Participant Intake, Return and Site Visits

Evaluation of the Adult and Dislocated Worker Program in the Workforce Investment Act

Documents and Forms

Document Name Document Type
WIA Evaluation - Appendix A.pdf Other-consent to participate
WIA Evaluation - Appendix B.pdf Other-intake form
Appendix C.pdf Other-protocols

Information Collection (IC) Details

IC Title:	Participant Intake, Return and Site Visits	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-consent to participate	WIA Evaluation - Appendix A.pdf	Yes	Yes	Fillable Printable
Other-intake form	WIA Evaluation - Appendix B.pdf	Yes	Yes	Fillable Printable
Other-protocols	Appendix C.pdf	Yes	Yes	Fillable Printable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title: DOL/ETA15DOL/ETA Evaluation, Research Pilot or Demonstration Contractors Project Files	FR Citation: 67 FR 16816

Number of Respondents: 65,224	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	65,224	65,224
Annual IC Time Burden (Hours)	14,307	14,307
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.