ETA-9103-3 Planning Form (Dual Enrollment)

U.S. Department of Labor OMB Control No. 1205-0439

Employment and Training Administration Expiration Date: 6/30/2010

Planning Form (Dual Enrollment), ETA-9103-3

National Emergency Grant Electronic Application System

All quarterly entries are CUMULATIVE over all previous quarters.

PERFORMANCE FACTOR	PROGRAM YEAR QUARTER
	ADMIN	PROGRAM	QTR1	QTR2	QTR3	QTR4	QTR5	QTR6	QTR7
IMPLEMENTATION SCHECULE
Receiving Intensive Services
Enrolled In Training (NEG Funded Only)
Receiving Supportive Services (NEG Funded Only)
Exits
Entering Employment At Exit
Total Planned Participants
Supportive Services
Admin Excluding NRP Processing
NRP Processing
Other*
Total: Program Management and Oversight
Indirect*
Other*
Total Expenditures: Grantee Level
Core and Intensive Services
Training (NEG Funded Only)
Supportive Services (NEG Funded Only)
Other*
Admin Excluding NRP Processing*
NRP Processing *
Other*
Total: Program Management and Oversight
Total: Expenditures: Project Operator Level
Total: Expenditures: Grantee and Project Operator Level

Public Burden Statement:

Persons are not required to respond to this collection of information unless it displays a currently valid OMB Control number. Respondents’ obligation to complete this form is required to obtain or retain benefits ( PL: 107-210). Public reporting burden for this collection of information is estimated to average 90 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This is public information and there is no expectation of confidentiality. Send comments regarding this burden estimate to the U.S. Department of Labor, Office of National Response, Room C-5311, Washington, D.C. 20210 (Paperwork Reduction Project 1205-0439).

ETA Form 9103-3 (March 2004)

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