Economic Development Administration
GPRA Data Collection Form
University Centers
PART I
Date
___________________________________________________________________
Recipient Name
___________________________________________________________________
Full Address
___________________________________________________________________
City
Zip Code
State
Street
Authorized Contact
___________________________________________________________________
Telephone
____________________________
Fax ______________________________
Email (not optional)
___________________________________________________________________
EDA Investment
Technical Assistance - University Center
Investment Number
___________________________________________________________________
Award Period
___________________ to _________________
Description of Activities:
Technology _____
Economic Development _____
PART II
Recipients are required to report the following:
a. Number of University Center (UC) clients provided 8 or more hours of technical assistance.
__________
(count only clients who received UC technical assistance; count only once even if it received assistance for more than one task)
b. Number of UC clients reported in a taking action as a result of the assistance facilitated by UC.
__________
c. Number of those actions taken by UC clients reported in b that achieved the expected results.
__________
(Please attach a list of clients and actions that achieved expected results)
d. Estimated number of jobs created or retained as a result of c.
______________
e. Estimated amount of private sector investment generated as a result of c.
______________
f. Estimated amount of public sector investment generated as a result of c.
______________
g. Other economic benefits resulting from technical assistance (
written examples, dollar amounts can be included as part
).
of the example
________________________________________________________________________________________________
________________________________________________________________________________________________
h. Categorize type of assistance provided:
Quantity
Quantity
Economic development plan
____
Partnership Strategies
____
Strategic partnering to
Project Management
____
Public-or private sector entities
____
GIS Service
____
Client Services
____
Studies
____
Technology Transfer
____
Business Sector Services
____
OMB Approved ED-917
OMB Control Number 0610-0098
Expires 11/30/2017
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