Part 1 - Title IV-E SSW Programmatic

1. Semester

2. University
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3. Prepared by
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4. Report Name

Part 2 - PROGRAM

5. DFCS region(S) does your university most closely work with

Regional Map

6. Student Data Tracking Table

#	Total # of Applicants	# of SEED Applicants	Wait List	Withdrawal / Non-returning Students	Continuing Students	Graduating Students	Enrolled Parttime	Enrolled Fulltime	Enrolled DFCS	Enrolled non DFCS
Year 1 BSW Students
Year 2 BSW Students
1st Year MSW
2nd Year MSW
3rd Year MSW
Advanced Standing MSW

6.1 Please provide explanation for any non-retuning student.

7. Please list the child welfare classes offered this reporting period that meet the required curriculum standards of the DFCS Training Modules.

#	Title	Instructors Name	Number of IV-E Students Enrolled	Credit Hours
Course 1
Course 2

8. Please provide information on the child welfare courses claimed as part of your reimbursement curriculum statistic for this reporting period.

#	Course Name/Section Title	Instructor	Credit Hours	Total # of Students Enrolled	# of Title IV-E Students Enrolled	Action
Course

Part 3 - RECRUITMENT & RETENTION

9. Please describe any recruitment efforts/strategies implemented this reporting period at the university level.

10. Please describe recruitment efforts/strategies implemented this reporting period targeted toward current DFCS employees.

11. Did you use social media to promote your Title IV-E project this reporting period? Yes No

12 Did you conduct any Title IV-E informational/interest sessions this semester? Yes No

13. Did your university/Title IV-E program assist DHS’ Office of Human Resource Management and Development (OHRMD) in hosting a career fair this semester?
Yes No

Part 4 - CONFERENCES & TRAINING

14. Were there any child welfare related conferences or trainings attended by Title IV-E Faculty,staff and participants? Yes No

15. If Yes, please provide some additional information about the conference/training.

Conference Agenda

16. Please list the number of people associated with your School of Social Work's Title IV-E program that attend the conference/training.

#	BSW students	MSW Students	IV-E Faculty/Staff
Number in attendance

17. Did you attend a second conference or training this reporting period?
Yes No

18. If Yes, please provide some additional information about the second conference/training.

19. Please list the number of people associated with your School of Social Work's Title IV-E program that attend the conference/training.

#	BSW students	MSW Students	IV-E Faculty/Staff
Number in attendance

20. Did you attend a third conference or training this reporting period?
Yes No

21. If Yes, please provide some additional information about the second conference/training.

22. Please list the number of people associated with your School of Social Work's Title IV-E program that attend the conference/training.

#	BSW students	MSW Students	IV-E Faculty/Staff
Number in attendance

#	A Considerable Amount	Quite a Bit	Some	None
New student recruitment
Communication with current students
Aid in retention efforts
Reach out to alumni

Reporting Form

Part 1 - Title IV-E SSW Programmatic

Part 2 - PROGRAM

Part 3 - RECRUITMENT & RETENTION

Part 4 - CONFERENCES & TRAINING