Page 1 of 8 ^M Precollege Program Form Go To: [Help] [Report Tools] [SG Main Menu] [Operation/Project Listing] ^M Make changes then click on Update Precollege Project (Do not type anything - System Gener Project Information Name of Project: Contact Person: Address: (Required) City: State: Zip Code: Contact Phone: (Format: ##########) Name of sponsor(s) of project if other than affiliate: Location of Project Activities : Nasa Center(s) University Campus(es) Elementary/Middle/High School Community Facilities Museum/Planetarium(s) Industry or Private sector Facilities Other Project Status: Choose Project Status Developing Newly Implemented Continuing Ending End Date of Project: Format:DD-MMM-YY Example: 24-SEP-97
Page 2 of 8 Descriptive Information Please provide a brief description of the project: Continuation of description of the project Are Evaluation mechanisms in place? Describe Evaluation Methodology: Primary Discipline: If Other, enter name of Discipline: If applicable, Secondary Discipline: If Other, enter name of Discipline: Choose most closely related discipline Choose Discipline Also use this field to enter actual discipline name and/or short description of discipline Choose most closely related discipline Choose Discipline Also use this field to enter actual discipline name and/or short description of discipline Funding and Collaboration Information Actual Sources of Funding for this reporting period (include cash or noncash). Enter whole number only: CASH NASA Space Grant: $ 0 Other Federal: $ 0 Carryover: $ 0 NON-CASH TOTAL(No Entry) Industry: $ 0 $ 0 $ 0
Page 3 of 8 Lead Institution: $ 0 $ 0 $ 0 Non-Profit Organizations: $ 0 $ 0 $ 0 Academic Affiliates: $ 0 $ 0 $ 0 State/Local Government: $ 0 $ 0 $ 0 Participants: $ 0 $ 0 $ 0 Other: $ 0 $ 0 $ 0 Totals $ 0 $ 0 $ 0 Actual Cost of Project for this reporting period (or contribution if supplement): Enter whole number only: $ 0 Balance/Difference: $ 0 NOTE:JavaScript must be enabled on your Web Browser in order for calculations to wor Please provide reason if no project costs and funding sources listed: Collaborative efforts (mark all that apply): In Same Department Other Departments in same Institution Other Institution of Higher Education Community College K-12 Institution(s) Teacher Resource Centers Non-Profit Organizations Underrepresented Organizations Industry Community Partnership Give name of business and type of industry and describe collaboration: NASA Installation(s) (mark all that apply): Ames Research Center Dryden Flight Research Center Goddard Space Flight Center Jet Propulsion Laboratory Johnson Space Center
Page 4 of 8 Kennedy Space Center Langley Research Center Glenn Research Center at Lewis Field Marshall Space Flight Center Stennis Space Center Wallops NASA Headquarters NASA Installation Collaboration. Please specify: NASA Enterprises (mark all that apply): Human Exploration and Development of Space Earth Science Office of Aero-space Technology Space Science List type of Collaboration: Other Space Grant Programs. Please Specify (List Consortium and name of program): Other Federal Government. Please Specify (List Agency name): Other State Agencies. Please Specify: Other Collaboration(s). Please Specify:
Page 5 of 8 Additional Collaboration Information. Please Specify: Scheduling Mark all that apply: School Year Summer During School After School Weekend Activity and Participant Information Activities (mark all that apply): Conference Science Fair/Exhibit Workshop Academic Program Other This project was designed to promote: Students (choose one): Teachers (choose one): Components (mark all that apply): Book Course Outline Course Revision Demonstration Field Trip Choose one Increase Awareness Expand Knowledge/skills Career Guidance Choose one Increase Awareness Expand Knowledge Improve Teaching Methods
Page 6 of 8 Hands-on Lab Tour Lab Lesson Plan Mentors Other Components Problem Sets Research Role models for underrepresented groups Software Teacher's Manual Video Wall Sheets Number of Teachers. Enter number only: Male Male Female Female Unknown not Underrep Underrep not Underrep Underrep Race/Gender or disabled or disabled Grades K-4 Grades 5-8 Grades 9-12 Number of Students: Enter number only: Grades K-4 Grades 5-8 Grades 9-12 Male Male Female Female Unknown not Underrep Underrep not Underrep Underrep Race/Gender or disabled or disabled Number of Parents : Number of Administrators : Are any kind of recruitment and/or retention strategies for members of underrepresented groups in place? If so, please describe: Did the project exclusively target underrepresented minority and persons with dis If yes, mark the group(s) targeted:
Page 7 of 8 African American Native American Hispanic Pacific Islander Persons with Disabilities With respect to underrepresented groups, note the level of project participation as,, or the population represented in your state : African American : Hispanic : Pacific-Islander : Native American : Persons with Disabilities : Was support provided for any of the following Standards?(mark all that apply): National Mathematics Standards National Science Standards National Geography Standards National Technology Standards State Frameworks Local Frameworks Other Overall Comments: Last Updated On: (Do not change. Updated automatically) Go To: [Help] [Report Tools] [SG Main Menu] [Operation/Project Listing]
Page 8 of 8 Make changes then click on Update Precollege Program