ETA-9148 Wagner-Peyser Employment Service and Reemployment Servic

WAGNER-PEYSER EMPLOYMENT SERVICE and REEMPLOYMENT SERVICES GRANTS

MONTHLY REPORT

ETA Form: ETA-9147

Report Due Date: mm/dd/yyyy

OMB No.

1205-0474

Report Month End Date: mm/dd/yyyy

Expires:

11/30/2009

State: ________________________________________

Performance Items

STAFF-ASSISTED SERVICES

SELF-SERVICES

Current Month (A)

Previous Month (B)

Program-to-Date (C)

Current Month (A)

Previous Month (B)

Program-to-Date (C)

All Job Seekers

All Job Seekers

All Job Seekers

All Job Seekers

All Job Seekers

All Job Seekers

A. WAGNER-PEYSER EMPLOYMENT SERVICE PARTICIPANT SUMMARY INFORMATION

1. Total number of new participants served

2. Total number of participants served

3. Number of Veterans served

4. Number received workforce information services

5. Number received career guidance

6. Number received job search activities

7. Number referred to employment

8. Number referred to WIA services

Performance Items

STAFF-ASSISTED SERVICES

Current Month (A)

Previous Month (B)

Program-to-Date (C)

RES Participants

RES Participants

RES Participants

B. REEMPLOYMENT SERVICES PARTICIPANT SUMMARY INFORMATION

1. Total number of new participants served

2. Total number of participants served

3. Number of Veterans served

4. Number received workforce information services

5. Number received career guidance

6. Number received job search activities

7. Number referred to employment

8. Number referred to WIA services

9. Number referred to training, including WIA-funded training

C. REPORT CERTIFICATION/ADDITIONAL COMMENTS

Grantee Remarks:

Name of Grantee Certifying Official:

Telephone Number:

Email:

This reporting requirement is approved under the Paperwork Reduction Act of 1995, OMB Control No. 1205-0474 expiring 11/30/2009. Persons are not required to respond to this collection of information unless it displays a currently valid OMB number and expiration date. Public reporting burden for this collection of information is estimated to average 9 hours per response, including time for reviewing instructions, searching existing data sources, gathering and reviewing the collection of information. The reason for the collection of information is general program oversight, evaluation and performance assessment. Send comments regarding this burden, to the U.S. Department of Labor, Employment and Training Administration, Office of Performance and Technology, 200 Constitution Avenue, NW, Room S-5206, Washington, D.C. 20210 (Paperwork Reduction Project 1205-0474).