Demographic Information: All Allowable Activities
Please remember that the numbers you submitfor this form should be an unduplicated count of participants across all Allowable Activities.
Line 1.a. Enter the number of people who have enrolled grant activities during this reporting period across all Allowable Activities.If you did not collect this data, check the box “data not collected”.
Line 2.a. Enter the number of people who have completed grant activitiesduring this reporting period across all Allowable Activities. If you did not collect this data, check the box “data not collected”.
Line 3.a. Sex. Of the people enrolled during this reporting period across all Allowable Activities, enter the number of people who were female, and enter the number of people that were male. If you did not collect this data, check the box “data not collected”.
Line 3.b. Age.Of the people enrolled during this reporting period across all Allowable Activities, enter the number of people who were under 18 years of age; 18-24 years; 25-34 years; 35-44 years; 45-54 years; 55-64 years; and 65 years or older. If you did not collect this data, check the box “data not collected”.
Line 3.c. Marital Status. Of the people enrolled during this reporting period across all Allowable Activities, enter the number of people who were single/never married; in a committed relationship but not married; married; separated; divorced; and widowed. If you did not collect this data, check the box “data not collected”.
Line 3.d. Ethnicity. Of the people enrolled during this reporting period across all Allowable Activities, enter the number of people who are Hispanic and Non-Hispanic. If you did not collect this data, check the box “data not collected”.
Line 3.e. Race. Of those who enrolled during this reporting period across all Allowable Activities, enter the number of people who are American Indian or Alaskan Native; Asian; Black or African American; Native Hawaiian or other Pacific Islander; and White. If you did not collect this data, check the box “data not collected”.
Line 3.f.Educational Attainment. Of the people enrolled during this reporting period across all Allowable Activities, enter the number of people that had No degree or diploma; High School diploma or GED; Vocational or Technical Certification; Associate’s degree; Bachelor’s degree;and a Master’s or Advanced degree. If you did not collect this data, check the box “data not collected”.
Line 3.g. Employment Status. Of the peopleenrolled during this reporting period across all Allowable Activities, enter the numberof people who hadfull-time employment; part-time employment; who were retired; student; disabled; and unemployed. If you did not collect this data, check the box “data not collected”.
Line 3.h. Income.Of the peopleenrolled during this reporting period across all Allowable Activities, enter the number of people whose income was less than$10,000; $10,000-$19,999; $20,000-$29,999; $30,000-$39,999; $40,000-$49,999; $50,000-$59,999; $60,000-$69,999; $70,000-$79,999;and more than $80,000. If you did not collect this data, check the box “data not collected”.
Allowable Activity 2: Education in High Schools on the Value of Marriage, Relationship Skills, and Budgeting
Line 1. Enter the number of students who were enrolled in this allowable activity and the number of people who completed this allowable activity program during this reporting period. If you did not collect this data, check the box “data not collected”.
Section A: Demographic Information
Line 2.a. Sex. Of the students enrolled during this reporting period for Allowable Activity 2, enter the number of people who were female, and enter the number that were male. If you did not collect this data, check the box “data not collected”.
Line 2.b. Age. Of the students enrolled during this reporting period for Allowable Activity 2, enter the number of people who were under 15 years of age;15-16 years; 17-18 years; and older than 18 years. If you did not collect this data, check the box “data not collected”.
Line 2.c. Grade. Of the students enrolled during this reporting period for Allowable Activity 2, enter the number of people who were below the 9th grade; in the 9th grade; in the 10th grade; in the 11th grade; and in the 12th grade. If you did not collect this data, check the box “data not collected”.
Line 2.d. Ethnicity. Of the students enrolled during this reporting period for Allowable Activity 2, enter the number of people who are Hispanic and Non-Hispanic. If you did not collect this data, check the box “data not collected”.
Line 2.e. Race. Of the students enrolled during this reporting period for Allowable Activity 2, enter the number of people who are American Indian or Alaskan Native; Asian; Black or African American; Native Hawaiian or other Pacific Islander; and White. If you did not collect this data, check the box “data not collected”.
Section B: Activities and Skills Received
Line 3.a. Abuse prevention skills.Of the studentsenrolled and completed during this reporting period for Allowable Activity 2, enter the number of people who enrolled in Abuse prevention activities and the number of people who completed Abuse prevention activities. If you did not collect this data, check the box “data not collected”. If you did not administer this activity, check the box “activity not conducted”.
Line 3.b. Budgeting/financial skills.Of the students enrolled and completed during this reporting period for Allowable Activity 2, enter the number of people who received Budgeting/financial skills services. If you did not collect this data, check the box “data not collected”. If you did not administerthis activity, check the box “activity not conducted”.
Line 3.c. Communication skills. Of those who enrolled and completed during this reporting period for Allowable Activity 2, enter the number of people who received Communication skills services. If you did not collect this data, check the box “data not collected”. If you did not administer this activity, check the box “activity not conducted”.
Line 3.d. Conflict resolution skills. Of those who enrolled and completed during this reporting period for Allowable Activity 2, enter the number of people who received Conflict resolution skills services. If you did not collect this data, check the box “data not collected”. If you did not administer this activity, check the box “activity not conducted”.
Section C: Improved Attitudes and Skills
Line 4.a. Of those who completed Abuse prevention skills, enter the number of people who showed improvement for Allowable Activity 2. If you did not collect this data, check the box t “data not collected”. If you did not administer this activity, check the box “activity not conducted”.
Line 4.a.1. Enter the number of individuals who completed a post-test for abuse prevention skills. If no post-test was conducted, check the box “not applicable”.
Line 4.b. Of those who completed Budgeting/financial skills, enter the number of people who showed improvement for Allowable Activity 2. If you did not collect this data, check the box “data not collected”. If you did not administer this activity, check the box “activity not conducted”.
Line 4.b.1. Enter the number of individuals who completed a post-test for budgeting/financial skills. If no post-test was conducted, check the box “not applicable”.
Line 4.c. Of those who completed Communication skills, enter the number of people who showed improvement for Allowable Activity 2. If you did not collect this data, check the box “data not collected”. If you did not administer this activity, check the box “activity not conducted”.
Line 4.c.1. Enter the number of individuals who completed a post-test for communication skills. If no post-test was conducted, check the box “not applicable”.
Line 4.dOf those who completed Conflict resolution skills, enter the number of people who showed improvement for Allowable Activity 2. If you did not collect this data, check the “data not collected”. If you did not administer this activity, check the box “activity not conducted”.
Line 4.d.1. Enter the number of individuals who completed a post-test for conflict resolution skills. If no post-test was conducted, check the box “not applicable”.
Line 5.a. Of those who completed Allowable Activity 2, enter the number of people who showed improvement in attitudes towards marriage. If you did not collect this data, check the box “data not collected”.
Line 5.a.1. For Allowable Activity 2,enter the number of people who completed the post-test that showed improvement in their attitudes towards marriage. If no post-test was conducted, check the box “not applicable”.
Line 6. Please discuss in detail how your program measured improvement in Healthy Marriage skills and attitudes towards marriage for Allowable Activity 2.
Line 7. Attach a copy of any instruments that your program used to measure improvement in marriage skills and attitudes towards marriage for Allowable Activity 2.
Allowable Activity 3: Marriage education, marriage skills, and relationship skills programs that may include parenting skills, financial management, conflict resolution and job and career advancement
Section A: Demographic Information
Line 1.a. Sex. Of those who enrolled during this reporting period for Allowable Activity 3, enter the number of people who were female, and enter the number that were male. If you did not collect this data, check the box“data not collected”.
LIne 1.b. Age. Of those who enrolled during this reporting period for Allowable Activity 3, enter the number of people who were under 18 years of age; 18-24 years; 25-34 years; 35-44 years; 45-54 years; 55-64 years; and 65 years or older. If you did not collect this data, check the box “data not collected”.
Line 1.c. Marital Status. Of those who enrolled during this reporting period for Allowable Activity 3, enter the number of people who were single/never married; in a committed relationship but not married; married; separated; divorced; and widowed. If you did not collect this data, check the box “data not collected”.
Line 1.d. Ethnicity. Of those who enrolled during this reporting period for Allowable Activity 3, enter the number of people who are Hispanic and Non-Hispanic. If you did not collect this data, check the box “data not collected”.
Line 1.e. Race. Of those who enrolled during this reporting period for Allowable Activity 3, enter the number of people who are American Indian or Alaskan Native; Asian; Black or African American; Native Hawaiian or other Pacific Islander; and White. If you did not collect this data, check the box “data not collected”.
Line 1.f.Educational Attainment. Of those who enrolled during this reporting period for Allowable Activity 3, enter the number of people that had No degree or diploma; High School diploma or GED; Vocational or Technical Certification; Associate’s degree;Bachelor’s degree; and a Master’s or Advanced degree. If you did not collect this data, check the box “data not collected”.
Line 1.g. Employment Status. Of those who enrolled during this reporting period for Allowable Activity 3, enter the number of people who had full-time employment; part-time employment; who were retired; student; disabled; and unemployed. If you did not collect this data, check the box “data not collected”.
Line 1.h. Income.Of those who enrolled during this reporting period for Allowable Activity 3, enter the number of people whose income was less than$10,000; $10,000-$19,999; $20,000-$29,999; $30,000-$39,999; $40,000-$49,999; $50,000-$59,999; $60,000-$69,999; $70,000-$79,999; and more than $80,000. If you did not collect this data, check the box “data not collected”.
Section B: Activities and Skills Received
Line 2. Please enter the number of people who have enrolled in and who have completed Allowable Activity 3 for this reporting period. If you did not collect this data, check the box “data not collected”.
Line 3.a. Abuse prevention skills. Of those who enrolled and completed during this reporting period for Allowable Activity 3, enter the number of people who received Abuse prevention skills services. If you did not collect this data, check the box “data not collected”. If you did not administer this activity, check the box “activity not conducted”.
Line 3.b. Budgeting/financial skills. Of those who enrolled and completed during this reporting period for Allowable Activity 3, enter the number of people who received Budgeting/financial skills services. If you did not collect this data, check the box “data not collected”. If you did not administer this activity, check the box “activity not conducted”.
Line 3.c. Communication skills. Of those who enrolled and completed during this reporting period for Allowable Activity 3, enter the number of people who received Communication skills services. If you did not collect this data, check the box “data not collected”. If you did not administer this activity, check the box“activity not conducted”.
Line 3.d. Conflict resolution skills. Of those who enrolled and completed during this reporting period for Allowable Activity 3, enter the number of people who received Conflict resolution skills services. If you did not collect this data, check the box “data not collected”. If you did not administer this activity, check the box “activity not conducted”.
Line 3.e. Job & career advancement. Of those who enrolled and completed during this reporting period for Allowable Activity 3, enter the number of people who received Job and career advancement services. If you did not collect this data, check the box “data not collected”. If you did not administer this activity, check the box “activity not conducted”.
Line 3.f. Parenting.Of those who enrolled and completed during this reporting period for Allowable Activity 3, enter the number of people who received Parentingservices. If you did not collect this data, check the box “data not collected”. If you did not administer this activity, check the box “activity not conducted”.
Section C: Improved Attitudes and Skills
Line 4.a. Of those who completed Abuse prevention skills, enter the number of people who showed improvement. If you did not collect this data, check the box “data not collected”. If you did not administer this activity, check the box “activity not conducted”.
LIne 4.a.1. Enter the number of individuals who completed a post-test for abuse prevention skills. If no post-test was conducted, check the box “not applicable”.
Line 4.b. Of those who completed Budgeting/financial skills, enter the number of people who showed improvement. If you did not collect this data, check the box “data not collected”. If you did not administer this activity, check the box “activity not conducted”.
Line 4.b.1. Enter the number of individuals who completed a post-test for budgeting/financial skills. If no post-test was conducted, check the box “not applicable”.
Line 4.c. Of those who completed Communication skills, enter the number of people who showed improvement. If you did not collect this data, check the box “data not collected”. If you did not administer this activity, check the box “activity not conducted”.
Line 4.c.1. Enter the number of individuals who completed a post-test for communication skills. If no post-test was conducted, check the box “not applicable”.
Line 4.d. Of those who completed Conflict resolution skills, enter the number of people who showed improvement. If you did not collect this data, check the box “data not collected”. If you did not administer this activity, check the box “activity not conducted”.
Line 4.d.1. Enter the number of individuals who completed a post-test for conflict resolution skills. If no post-test was conducted, check the box “not applicable”.
Line 4.e.1. Of those who completed Job & career advancement skills, enter the number of people who obtained full-time unsubsidized employment with wage increase. If you did not collect this data, check the box “data not collected”.
Line 4.e.2. Of those who completed Job & career advancement skills, enter the number of people who obtained part-time unsubsidized employment with wage increase. If you did not collect this data, check the box “data not collected”.
Line 4.e.3. Of those who completed Job & career advancement skills, enter the number of people who obtained new qualifications, for example, a certification. If you did not collect this data, check the box “data not collected”.