BoR/SREB FELLOWSHIPS 
FINAL PROJECT & EXPENDITURES REPORT
FORM SREB-DS-3
Page 1 of 4	

INSTRUCTIONS:

All elements of the project report are due immediately upon termination of this contract. The final expenditures report (page 5) is due ninety (90) days after termination of the contract and must be completed by the institutional fiscal agent. All unexpended BoRSF funds must be remitted to the Board of Regents with the final expenditure report. 

Submit all forms to:

Christine Norton
Grants and Contracts Manager
Louisiana Board of Regents 
P. O. Box 3677
Baton Rouge, LA 70821-3677

LEQSF Contract No.: ___________________________   Date: __________________________

Project Director(s): _____________________________   _______________________________

Institution: ____________________________________________________________________

Department(s): ________________________________________________________________

Contract Term: ______________________________ to ________________________________

Project Title: __________________________________________________________________

Signature(s) of Project Director(s):  _______________________   _______________________
		
Signature of Authorized Institutional Representative: ____________________________

STUDENT PROFILE
Page 2 of 4

(Complete a form for each student who held a support slot under this contract)

Student Name: ___________________________________		GRE Score: _____________

Department Affiliation: ___________________________________

Gender: ___________

Ethnicity: 	________ Hispanic or Latino			________ Not Hispanic or Latino
		
Race:		________ White			________ Black or African American
	
		________ American Indian or Alaska Native	________ Asian

		________ Native Hawaiian or Other Pacific Islander

Institution of Bachelor’s Degree: __________________________		Date: _________

Institution of Master’s Degree: ____________________________		Date: _________	

Number of years in BoR/SREB program: ___________________________

Has student graduated? ____________	If so, when? _________

Student’s plans after graduation: ___________________________________________

If employed, name of employer and state of employment: _____________________________
____________________________________________________________________________

CONTRACT/PROGRAM EVALUATION
Page 3 of 4

1) 	Did you have any problems in appointing students to this contract? If yes, explain. 
	_____________________________________________________________________
	_____________________________________________________________________
	_____________________________________________________________________

2)	Did you have any problems retaining students for this contract? If yes, explain.
	_____________________________________________________________________
	_____________________________________________________________________
	_____________________________________________________________________

3)	In your opinion, have this supplementary support and membership in the SREB Doctoral Scholars Program enhanced the success of students provided with the award? If so, how?  
_____________________________________________________________________
	_____________________________________________________________________
	_____________________________________________________________________

FINAL CUMULATIVE STATUS REPORT
Page 4 of 4

Student Recipient’s Full Name	

Annual Payment
($15,000/slot)	

	
		
First Pmt.	
Second Pmt.	
First Pmt.	
Second Pmt.	
First Pmt.	
Second Pmt.	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

Total Slots Awarded Per Payment Period