This document is a cost effectiveness template for a program that tracks revenues and costs over three fiscal years (FY2009 to FY2011). It collects information on revenue sources like tuition, fees, gifts, and grants, as well as expenses categories including salaries, benefits, supplies, equipment, and other program costs. The template also requests details on grants and anticipated future equipment needs and their estimated costs.

1. costeffectivenessdatacollection922-110927090203-phpapp02.xlsx
Program Name:
REVENUES
Tuition
Other Student Fees
Restricted Gifts
Endowment Earnings
Grants*
Tickets
Outside Contracts
Other (specify):
Total Revenue - - -
FY2009 FY2010 FY2011
Actual Actual Actual
COSTS
Full-Time Salaries
Part-Time Salaries
Summer School Salaries
Benefits
Equipment Purchases
Equipment Maintenance
(contracts/repairs)
Travel costs
Supplies costs
Printing costs
Scholarship Costs
Memberships
Professional Development
Accreditation costs
Contracted services costs
Other program costs (specify):
Total Cost - - -
Number of Full-Time Employees
Number of Part-Time Employees
*Please provide details regarding the grant term and possibility of renewal
Note: If there is an unusual, nonrecurring cost or revenue item in any particular
year, you may provide an written explanation (not to exceed 1/2 page in length)
and attach it to the Cost Effectiveness Template.
Anticipated Future Equipment
Needs:
Estimated
Equipment Item Year Needed
Cost
MCCKC Confidential 9/27/2011 Page 1