Achieving the Dream Application for
Joining the Network
2016 Cohort
Application Form
Early Admissions Deadline:
December 4, 2015
Final Deadline:
April 1, 2016
Table of Contents
To skip to a particular section, press and hold the CTRL key and click on the title of the section you
would like to review.
Page
Number
Section
Application Summary
2
Contacts
3
Narrative Questions
4
Enrollment and Graduation Data
6
Leadership Support Documents
7
www.AchievingtheDream.org/Join
Application Summary
Thank you for your interest in applying to join the Achieving the Dream National Reform
Network! Below is a summary of the information you will need to apply. We strongly encourage
applicants to review this document in full before completing and submitting their application.
Submitting the Application
Complete the application form (Word document) located on the Apply to the Network page
located on the Achieving the Dream web site.
We ask that you combine your application, data, and Board statement into one document, if
possible. Your file should be clearly named, for example "2016ATDApplication_CollegeName."
Once completed, submit your application via this link.
(https://achievingthedream.qualtrics.com/SE/?SID=SV_aXjZZAOf0IUV3LL)
Deadlines
Early Admissions Deadline: December 4, 2015
Final Deadline: April 1, 2016
Early Admissions Benefits
Institutions that submit their completed application on or before December 4,
2015 will receive two complimentary registrations for DREAM 2016, Achieving
the Dream’s annual institute on student success.
Questions
Contact Julia Lawton, Assistant Director of Programs, at jlawton@achievingthedream.org or
(240) 450-3836.
ACHIEVING THE DREAM NEW COLLEGE GUIDE | APPLICATION SUMMARY
2
Contacts
Institution Details
Institution Name
Mailing Address, Line 1
Mailing Address, Line 2
City
State
Zip Code
Key Contacts
Please provide the names of the following key individuals at your institution. Most of these
individuals will become part of your ATD Core Team or Data Team. The Core Team will lead
the process of institutional change at your institution while the Data Team will be responsible for
collecting, analyzing, and sharing data regarding student progression and success. To learn more
about these teams, refer to the General Application Information and Guidelines document
located on our website at www.AchievingtheDream.org/Join.
Name
Title
Email
Phone
Main
Contact*
President/CEO
Assistant to the
President/CEO
Person
Completing this
Application
Financial
Contact
Chief Academic
Officer
Chief Student
Services Officer
Chief
Institutional
Researcher
ACHIEVING THE DREAM NEW COLLEGE GUIDE | CONTACTS
3
Public
Information
Officer
Key Faculty
Leader
Other (optional)
Other (optional)
Other (optional)
Other (optional)
* Individuals named as a main contact will receive all communications regarding the ATD
process, including required submissions and Kickoff logistics, and will become the main point of
contact for your coaching team throughout the first year. Note: You will be able to change this contact as
needed throughout the year. All team members listed above will automatically receive generic ATD communications,
such as the ATD Newsletter as well as those related to first year webinars.
Narrative Questions
1. Please provide a brief description of any major student success initiatives that are currently
planned or underway at your institution. Be sure to include any national student success
initiatives your institution is involved in (for example, CSSSE, Complete College America,
Foundations of Excellence, etc.)?
Enter Answers Here
2. In one sentence describe how change happens at your institution.
Enter Answers Here
3. Briefly identify your main strengths and challenges in the following areas:
a. Building and empowering leadership at all levels of the college.
b. Engaging a broad range of stakeholders in your student success efforts.
c. Building and maintaining a strong teaching and learning environment.
d. Using data or other evidence to improve programs and services.
ACHIEVING THE DREAM NEW COLLEGE GUIDE | NARRATIVE QUESTIONS
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e. Identifying, discussing, and addressing the causes and consequences of achievement
gaps.
Enter Answers Here
4. What type of student information system(s) do you currently have in place (for example,
People Soft, Banner, Ellucian, etc.)? What types of data reporting tools are used by your IR or
IT departments (for example, SAS, SPSS, Discoverer, Crystal Reports, etc.)?
Enter Answers Here
5. What does your institution hope to gain from being part of the Achieving the Dream National
Reform Network?
Enter Answers Here
6. How does the institution anticipate funding its Achieving the Dream participation for the first
three years? Click on the appropriate checkbox below. [Note: This is for informational purposes
only. Please be assured that Achieving the Dream will not contact your funders.]
☐ Institution covers all costs. Please indicate the source of the funding (for example, Title
III funds, HBCU funds, reallocating general funds, etc.)
☐ A mix of institutional funds and external funds solicited explicitly for Achieving the
Dream participation. Please identify the name of the funder(s) and the proportion of the
participation costs to be covered by that funder(s).
☐ Fully externally funded. Please identify the name of the funder(s).
☐ Other: Please specify
Enter Answers Here
ACHIEVING THE DREAM NEW COLLEGE GUIDE | NARRATIVE QUESTIONS
5
Enrollment and Graduation Data
Provide the following enrollment data based on your fall 2014 data submission for IPEDS.
Enrollment Data
2014 Institution Enrollment (#)
2014 Institution Enrollment
(%)
100
Total Enrollment
American Indian or Alaska
Native
Asian/Native Hawaiian/Pacific
Islander
Black or African American
Hispanic/Latino/a
White
Two or More Races
Race/Ethnicity Unknown
Pell Recipients
Other Disaggregation
(optional)
Other Disaggregation
(optional)
Other Disaggregation
(optional)
Other Disaggregation
(optional)
Graduation/Transfer Rate Data
Provide the following data on your institution’s fall 2011 cohort graduation and transfer rates*.
Graduation Rate (%)
Transfer Rate (%)
Institution Graduation or
Transfer Rate**
American Indian or Alaska
Native
Asian/Native Hawaiian/Pacific
Islander
Black or African American
ACHIEVING THE DREAM NEW COLLEGE GUIDE | ENROLLMENT AND GRADUATION DATA
6
Hispanic/Latino/a
White
Two or More Races
Race/Ethnicity Unknown
Pell Recipients
Other Disaggregation
(optional)
Other Disaggregation
(optional)
Other Disaggregation
(optional)
Other Disaggregation
(optional)
* Graduation rates are based on Student Right to Know definitions, as reported on 2014 IPEDS files. This includes
the percent of the fall 2010 first-time, full-time student cohort who completed a degree, certificate, or transfer
preparatory program within 150% of normal program time.
** Institution graduation rates include all full-time, first-time degree/certificate-seeking undergraduate students
entering the institution either during the fall term or during the academic year 2011-2012.
Leadership Support Documents
Trustee Statement
Applicants must include a statement of commitment from the Board of Trustees. If a board
resolution is not feasible by either deadline, a letter from the Board Chair will be accepted.
President/CEO Signature
As President/CEO of the applying institution, I have reviewed and approve my institution’s
application to join the Achieving the Dream Network as part of the 2016 Cohort.
President/CEO
Date
ACHIEVING THE DREAM NEW COLLEGE GUIDE | LEADERSHIP SUPPORT DOCUMENTS
7