Changes to the FY14 activity report form
NIFA requires that we collect racial, ethnic and gender information on our clients to comply with federal civil rights regulations. We are expected to have two complete years of information
during formal civil rights reviews, which are done periodically.
We need this information for credit and noncredit classes (workshops), conference/meeting participation, presentations and face-to-face consultations. We also need it for all our program
volunteers, including 4-H and Master Gardeners. We do not need racial, ethnic and gender information on the clients the volunteers reach.
Those of you who remember our previous racial and ethnic categories will notice a few differences. We are expected to report on a minimum of two ethnic categories: 1) Hispanic and Latino and
2) Not Hispanic or Latino.
Additionally, we must report separately on seven race categories:
 American Indian/Alaska Native
 Asian
 Black/African American
 Native Hawaiian or Pacific Islander
 White
 Two or more races
 Some other race
These are the same categories used by the U.S. Census. In theory, the total number of people counted in the racial categories should add up to the total number of participants.
How best to collect that information? In the past, Extension faculty have simply “eyeballed it” and guessed at racial background of clients. Guidelines from the Office of Management and Budget
suggest that this identification by observation is OK, but generally not as good as asking for individuals to identify their race. For instance, people of Hispanic origin may identify themselves as
white, black or another race.
Self-identification involves asking clients to identify their race, ethnicity and gender information on a form handed out during the workshop. Alda has developed a form to help faculty with this.
The demographics form can be administered separately, or in combination with one of the program evaluation forms posted on the Extension reporting site. Use the counting method that works
best for you.
Note that instead of asking for “total number of participants,” we are asking for adult and youth participants separately. This will make it easier to count.
Also, please use this date format to make it easier to sort the data: 6/1/13
Faculty may use this form for their FY14 annual report or transfer their information to the university’s electronic form once it gets modified for Extension.
Please contact Debbie Carter at 474-5406 or dscarter@alaska.edu with any questions.
Period of July 1, 2013 –June. 30, 2014
Page 2 of 11
Cooperative Extension Service
University of Alaska Fairbanks
Annual Activities Report
Covers the Period: July 1, 2013 –June 30, 2014
1. Personal Information
Name
Academic Title
Department/Division
2. Workload Summary
Year
2013– 2014
Teaching
Percentage:
Units:
(1) Include management under service.
Research
Percentage:
Units:
Service (1)
Percentage:
Units:
3. Teaching
Table 3.1: Instructional Activities
Campus/
Semester
Course Name,
Number & Title
M/I Credit Contact
No. of
(1) Hours Hours Students
Shared
(2)
KNWL Adult
YTH
Area Partici(3)
Codes pants
M
(3)
F
(3)
Not
HS/LT
AI/AK
HS/LT
(4)
(5)
(4)
AS
(5)
BK
(5)
HI
(5)
WH 2+ OTH
(5) (5) (5)
Totals
(1) Multistate (M) or integrated (I) activity: place an M and/or an I in the space to indicate if the activity involved more than one state (multistate) and/or integrated research and Extension (integrated).
(2) Name(s) of instructors if course is team taught.
(3) Age and gender abbreviations: YTH = Youth; M = Male; F = Female
(4) Ethnic abbreviations: HS/LT = Hispanic or Latino; Not HS/LT = Not Hispanic or Latino
(5) Racial abbreviations: AI/AK = American Indian/Alaska Native; AS = Asian; BK = Black/African American; HI = Native Hawaiian/Pacific Islander; WH = White; 2+ = Two or more races; OTH = Some
other race
Form updated: 06/21/2013
Period of July 1, 2013 –June. 30, 2014
Page 3 of 11
Table 3.2: Instructional Activities – Non-credit (instructor) (1)
Date
Class Title
M/I
Location
Hours
KNWL Adult
YTH
Area Partici(2)
Codes pants
M
(2)
F
(2)
HS/LT
(3)
Not
HS/LT
(3)
AI/AK
(4)
AS
(4)
BK
(4)
HI
(4)
WH
(4)
2+
(4)
OTH
(4)
Totals
(1)
(2)
(3)
(4)
A non-credit instructional activity that is taught by the faculty member. These instructional activities are developed from research-based information and could include a student evaluation of the class.
Age and gender abbreviations: YTH = Youth; M = Male; F = Female
Ethnic abbreviations: HS/LT = Hispanic or Latino; Not HS/LT = Not Hispanic or Latino
Racial abbreviations: AI/AK = American Indian/Alaska Native; AS = Asian; BK = Black/African American; HI = Native Hawaiian/Pacific Islander; WH = White; 2+ = Two or more races; OTH = Some
other race
Table 3.3: Instructional Activities – Non-credit (leadership in arranging) (1)
Date
Class Title
M/I
Location
Hours
KNWL Area Code
Totals
(1) A non-credit instructional activity that is arranged or coordinated by the faculty member. In Extension this could include classes, conferences, workshops or other instructional activities (specify) sponsored
and coordinated by the Extension faculty where other experts are the instructors.
Table 3.4: Curriculum Development (1)
Date
Curriculum Title
M/I
Author(s) &
Collaborator(s)
Purpose
(1)
Hours
KNWL Area
Codes
Totals
(1) The purpose of this curriculum development was: new curriculum; major revision; periodic update.
Table 3.5: Graduate Committee Chair
Date
Student Name
Campus/Degree Sought
Student Status
KNWL Area
Hours
(1)
Codes
Totals
(1) Active, inactive or graduated (if graduated indicate year degree was awarded).
Table 3.6: Student Advising - Graduate or Undergraduate
Student Name & Status
Date
Degree Sought
(1)
Type
(2)
Hours
KNWL Area
Codes
Form updated: 06/21/2013
Period of July 1, 2013 –June. 30, 2014
Page 4 of 11
Totals
(1) Active, inactive or graduated (if graduated indicate year degree was awarded).
(2) Member of graduate, undergraduate or senior thesis committee; individual advising of graduate students.
4. Research, Scholarly and Other Creative Activities
Table 4.1: Publications from Original Research
Date
Published
Citation
(1)
M/I
Type
(2)
Review
(3)
Level of
Outreach
(4)
Hours
KNWL Area
Codes
Totals
(1) Give full citation, including all co-authors.
(2) Published journal articles, abstracts, conference proceedings, books, pamphlets, publications, guides, technical manuals, reports or other published documents that are based on original research.
(3) Type of review: peer, editor or board of editors, conference committee, conference session chair, or other (specify).
(4) Potential audience for publication: state, national, international, universe.
Table 4.2: Non-Journal Publications from Original Research
Date
Citation
M/I
Type
Review
Published
(1)
(2)
(3)
Level of
Outreach (4)
Hours
KNWL Area
Codes
Totals
(1) Give full title of publication, name of publisher and all authors and co-authors.
(2) Published Extension publication, pamphlets, guides, technical manuals, reports, conference proceedings, or other documents that are based on original research.
(3) Type of review: peer (Alaska and/or other states), conference committee, conference session chair, or other (specify).
(4) Potential audience and distribution for publication: state, national, international, universe.
Table 4.3: Publications in PRESS (1)
Date
Citation
Published
(2)
M/I
Type
(3)
Review
(4)
Hours
KNWL Area
Codes
Totals
(1) List those publications for which all editorial work is complete and awaiting scheduled publication.
(2) Give full title of publication, name of publisher and all authors and co-authors.
(3) Any type (journal, abstract, Extension, report, etc.) of publication from original research.
(4) Type of review: peer (Alaska and/or other states), conference committee, conference session chair, or other (specify).
Table 4.4: Professional, Creative Activities
Form updated: 06/21/2013
Period of July 1, 2013 –June. 30, 2014
Date
Page 5 of 11
Nature of Activity/Title
(1)
Participating Level of Activity
KNWL Area
Hours
Individual(s)
(2)
Codes
M/I
Totals
(1) List activities that are original creations or from original research, such as: performances, exhibits, presentations, audio/video recordings, computer programs, musical compositions, poems, concert performances.
(2) Local, regional, state, national, international.
Table 4.5: Sponsored Projects/Commissions Received
Date
Names
PI or
Granted &
Project Title
(1)
Co-PI
Duration
M/I
Grant Sponsor
Grant
KNWL
Amount Area Codes
Totals
(1) Include names of all investigators.
Table 4.6: Other Scholarly Work in Progress
Nature of Activity
Names
Date
(1)
(2)
Publication/Project
KNWL
M/I Hours
Title
Area Codes
Totals
(1) Document scholarly work in progress. This will include but is not limited to: proposals pending, proposals in preparation, proposals denied during review period, manuscripts at all stages up to IN PRESS,
unfunded projects/activity.
(2) Names of PI/Co-PI, author, co-author(s) or collaborators on proposals, manuscripts or projects/activities.
Table 4.7: Conference/Meeting Participation
Date
Conference
Name
Type
(1)
Title
Names
(2)
M/I
KNWL Adult
Area ParticiCodes
pants
YTH
(3)
M
(3)
F
(3)
HS/LT
(4)
Not
HS/LT
(4)
AI/AK
(5)
AS
(5)
BK
(5)
HI
(5)
WH
(5)
2+
(5)
OTH
(5)
Totals
(1) Type of presentation or activity could include: poster session, roundtable, formal presentation or other (specify) from original research.
(2) Names of presenter(s).
(3) Age and gender abbreviations: YTH = Youth; M = Male; F = Female
(4) Ethnic abbreviations: HS/LT = Hispanic or Latino; Not HS/LT = Not Hispanic or Latino
(5) Racial abbreviations: AI/AK = American Indian/Alaska Native; AS = Asian; BK = Black/African American; HI = Native Hawaiian/Pacific Islander; WH = White; 2+ = Two or more races; OTH = Some
other race
5. Public, University and Professional Service
Form updated: 06/21/2013
Period of July 1, 2013 –June. 30, 2014
Page 6 of 11
Table 5.1.1: Public Service (1): Presentation to Groups, Agencies or Organizations
Date
Title of
Presentation
M/I
Name
(2)
Location
KNWL Adult
Level of
Hours Area ParticiActivity (3)
Codes
pants
YTH
(3)
M
(3)
F
(3)
HS/LT
(4)
Not
HS/LT
(4)
AI/AK
(5)
AS
(5)
BK
(5)
HI
(5)
WH
(5)
2+
(5)
OTH
(5)
Totals
(1) Public service: in organized, non-remunerative, educational and consultative activities which devolve from a faculty member’s professional expertise and further the interests or prestige of the university.
(2) Name of group, agency or organization to whom the presentation was given.
(3) Your role in the presentation: presented, OR arranged by the faculty member.
(4) Age and gender abbreviations: YTH = Youth; M = Male; F = Female
(5) Ethnic abbreviations: HS/LT = Hispanic or Latino; Not HS/LT = Not Hispanic or Latino
(6) Racial abbreviations: AI/AK = American Indian/Alaska Native; AS = Asian; BK = Black/African American; HI = Native Hawaiian/Pacific Islander; WH = White; 2+ = Two or more races; OTH = Some
other race
Table 5.1.2: Public Service: Face-to-Face Consultations with Individuals, Groups, Agencies or Organizations
KNWL Adult
Individual or Name
YTH
Date
Subject
M/I Hours Area Partici(1)
(2)
Codes
pants
M
(2)
F
(2)
HS/LT
(3)
Not
HS/LT
(3)
AI/AK
(4)
AS
(4)
BK
(4)
HI
(4)
WH
(4)
2+
(4)
OTH
(4)
Totals
(1) Enter who the consultation was with: an individual OR name of group, agency or organization. Do not enter an individual’s actual name, just enter the word individual.
(2) Age and gender abbreviations: YTH = Youth; M = Male; F = Female
(3) Ethnic abbreviations: HS/LT = Hispanic or Latino; Not HS/LT = Not Hispanic or Latino
(4) Racial abbreviations: AI/AK = American Indian/Alaska Native; AS = Asian; BK = Black/African American; HI = Native Hawaiian/Pacific Islander; WH = White; 2+ = Two or more races; OTH = Some
other race
Table 5.1.2a: Public Service: Phone and E-mail Consultations with Individuals, Groups, Agencies or Organizations
KNWL
Adult
Individual or Name
Date
Subject
M/I
Hours
Area
Partici- YTH
(1)
Codes
pants
Totals
(1) Enter who the consultation was with: an individual OR name of group, agency or organization. Do not enter an individual’s actual name, just enter the word individual.
Table 5.1.3: Public Service: Popular Media – Newspaper and Magazine Articles
Form updated: 06/21/2013
Period of July 1, 2013 –June. 30, 2014
Date
Published
Title
Page 7 of 11
Author or
Resource (1)
M/I
Publication
(2)
Circulation
Hours
(3)
KNWL
Area
Codes
Totals
(1) Were the newspaper or magazine articles authored by you OR were you a resource to the reporter/author.
(2) Name of newspaper or magazine.
(3) Number of subscribers or readers of the newspaper or magazine.
Table 5.1.4: Public Service: Publications, DVDs, Web Modules and Websites
Date
KNWL
Type
Review Distribution
Published/
Title
Author(s)
M/I
Hours Area
(1)
(2)
(3)
Released
Codes
Totals
(1) What kind of publication is this: newsletter (electronic and/or printed), DVD, web-based modules, websites, fact sheet, bulletin, pamphlet, technical publication, guide or other (specify).
(2) Kind of review, if applicable: peer (specify Alaska or other states), district, other (specify).
(3) Local, district, state, national, international.
Table 5.1.5: Public Service: Publications – Journal Articles Not from Original Research
Date
Published
Citation
(1)
M/I
Type
(2)
Review
(3)
Distribution
Hours
(4)
KNWL
Area
Codes
Totals
(1) Give full citation including: title, publisher, issue, author(s) and co-authors.
(2) Published journal articles, abstracts, conference proceedings or other published documents that are not from original research.
(3) Kind of review: peer, editor or board of editors, conference committee, conference session chair, or other (specify).
(4) Potential audience for publication: state, national, international, universe.
Table 5.1.6: Public Service: Television and Radio
Date
Aired
Program Title
M/I
Type
(1)
Station/
KNWL
Program Hours
Location
Area
Duration (3) (4)
(2)
Codes
Totals
(1) Program, public service announcement, interview, demonstration, other (specify).
(2) Station call letters and location.
Form updated: 06/21/2013
Period of July 1, 2013 –June. 30, 2014
Page 8 of 11
(3) Duration, in minutes, of television or radio program, public service announcement, interview or other.
(4) Time spent in preparation and recording.
Table 5.1.7: Public Service: Paraprofessional and Volunteer Programs Supervised by Faculty (1)
Audience Type
Number
Faculty KNWL Adult
Title
Hours
ParticiDate
M/I
& Location
Paraprofs/ Hours Area
(2)
(3)
pants
(4)
Volunteers (5) (6)
Codes
YTH
(8)
M
(8)
F
(8)
HS/LT
(9)
Not
HS/LT
(9)
AI/AK
(10)
AS
(10)
BK
(10)
HI
(10)
WH
(10)
2+
(10)
OTH
(10)
Totals
(1) The purpose of this table is to document the educational outreach activities of volunteers and paraprofessionals whose programs are supported by faculty.
(2) Titles could include: consolidated categories of programs or activities for FSNEP, EFNEP, Master Gardeners, Master Food Preservers, 4-H volunteer leaders, FCE volunteers, other (specify) OR the title of a
specific program, class, presentation or activity carried out by volunteers or paraprofessionals.
(3) The amount of time (hours) the volunteers or paraprofessionals spent carrying out the program or activity.
(4) Indicate if the audience was a specific agency, organization, group or the general public and the location (city) where the program or activity was offered.
(5) Document the number of paraprofessionals or volunteers who provided leadership or instruction for the program or activity.
(6) Document the number of faculty hours spent in providing subject matter support, supervision, or general oversight of the paraprofessional(s) or volunteer(s) programs or activities.
(7) Document the number of participants in the program or activity offered by the volunteer(s) or paraprofessional(s).
(8) Volunteer information— Age and gender abbreviations: YTH = Youth; M = Male; F = Female
(9) Volunteer information — Ethnic abbreviations: HS/LT = Hispanic or Latino; Not HS/LT = Not Hispanic or Latino
(10) Volunteer information — Racial abbreviations: AI/AK = American Indian/Alaska Native; AS = Asian; BK = Black/African American; HI = Native Hawaiian/Pacific Islander; WH = White; 2+ = Two or
more races; OTH = Some other race
Table 5.2.1: University Service: Service to District (1)
Date/
Activity
M/I
Duration
Your Role
Hours
KNWL
Area Codes
Totals
(1) Service to District: Include community work. Examples may include but are not limited to: coordination or participation in district needs assessments, coordination and/or representation at state fair and health
fair booths, participation on advisory boards, etc.
Table 5.2.2: University Service: Service to Cooperative Extension (1)
Date/
Activity
M/I
Your Role
Duration
Hours
KNWL Area
Codes
Totals
(1) Service to Cooperative Extension: Include service as office coordinator, program supervisor (ANEP, EFNEP, IPM), program chair, member or chair of a search committee or advisory board, etc.
Table 5.2.3: University Service: Service to University (1)
Form updated: 06/21/2013
Period of July 1, 2013 –June. 30, 2014
Date/
Duration
Activity
Page 9 of 11
M/I
Your Role
Hours
KNWL Area
Codes
Totals
(1) Service to University: Include service on faculty senate, universitywide committees or boards, and service as a university or Extension representative or liaison to other agencies, organizations, or University
of Alaska MAUs, etc.
Table 5.2.4: University Service: Regional/National Service (1)
Date/
Activity
M/I
Duration
Your Role
Hours
KNWL Area
Codes
Totals
(1) National Service: Include service on regional or national committees or advisory boards, service as an officer in regional or national organizations, etc.
Table 5.3: Professional Service (1)
Date/
Activity
Duration
M/I
Your Role
Hours
KNWL Area
Codes
Totals
(1) Professional service: on grant, journal, or accreditation review boards, or as an ad hoc reviewer, in the faculty member’s area of expertise; as an officer in a professional society; organizing and/or chairing
conferences, symposia, seminars, etc.; editing journals, books, special volumes of papers, etc. In Extension activities could include: peer review of publications; peer review of storyboards or scripts for DVDs
and web-based modules; peer review of teaching and curriculum; faculty mentoring committee; and other (specify). Activities in this category require a faculty member’s professional expertise for
participation.
6. Professional Development
Table 6.1: Professional Development: Conferences and Meetings
Date
Conference Title
Location
Hours
Your Role
Totals
Table 6.2: Professional Development: Formal Education
Date
Course Title/Activity
Institution
Credits
Form updated: 06/21/2013
Period of July 1, 2013 –June. 30, 2014
Page 10 of 11
Table 6.3: Professional Development: Membership in Professional Organizations
Date(s)
Organization
Your Role
7. Honors and Awards
Table 7.1: Honors and Awards
Date
Honor or Award
Presented By
Reason for Honor/Award
8. Narrative Self-Evaluation
In each of the following categories which constituted part of your workload in the period covered by the report, briefly assess your own efforts. Focus your comments on 1) how your effort “made a difference”
and 2) frustrations/shortcomings and how you intend to address them.
A. Teaching
B. Research, Scholarly and other Creative Activities
C. Service
9. Curriculum Vitae
Please attach a current copy of your curriculum vitae (annual reports only).
10. Success Stories and Impacts
Briefly describe your success stories, those that had the most significant impact and why. This helps us explain your work on federal reports and to others. NIFA particularly likes longer term impact stories
with dollar figures attached. Of course, many success stories or impact statements don’t carry price tags.
For example, NIFA offered this example of a good impact from Colorado Extension.
Form updated: 06/21/2013
Period of July 1, 2013 –June. 30, 2014
Page 11 of 11
Issue: During the past five years, Colorado wheat farmers have planted an average of 20% of their fields to newly released and improved wheat varieties. This is a faster adoption rate of improved wheat varieties
than for growers from comparable states. Producers, seedsmen, grain merchandisers, processors, crop consultants, plant breeders, and extension staff are interested in new cultivars that bring them increased
revenue.
What has been done: The Colorado State University (CSU) Extension Wheat Improvement Work Team provided 18% of the total investment in developing and promoting CSU wheat varieties.
Results: Plantings of improved wheat varieties increased Colorado farmers' farm gate income by $12,840,000 in 2012. Extension's share (18%) of this impact for the Colorado wheat industry is $2,311,000, or
about $13.70 returned for each $1.00 invested.
Form updated: 06/21/2013