Participant Data Collection, Participant Burden

Reintegration of Ex-Offenders, Adult Reporting System

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Participant Data Collection, Participant Burden

OMB: 1205-0455

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Prisoner Reentry Initiative Data Elements

No. DATA ELEMENT NAME DATA ELEMENT DEFINITIONS/INSTRUCTIONS VALID VALUES EDITS ERROR MESSAGES
Global Edits


Duplicate Detection

A. If multiple records have the same Social Security Number (field 1), then no record can have a field 46 (Date of Participation) or a field 47 (Date or Exit) between the Date of Program Participation and the Date of Exit plus 90 days of any other record with the same Individual Identifier.

B. If multiple records have the same Individual Identifier, then only the record with the most recent Date of Participation can have a blank Date of Exit.


Age

A. Must be greater than or equal to 18 and less then or equal to 100 years old at Date of Participation. Age = DATE OF PARTICIPATION minus DATE OF BIRTH A. Invalid age - Participant cannot be younger than 18 or older than 100 years old at participation.
SECTION I - INDIVIDUAL INFORMATION


SECTION I.A - IDENTIFYING AND DEMOGRAPHIC INFORMATION


1 Social Security Number Record the unique identification number assigned to the individual. At a minimum, this identifier for a person must be the same for every period of participation in the program. XXX-XX-XXXX

(No hyphens)
Mandatory field A. Social Security Number is missing or invalid.
2 Criminal Justice System Identifier Enter the individual's unique criminal justice system identifier that was assigned to the inidividual while in prison. Text

3 Type of Criminal Justice Identifier Select the appropriate type of criminal justice identifier used in element 2. 1 = Federal ID
State CJ Record ID
2 = State Prison ID
3 = State Parole/ Probation Agency ID
4 = Local Probation Agency ID
5 = Local Jail ID
6 = Other
A. Must not be blank if field 2 (Criminal Justice System Identifier) is not blank. A. Criminal Justice System Identifier is specified, but Type of Criminal Justice System Identifier is not given.
4 Specify Other Criminal Justice Identifier Specify the type of criminal justice identifier if other was used for element 3. Text A. Must not be blank if field 3 (Type of Criminal Justice Identifier) is 6. A. Type of Criminal Justice System Identifier is specified as Other (6), but Other Type of Criminal Justice Identifier is not given.
5 Non-Violent Offender Select Yes if the participant is a non-violent offender.

Select No if the participant is not a non-violent offender.
1 = Yes
2 = No
A. Must be Yes to participate in the program. A. Field 5 (Non-Violent Offender) must = 1 (Yes) to participate in the program.
6 Date of Birth Record the individual's date of birth. MM/DD/YYYY

7 Gender Indicate the participant's gender by select Male or Female

Leave blank if the individual does not wish to disclose his/her gender.
1 = Male
2 = Female
Blank = no self-disclosure


8 Ethnicity Hispanic/ Latino Indicate the participant's ethnicity by selecting Yes or No.

Leave blank if the participant does not disclose his/her ethnicity.
1 = Yes
2 = No
Blank = no self-disclosure


9 American Indian or Alaska Native Indicate whether the participant is American Indian or Alaska Native by selecting Yes.

Leave blank if the participant is not American Indian or Alaska Native or refused to report on this element.
1 = Yes
Blank = not reported


10 Asian Indicate whether the participant is Asian by selecting Yes or Not Reported.

Leave blank if the participant is not Asian or refused to report on this element.
1 = Yes
Blank = not reported


11 Black or African American Indicate whether the participant is Black or African American by selecting Yes or Not Reported.

Leave blank if the participant is not Black or African American or refused to report on this element.
1 = Yes
Blank = not reported


12 Hawaiian Native or other Pacific Islander Indicate whether the participant is Hawaiian Native or other Pacific Islander by selecting Yes or Not Reported.

Leave blank if the participant is not Hawaiian Native or other Pacific Islander or refused to report on this element.
1 = Yes
Blank = not reported


13 White Indicate whether the participant is White by selecting Yes or Not Reported.

Leave blank if the participant is not White or refused to report on this element.
1 = Yes
Blank = not reported


SECTION I.B - ENROLLMENT INFORMATION


14 Marital status Enter the participants marital status at time of enrollment 1 = Married
2 = Single
3 = Divorced
4 = Widowed
5 = Separated


15 Children Enter the number of children under 18 years of age that the participant has, including biological, adopted, step, and foster children. 00

16 Children living with participant Enter the number of the participant's own children under 18 years of age living in the household, including biological, adopted, step, and foster children. 00 A. Must be less than or equal to field 15 (Children). A. Number of Children Living With Participant cannot be greater than the Number of Children participant has.
17 Other dependents living with participant Enter the number of dependents other than children living with the participant. 00

18 Highest School Grade Completed Use the appropriate code to record the highest school grade completed by the individual.

Record 87 if the individual completed the 12th grade and attained a high school diploma.
Record 88 if the individual completed the 12th grade and attained a GED or equivalent.
Record 89 if the individual with a disability received a certificate of attendance/completion.
00 = No school grades completed
01 - 12 = Number of elementary/secondary school grades completed
13-15 = Number of college, or full-time technical or vocational school years completed
16 = Bachelor's degree or equivalent
17 = Education beyond the Bachelor's degree
87 = Attained High School Diploma
88 = Attained GED or Equivalent
89 = Disabled Person Attained a Certificate of Attendance/Completion


19 Eligible Veteran Status Select yes, <= 180 days if the individual is a person who served in the active U.S. military, naval, or air service for a period of less than or equal to 180 days, and who was discharged or released from such service under conditions other than dishonorable.
Select yes, eligible veteran if the individual served on active duty for a period of more than 180 days and was discharged or released with other than a dishonorable discharge; or was discharged or released because of a service connected disability; or as a member of a reserve component under an order to active duty pursuant to section 167 (a), (d), or, (g), 673 (a) of Title 10, U.S.C., served on active duty during a period of war or in a campaign or expedition for which a campaign badge is authorized and was discharged or released from such duty with other than a dishonorable discharge.
Select yes, other eligible person if the individual is a person who is
(a) the spouse of any person who died on active duty or of a service-connected disability,
(b) the spouse of any member of the Armed Forces serving on active duty who at the time of application for assistance under this part, is listed, pursuant to 38 U.S.C 101 and the regulations issued thereunder, by the Secretary concerned, in one or more of the following categories and has been so listed for more than 90 days:
(i) missing in action;
(ii) captured in the line of duty by a hostile force; or
(iii) forcibly detained or interned in the line of duty by a foreign government or power; or
(c) the spouse of any person who has a total disability permanent in nature resulting from a
service-connected disability or the spouse of a veteran who died while a disability so evaluated
was in existence.
Select no if the individual does not meet any one of the conditions
described above.
1 = Yes, <= 180 days
2 = Yes, Eligible Veteran
3 = Yes, Other Eligible Person
4 = No


20 Limited English Proficient Select Yes if the individual is a person who has limited ability in speaking, reading, writing or understanding the English language and (a) whose native language is a language other than English, or (b) who lives in a family or community environment where a language other than English is the dominant language.
Select No if the individual does not meet the conditions described above.
1 = Yes
2 = No


21 Individual with a Disability Select Yes if the individual indicates that he/she has any "disability," as defined in Section 3(2)(a) of the Americans with Disabilities Act of 1990 (42 U.S.C. 12102). Under that definition, a "disability" is a physical or mental impairment that substantially limits one or more of the person's major life activities. (For definitions and examples of "physical or mental impairment" and "major life activities," see paragraphs (1) and (2) of the definition of the term "disability" in 29 CFR 37.4, the definition section of the WIA non-discrimination regulations.)
Select No if the individual indicates that he/she does not have a disability that meets the definition.
Leave blank if the individual does not wish to self-identify.
1 = Yes
2 = No
Blank = no self-identification


New Health Issues Select Sigificant health issues if the participant has any health issue that could impact the individual's ability to work. Examples of such health issues can include, but are not limited to, untreated high blood pressure, HIV/STDs, asthma, depression, and other metnal/physical health issues.

Otherwise, select No significant health issues.
1 = Significant health issues
2 = No significant health issues


22 Employment Status at Participation Record Employed if the participant is a person who either (a) did any work at all as a paid employee, (b) did any work at all in his or her own business, profession, or farm, (c) worked 15 hours or more as un unpaid worker in an enterprise operated by a member of the family, or (d) is one who was not working, but has a job or business from which he or she was temporarily absent because of illness, bad weather, vacation, labor-management dispute, or personal rea­sons, whether or not paid by the employer for time-off, and whether or not seeking another job.
Record Employed, but Received Notice of Termination of Employment or Military Separation if the participant is a person who, although employed, either (a) has received a notice of termination of employment or the employer has issued a Worker Adjustment and Retraining Notification (WARN) or other notice that the facility or enterprise will close, or (b) is currently on active military duty and has been provided with a firm date of separation from military service.
Record Not Employed if the individual does not meet any one of the conditions described above.
1 = Employed
2 = Employed, but Received Notice of Termination of Employment or Military Separation
3 = Not Employed
A. Must be 1 or 2 if field 23 (Occupation at Enrollment) is >0.

B. Must be 1 or 2 if field 24 (Hours Worked at Enrollment) is >0.

C. Must be 1 or 2 if field 25 (Average Hourly Wage at Enrollment) is >0.

D. Must be 1 or 2 if field 26 (Start Date for Job at Enrollment) is not blank.

E. Must be completed within two weeks of opening the record.
A. Occupation at Enrollment must be blank or 0 if Employment Status at Participation is Not Employed (3).

B. Hours Worked at Enrollment must be blank or 0 if Employment Status at Participation is Not Employed (3).

C. Earnings at Enrollment must be blank or 0 if Employment Status at Participation is Not Employed (3).

D. Start Date for Job at Enrollment must be blank if Employment Status at Participation is Not Employed (3).

E. Employment Status at Participation cannot be blank.
23 Occupation at Enrollment Record the occupational area that best describes the individual's employment at enrollment.

Leave blank if the participant is not employed at participation.

Architecture and Engineering
Arts, Design, Entertainment, Sports, and Media
Building and Grounds Cleaning and Maintenance
Business and Financial Operations
Community and Social Services
Computer and Mathematical Occupations
Construction and Extraction



Education, Training, and Library
Farming, Fishing and Forestry
Food Preparation and Serving R+D related
Healthcare Practitioner and Technical
Healthcare Support



Installation, Maintenance, and Repair
Legal
Life, Physical, and Social Science
Management
Military Specific
Office and Administrative Support
Personal Care and Service
Production
Protective Service
Sales and Related
Transportation and Material Moving


24 Hours Worked at Enrollment Enter the average hours per week that the participant works at the above occupation.

Leave blank if the participant is not employed at participation.
00
Blank = not employed
A. Must be greater than 0 if field 22 (Employment Status at Participation) is 1 or 2. A. Participant is Employed at Participation, but Hours Worked are not given.
25 Average Hourly Wage at Enrollment Enter the participant's average hourly wage at the above occupation.

Leave blank if the participant is not employed at participation.
00.00
Blank = not employed
A. Must be greater than 0 if field 22 (Employment Status at Participation) is 1 or 2. A. Participant is Employed at Participation, but no Hourly Wage is given.
26 Start Date for Job at Enrollment Enter the date on which the participant began to work at the above job.

Leave blank if the participant is not employed at participation.
MM/DD/YYYY
Blank = not employed
A. Must not be blank if field 22 (Employment Status at Participation) is 1 or 2. A. Participant is Employed at Participation, but no Start Date for Job at Participation is given.
27 Housing Status at Enrollment Select Own/Rent Apartment, Room, Or House if, at enrollment, the individual is living in an apartment, room, or house that the he/she owns or rents.

Select Staying at someone's apartment, room, or house (Stable) if, at enrollment, the individual is living in an apartment, room, or house that somebody else owns or rents and if the person is not at risk of being displaced from this housing, i.e the housing situation is long-term.

Select Halfway house/transitional house if, at enrollment, the individual is living in a residence designed to assist persons as they re-enter society and learn to adapt to independent living after having been in prison.

Select Residential treatment if, at enrollment, the individual lives in a residential treatment center. A residential treatment center is a group home that provides room and board, and provides specialized treatment or rehabilitation persons with emotional, psychological, or developmental problems as well as chemical dependencies.

Select Homeless if, at enrollment, the individual lacks a fixed, regular, adequate night time residence. This definition includes any individual who has a primary night time residence that is a publicly or privately operated shelter for temporary accommodation; an institution providing temporary residence for individuals intended to be institutionalized; or a public or private place not designated for or ordinarily used as a regular sleeping accommodation for human beings. This definition does not include an individual imprisoned or detained under an Act of Congress or State law. An individual who may be sleeping in a temporary accommodation while away from home should not, as a result of that alone, be recorded as homeless.

Select Staying at someone's apartment, room, or house
(Unstable) if, at enrollment, the individual is living in an apartment,
room, or house that somebody else owns or rents and if the person is
at risk of being displaced from this housing, i.e the housing situation is
short-term.
1 = Own/rent apartment, room, or house
2 = Staying at someone's apartment, room, or house (Stable)
3 = Halfway house/ transitional house
4 = Residential treatment
5 = Homeless
6 = Staying at someone's apartment, room, or house (Unstable)
A. Must be completed within two weeks of opening the record. A. Housing Status at Enrollment cannot be blank.
28 Alcohol Abuse/ Drug Use at Enrollment Select prior to incarceration if the individual used illegal drugs or abused legal drugs or alcohol within 3 months prior to incarceration.
Select prior to enrollment if the individual used illegal drugs or abused legal drugs or alcohol 3 months prior to enrollment.
Select both if the individual used illegal drugs or abused legal drugs or alcohol within 3 months prior to incarceration and 3 months prior to enrollment.
Select no if the individual did not use illegal drugs or abuse alcohol 3 months prior to incarceration or 3 month prior to enrollment.
1 = Prior to incarceration
2 = Prior to enrollment
3 = Both
4 = No
A. Must be completed within two weeks of opening the record.
29 Referral Source Enter the name of the organization or individual who referred the applicant to the PRI program Text

30 Post-Release Status at Enrollment Select parole if the participant is on parole on the date of participation.
Select probation if the participant is on probation on the date of participation.
Select other criminal justice/court supervision if the participant is on post-release supervision other than parole or probation on the date of participation.
Select none if the participant is not on any form of post-release supervision.
1 = Parole
2 = Probation
3 = Other Criminal Justice/Court Supervision
4 = None
A. Must be completed within two weeks of opening the record. A. Post-Release Status at Enrollment cannot be blank.
31 Mandated participation Select Yes if participation in the PRI program is mandated by a criminal justice agency or agent as a condition of parole, probation, or other supervision.

Select No if participation in the PRI program is not mandated by a criminal justice agency or agent
1 = Yes
2 = No


SECTION I.C - INFORMATION AT AND PRIOR TO INCARCERATION
This information is collected at enrollment.


32 Employment Status at Incarceration Prior to your most recent incarceration, indicate whether the indiviidual was employed within two weeks of arrest. 1 = Employed full-time
2 = Employed part-time
3 = Not employed


33 Date of Incarceration for Most Recent Crime Prior to Participation Enter the date on which the participant was incarcerated for the most recent crime committed prior to participation. MM/DD/YYYY A. Must be less than field 34 (Date of Release for Most Recent Crime Prior to Participation). A. Date of Release for Most Recent Crime Prior to Participation is before Date of Incarceration for Most Recent Crime Prior to Participation.
34 Date of Release for Most Recent Crime Prior to Participation Enter the date on which the participant was most recently released from prison prior to participation. MM/DD/YYYY A. Must be less than field 47 (Date of Program Participation).

B. Must be completed within two weeks of opening the record.
A. Date of Program Participation is before Date of Release for Most Recent Crime Prior to Participation.
35 Institution Enter the name of the institution at which the participant was incarcerated most recently prior to enrollment. Text

36 Type of institution Select the type of institution at which the participant was incarcerated most recently prior to enrollment 1 = Federal prison
2 = State prison
3 = County/city jail


37 Total Time Incarcerated Enter the total number of years and months that the participant has been incarcerated during his/her lifetime. YY/MM A. Must be completed within two weeks of opening the record. A. Total Time Incarcerated cannot be blank.
38 Property Crime Select the appropriate type(s) of property crime for the participant's most recent conviction. Property crimes include, but are not limited to, burglary, larceny, motor vehicle theft, and receiving stolen property.

If a participant was convicted for more than one type of offense, select all appropriate offenses.

Leave blank if the participant's most recent conviction was not for a property crime.
1 = Burglary
2 = Larceny
3 = Motor vehicle theft
4 = Receiving stolen property
5 = Other property crime
Blank = not a property crime
A. Must be completed within two weeks of opening the record. A. Field 38 (Property Crime) cannot be blank.
39 Type of Other Property Crime Specify the other property crime.

Leave blank if the participant most recent conviction did not include other property crimes.
Text
Blank = did not include other property crime
A. Must not be blank if field 38 (Property Crime) is 5. A. Other Property Crime is indicated, but Type of Other Property Crime is not specified.
40 Drug Crime Select the appropriate type(s) of drug crimes for the participant's most recent conviction. Drug crimes include, but are not limited to, possession of a controlled substance, traffic in a controlled substance, and possession of drug paraphernalia.

If a participant was convicted for more than one type of offense, select all appropriate offenses.

Leave blank if the participant's most recent conviction was not for a drug crime.
1 = Possession of a controlled substance
2 = Traffic in a controlled substance
3 = Possession of drug paraphernalia
4 = Other drug crime
Blank = not a drug crime
A. Must be completed within two weeks of opening the record. A. Field 40 (Drug Crime) cannot be blank.
41 Type of Other Drug Crime Specify the other drug crime.

Leave blank if the participant's most recent conviction did not include other drug crimes.
Text
Blank = did not include other drug crime
A. Must not be blank if field 40 (Drug Crimes) is 4. A. Other Drug Crime is indicated, but Type of Other Drug Crime is not specified.
42 Public Order Offenses Select the appropriate type(s) of public order offenses for the participant's most recent conviction. Public order offenses include, but are not limited to, commercial vice, gambling, animal cruelty, and driving while intoxicated.

If a participant was convicted for more than one type of offense, select all appropriate offenses.

Leave blank if the participant's most recent conviction was not for a public order offense.
1 = Commercial vice
2 = Gambling
3 = Animal cruelty
4 = Driving while intoxicated
5 = Other public order offense
Blank = not a public order offense
A. Must be completed within two weeks of opening the record. A. Field 42 (Public Order Offenses) cannot be blank.
43 Type of Other Public Order Offenses Specify the other public order offense.

Leave blank if the participant's most recent conviction did not include other public order offenses.
Text
Blank = did not include other public order offense
A. Must not be blank if field 42 (Public Order Offenses) is 5. A. Other Public Order Offense is indicated, but Type of Other Public Order Offense is not specified.
44 Other Offenses Select Yes if the participant's most recent conviction was for any offense not included in property, drug, or public order offenses.

1 = Yes
2 = No
A. Must be completed within two weeks of opening the record. A. Field 44 (Other Offenses) cannot be blank.
45 Type of Other Offenses Specify the other offenses.

Leave blank if the participant's most recent conviction did not include other offenses.
Text
Blank = did not include other offenses
A. Must not be blank if field 44 (Other Offenses) is 1. A. Other Offense is indicated, but Type of Other Offense is not specified.
46 Received DoJ Pre-Release Services Select Yes if the participant indicated that he/she was enrolled in the Department of Justice's pre-release program. 1 = Yes
2 = No
A. Must be completed within two weeks of opening the record. A. Field 46 (Received DoJ Pre-Release Services) cannot be blank.
SECTION II - PROGRAM ACTIVITIES AND SERVICES INFORMATION

SECTION II.A - PROGRAM PARTICIPATION DATA

47 Date of Program Participation Record the date on which the individual begins receiving his/her first service funded by the program following a determination of eligibility to participate in the program.

MM/DD/YYYY

A. Must be less than or equal to field 48 (Date of Exit) and all service fields in section II.B of the record layout. A. Date of Participation is after the Date of Exit or service dates.
New Date Entered Follow-up Services Record that date in which the program begins the follow-up services with the participant, which means the participant has completed services and there is an expectation that no additional services, other than support or follow-up services, will be needed.

This field should not be populated until the case manager expects the participant will receive no more services.
MM/DD/YYYY

A. Must be greater than or equal to field 47 (Date of Participation).

B. Must be greater than or equal all dates provided in the service fields except supportive services (Section II.B).
A. Date Entered Follow-up Services is before the field 47 (Date of Participation).

B. Date Entered Follow-up Services is before provide name of sevice date.
48 Date of Exit Record the date on which the participant exited the program. For most participants this will be the date that the last service funded by the program or a partner program (excluding supportive services) is received by the participant or the date of incarceration, whichever occurs first.

Once a participant has not received any services funded by the program (excluding supportive services) or a partner program for 90 consecutive calendar days, has no planned gap in service, and is not scheduled for future services, the date of exit is applied retroactively to the last day on which the individual received a service funded by the program or a partner program.

For special "Other Reasons" for exit, to include only death, incapacitation for health reasons, and inabilty to participate because of the need to care for a family member, the date of exit is the date that occassioned the other reason for program exit.

MM/DD/YYYY A. This date will be autogenerated by the system to be the date on which the individual received his/her last service.
49 Prerelease Contact Select Yes if the DoL grantee had any contact with the participant prior to registration
in the program.

Select No if the DoL grantee did not have any contact with the participant prior to registration in the program.

1 = Yes
2 = No


50 Other Reasons for Exit (at time of exit or during 3-quarter measurement period following the quarter of exit) Select Health/Medical if the participant is receiving medical treatment that precludes entry into unsubsidized employment or continued participation in the program. Does not include temporary conditions expected to last for less than 90 days.

Select Deceased if the participant was found to be deceased or no longer living.

Select Family Care if the participant is providing care for a family member that precludes entry into unsubsidized employment or continued participation in the program. Does not include temporary conditions expected to last for less than 90 days.


Leave blank if the none of the above reasons apply.
02 = Health/Medical
03 = Deceased
04 = Family Care
Blank = none of the above
A. Must be blank if field 48 (Date of Exit) and field New (Date Entered Follow-up Services) is blank. A. Other Reason for Exit is specified (01 - 05), but no Date of Exit or Date Entered Follow-up Services is given.
SECTION II.B - SERVICES AND OTHER RELATED ASSISTANCE DATA

Education or Job Training Activities

51 Date Entered Math/Reading Remediation Enter the date on which the participant started math/reading remediation.

Math/Reading remediation consists of classroom instruction designed to improve an participant’s reading and/or math skills for those participants who are determined to be basic literacy skills deficient. Basic education skills include reading comprehension, math computation, writing, speaking, listening, problem solving, reasoning, and the capacity to use these skills.
MM/DD/YYYY

New Provider Type Select Faith-based Provider if the non-emergency medical care is provided by a faith-based organization.

Select Community-based Provider if the non-emergency medical care is provided by a community-based organization.

Select Public Provider if the non-emergency medical care is provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


52 Expected Completion Date of Math/Reading Remediation Enter the date on which the participant is expected to complete math/reading Remediation. MM/DD/YYYY A. Must be blank or greater than or equal to field 51 (Date Entered Math/Reading Remediation) A. Expected Completion Date of Math/Reading Remediation is before Date Entered Math/Reading Remediation.
53 Date of Last Math/Reading Remediation Services During the Month Enter the last date during the month in which the participant received math/remediation services.

Note: This field must repeat for every month in which the participant receives math/remediation services.
MM/DD/YYYY A. Must be blank or greater than or equal to field 51 (Date Entered Math/Reading Remediation) A. Date of Last Math/Reading Remediation Services During the Month is before Date Entered Math/Reading Remediation.
54 Date Ended Math/Reading Remediation Enter the date on which the participant exited math/reading remediation. MM/DD/YYYY A. Must be blank or greater than or equal to field 51 (Date Entered Math/Reading Remediation).

B. Must not be blank if field 55 (Completed Math/Reading Remediation) is 1.
A. Date Ended Math/Reading Remediation is before Date Entered Math/Reading Remediation.

B. Completed Math/Reading Remediation is Yes (1), but no Date Ended Math/Reading Remediation is given.
55 Completed Math/Reading Remediation Select Yes if the participant successfully completed math/reading remediation.

Select No if the participant did not successfully complete math/reading remediation.

1 = Yes
2 = No
A. Must not be blank if field 54 (Date Ended Math/Reading Remediation) is a valid date. A. Completed Math/Reading Remediation cannot be blank if Date Ended Math/Reading Remediation is given.
56 Date Entered GED Preparation Enter the date on which the participant started GED preparation.

GED preparation is an activity intended to prepare an participant for passing the GED examination.
MM/DD/YYYY

New Provider Type Select Faith-based Provider if the math/reading remediation is provided by a faith-based organization.

Select Community-based Provider if the math/reading remediation is provided by a community-based organization.

Select Public Provider if the math/reading remediation is provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


57 Expected Completion Date of GED Preparation Enter the date on which the participant is expected to complete GED preparation.

MM/DD/YYYY A. Must be blank or greater than or equal to field 56 (Date Entered GED Preparation) A. Expected Completion Date of GED Preparation is before Date Entered GED Preparation.
58 Date of Last GED Preparation Services During the Month Enter the last date during the month in which the participant received GED preparation services.

Note: This field must repeat for every month in which the participant receives GED preparation services.
MM/DD/YYYY A. Must be blank or greater than or equal to field 56 (Date Entered GED Preparation) A. Date of Last GED Preparation Service During the Month is before Date Entered GED Preparation.
59 Date Ended GED Preparation Enter the date on which the participant exits GED preparation.

MM/DD/YYYY A. Must be blank or greater than or equal to field 56 (Date Entered GED Preparation).

B. Must not be blank if field 60 (Completed GED Preparation) is 1.
A. Date Ended GED Preparation is before Date Entered GED Preparation.

B. Completed GED Preparation is Yes (1), but no Date Ended GED Preparation is given.
60 Completed GED Preparation Select Yes if the participant successfully completed GED preparation

Select No if the participant did not successfully complete GED preparation.

1 = Yes
2 = No
A. Must not be blank if field 59 (Date Ended GED Preparation) is a valid date. A. Completed GED Preparation cannot be blank if Date Ended GED Preparation is given.
61 Date Entered Vocational/ Occupational Skills Training Services Enter the date on which the participant started vocational/occupational skills training.

Vocational/ occupational skills training is a type of long term occupational training consisting of specific classroom and work-based study in a specific occupation leading to a degree or certificate.
MM/DD/YYYY

New Provider Type Select Faith-based Provider if the vocational/occupational skills training is provided by a faith-based organization.

Select Community-based Provider if the vocational/occupational skills training is provided by a community-based organization.

Select Public Provider if the vocational/occupational skills training is provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


62 Expected Completion Date of Vocational/ Occupational Skills Training Services Enter the date on which the participant is expected to complete vocational/occupational skills training.

MM/DD/YYYY A. Must be blank or greater than or equal to field 61 (Date Entered Vocational/ Occupational Skills Training Services). A. Expected Completion Date of Vocational/ Occupational Skills Training Services is before Date Entered Vocational/ Occupational Skills Training Services.
63 Date of Last Vocational/ Occupational Skills Training Services During the Month Enter the last date during the month in which the participant received vocational/occupational skills training services.

Note: This field must repeat for every month in which the participant receives vocational/occupational skills training services.
MM/DD/YYYY A. Must be blank or greater than or equal to field 61 (Date Entered Vocational/ Occupational Skills Training Services). A. Date of Last Vocational/ Occupational Skills Training Service During the Month is before Date Entered Vocational/ Occupational Skills Training Services.
64 Date Ended Vocational/ Occupational Skills Training Services Enter the date on which the participant exited vocational/occupational skills training.

MM/DD/YYYY A. Must be blank or greater than or equal to field 61 (Date Entered Vocational/ Occupational Skills Training Services).

B. Must not be blank if field 65 (Completed Vocational/ Occupational Skills Training Services) is 1.
A. Date Ended Vocational/ Occupational Skills Training Services is before Date Entered Vocational/ Occupational Skills Training Services.

B. Completed Vocational/ Occupational Skills Training Services is Yes (1), but no Date Ended Vocational/ Occupational Skills Training Services is given.
65 Completed Vocational/ Occupational Skills Training Services Select Yes if the participant successfully completed vocational/occupational skills training.

Select No if the participant did not successfully complete vocational/ occupational skills training.

1 = Yes
2 = No
A. Must not be blank if field 64 (Date Ended Vocational/ Occupational Skills Training Services) is a valid date. A. Completed Vocational/ Occupational Skills Training Services cannot be blank if Date Ended Vocational/ Occupational Skills Training Services is given.
66 Expected Duration of Vocational/ Occupational Skills Training Select the duration of the vocational/occupational skills training program that the participant has entered 1 = 5 or fewer hours per week
2 = 6 to 15 hours per week
3 = 16 to 25 hours per week
4 = 25 or more hours per week
A. Must not be blank if field 61 (Date Entered Vocational/ Occupational Skills Training Services) is a valid date. A. Expected Duration of Vocational/ Occupational Skills Training cannot be blank if Date Entered Vocational/ Occupational Skills Training Services is given.
67 Expected Cost of Vocational/ Occupational Skills Training Enter the expected cost of the vocational/occupational skills training program that the participant has entered. 0000.00 A. Must not be blank if field 61 (Date Entered Vocational/ Occupational Skills Training Services) is a valid date. A. Expected Cost of Vocational/ Occupational Skills Training cannot be blank if Date Entered Vocational/ Occupational Skills Training Services is given.
68 Date Entered On the Job Training (OJT) Enter the date on which the participant started on-the-job training (OJT).

OJT is training provided by an employer that pays the participant while the participant is engaged in productive work. The job provides knowledge or skills essential to the full and adequate performance of the job, provides reimbursement to the employer of up to 50% of the wage rate of the participant, and is limited in duration to a period appropriate to the occupation for which the participant is being trained.
MM/DD/YYYY

New Provider Type Select Faith-based Provider if the on-the-job training (OJT) is provided by a faith-based organization.

Select Community-based Provider if the on-the-job training (OJT) is provided by a community-based organization.

Select Public Provider if the on-the-job training (OJT) is provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


69 Expected Completion Date of On the Job Training (OJT) Enter the date on which the participant is expected to complete on-the-job training (OJT).

MM/DD/YYYY A. Must be blank or greater than or equal to field 68 (Date Entered On the Job Training). A. Expected Completion Date of On the Job Training is before Date Entered On the Job Training.
70 Date of Last On the Job Training (OJT) Services During the Month Enter the last date during the month in which the participant received on the job training (OJT) services.

Note: This field must repeat for every month in which the participant receives on the job training (OJT) services.
MM/DD/YYYY A. Must be blank or greater than or equal to field 68 (Date Entered On the Job Training). A. Date of Last On the Job Training Service During the Month is before Date Entered On the Job Training.
71 Date Ended On the Job Training (OJT) Enter the date on which the participant exited on-the-job training (OJT).

MM/DD/YYYY A. Must be blank or greater than or equal to field 68 (Date Entered On the Job Training).

B. Must not be blank if field 72 (Completed On the Job Training ) is 1.
A. Date Ended On the Job Training is before Date Entered On the Job Training.

B. Completed On the Job Training is Yes (1), but no Date Ended On the Job Training is given.
72 Completed On the Job Training (OJT) Select Yes if the participant successfully completed OJT.

Select No if the participant did not successfully complete OJT.

1 =Yes
2 = No
A. Must not be blank if field 71 (Date Ended On the Job Training) is a valid date. A. Completed On the Job Training cannot be blank if Date Ended On the Job Training is given.
73 Date Entered Other Education Or Job Training Activities Enter the date on which the participant started other education or job training activities .
MM/DD/YYYY

New Provider Type Select Faith-based Provider if the other education or job training activities is provided by a faith-based organization.

Select Community-based Provider if the other education or job training activities is provided by a community-based organization.

Select Public Provider if the other education or job training activities is provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


74 Type of Other Education or Job Training Activities Specify the type of other education or job training activities .

Text A. Must not be blank if field 73 (Date Entered Other Education Or Job Training Activities) is a valid date. A. Date Entered Other Education or Job Training Activities is specified, but Type of Other Education or Job Training Activities is not specified.
75 Expected Completion Date of Other Education Or Job Training Activities Enter the date on which the participant is expected to complete other education or job training activities .

MM/DD/YYYY A. Must be blank or greater than or equal to field 73 (Date Entered Other Education Or Job Training Activities). A. Expected Completion Date of Other Education or Job Training Activities is before Date Entered Other Education or Job Training Activities.
76 Date of Last Other Education or Job Training Activities Services During the Month Enter the last date during the month in which the participant received other education or job training -activities services.

Note: This field must repeat for every month in which the participant receives other education or job training -activities services.
MM/DD/YYYY A. Must be blank or greater than or equal to field 73 (Date Entered Other Education Or Job Training Activities). A. Date of Last Other Education or Job Training Activities Service During the Month is before Date Entered Other Education or Job Training Activities.
77 Date Ended Other Education Or Job Training Activities Enter the date on which the participant exits other education or job training activities .

MM/DD/YYYY A. Must be blank or greater than or equal to field 73 (Date Entered Other Education or Job Training Activities).

B. Must not be blank if field 78 (Completed Other Education Or Job Training Activities) is 1.
A. Date Ended Other Education or Job Training Activities is before Date Entered Other Education or Job Training Activities.

B. Completed Other Education or Job Training Activities is Yes (1), but no Date Ended Other Education or Job Training Activities is given.
78 Completed Other Education Or Job Training Activities Select Yes if the participant successfully completed other education or job training activities

Select No if the participant did not successfully complete other education or job training activities .

1 = Yes
2 = No
A. Must not be blank if field 77 (Date Ended Other Education Or Job Training Activities) is a valid date. A. Completed Other Education or Job Training Activities cannot be blank if Date Ended Other Education or Job Training Activities is given.
Workforce Preparation Activities

79 Date Entered Subsidized Employment Enter the date on which the participant started subsidized employment.

MM/DD/YYYY

New Provider Type Select Faith-based Provider if the subsidiized employment is provided by a faith-based organization.

Select Community-based Provider if the subsidiized employment is provided by a community-based organization.

Select Public Provider if the subsidiized employment is provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


80 Expected Completion Date of Subsidized Employment Enter the date on which the participant is expected to complete subsidized employment.

MM/DD/YYYY A. Must be blank or greater than or equal to field 79 (Date Entered Subsidized Employment). A. Expected Completion Date of Subsidized Employment is before Date Entered Subsidized Employment.
81 Date of Last Subsidized Employment Services During the Month Enter the last date during the month in which the participant received subsidized employment services.

Note: This field must repeat for every month in which the participant receives subsidized employment services.
MM/DD/YYYY A. Must be blank or greater than or equal to field 79 (Date Entered Subsidized Employment). A. Date of Last Subsidized Employment Service During the Month is before Date Entered Subsidized Employment.
82 Date Ended Subsidized Employment Enter the date on which the participant exited subsidized employment.

MM/DD/YYYY A. Must be blank or greater than or equal to field 79 (Date Entered Subsidized Employment).

B. Must not be blank if field 83 (Completed Subsidized Employment) is 1.
A. Date Ended Subsidized Employment is before Date Entered Subsidized Employment.

B. Completed Subsidized Employment is Yes (1), but no Date Ended Subsidized Employment is given.
83 Completed Subsidized Employment Select Yes if the participant successfully completed OJT.

Select No if the participant did not successfully complete OJT.

1 = Yes
2 = No
A. Must not be blank if field 82 (Date Ended Subsidized Employment) is a valid date. A. Completed Subsidized Employment cannot be blank if Date Ended Subsidized Employment is given.
84 Date Entered Internship Enter the date on which the participant started internship.

Internship consists of onsite work experience designed to improve an enrollee’s occupational skills and readiness for the world of work.
MM/DD/YYYY

New Provider Type Select Faith-based Provider if the internship is provided by a faith-based organization.

Select Community-based Provider if the internship is provided by a community-based organization.

Select Public Provider if the internship is provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


85 Expected Completion Date of Internship Enter the date on which the participant is expected to complete internship.

MM/DD/YYYY A. Must be blank or greater than or equal to field 84 (Date Entered Internship). A. Expected Completion Date of Internship is before Date Entered Internship.
86 Date of Last Internship During the Month Enter the last date during the month in which the participant participated in an internship..

Note: This field must repeat for every month in which the participant is in the internship.
MM/DD/YYYY A. Must be blank or greater than or equal to field 84 (Date Entered Internship). A. Date of Last Internship Service During the Month is before Date Entered Internship.
87 Date Ended Internship Enter the date on which the participant exits internship.

MM/DD/YYYY A. Must be blank or greater than or equal to field 84 (Date Entered Internship).

B. Must not be blank if field 88 (Completed Internship) is 1.
A. Date Ended Internship is before Date Entered Internship.

B. Completed Internship is Yes (1), but no Date Ended Internship is given.
88 Completed Internship Select Yes if the participant successfully completed internship

Select No if the participant did not successfully complete internship.

1 = Yes
2 = No
A. Must not be blank if field 87 (Date Ended Internship) is a valid date. A. Completed Internship cannot be blank if Date Ended Internship is given.
89 Date Entered Workforce Information Services Enter the date on which the participant started workforce information services.

Workforce information services include, but is not limited to, providing information on state and local labor market conditions; industries, occupations and characteristics of the workforce; area business identified skills needs; employer wage and benefit trends; short- and long-term industry and occupational projections; worker supply and demand; and job vacancies survey results. Workforce information also includes local employment dynamics information such as workforce availability; business turnover rates; job creation; job destruction; new hire rates, worker residency, commuting pattern information; and the identification of high growth and high demand industries.
MM/DD/YYYY

New Provider Type Select Faith-based Provider if the workforce information services is provided by a faith-based organization.

Select Community-based Provider if the workforce information services is provided by a community-based organization.

Select Public Provider if the workforce information services is provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


90 Expected Completion Date of Workforce Information Services Enter the date on which the participant is expected to complete workforce information services.

MM/DD/YYYY A. Must be blank or greater than or equal to field 89 (Date Entered Workforce Information Services). A. Expected Completion Date of Workforce Information Services is before Date Entered Workforce Information Services.
91 Date of Last Workforce Information Services During the Month Enter the last date during the month in which the participant received workforce information services .

Note: This field must repeat for every month in which the participant receives workforce information services .
MM/DD/YYYY A. Must be blank or greater than or equal to field 89 (Date Entered Workforce Information Services). A. Date of Last Workforce Information Service During the Month is before Date Entered Workforce Information Services.
92 Date Ended Workforce Information Services Enter the date on which the participant exits workforce information services.

MM/DD/YYYY A. Must be blank or greater than or equal to field 89 (Date Entered Workforce Information Services).

B. Must not be blank if field 93 (Completed Workforce Information Services) is 1.
A. Date Ended Workforce Information Services is before Date Entered Workforce Information Services.

B. Completed Workforce Information Services is Yes (1), but no Date Ended Workforce Information Services is given.
93 Completed Workforce Information Services Select Yes if the participant successfully completed workforce information services

Select No if the participant did not successfully complete workforce information services.

1 = Yes
2 = No
A. Must not be blank if field 92 (Date Ended Workforce Information Services) is a valid date. A. Completed Workforce Information Services cannot be blank if Date Ended Workforce Information Services is given.
94 Date Entered Work Readiness Training Enter the date on which the participant started work readiness training.

Work readiness training includes world of work awareness, labor market knowledge, occupational information, values clarification and personal understanding, career planning and decision-making, and job search techniques (resumes, interviews, applications, and follow-up letters). It also includes positive work habits, attitudes, and behavior such as punctuality, regular attendance, presenting a neat appearance, getting along and working well with others, exhibiting good conduct, following instructions and completing tasks, accepting constructive criticism from supervisors and co-workers, showing initiative and reliability, and assuming the responsibilities involved in maintaining a job.
MM/DD/YYYY

New Provider Type Select Faith-based Provider if the work readiness training is provided by a faith-based organization.

Select Community-based Provider if the work readiness training is provided by a community-based organization.

Select Public Provider if the work readiness training is provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


95 Expected Completion Date of Work Readiness Training Enter the date on which the participant is expected to complete work readiness training.

MM/DD/YYYY A. Must be blank or greater than or equal to field 94 (Date Entered Work Readiness Training). A. Expected Completion Date of Work Readiness Training is before Date Entered Work Readiness Training.
96 Date of Last Work Readiness Training Services During the Month Enter the last date during the month in which the participant received work readiness training services.

Note: This field must repeat for every month in which the participant receives work readiness training services.
MM/DD/YYYY A. Must be blank or greater than or equal to field 94 (Date Entered Work Readiness Training). A. Date of Last Work Readiness Training Service During the Month is before Date Entered Work Readiness Training.
97 Date Ended Work Readiness Training Enter the date on which the participant exits work readiness training.

MM/DD/YYYY A. Must be blank or greater than or equal to field 94 (Date Entered Work Readiness Training.)

B. Must not be blank if field 98 (Completed Work Readiness Training) is 1.
A. Date Ended Work Readiness Training is before Date Entered Work Readiness Training.

B. Completed Work Readiness Training is Yes (1), but no Date Ended Work Readiness Training is given.
98 Completed Work Readiness Training Select Yes if the participant successfully completed work readiness training

Select No if the participant did not successfully complete work readiness training.

1 = Yes
2 = No
A. Must not be blank if field 97 (Date Ended Work Readiness Training) is a valid date. A. Completed Work Readiness Training cannot be blank if Date Ended Work Readiness Training is given.
99 Date Entered Career/Life Skills Counseling Enter the date on which the participant started career/life skills counseling.

Career/Life skills counseling is any formal counseling provided on a specific life skill or related to career guidance.
MM/DD/YYYY

New Provider Type Select Faith-based Provider if the career/life skills counseling is provided by a faith-based organization.

Select Community-based Provider if thecareer/life skills counseling is provided by a community-based organization.

Select Public Provider if the career/life skills counseling is provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


100 Expected Completion Date of Career/Life Skills Counseling Enter the date on which the participant is expected to complete career/life skills counseling.

MM/DD/YYYY A. Must be blank or greater than or equal to field 99 (Date Entered Career/Life Skills Counseling). A. Expected Completion Date of Career/Life Skills Counseling is before Date Entered Career/Life Skills Counseling.
101 Date of Last Career/Life Skills Counseling Services During the Month Enter the last date during the month in which the participant received career/life skills counseling services.

Note: This field must repeat for every month in which the participant receives career/life skills counseling services.
MM/DD/YYYY A. Must be blank or greater than or equal to field 99 (Date Entered Career/Life Skills Counseling). A. Date of Last Career/Life Skills Counseling Service During the Month is before Date Entered Career/Life Skills Counseling.
102 Date Ended Career/Life Skills Counseling Enter the date on which the participant exits career/life skills counseling.

MM/DD/YYYY A. Must be blank or greater than or equal to field 99 (Date Entered Career/Life Skills Counseling).

B. Must not be blank if field 103 (Completed Career/Life Skills Counseling) is 1.
A. Date Ended Career/Life Skills Counseling is before Date Entered Career/Life Skills Counseling.

B. Completed Career/Life Skills Counseling is Yes (1), but no Date Ended Career/Life Skills Counseling is given.
103 Completed Career/Life Skills Counseling Select Yes if the participant successfully completed career/life skills counseling

Select No if the participant did not successfully complete career/life skills counseling.

1 = Yes
2 = No
A. Must not be blank if field 102 (Date Ended Career/Life Skills Counseling) is a valid date. A. Completed Career/Life Skills Counseling cannot be blank if Date Ended Career/Life Skills Counseling is given.
104 Date Entered Other Workforce Preparation Activities Enter the date on which the participant started other workforce preparation activities.

MM/DD/YYYY

New Provider Type Select Faith-based Provider if the other workforce preparation activities is provided by a faith-based organization.

Select Community-based Provider if the other workforce preparation activities is provided by a community-based organization.

Select Public Provider if the other workforce preparation activities is provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


105 Type of Other Workforce Preparation Activities Specify the type of other workforce preparation activities.

Text A. Must not be blank if field 104 (Date Entered Other Workforce Preparation Activities) is a valid date. A. Date Entered Other Workforce Preparation Activities is specified, but Type of Other Workforce Preparation Activities is not specified.
106 Expected Completion Date of Other Workforce Preparation Activities Enter the date on which the participant is expected to complete other workforce preparation activities.

MM/DD/YYYY A. Must be blank or greater than or equal to field 104 (Date Entered Other Workforce Preparation Activities). A. Expected Completion Date of Other Workforce Preparation Activities is before Date Entered Other Workforce Preparation Activities.
107 Date of Last Other Workforce Preparation Activities Services During the Month Enter the last date during the month in which the participant received other workforce preparation activities services.

Note: This field must repeat for every month in which the participant receives other workforce preparation activities services.
MM/DD/YYYY A. Must be blank or greater than or equal to field 104 (Date Entered Other Workforce Preparation Activities). A. Date of Last Other Workforce Preparation Activities Service During the Month is before Date Entered Other Workforce Preparation Activities.
108 Date Ended Other Workforce Preparation Activities Enter the date on which the participant exits other workforce preparation activities.

MM/DD/YYYY A. Must be blank or greater than or equal to field 104 (Date Entered Other Workforce Preparation Activities).

B. Must not be blank if field 109 (Completed Other Workforce Preparation Activities) is 1.
A. Date Ended Other Workforce Preparation Activities is before Date Entered Other Workforce Preparation Activities.

B. Completed Other Workforce Preparation Activities is Yes (1), but no Date Ended Other Workforce Preparation Activities is given.
109 Completed Other Workforce Preparation Activities Select Yes if the participant successfully completed other workforce preparation activities

Select No if the participant did not successfully complete other workforce preparation activities.

1 = Yes
2 = No
A. Must not be blank if field 108 (Date Ended Other Workforce Preparation Activities) is a valid date. A. Completed Other Workforce Preparation Activities cannot be blank if Date Ended Other Workforce Preparation Activities is given.
Community Involvement Activities

110 Date Entered Community Service Enter the date on which the participant started community service.

Community service is an activity in which the participants perform volunteer work that benefits the community
MM/DD/YYYY

New Provider Type Select Faith-based Provider if the community service is provided by a faith-based organization.

Select Community-based Provider if the community service is provided by a community-based organization.

Select Public Provider if the community service is provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


111 Expected Completion Date of Community Service Enter the date on which the participant is expected to complete community service.

MM/DD/YYYY A. Must be blank or greater than or equal to field 110 (Date Entered Community Service). A. Expected Completion Date of Community Service is before Date Entered Community Service.
112 Date of Last Community Service Services During the Month Enter the last date during the month in which the participant received community service services.

Note: This field must repeat for every month in which the participant receives community service services.
MM/DD/YYYY A. Must be blank or greater than or equal to field 110 (Date Entered Community Service). A. Date of Last Community Service During the Month is before Date Entered Community Service.
113 Date Ended Community Service Enter the date on which the participant exits community service.

MM/DD/YYYY A. Must be blank or greater than or equal to field 110 (Date Entered Community Service).

B. Must not be blank if field 114 (Completed Community Service) is 1.
A. Date Ended Community Service is before Date Entered Community Service.

B. Completed Community Service is Yes (1), but no Date Ended Community Service is given.
114 Completed Community Service Select Yes if the participant successfully completed community service

Select No if the participant did not successfully complete community service.

1 = Yes
2 = No
A. Must not be blank if field 113 (Date Ended Community Service) is a valid date. A. Completed Community Service cannot be blank if Date Ended Community Service is given.
115 Date Entered Other Community Involvement Activities Enter the date on which the participant started other community involvement activities.

MM/DD/YYYY

New Provider Type Select Faith-based Provider if the other community involvement activities is provided by a faith-based organization.

Select Community-based Provider if the other community involvement activities is provided by a community-based organization.

Select Public Provider if the other community involvement activities is provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


116 Type of Other Community Involvement Activities Specify the type of other other community involvement activities.

Text A. Must not be blank if field 115 (Date Entered Other Community Involvement Activities) is a valid date. A. Date Entered Other Community Involvement Activities is specified, but Type of Other Community Involvement Activities is not specified.
117 Expected Completion Date of Other Community Involvement Activities Enter the date on which the participant is expected to complete other community involvement activities.

MM/DD/YYYY A. Must be blank or greater than or equal to field 115 (Date Entered Other Community Involvement Activities). A. Expected Completion Date of Other Community Involvement Activities is before Date Entered Other Community Involvement Activities.
118 Date of Last Other Community Service Services During the Month Enter the last date during the month in which the participant receive other community involvement activities

Note: This field must repeat for every month in which the participant receives other community involvement activities.
MM/DD/YYYY A. Must be blank or greater than or equal to field 115 (Date Entered Other Community Involvement Activities). A. Date of Last Other Community Involvement Activities Service During the Month is before Date Entered Other Community Involvement Activities.
119 Date Ended Other Community Involvement Activities Enter the date on which the participant exits other community involvement activities.

MM/DD/YYYY A. Must be blank or greater than or equal to field 115 (Date Entered Other Community Involvement Activities).
B. Must not be blank if field 120 (Completed Other Community Involvement Activities) is 1.
A. Date Ended Other Community Involvement Activities is before Date Entered Other Community Involvement Activities.
B. Completed Other Community Involvement Activities is Yes (1), but no Date Ended Other Community Involvement Activities is given.
120 Completed Other Community Involvement Activities Select Yes if the participant successfully completed other community involvement activities.

Select No if the participant did not successfully complete other community involvement activities.

1 = Yes
2 = No
A. Must not be blank if field 119 (Date Ended Other Community Involvement Activities) is a valid date. A. Completed Other Community Involvement Activities cannot be blank if Date Ended Other Community Involvement Activities is given.
Mentoring Activities

121 Date Entered Mentoring Activities Enter the date on which the participant started mentoring activities.

Mentoring is a sustained relationship between a mentor and participant, whether one on one or in a group setting. Through continued involvement, a mentor offers support and guidance in the individual’s development to become a responsible member of the community. A variety of approaches may be used such as coaching, training, discussion, and counseling.
MM/DD/YYYY

New Provider Type Select Faith-based Provider if the mentoring activities are provided by a faith-based organization.

Select Community-based Provider if the mentoring activities are provided by a community-based organization.

Select Public Provider if the mentoring activities are provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


122 Expected Completion Date of Mentoring Activities Enter the date on which the participant is expected to complete mentoring activities.

MM/DD/YYYY A. Must be blank or greater than or equal to field 121 (Date Entered Mentoring Activities). A. Expected Completion Date of Mentoring Activities is before Date Entered Mentoring Activities.
123 Date of Last Mentoring Activities Services During the Month Enter the last date during the month in which the participant received mentoring activities services.

Note: This field must repeat for every month in which the participant receives mentoring activities services.
MM/DD/YYYY A. Must be blank or greater than or equal to field 121 (Date Entered Mentoring Activities). A. Date of Last Mentoring Activities Service During the Month is before Date Entered Mentoring Activities.
124 Date Ended Mentoring Activities Enter the date on which the participant exits mentoring activities.

MM/DD/YYYY A. Must be blank or greater than or equal to field 121 (Date Entered Mentoring Activities).

B. Must not be blank if field 125 (Completed Mentoring Activities) is 1.
A. Date Ended Mentoring Activities is before Date Entered Mentoring Activities.

B. Completed Mentoring Activities is Yes (1), but no Date Ended Mentoring Activities is given.
125 Completed Mentoring Activities Select Yes if the participant successfully completed mentoring activities

Select No if the participant did not successfully complete mentoring activities.

1 = Yes
2 = No
A. Must not be blank if field 124 (Date Ended Mentoring Activities) is a valid date. A. Completed Mentoring Activities cannot be blank if Date Ended Mentoring Activities is given.
Health Services

New Date Entered Substance Abuse Treatment Enter the date on which the participant started substance abuse treatment.
MM/DD/YYYY

New Provider Type Select Faith-based Provider if the substance abuse treatment is provided by a faith-based organization.

Select Community-based Provider if the substance abuse treatment is provided by a community-based organization.

Select Public Provider if the substance abuse treatment is provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


New Expected Completion Date of Substance Abuse Treatment Enter the date on which the participant is expected to complete substance abuse treatment.

MM/DD/YYYY A. Must be blank or greater than or equal to Date Entered Substance Abuse Treatment.
New Date of Last Substance Abuse Treatment During the Month Enter the last date during the month in which the participant received substance abuse treatment.

Note: This field must repeat for every month in which the participant receives substance abuse treatment.
MM/DD/YYYY A. Must be blank or greater than or equal to Date Entered Substance Abuse Treatment.
New Date Ended Substance Abuse Treatment Enter the date on which the participant exited substance abuse treatment

MM/DD/YYYY A. Must be blank or greater than or equal to Date Entered Substance Abuse Treatment.

B. Must not be blank if Completed Substance Abuse Treatment.is 1.

New Completed Substance Abuse Treatment Select Yes if the participant successfully completed substance abuse treatment.

Select No if the participant did not successfully complete substance abuse treatment.

1 =Yes
2 = No
A. Must not be blank if Date Ended Substance Abuse Treatment is a valid date.
New Date Entered Mental Health Treatment Enter the date on which the participant started mental health treatment.
MM/DD/YYYY

New Provider Type Select Faith-based Provider if the mental health treatement is provided by a faith-based organization.

Select Community-based Provider if the mental health treatement is provided by a community-based organization.

Select Public Provider if the mental health treatement is provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


New Expected Completion Date of Mental Health Treatment Enter the date on which the participant is expected to complete mental health treatment.

MM/DD/YYYY A. Must be blank or greater than or equal to Date Entered Mental Health Treatment.
New Date of Last Mental Health Treatment During the Month Enter the last date during the month in which the participant received mental health treatment.

Note: This field must repeat for every month in which the participant receives mental health treatment.
MM/DD/YYYY A. Must be blank or greater than or equal to Date Entered Mental Health Treatment.
New Date Ended Mental Health Treatment Enter the date on which the participant exited mental health treatment

MM/DD/YYYY A. Must be blank or greater than or equal to Date Entered Mental Health Treatment.

B. Must not be blank if Completed Mental Health Treatment.is 1.

New Completed Mental Health Treatment Select Yes if the participant successfully completed mental health treatment.

Select No if the participant did not successfully complete mental health treatment.

1 =Yes
2 = No
A. Must not be blank if Date Ended Mental Health Treatment is a valid date.
New Date Entered Emergency Medical Care Enter the date on which the participant started emeregency medical care.
MM/DD/YYYY

New Provider Type Select Faith-based Provider if the emergency medical care is provided by a faith-based organization.

Select Community-based Provider if the emergency medical care is provided by a community-based organization.

Select Public Provider if the emergency medical care is provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


New Expected Completion Date of Emergency Medical Care Enter the date on which the participant is expected to complete emeregency medical care.

MM/DD/YYYY A. Must be blank or greater than or equal to Date Entered Emergency Medical Care.
New Date of Last Emergency Medical Care During the Month Enter the last date during the month in which the participant received emeregency medical care.

Note: This field must repeat for every month in which the participant receives emeregency medical care.
MM/DD/YYYY A. Must be blank or greater than or equal to Date Entered Emergency Medical Care.
New Date Ended Emergency Medical Care Enter the date on which the participant exited emeregency medical care

MM/DD/YYYY A. Must be blank or greater than or equal to Date Entered Emergency Medical Care.

B. Must not be blank if Completed Emergency Medical Care.is 1.

New Completed Emergency Medical Care Select Yes if the participant successfully completed emeregency medical care.

Select No if the participant did not successfully complete emeregency medical care.

1 =Yes
2 = No
A. Must not be blank if Date Ended Emergency Medical Care is a valid date.
New Date Entered Non-Emergency Medical Care Enter the date on which the participant started non-emergency medical care.
MM/DD/YYYY

New Provider Type Select Faith-based Provider if the non-emergency medical care is provided by a faith-based organization.

Select Community-based Provider if the non-emergency medical care is provided by a community-based organization.

Select Public Provider if the non-emergency medical care is provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


New Expected Completion Date of Non-Emergency Medical Care Enter the date on which the participant is expected to complete non-emergency medical care.

MM/DD/YYYY A. Must be blank or greater than or equal to Date Entered Non-Emergency Medical Care.
New Date of Last Non-Emergency Medical Care During the Month Enter the last date during the month in which the participant received non-emergency medical care.

Note: This field must repeat for every month in which the participant receives non-emergency medical care.
MM/DD/YYYY A. Must be blank or greater than or equal to Date Entered Non-Emergency Medical Care.
New Date Ended Non-Emergency Medical Care Enter the date on which the participant exited non-emergency medical care

MM/DD/YYYY A. Must be blank or greater than or equal to Date Entered Non-Emergency Medical Care.

B. Must not be blank if Completed Non-Emergency Medical Care.is 1.

New Completed Non-Emergency Medical Care Select Yes if the participant successfully completed non-emergency medical care.

Select No if the participant did not successfully complete non-emergency medical care.

1 =Yes
2 = No
A. Must not be blank if Date Ended Non-Emergency Medical Care is a valid date.
New Date Entered Other Health Services Enter the date on which the participant started other health services.
MM/DD/YYYY

New Provider Type Select Faith-based Provider if the other health services are provided by a faith-based organization.

Select Community-based Provider if the other health services are provided by a community-based organization.

Select Public Provider if the other health services are provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


New Expected Completion Date of Other Health Services Enter the date on which the participant is expected to complete other health services.

MM/DD/YYYY A. Must be blank or greater than or equal to Date Entered Other Health Services.
New Date of Last Other Health Services During the Month Enter the last date during the month in which the participant received other health services.

Note: This field must repeat for every month in which the participant receives other health services.
MM/DD/YYYY A. Must be blank or greater than or equal to Date Entered Other Health Services.
New Date Ended Other Health Services Enter the date on which the participant exited other health services

MM/DD/YYYY A. Must be blank or greater than or equal to Date Entered Other Health Services.

B. Must not be blank if Completed Other Health Services.is 1.

New Completed Other Health Services Select Yes if the participant successfully completed other health services.

Select No if the participant did not successfully complete other health services.

1 =Yes
2 = No
A. Must not be blank if Date Ended Other Health Services is a valid date.
Supportive Services

126 Date Entered Transportation Services Enter the date on which the participant started transportation services. Transportation services include assistance or cash paid to participants for the purpose of transportation. MM/DD/YYYY

New Provider Type Select Faith-based Provider if the transportation services are provided by a faith-based organization.

Select Community-based Provider if the transportation services are provided by a community-based organization.

Select Public Provider if the transportation services are provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


127 Date of Last Transportation Services During the Month Enter the last date during the month in which the participant received transportation services .

Note: This field must repeat for every month in which the participant receives transportation services .
MM/DD/YYYY A. Must be blank or greater than or equal to field 126 (Date Entered Transportation Services). A. Date of Last Transportation Service During the Month is before Date Entered Transportation Services.
128 Date Ended Transportation Services Enter the date on which the participant exits transportation services.

MM/DD/YYYY A. Must be blank or greater than or equal to field 126 (Date Entered Transportation Services). A. Date Ended Transportation Services is before Date Entered Transportation Services.
129 Date Entered Child Care Services Enter the date on which the participant started child care services. Child care services provide participants during program participation with child care that can be inside or outside the home, as well as after-school programs. It usually includes supervision and shelter. MM/DD/YYYY

New Provider Type Select Faith-based Provider if the child care services are provided by a faith-based organization.

Select Community-based Provider if the child care services are provided by a community-based organization.

Select Public Provider if the child care services are provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


130 Date of Last Child Care Services During the Month Enter the last date during the month in which the participant received child care services .

Note: This field must repeat for every month in which the participant receives child care services .
MM/DD/YYYY A. Must be blank or greater than or equal to field 129 (Date Entered Child Care Services). A. Date of Last Child Care Service During the Month is before Date Entered Child Care Services.
131 Date Ended Child Care Services Enter the date on which the participant exits child care services.

MM/DD/YYYY A. Must be blank or greater than or equal to field 129 (Date Entered Child Care Services). A. Date Ended Child Care Services is before Date Entered Child Care Services.
132 Date Entered Needs Related Payments Enter the date on which the participant started needs related payments.

Needs-related payments provide financial assistance to participants for the purpose of enabling individuals to participate in training
MM/DD/YYYY

New Provider Type Select Faith-based Provider if the needs-related payments are provided by a faith-based organization.

Select Community-based Provider if the needs-related payments are provided by a community-based organization.

Select Public Provider if the needs-related payments are provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


133 Date of Last Needs Related Payments During the Month Enter the last date during the month in which the participant received needs related payments services.

Note: This field must repeat for every month in which the participant receives needs related payments services.
MM/DD/YYYY A. Must be blank or greater than or equal to field 132 (Date Entered Needs Related Payments). A. Date of Last Needs Related Payment During the Month is before Date Entered Needs Related Payments.
134 Date Ended Needs Related Payments Enter the date on which the participant exits needs related payments.
MM/DD/YYYY A. Must be blank or greater than or equal to field 132 (Date Entered Needs Related Payments). A. Date Ended Needs Related Payments is before Date Entered Needs Related Payments.
135 Date Entered Follow-up Mentoring Services Enter the date on which the participant started follow-up mentoring services.

Follow-up mentoring services are on-going mentoring that occurs after exit.
MM/DD/YYYY

New Provider Type Select Faith-based Provider if the mentoring services are provided by a faith-based organization.

Select Community-based Provider if the mentoring services are provided by a community-based organization.

Select Public Provider if the mentoring services are provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


136 Last Date of Follow-up Mentoring Services During Month Enter the last date during the month in which the participant received follow-up mentoring services.

Note: This field must repeat for every month in which the participant receives follow-up mentoring services.
MM/DD/YYYY A. Must be blank or greater than or equal to field 135 (Date Entered Follow-up Mentoring Services). A. Date of Last Follow-up Mentoring Service During the Month is before Date Entered Follow-up Mentoring Services.
137 Date Ended Follow-up Mentoring Services Enter the last date on which the participant received follow-up mentoring services. MM/DD/YYYY A. Must be blank or greater than or equal to field 135 (Date Entered Follow-up Mentoring Services). A. Date Ended Follow-up Mentoring Services is before Date Entered Follow-up Mentoring Services.
138 Date Entered Other Follow-up Services Enter the date on which the participant started other follow-up services.

Other follow-up services are on-going mentoring that occurs after exit.
MM/DD/YYYY

New Provider Type Select Faith-based Provider if the other follow-up services are provided by a faith-based organization.

Select Community-based Provider if the other follow-up services are provided by a community-based organization.

Select Public Provider if the other follow-up services are provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


139 Last Date of Other Follow-up Services During Month Enter the last date during the month in which the participant received other follow-up services.

Note: This field must repeat for every month in which the participant receives other follow-up services.
MM/DD/YYYY A. Must be blank or greater than or equal to field 138 (Date Entered Other Follow-up Services). A. Date of Last Other Follow-up Service During the Month is before Date Entered Other Follow-up Services.
140 Date Ended Other Follow-up Services Enter the last date on which the participant received other follow-up services. MM/DD/YYYY A. Must be blank or greater than or equal to field 138 (Date Entered Other Follow-up Services). A. Date Ended Other Follow-up Services is before Date Entered Other Follow-up Services.
141 Date Entered Other Supportive Services Enter the date on which the participant started other supportive services. Other supportive services includes all supportive services not listed above. MM/DD/YYYY

New Provider Type Select Faith-based Provider if the other supportive services are provided by a faith-based organization.

Select Community-based Provider if the other supportive services are provided by a community-based organization.

Select Public Provider if the other supportive services are provided by a public organization.
1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider


142 Date of Last Other Supportive Services During the Month Enter the last date during the month in which the participant received other supportive services .

Note: This field must repeat for every month in which the participant receives other supportive services .
MM/DD/YYYY A. Must be blank or greater than or equal to field 141 (Date Entered Other Supportive Services). A. Date of Last Other Supportive Service During the Month is before Date Entered Other Supportive Services.
143 Date Ended Other Supportive Services Enter the date on which the participant exits other supportive services. MM/DD/YYYY A. Must be blank or greater than or equal to field 141 (Date Entered Other Supportive Services). A. Date Ended Other Supportive Services is before Date Entered Other Supportive Services.
SECTION III - PROGRAM OUTCOMES INFORMATION

SECTION III.A - FOLLOW-UP

SECTION III.B - SHORT-TERM OUTCOME STATUS

146 Alcohol Abuse/ Drug Use at 6 Months Based on asking the participant at 6 month date after enrollment:

Select has not abused alcohol or used drugs in the last month if the individual has not abused legal drugs or alcohol or used illegal drugs within the sixth month after enrollment

Select occasional alcohol abuse or drug use in the last month if the individual occasionally abuses legal drugs or alcohol or occasionally uses illegal drugs within the sixth month after enrollment

Select regular (weekly) alcohol abuse or drug use in the last month if, on a weekly basis, the individual abuses legal drugs or alcohol or uses illegal drugs within the sixth month after enrollment.
1 = Has not abused alcohol or used drugs within the last month
2 = Occasional alcohol abuste or drug use within the last month
3 = Regular (weekly) alcohol abuse or drug use within the last montht
A. Must be 1 or 2 if field 28 (Alcohol Abuse/ Drug Use at Enrollment) is 1, 2, or 3 and the report period is after the end of the second quarter after the exit quarter.

A. Alcohol Abuse/ Drug Use at 6 Months cannot be blank if Alcohol Abuse/Drug Use at Enrollment is indicated (1, 2, or 3).
147 Housing Status at 6 Months Select Own/Rent Apartment, Room, Or House if, 6 months after enrollment, the individual is living in an apartment, room, or house that the he/she owns or rents.

Select Staying at someone's apartment, room, or house (Stable) if, 6 months after enrollment, the individual is living in an apartment, room, or house that somebody else owns or rents and if the person is not at risk of being displaced from this housing, i.e the housing situation is long-term.

Select Halfway house/transitional house if, 6 months after enrollment, the individual is living in a residence designed to assist persons as they re-enter society and learn to adapt to independent living after having been in prison.

Select Residential treatment if, 6 months after enrollment, the individual lives in a residential treatment center. A residential treatment center is a group home that provides room and board, and provides specialized treatment or rehabilitation persons with emotional, psychological, or developmental problems as well aschemical dependencies.

Select Homeless if, 6 months after enrollment, the individual lacks a fixed, regular, adequate night time residence. This definition includes any
individual who has a primary night time residence that is a publicly or privately operated shelter for temporary accommodation; an institution
providing temporary residence for individuals intended to be institutionalized; or a public or private place not designated for or ordinarily used as a
regular sleeping accommodation for human beings. This definition does not include an individual imprisoned or detained under an Act of Congress
or State law. An individual who may be sleeping in a temporary accommodation while away from home should not, as a result of that alone, be
recorded as homeless.

Select Staying at someone's apartment, room, or house
(Unstable) if, 6 months after enrollment, the individual is living in an
apartment, room, or house that somebody else owns or rents and if
the person is at risk of being displaced from this housing, i.e the
housing situation is short-term.
1 = Own/rent apartment, room, or house
2 = Staying at someone's apartment, room, or house (Stable)
3 = Halfway house/ transitional house
4 = Residential Treatment
5 = Homeless
6 = Staying at someone's apartment, room, or house (Unstable)


148 Date of Initial Placement Into Unsubsidized Employment Enter the date on which the participant started the initial unsubsidized employment MM/DD/YYYY

149 Employer Name for Initial Placement Into Unsubsidized Employment Enter the employer's name for the participant's initial placement into unsubsidized employment. Text A. Must not be blank if field 148 (Date of Initial Placement Into Unsubsidized Employment) has a valid date. A. Date of Initial Placement Into Unsubsidized Employment is specified, but no Employer Name for Initial Placement Into Unsubsidized Employment is given.
150 Employer Contact for Initial Placement Into Unsubsidized Employment Enter the contact information for the employer for the participant's placement into unsubsidized employment. Text

151 Last Date of Employment for Initial Placement into Unsubsidized Employment Enter the last date on which the participant worked for the employer. MM/DD/YYYY A. Must be blank or greater than or equal to field 148 (Date of Initial Placement Into Unsubsidized Employment). A. Last Date of Employment for Initial Placement into Unsubsidized Employment is before Date of Initial Placement Into Unsubsidized Employment.
152 Hourly Wage at Placement for Initial Placement into Unsubsidized Employment Enter the hourly wage for the initial unsubsidized unemployment at placement. 00.00 A. Must be greater than 0 if field 148 (Date of Initial Placement Into Unsubsiized Employment) has a valid date. A. Date of Initial Placement Into Unsubsidized Employment is specified, but no Hourly Wage at Placement for Initial Placement into Unsubsidized Employment is given.
153 Number of Hours Worked During the 1st Full Week in Initial Placement into Unsubsidized Employment. Enter the number of hours worked during the first full week for the initial job placement. 00 A. Must be greater than 0 if field 148 (Date of Initial Placement Into Unsubsiized Employment) has a valid date. A. Date of Initial Placement Into Unsubsidized Employment is specified, but no Number of Hours Worked During the 1st Full Week in Initial Placement into Unsubsidized Employment is given.
154 Date of Placement Into Unsubsidized Employment #1 Enter the date on which the participant started the unsubsidized employment. MM/DD/YYYY A. Must be blank or greater than or equal to field 148 (Date of Initial Placement Into Unsubsidized Employment). A. Date of Placement Into Unsubsidized Employment #1 is before Date of Initial Placement Into Unsubsidized Employment
155 Employer Name for Placement Into Unsubsidized Employment #1 Enter the employer's name for the participant's placement into unsubsidized employment. Text A. Must not be blank if field 154 (Date of Placement Into Unsubsidized Employment #1) has a valid date. A. Date of Placement Into Unsubsidized Employment #1 is specified, but no Employer Name for Placement Into Unsubsidized Employment #1 is given.
156 Employer Contact for Placement Into Unsubsidized Employment #1 Enter the contact information for the employer for the participant's placement into unsubsidized employment. Text

157 Last Date of Employment for Placement into Unsubsidized Employment #1 Enter the last date on which the participant worked for the employer. MM/DD/YYYY A. Must be blank or greater than or equal to field 154 (Date of Placement Into Unsubsidized Employment #1). A. Last Date of Employment for Placement into Unsubsidized Employment #1 is before Date of Placement Into Unsubsidized Employment #1.
158 Hourly Wage at Placement for Placement into Unsubsidized Employment #1 Enter the hourly wage for the unsubsidized unemployment at placement. 00.00 A. Must be greater than 0 if field 154 (Date of Placement Into Unsubsiized Employment #1) has a valid date. A. Date of Placement Into Unsubsidized Employment #1 is specified, but no Hourly Wage at Placement for Placement into Unsubsidized Employment #1 is given.
159 Number of Hours Worked During the 1st Full Week in Placement into Unsubsidized Employment #1 Enter the number of hours worked during the first full week for the placement into unsubsidized employment.. 00 A. Must be greater than 0 if field 154 (Date of Placement Into Unsubsiized Employment #1) has a valid date. A. Date of Placement Into Unsubsidized Employment #1 is specified, but no Number of Hours Worked During the 1st Full Week in Placement into Unsubsidized Employment #1 is given.
160 Repeat Fields 154 to 159 for Additional Jobs Grantees must be able to collect the above job information for as many jobs as the participant has.
Same Edits as for fields 154 to 159. Same Error Messages as for fields 154 to 159.
161 Re-Arrested/ Re-Incarcerated Select the appropriate choice from below:

Re-arrested for a new crimeif the participant is arrested for a new crime.

Re-incarcerated for a revocation of the parole or probation order for violations of terms of sentence.

Otherwise violated the terms and condition of their sentence if the participant violates his/her parole or probation and is not re-incarcerated. (Note: This option does not count towards the recidivism rate.)

Select No if none of the above conditions apply.

This field repeats as needed.
1 = Re-arrested for a new crime
2 = Re- incarcerated for a revocation of the parole or probation order for violations of terms of sentence
3 = Otherwise violated the terms and condition of their sentence
4 = No


162 Date Re-Arrested/ Re-Incarcerated Enter the date on which the participant was re-arrested for a new crime or re-incarcerated for a violation of parole or probation.

This field repeats as needed for repeated.
MM/DD/YYYY A. Must not be blank if field 161 (Re-Arrested/Re-Incarcerated) is 1 or 2. A. Participant was Re-Arrested/Re-Incarcerated for a new crime, but no Date Re-Arrested/ Re-Incarcerated is given.
New Date Re-arrested and Released Enter the date on which the participant was released from custody if the arrest charges were not upheld and the participant was not convicted of the crime for which they were arrested MM/DD/YYYY

163 Date Entered Post-Secondary Education Enter the date on which the participant enrolled in post-secondary education during program participation..

Leave blank if the participant does not enter post-secondary education during program participation.
MM/DD/YYYY
Blank = did not enter post-secondary education


SECTION III.C - POST-PROGRAM EMPLOYMENT AND JOB RETENTION DATA

164 Employed in 1st Quarter After Exit Quarter Select Yes if the participant was employed in the first quarter after the quarter of exit.
Select No if the participant was not employed in the first quarter after the quarter of exit.
1 = Yes
2 = No

A. Must be blank if field 48 (Date of Exit) and field new (Date Entered Follow-up Services) is blank.

B. Must be 1 or 2 if field 167 (Successful Follow-up for 1st Quarter After the Exit Quarter Employment and Wage Information) is 1.
A. Employed in 1st Quarter After Exit must be blank if no Date of Exit or Date Entered Follow-up Services is given.

B. Employed in 1st Quarter After Exit must be 1 (Yes) or 2 (No) if Successful Follow-up for 1st Quarter After the Exit Quarter Employment and Wage Information is 1 (Yes).
165 Type of Employment Match 1st Quarter After Exit Quarter Use the appropriate code to identify the method used in determining the individual's employment status in the first quarter following the quarter of exit. If the individual is found in more than once source of employment, record the data source for which the individual's earnings are greatest.

1 = UI Wage Records (In-State & WRIS)
2 = Federal Employment Records (OPM, USPS)
3 = Military Employment Records (DOD)
4 = Other Administrative Wage Records
5 = Supplemental through case management, participant survey, and/or verification with the employer
Blank = Not Employed.
A. If field 164 (Employed in 1st Quarter after Exit Quarter) is 1, this field will be auto-generated as 5 because of lack of wage records.

B. If field 164 (Employed in 1st Quarter after Exit Quarter) is 2 or blank, this field will be auto-generated as blank.

166 Date of Follow-up for 1st Quarter After the Exit Quarter Employment and Wage Information Enter the date on which the grantee attempted to contact the participant or employer to obtain information on employment and earnings for the 1st quarter after the exit quarter post-program.

Repeat for each follow-up attempt.
MM/DD/YYYY

A. Must not be blank if field 164 (Employed in 1st Quarter After Exit Quarter) is 1.

B. Must not be blank if field 167 (Successful Follow-up for 1st Quarter After the Exit Quarter Employment and Wage Information) is 1 or 2.
A. Employed in 1st Quarter After Exit Quarter is Yes (1), but no Date of Follow-up for 1st Quarter After the Exit Quarter Employment and Wage Information is given.

B. Successful Follow-up for 1st Quarter After the Exit Quarter Employment and Wage Information is specified, but Date of Follow-up is not given.
167 Successful Follow-up for 1st Quarter After the Exit Quarter Employment and Wage Information Enter Yes if the grantee successfully contacted the participant to collect employment and earnings information for the 1st quarter after the exit quarter.

Enter No if the grantee did not successfully contact the participant to collect this information.

Repeat for each follow-up attempt.
1 = Yes
2 = No
A. Must not be blank if field 166 (Date of Follow-up for 1st Quarter After the Exit Quarter Employment and Wage Information) is a valid date. A. Date of Follow-up for 1st Quarter After the Exit Quarter Employment and Wage Information is given, but Successful Follow-up for 1st Quarter After the Exit Quarter Employment and Wage Information is not specified.
168 Employed in 2nd Quarter After Exit Quarter Select Yes if the participant was employed in the second quarter after the quarter if exit.
Select No if the participant was not employed in the second quarter after the quarter of exit.
1 = Yes
2 = No
A. Must be blank if field 48 (Date of Exit) and field new (Date Entered Follow-up Services) is blank.

B. Must be 1 or 2 if field 167 (Successful Follow-up for 1st Quarter After the Exit Quarter Employment and Wage Information) is 1.
A. Employed in 2nd Quarter After Exit must be blank if no Date of Exit or Date Entered Follow-up Services is given.

B. Employed in 2nd Quarter After Exit must be 1 (Yes) or 2 (No) if Successful Follow-up for 2nd Quarter After the Exit Quarter Employment and Wage Information is 1 (Yes).
169 Type of Employment Match 2nd Quarter After Exit Quarter Use the appropriate code to identify the method used in determining the individual's employment status in the second quarter following the quarter of exit. If the individual is found in more than once source of employment, record the data source for which the individual's earnings are greatest.

1 = UI Wage Records (In-State & WRIS)
2 = Federal Employment Records (OPM, USPS)
3 = Military Employment Records (DOD)
4 = Other Administrative Wage Records
5 = Supplemental through case management, participant survey, and/or verification with the employer
Blank = Not Employed.
A. If field 168 (Employed in 2nd Quarter after Exit Quarter) is 1, this field will be auto-generated as 5 because of lack of wage records.

B. If field 168 (Employed in 2nd Quarter after Exit Quarter) is 2 or blank, this field will be auto-generated as blank.

170 Hours Worked First Full Week for the 2nd Quarter After the Exit Quarter. Enter the number of hours worked in the first full week of employment during the 2nd quarter after the exit quarter. 00 A. Must be >0 if field 168 (Employed in 2nd Quarter After Exit Quarter) is 1. A. Participant is Employed in 2nd Quarter After Exit Quarter, but Hours Worked First Full Week for the 2nd Quarter After the Exit Quarter are not given.
171 Hourly Wages First Full Week of Work for the 2nd Quarter After the Exit Quarter Enter the hourly wage for the job listed in the above element for in the first full week of employment during the 2nd quarter after the exit quarter. 00.00 A. Must be >0 if field 168 (Employed in 2nd Quarter After Exit Quarter) is 1. A. Participant is Employed in 2nd Quarter After Exit Quarter, but Hourly Wages First Full Week for the 2nd Quarter After the Exit Quarter are not given.
172 Date of Follow-up for 2nd Quarter After the Exit Quarter Employment and Wage Information Enter the date on which the grantee attempted to contact the participant to obtain information on employment and earnings for the 2nd quarter after the exit quarter post-program.

Repeat for each follow-up attempt.
MM/DD/YYYY

A. Must not be blank if field 168 (Employed in 2nd Quarter After Exit Quarter) is 1.

B. Must not be blank if field 173 (Successful Follow-up for 2nd Quarter After the Exit Quarter Employment and Wage Information) is 1.
A. Employed in 2nd Quarter After Exit Quarter is Yes (1), but no Date of Follow-up for 1st Quarter After the Exit Quarter Employment and Wage Information is given.

B. Successful Follow-up for 2nd Quarter After the Exit Quarter Employment and Wage Information is specified, but Date of Follow-up is not given.
173 Successful Follow-up for 2nd Quarter After the Exit Quarter Employment and Wage Information Enter yes if the grantee successfully contacted the participant to collect employment and earnings information for the 2nd quarter after the exit quarter.

Enter no if the grantee did not successfully contact the participant to collect this information.

Repeat for each follow-up attempt.
1 = Yes
2 = No
A. Must not be blank if field 172 (Date of Follow-up for 2nd Quarter After the Exit Quarter Employment and Wage Information) is a valid date. A. Date of Follow-up for 2nd Quarter After the Exit Quarter Employment and Wage Information is given, but Successful Follow-up for 2nd Quarter After the Exit Quarter Employment and Wage Information is not specified.
174 Employed in 3rd Quarter After Exit Quarter Select Yes if the participant was employed in the third quarter after the quarter of exit.
Select No if the participant was not employed in the third quarter after the quarter of exit.
1 = Yes
2 = No
A. Must be blank if field 48 (Date of Exit) and field new (Date Entered Follow-up Services) is blank.

B. Must be 1 if field 176 (Hours Worked First Full Week for the 3rd Quarter After the Exit Quarter) is > 0.
A. Employed in 3rd Quarter After Exit must be blank if no Date of Exit and Date Entered Follow-up Services is given.

B. Employed in 3rd Quarter After Exit must be 1 (Yes) if Hours Worked First Full Week for the 3rd Quarter After the Exit Quarter is >0 .
175 Type of Employment Match 3rd Quarter After Exit Quarter Use the appropriate code to identify the method used in determining the individual's employment status in the third quarter following the quarter of exit. If the individual is found in more than once source of employment, record the data source for which the individual's earnings are greatest.

1 = UI Wage Records (In-State & WRIS)
2 = Federal Employment Records (OPM, USPS)
3 = Military Employment Records (DOD)
4 = Other Administrative Wage Records
5 = Supplemental through case management, participant survey, and/or verification with the employer
Blank = Not Employed.
A. If field 174 (Employed in 3rd Quarter after Exit Quarter) is 1, this field will be auto-generated as 5 because of lack of wage records.

B. If field 174 (Employed in 3ed Quarter after Exit Quarter) is 2 or blank, this field will be auto-generated as blank.

176 Hours Worked First Full Week for the 3rd Quarter After the Exit Quarter. Enter the number of hours worked in the first full week of employment during the 3rd quarter after the exit quarter. 00 A. Must be >0 if field 174 (Employed in 3rd Quarter After Exit Quarter) is 1. A. Participant is Employed in 3rd Quarter After Exit Quarter, but Hours Worked First Full Week for the 3rd Quarter After the Exit Quarter are not given.
177 Hourly Wages First Full Week of Work for the 3rd quarter after the exit quarter Enter the hourly wage for the job listed in the above element for in the first full week of employment during the 3rd quarter after the exit quarter. 00.00 A. Must be >0 if field 174 (Employed in 3rd Quarter After Exit Quarter) is 1. A. Participant is Employed in 3rd Quarter After Exit Quarter, but Hourly Wages First Full Week for the 3rd Quarter After the Exit Quarter are not given.
178 Date of Follow-up for 3rd Quarter After the Exit Quarter Employment and Wage Information Enter the date on which the grantee attempted to contact the participant to obtain information on employment and earnings for the 3rd quarter after the exit quarter post-program.

Repeat for each follow-up attempt.
MM/DD/YYYY

A. Must not be blank if field 174 (Employed in 3rd Quarter After Exit Quarter) is 1.

B. Must not be blank if field 179 (Successful Follow-up for 3rd Quarter After the Exit Quarter Employment and Wage Information) is 1.
A. Employed in 3rd Quarter After Exit Quarter is Yes (1), but no Date of Follow-up for 1st Quarter After the Exit Quarter Employment and Wage Information is given.

B. Successful Follow-up for 3rd Quarter After the Exit Quarter Employment and Wage Information is specified, but Date of Follow-up is not given.
179 Successful Follow-up for 3rd Quarter After the Exit Quarter Employment and Wage Information Enter Yes if the grantee successfully contacted the participant to collect employment and earnings information for the 3rd quarter after the exit quarter.

Enter No if the grantee did not successfully contact the participant to collect this information.

Repeat for each follow-up attempt.
1 = Yes
2 = No
A. Must not be blank if field 178 (Date of Follow-up for 3rd Quarter After the Exit Quarter Employment and Wage Information) is a valid date. A. Date of Follow-up for 3rd Quarter After the Exit Quarter Employment and Wage Information is given, but Successful Follow-up for 3rd Quarter After the Exit Quarter Employment and Wage Information is not specified.
SECTION II.D - POST-PROGRAM WAGE DATA
These fields are to be used for wage record data only.


180 Wages 1st Quarter After Exit Quarter Record total earnings from wage records for the first quarter after the quarter of exit.
Enter 999999.99 if data is not yet available.
000000.00 A. This field will not be included in the system until grantees obtain access to wage records.
181 Wages 2nd Quarter After Exit Quarter Record total earnings from wage records for the second quarter after the quarter of exit.
Enter 999999.99 if data is not yet available.
000000.00 A. This field will not be included in the system until grantees obtain access to wage records.
182 Wages 3rd Quarter After Exit Quarter Record total earnings from wage records for the third quarter after the quarter of exit.
Enter 999999.99 if data is not yet available.
000000.00 A. This field will not be included in the system until grantees obtain access to wage records.
SECTION III.E - EDUCATION AND CREDENTIAL DATA

183 Attained Diploma, GED, or Certificate #1 Select individual attained a secondary school diploma individual attained a secondary school (high school) diploma recognized by the State.
Select individual attained a GED or high school equivalency diploma if the individual attained a GED or high school equivalency diploma recognized by the State.
Select individual attained a certificate in recognition of attainment of technical or occupational skills if the individual attained a certificate in recognition of attainment of technical or occupational skills.
Select individual did not attain a diploma, GED, or certificate if the individual did not attain a diploma, GED, or certificate.
Select individual attained an AA or AS if individual attained an associate's degree.
Select individual attained a BA or BS if individual attained an bachelor's degree.
1 = Individual attained a secondary school (high school) diploma.
2 = Individual attained a GED or high school equivalency diploma.
3 = Individual attained a certificate in recognition of an individual's attainment of technical or occupational skills.
4 = Individual did not attain a diploma, GED, or certificate
5 = Individual attained an AA or AS
6 = Individual attained an BA or BS
A. Must not be 1 or 2 if field 18 (Highest School Grade Completed) is 16, 17, 87, 88, or 90. A. Attained Diploma, GED, or Certificate #1 and Highest School Grade Completed values are contradictory.
184 Date Attained Degree or Certificate #1 Record the date on which the individual attained a diploma, GED, or certificate.

Leave "blank" if the individual did not attain a diploma, GED, or certificate.
MM/DD/YYYY
Blank = did not attain diploma, GED, or certificate
A. Must be greater than field 47 (Date of Participation) if field 183 (Attained Diploma, GED, or Certificate #1) is 1, 2, 3, 5, or 6.

B. Must be blank if field 183 (Attained Diploma, GED, or Certificate #1) is blank or 4.
A. Date Attained Degree or Certificate #1 must be after Date of Participation.

B. Date Attained Degree or Certificate #1 must be blank if participant Did not attain a diploma, GED, or certificate.
185 Specify the Name of Certificate #1 Specify the name of the first certificate achieved.

Leave blank if no certificate was achieved.
Text
Blank = no certificate achieved
A. Must not be blank if field 183 (Attained Diploma, GED, or Certificate #1) is 3. A. Participant Attained a Diploma, GED, or Certificate #1, but Name of Certificate is not specified.
186 Attained Diploma, GED, or Certificate #2 Select individual attained a secondary school diploma individual attained a secondary school (high school) diploma recognized by the State.
Select individual attained a GED or high school equivalency diploma if the individual attained a GED or high school equivalency diploma recognized by the State.
Select individual attained a certificate in recognition of attainment of technical or occupational skills if the individual attained a certificate in recognition of attainment of technical or occupational skills.
Select individual did not attain a diploma, GED, or certificate if the individual did not attain a diploma, GED, or certificate.
Select individual attained an AA or AS if individual attained an associate's degree.
Select individual attained a BA or BS if individual attained an bachelor's degree.
1 = Individual attained a secondary school (high school) diploma.
2 = Individual attained a GED or high school equivalency diploma.
3 = Individual attained a certificate in recognition of an individual's attainment of technical or occupational skills.
4 = Individual did not attain a diploma, GED, or certificate
5 = Individual attained an AA or AS
6 = Individual attained an BA or BS
A. Must not be 1 or 2 if field 18 (Highest School Grade Completed) is 16, 17, 87, 88, or 90. A. Attained Diploma, GED, or Certificate #2 and Highest School Grade Completed values are contradictory.
187 Date Attained Degree or Certificate #2 Record the date on which the individual attained a diploma, GED, or certificate.

Leave "blank" if the individual did not attain a diploma, GED, or certificate.
MM/DD/YYYY
Blank = did not attain diploma, GED, or certificate
A. Must be greater than field 47 (Date of Participation) if field 186 (Attained Diploma, GED, or Certificate #2) is 1, 2, 3, 5, or 6.

B. Must be blank if field 186 (Attained Diploma, GED, or Certificate #2) is blank or 4.
A. Date Attained Degree or Certificate #2 must be after Date of Participation.

B. Date Attained Degree or Certificate #2 must be blank if participant Did not attain a diploma, GED, or certificate.
188 Specify the Name of Certificate #2 Specify the name of the second certificate achieved.

Leave blank if no certificate was achieved.
Text
Blank = no certificate achieved
A. Must not be blank if field 186 (Attained Diploma, GED, or Certificate #2) is 1, 2, or 3. A. Participant Attained a Diploma, GED, or Certificate #2, but Name of Certificate is not specified.
File Typeapplication/vnd.ms-office
AuthorPeacock
Last Modified Bynaradzay.bonnie
File Modified2012-01-19
File Created2004-01-02

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