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 Appendix A. Program Review PreparationWorksheet 
Date
 
I
NSTITUTIONAL
I
NFORMATION
School Name
 
OPE ID
 ______________ 
Address
 
TIN
 __________________ 
City, State ZIP Code
 
DUNS
 
Contact Person
 
Title
 
PhoneFax # Website
 
Funding Method
Advance
CM1
CM2
Reimbursement
Just inTime
Additional Location Address(es)
(and Phone Number(s))1.2.3.
Title IV Participation/ Current Funding Amount (Year_____)
 
Pell $
FSEOG$
Perkins$
FFEL$
FWS$
DL$
P
ROGRAM
R
EVIEW
P
LANNING
I
NFORMATION
Reviewer(s) NamesReason School Selected for ReviewProgram Review DatesLocationType of ReviewStatistical Sample SizeSource of Sampling Data
School
NSLDS
Appendix A - 1
 
Award Years to ReviewEntrance Conference TimeNumber of Title IV RecipientsRandom Sample Size
Appendix A - 2
 
S
CHOOL
N
AME
: OPE ID:
Announced Review
Unannounced Review
S
UMMARY 
 
OF
A
REAS
 
FOR
P
ROGRAM
R
EVIEW
F
OCUS
 
R
ESEARCH
/B
ACKGROUND
I
NFORMATION
 AAAD/OGC/OIG A
CTIONS
History of Admin Actions/Fines?
Yes
NoIssue(s)
 
Resolution(s)Any OIG Investigations?
Yes
NoIssue(s)Resolution(s)
P
RIOR
ED P
ROGRAM
R
EVIEW
I
NFORMATION
PRCN Review Date Report Date AYs Reviewed
Finding(s)
 
LiabilitiesReview Closed?
Yes
No Date:Liabilities Paid?
Appendix A - 3
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