Grantee Information Collection

Youthbuild Site Visit Protocols

Documents and Forms

Document Name Document Type
Appendix A - Organizational Structure.doc Other-interview protocol - organizat
Appendix B - Recruitment, Intake, Assessment.doc Other-interview protocol, recruitmen
Appendix C - MTO.doc Other-mental toughness orientation
Appendix D - Case Management.doc Other-case management
Appendix E - Academic Services.doc Other-protocol, academic services
Appendix F - Vocational And Construction Training.doc Other-vocational and construction tr
Appendix G - Employment Services.doc Other-protocol, employment services
Appendix H - Youth Leadership And Community Service.doc Other-protocol, youth leadership & c
Appendix I - Partnerships.doc Other-protocol, partnerships
Appendix J - Alternative Youth Services.doc Other-protocol, alternative youth se
Appendix P - Grantee Info Form.doc Other-grantee information checklist
Cost data Collection Worksheet Appendix_K_-_Cost_Data_Collection_Worksheet.doc Form
Appendix N - Classroom Observation Checklist.doc classroom checklist IC Document
Appendix O - Worksite Observation Checklist.doc worksite checklist IC Document

Information Collection (IC) Details

IC Title:	Grantee Information Collection	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-interview protocol - organizational structure			Appendix A - Organizational Structure.doc	Yes	Yes	Paper Only
Other-interview protocol, recruitment intake assessment			Appendix B - Recruitment, Intake, Assessment.doc	Yes	Yes	Paper Only
Other-mental toughness orientation			Appendix C - MTO.doc	Yes	Yes	Paper Only
Other-case management			Appendix D - Case Management.doc	Yes	Yes	Paper Only
Other-protocol, academic services			Appendix E - Academic Services.doc	Yes	Yes	Paper Only
Other-vocational and construction training			Appendix F - Vocational And Construction Training.doc	Yes	Yes	Paper Only
Other-protocol, employment services			Appendix G - Employment Services.doc	Yes	Yes	Fillable Fileable
Other-protocol, youth leadership & community service			Appendix H - Youth Leadership And Community Service.doc	Yes	Yes	Paper Only
Other-protocol, partnerships			Appendix I - Partnerships.doc	Yes	Yes	Paper Only
Other-protocol, alternative youth services			Appendix J - Alternative Youth Services.doc	Yes	Yes	Paper Only
Other-grantee information checklist			Appendix P - Grantee Info Form.doc	Yes	Yes	Paper Only
Form	NA	Cost data Collection Worksheet	Appendix_K_-_Cost_Data_Collection_Worksheet.doc	No		Paper Only

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 83	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	996	996
Annual IC Time Burden (Hours)	996	996
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
classroom checklist	Appendix N - Classroom Observation Checklist.doc	05/22/2012
worksite checklist	Appendix O - Worksite Observation Checklist.doc	05/22/2012

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