Page 1Attachment III
V-STOP Data Sheet
Year of Funding : 2002 2003 2004X 2005 2006
Name of Applicant: ______Current Grant #:______
Service Area(s): ______
* Crime(s)Applicant Category
Domestic Violence Law Enforcement
Sexual Assault Prosecution
Stalking Victims Services
Protective Order Courts-Please check if your program provides primary support for a court advocate position.
Violations Discretionary
Purpose Area(s) Geographic DistributionGeographic Region(s)
Units Tribes Central City Southwest
Data Statewide Rural County /Other City Northern
Victims Forensic Suburban City/County Valley
Training Disabled Statewide Central
Protocol Immigration Coastal
Stalking Statewide
Brief Project Summary (please use same language as on face sheet):
2005 Amount requested: $______(not including match)
If there are two or more part-time staff are requested, please indicate how many hours each one will work.
2005 Staff requested: ___ FT staff ___ PT staff ___ Other (explain)
___ hours______per week
2004 Amount Awarded: $ ______(not including match)
If there are two or more part-time staff working on the V-STOP grant, please indicate how many hours each one works.
2004 Staffing Level: ___ FT staff ___ PT staff ___ Other (explain)
___ hours______per week
* Any crime indicated must have a corresponding objective
Baseline Data for Calendar Year 2003
Provide information for all that apply to your agency or grant application for Calendar Year 2003.
Please use numbers.
Law Enforcement
Types of arrests (Misdemeanors)______DV* ______SA* ______ST* ______POV*
Types of arrests (Felonies)______DV* ______SA* ______ST* ______POV*
Total number of violence against women arrests ______
Number of emergency protective orders issued ______
Prosecution
Types of prosecutions (Misdemeanors)______DV* ______SA* ______ST* ______POV*
Types of prosecutions (Felonies)______DV* ______SA* ______ST* ______POV*
Total number of violence against women cases ______
Number of convictions______
Victims Services
Total number of victims served ______
Types of victims served______DV* ______SA* ______ST* ______POV*
Number and types of services provided
Criminal justice/court advocacy ______
Assistance in filing protective orders ______
Information and referral ______
Legal Services/Advocacy
Total number of protective orders sought ______
Total number of protective orders obtained ______
Number and types of protective orders sought
______EPO** ______PPO** ______PO** ______SPO** ______FPO** ______CPO**
Number and types of protective orders obtained
______EPO** ______PPO** ______PO** ______SPO** ______FPO** ______CPO**
Forensic
Number of PERKs completed ______DV*______SA*
Councils/Task Forces
Number of meetings ______
Number attending ______
Types of protocols developed ______DV* ______SA* ______ST* ______POV*
Training
Number of training events ______
Number attending ______
Types of training events ______DV* ______SA* ______ST* ______POV*
Number and discipline of attendees
______Law enforcement______Corrections______Social workers/counselors
______Prosecution______Victim advocates______Other
______Courts______Health care providers
Provide source of information, e.g. Uniform Crime Reports, Incident Based Reports, program records, court records, meeting minutes, etc.
______
*DV=domestic violence, SA=sexual assault, ST=stalking, POV=protective order violation
**EPO=emergency protective order, PPO=preliminary protective order, PO=protective order, SPO=stalking protective order, FPO=foreign protective order, CPO=child protective order