2006-2007 Wisconsin TRIO Yearbook


Wisconsin TRIO Survey Form


As we prepare for the upcoming policy seminar (March 9-11, 2008) the Public Relations and Communications Committee needs to gather information about each program in the state.  Each director should complete or have this form completed by February 8, 2008.  If you received a Program Account Name and Password you can just update last years numbers (fresh pictures and new quotes are still needed from you).  A yearbook for Wisconsin TRIO, featuring each program will be laid out and produced to be presented to our congressional representives (Additional copies will be made available to program directors to share with provosts, deans, or chancellors).   In addition to completing this survey you should attach to an email a group photo of your current students, a photo of one of your TRIO Achievers, a few other photos of your participants, your program logo (if we don't have it from last year) and your Institutions logo.  Your digital photos must be either JPG or GIF formated at the highest resolution you can provide.

Please provide the best numbers that you can, when actual numbers are too difficult
give us a reasonable estimate.  The Data you provide will be used to produce a summary picture of your congressional district.

Requested Photos/Images should be emailed as attachments to Dawn Grenzer at Dawn.Grenzer@UWC.EDU
or
Snail Mailed to:

Dawn Grenzer
UW-Fox Valley
1478 Midway Road
Menasha, WI   54952

Direct Technical Questions to: Michael Casbourne or phone 920-465-2663.

General Information - ONLY COMPLETE THE SECTIONS BELOW IF YOU DID NOT GET AN
ACCOUNT NAME AND PASSWORD -- IF YOU HAVE AN ACCOUNT NAME AND PASSWORD
USE THE LINK IN THE PARAGRAPH ABOVE TO LOG IN.
Institutional Name
Wisconsin By District
 District 1 - Paul D. Ryan (R)
District 2 - Tammy Baldwin (D)
District 3 - Ron J. Kind (D)
District 4 - Gwen Moore (D)
District 5 - James F. Sensenbrenner (R)
District 6 - Thomas E. Petri (R)
District 7 - David R. Obey (D)
District 8 - Steve Kagen (D)
Multiple District Represented
Numbers From Multiple Districts (i.e. 4,5)
Program Specific Information
UB   UBMS   ETS   SSS   EOC   McNair   UBVet  
Complete a seperate survey for each program (only submit information for one program per survey).
Program Director
Director's EMail Address
Program Website Address
Estimated Number of Eligible Students
In The Target Area or Institution
That Are Not Being Served.
Number of Years Program
has been in existence
06-07 Dollar Amount of Grant Award
Number of Students Funded to Serve 06-07
Percent of Students with both
Low-Income & 1st-Generation 06-07
Number of Students with Disabilities

Number of Full Time Staff
Please, List Staff and Position:
(i.e. Adams, John; SSS Math Specialist)
Names and this Information will be used
to help maintain and clean up
the current database.
Number of Part Time Staff
Please, List Staff, % Time and Position:
(i.e. Adams, John; 60%; SSS Math Specialist)
Names and this Information will be used
to help maintain and clean up
the current database.
Number of Summer Time Staff
(That Have NOT Been Counted Above)
Student Demographics for 06-07
Ethnic Background for 06-07
Percent of American Indian
Percent of African American
Percent of White
Percent of Asian American
Percent of Hispanic/Latino
Percent of Other
Gender Breakdown for 06-07
Percent of Males
Percent of Females
Upward Bound & UBVet Outcomes (complete then skip down to High Achievers & Testimonials)
Percent Still Enrolled (Expected
to return to program next year, Retention %)
Number dropped out of project 06-07
# Seniors Graduated High School 06-07
# Seniors Enrolled in PSE Programs
# Seniors in College/University PSE
# Seniors in Vocational/Technical PSE
# Seniors in Other PSE
# Seniors in Military
% Total for History Graduated High School
% Total for History Enrolled in PSE Programs
% Total for History in College/University PSE
% Total for History in Vocational/Technical PSE
% Total for History in Other PSE
% Total for History in Military
Upward Bound Math/Science Outcomes (complete then skip down to High Achievers & Testimonials)
Percent Still Enrolled (Expected
to return to program next year, Retention %)
Number dropped out of project
# Seniors Graduated High School 06-07
# Seniors Enrolled in PSE Programs
# Seniors in College/University PSE
# Seniors in Vocational/Technical PSE
# Seniors in Other PSE
# Seniors in Military
% Total for History Graduated High School
% Total for History Enrolled in PSE Programs
% Total for History in College/University PSE
% Total for History in Vocational/Technical PSE
% Total for History in Other PSE
% Total for History in Military
Student Support Services Outcomes (complete then skip down to High Achievers & Testimonials)
Number Still Enrolled (Expected
to return to program next year)
Number Leaving Institution
Number Dismissed or Withdrew
Number Transferred (did not graduate)
Number Graduated (did not transfer)
Number Graduated and Transferred
Prior Years Participants (previous years
participants not in program but still enrolled at
institution during current program year)
McNair Scholars Outcomes (complete then skip down to High Achievers & Testimonials)
Percent of Former Students That
Are Enrolled in Graduate Programs
Number Who Have Received Master Degrees
Number Who Have Received Doctoral Degrees
Talent Search & EOC Outcomes (complete then skip down to High Achievers & Testimonials)
Number with Age below 14
Number with Age 14 - 18
Number with Age 19 - 27
Number with Age Over 27
Number Still Enrolled (Expected
to return to program next year)
Number Graduated High School
Number Enrolled in PSE Programs
Number in College/University PSE
Number in Vocational/Technical PSE
Number in Other PSE
Number in Military
Number dropped out of project
Prior Years Participants
High Achievers & Testimonials
One Program Achiever
Name and Title
Biographical Information
for Achiever
Student Testimonial
(Not required to be from
the Achiever listed above)