Youth Offender-Beneficiary Choice Quarterly Progress Report

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STANDARDIZED QUARTERLY PERFORMANCE REPORT
PRISONER REENTRY INITIATIVE (PRI) GRANT
Report Due Date: mm/dd/yyyy
ETA Form No. ETA-9140-A

OMB No. 1205-0455
Expires: 1/31/2009

A. GRANTEE IDENTIFYING INFORMATION
Grantee Name:

Grant Number:

Program/Project Name:

Project or Sub-Project ID/Number:
Report Quarter End Date:

City ____________________________

State ______

Zip Code __________

Performance Items

Previous Quarter
(A)

Enrollment Goal:
Current Quarter
(B)

Cumulative for
Program Year
(C)

Program-to-Date
(D)

B. PARTICIPANT SUMMARY INFORMATION
1. Total Exiters
2. Total Participants Served
3. New Participants Served
Gender

4a. Male
4b Female
5a. Hispanic/Latino

Ethnicity / Race

5b. American Indian or Alaska Native
5c. Asian
5d Black or African American
5e. Hawaiian Native or Other Pacific Islander
5f. White

Education Level

6a. 8th grade and under
6b. 9th grade - 12th grade
6c. High School graduate or equivalent
6d. 1 - 3 years of college, or full-time technical or vocational
school
6e. 4 years college or more
7a. 18 - 29

Age

7b. 25 - 34
7c. 35 - 44
7d. 45 - 54
7e. 55 or older
Other Demographics

8. Eligible Veterans
9. Limited English Proficient
10. Persons with a Disability
11. Not Employed at Program Participation

C. Additional Participant Information to be collected at enrollment
1a. Own/rent apartment, room, or house
Housing Status

1b. Staying at someone's apartment, room or house (Stable)
1c.. Halfway house/transitional house
1d. Residential treatment
1e. Homeless
1f. Staying at someone's apartment, room or house (Unstable)
2. History of Alcohol Abuse/Drug Use
3. Average Number of Days Since Release

Type of Crime

Post-Release Status

4. Average Number of Years Incarcerated

DRAFT

5a. Parole
5b. Probation
5c. Other Post-Release Supervision
5d. None
6a. Property Crimes
6b. Drug Crimes
6c. Public Order Offenses
6d. Other Offenses
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7. DOJ Pre-Release Participants

DRAFT

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Performance Items

Previous Quarter
(A)
Value

Numerator
Denominator

Current Quarter
(B)
Value

Numerator
Denominator

Cumulative for
Program Year
(C)
Value

Numerator
Denominator

Program-to-Date
(D)
Value

Numerator
Denominator

D. PROGRAM SERVICES, ACTIVITIES, AND OTHER RELATED ASSISTANCE
1. Received Education or Job Training Activities
2. Received Workforce Preparation Activities
3. Community Involvement Activities
4. Received Mentoring Activities
5. Received Health Services
6. Received Supportive Services
7. Overall Participation Rate (participating in at least one activity
from 1 through 5. Does not include supportive services.)

Performance Items

Previous Quarter
(A)
Value

Numerator
Denominator

Current Quarter
(B)
Value

Numerator
Denominator

Cumulative for
Program Year
(C)
Value

Numerator
Denominator

Program-to-Date
(D)
Value

Numerator
Denominator

E. SHORT-TERM INDICATORS OF PERFORMANCE
Leading Indicators of Performance
1. Enrollment Rate
2. Abstained from Alcohol Abuse or Illegal Drug Use
(6 months after enrollment)
3. Stable Living Arrangements
(6 months after enrollment)
4a. Number of Initial Job Placements
4b. Average Hourly Wage Rate at Placement
4c. Number of Job Re-Placements
4d. Average Hours Worked 1st Week of Placement
5. Number Obtained High School Diploma or GED
6. Number Obtained a Certificate
7. Entered Post Secondary Education
8. Entered Vocational/Occupational Skills Training
9a. Number of Re-arrests for a New Crime
9b. Number of Re-Incarcerations for Revocation
9c. Number of
ReIncarcarations
for New Crime
6 Mos.
9d. Number of
ReIncarcarations
for New Crime
1 yr.
9e. Number of
re-Convictions
for New Crime
6 mos.
9f. Number of
re-Convictions
for New Crime
6 mos.

F. LONG-TERM INDICATORS OF PERFORMANCE
Common Performance Measures
1. Entered Employment Rate
2. Employment Retention (includes all participants who entered
employment, regardless of follow-up)
3. Attainment of a Degree Or Certificate
4. Average 6 Months Post-Program Earnings (includes only those
who have been successfully contacted during follow-up)
Additional Performance Measures
5. Recidivism Rate
DRAFT

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5. Recidivism Rate

G. REPORT CERTIFICATION/ADDITIONAL COMMENTS
Grantee Remarks:

Name of Grantee Certifying Official:

DRAFT

Telephone Number:

Email:

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