Enter $ Amount |
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8. Other |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
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Enter $ Amount |
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9. Total Direct Costs (lines 1-8) |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
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Enter $ Amount |
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10. Indirect Costs |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
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Enter $ Amount |
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11. Training Stipends |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
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Enter $ Amount |
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12. Total Costs (lines 9-11) |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
Enter $ Amount |
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Enter $ Amount |
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SECTION C – Non-Construction Programs: Budget Summary
Please provide an explanation if funds have not been drawn down from the G5 System to pay for the budget expenditure amounts reported in items 8a. – 8c of the Cover Sheet:
Please provide an explanation if you did not expend funds at the expected rate during the reporting period:
Describe any significant changes to your budget resulting from modification of project activities:
Please describe any changes to your budget that affected your ability to achieve your approved project activities and/or project objectives:
Do you expect to have any unexpended (carryover) funds at the end of the current budget period? ☐ Yes ☐ No.
If yes, please explain why, provide an estimate, and indicate how you plan to use the unexpended funds in the next budget period:
Describe any anticipated changes in your budget for the next budget period that require prior approval from the Department (see EDGAR, 2 CFR 200.407, as applicable):
SECTION D – Budget Narrative
Instructions
Provide an itemized budget breakdown, and justification by project year, for each budget category listed in Sections C. For grant projects that will be divided into two or more separately budgeted major activities or sub-projects, show for each budget category of a project year the breakdown of the specific expenses attributable to each sub-project or activity.
For non-Federal funds or resources listed in Section C that are used to meet a cost-sharing or matching requirement or provided as a voluntary cost-sharing or matching commitment, you must include:
The specific costs or contributions by budget category;
The source of the costs or contributions; and
In the case of third-party in-kind contributions, a description of how the value was determined for the donated or contributed goods or services.
[Please review ED’s general cost sharing and matching regulations, which include specific limitations in 2 CFR 200.306, and the applicable Office of Management and Budget (OMB) cost principles for your entity type regarding donations, capital assets, depreciation and use allowances. OMB cost principle circulars are available on OMB’s website at: http://www.whitehouse.gov/omb/circulars/index.html]
If applicable to this program, provide the rate and base on which fringe benefits are calculated.
If you are requesting reimbursement for indirect costs on line 10, this information is to be completed by your Business Office. Specify the estimated amount of the base to which the indirect cost rate is applied and the total indirect expense. Depending on the grant program to which you are applying and/or your approved Indirect Cost Rate Agreement, some direct cost budget categories in your grant application budget may not be included in the base and multiplied by your indirect cost rate. For example, you must multiply the indirect cost rates of “Training grants" (34 CFR 75.562) and grants under programs with “Supplement not Supplant” requirements ("Restricted Rate" programs) by a “modified total direct cost” (MTDC) base (34 CFR 75.563 or 76.563). Please indicate which costs are included and which costs are excluded from the base to which the indirect cost rate is applied.
When calculating indirect costs (line 10) for "Training grants" or grants under "Restricted Rate" programs, you must refer to the information and examples on ED’s website at: http://www.ed.gov/fund/grant/apply/appforms/appforms.html.
You may also contact (202) 377-3838 for additional information regarding calculating indirect cost rates or general indirect cost rate information.
Provide other explanations or comments you deem necessary.
Begin your response here:
SECTION D – Budget Narrative
SECTION E –Additional Information
Submit a copy of the project logic model if one was created.
Overview of the arts education national approach/model:
Description of key components of the arts education national approach/model necessary for successful implementation: (should include a description of the role of learning communities and school leaders; the use of resources and the use of data; the use of research based learning designs and research on teacher change; and alignment with standards – as applicable)
Description of activities, services, initiatives in which innovative instructional methods are used:
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☐ Dance |
☐ Folk Arts |
☐ Media Arts |
☐ Music |
☐ Theater |
☐ Visual Arts |
Core Content Focus (e.g., science, social studies, reading, math) (Enter all content areas):
Please indicate how your implementation of the arts education national approach or model has changed over the past year (if applicable):
SECTION E –Additional Information
Professional Development
List the professional development activities that you provided to Pre-K-Grade 12 arts educators during this reporting period.
Description of Activity |
Date(s) |
Arts Focus |
Number of Educator Participants |
Standard(s) on which Professional Development is Based |
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Are there professional development activities you proposed to conduct in your application that you are no longer conducting? ☐ Yes ☐ No. If Yes, Why?
Are there professional development activities that you did not propose in your application that you are now conducting?
☐ Yes ☐ No. If Yes, Why?
SECTION E –Additional Information
Arts-based Educational Programming
List the arts-based educational programming activities that were offered through this project during this reporting period to Pre-K-Grade 12 students and arts educators.
Activity Name and Description |
Date(s) |
Arts Focus |
Number of Educator Participants |
Number of Student Participants |
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Are there programming activities you proposed to conduct in your application that you are no longer conducting? ☐ Yes ☐ No. If Yes, Why?
Are there programming activities that you did not propose in your application that you are now conducting?
☐ Yes ☐ No. If Yes, Why?
SECTION E –Additional Information
Community and National Outreach Activities and Services
List the activities and services conducted during this reporting period that were designed to strengthen and expand partnerships among schools, school districts, and communities throughout the country.
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Complete for School-based Activities |
Complete for District-based Activities |
Complete for National Activities |
Complete for Community Based Activities |
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Activity |
Date(s) |
# Students Served |
# Teachers Served |
# Participating Schools |
# Participating School Districts |
National Activity? |
Total # Participating Local Communities |
# High Need Communities |
# Rural Communities |
# Urban Communities |
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Are there outreach activities and services you proposed to conduct in your application that you are no longer conducting? ☐ Yes ☐ No. If Yes, Why?
Are there outreach activities and services that you did not propose in your application that you are now conducting?
☐ Yes ☐ No. If Yes, Why?
SECTION E –Additional Information
Development and Dissemination of Instructional Materials
Please list the key resources that have been developed for arts educators through this project.
Name of Resource |
Description of Resource and How it Will Be Used and Disseminated |
Arts Focus/Core Content Focus |
Completion Date |
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Are there resources you proposed to develop in your application that you are no longer developing? ☐ Yes ☐ No. If Yes, Why?
Are there resources you did not propose in your application that you are now developing? ☐ Yes ☐ No. If Yes, Why?
SECTION E –Additional Information
Assessment Tools
Please list the participant assessment tools that are being used in this project.
Name and Description of Tool |
How it will be/has been administered |
Outcome being Measured |
Associated Performance Measure # |
Completion Date |
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Are there assessment tools you proposed to administer or develop in your application that you are no longer administering or developing? ☐ Yes ☐ No. If Yes, Why?
Are there assessment tools you did not propose in your application that you are now using or planning to use?
☐ Yes ☐ No. If Yes, Why?
SECTION E –Additional Information
Evaluation
Please list the evaluation activities that occurred during this reporting period.
Evaluation Activities |
Key Findings |
How findings were or will be used |
Associated Performance Measure # |
Completion Date |
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Are there evaluation activities that you proposed in your application that you are no longer conducting? ☐ Yes ☐ No. If Yes, Why?
Are there evaluation activities that you did not propose in your application that you are now conducting? ☐ Yes ☐ No. If Yes, Why?
Select the primary evaluation methodology being used to examine the impact of the project on participant outcomes
☐ Experimental study |
☐ Quasi-Experimental study |
☐ Other. Describe: Click here to enter text. |
Indicate the extent to which this study may meet What Works Clearing Evidence Standards:
☐ May meet What Works Clearinghouse Evidence Standards Without Reservations |
☐ Will not meet What Works Clearinghouse Evidence Standards. Explain: Click here to enter text. |
☐ May meet What Works Clearinghouse Evidence Standards With Reservation |
SECTION E –Additional Information
Other Activities
Please list any other key activities that occurred during this reporting period which have not been included above.
Are there other key activities that you proposed in your application that you are no longer conducting? ☐ Yes ☐ No.
If Yes, Why?
Are there other key activities that you did not propose in your application that you are now conducting? ☐ Yes ☐ No.
If Yes, Why?
SECTION E –Additional Information
How many Priorities did you address in your application? _________
Complete the table below for each priority addressed:
Priority Name |
How was the priority addressed during the reporting period |
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Paperwork Burden Statement
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 collection is 1855-0031. The time required to complete this information collection is estimated to average 40 hours per response, including the time to review instructions, search existing sources of data, gather data needed, and complete and review information collection. If you have comments concerning the accuracy of the time estimates or suggestions for improving this form, please write to the U.S. Department of Education, Washington, DC 20202-4651. If you have comments or concerns regarding the status of your individual submission, please contact Bonnie Carter at Bonnie.Carter@ed.gov or (202) 401-3576 or Asheley McBride at Asheley.McBride@ed.gov or 202-453-6398.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Modified | 0000-00-00 |
File Created | 2021-01-15 |