NAT Forms

Table 1 - NAT: Enrollment, Traineeship Support, Graduates, Graduates Supported and Projected Data

Complete Table 1 summarizing student enrollment, trainee/student support, graduates, graduates supported and projected student enrollment. Table 1 is modified to add year 2 and year 3 data for the number of prospective students. Instructions for completing Table 1 are below.

When completing the application electronically, ensure that you select the correct Current Fiscal Year [e.g., 2020] prior to inputting any data as the dates will dynamically be displayed based on the Fiscal Year selection. Incorrect date selections will create an error and require Data Validation completed by HRSA.

Students	Total # of Full-time Students Enrolled 07/01/18 – 6/30/19)	Total # of Students Supported (07/01/18 - 06/30/19)	Total # of Graduates (07/01/18 - 6/30/19)	Total # of Graduates Supported (07/01/18 - 06/30/19)	Projected # Enrolled Students in Award Year 1 (07/01/19 - 06/30/20)	Projected # Enrolled Students in Award Year 2 (07/01/20 - 06/30/21)	Projected # Enrolled Students in Award Year 3 (07/01/21 - 06/30/22)
# Master’s Students
# Doctoral Students
GRAND TOTAL

OMB Number ______________ - Expiration date ____________

Instructions for Completing Table 1 - NAT:

IMPORTANT NOTES:

• All applicants must complete this table. Do not make any changes to this table.

• When completing the application on-line, ensure that you select the correct current Fiscal Year prior to inputting any data.

• For “Total # of Full-time Students Enrolled”, enter the total number of NAT full-time students enrolled and have not graduated or completed the program by 07/01/2018–06/30/2019.

• For “Total # of Students Supported The total # of enrollees who received Nurse Anesthetist Traineeship support from 07/01/2018-06/30/2019. The “Total # of Students Supported” must be equal to or less than the “Total Number of Full-time Students Enrolled”.

• For “Total # of Graduates”, enter the total number of NAT graduates who completed degree requirements between 07/01/2018-06/30/2019. If this is a new program, enter “0" in the “Total # of Graduates” column.

• For “Total # of Graduates Supported”, enter the total number of NAT graduates who received NAT support and completed degree requirements between 07/01/2018-06/20/2019. If this is a new program, enter “0" in the “Total # of NAT Graduates” column. The “Total # of Graduates Supported” must be equal to or less than the “Total Number of Graduates”.

• For “Total # of Projected # Enrolled Students”, enter the total number of Master’s and/or Doctoral students projected in Award Year 1 from 07/01/2019-06/20/2020 - Award Year 2 from 07/01/2020-06/20/2021 – Award Year 3 from 07/01/20210-06/20/2022.

• For “Grand Total”, the electronic system will automatically calculate for each column.

OMB Number ______________ - Expiration date ____________