ETA 9095 NFJP Program Status Summary Report

Reporting and Performance Standards System for Migrant and Seasonal Farmworker Programs Under Title I, Section 167 of the Workforce Investment Act

NFJP PSS Form 9095 - PRA rev with quarters & narrative 8.10.12

Reporting and Performance Standards System for Migrant and Seasonal Farmworker Programs Under Title I, Section 167 of the Workforce Investment Act (WIA)

OMB: 1205-0425

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NATIONAL FARMWORKER JOBS PROGRAM

PROGRAM STATUS SUMMARY REPORT ETA FORM 9095

Program Status Summary

WIA, Title I-D, Section 167

U.S. Department of Labor

Employment and Training Administration

National Farmworker Jobs Shape1 Program (NFJP)



Part 1: Participant Data


Shape2

a. Grantee Name and Address

b. Grant Number

OMB Approval No: 1205-0425

Expires 112//31/2012

c. Period of Grant


From: To:

d. Reporting Period


From: To:


I. Participation Summary

Cumulative Quarters

1st Quarter

2nd Quarter

3rd Quarter

4th Quarter

A. Total Participants Served

(excluding individuals who only receive a determination of eligibility)





1. New Participants





2. Participants Carried Over From Previous Program Year





B. Total Number of Participants Exiting Program





II. Participant Outcomes





A. Placed in Unsubsidized Employment





B. Completed Training Services





III. Total Current Participants (End of Period)





IV. Participant Enrollments In Program Services




A. Core Services





B. Intensive Services





C. Training Services





D. Related Assistance Services (only)





Remarks:

V. CERTIFICATION I certify that to the best of my knowledge this report is correct and complete as set forth in the grant agreement.

Name and Title of Authorized Official

Phone Number



Signature

Date Submitted (Month, Day, Year)

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The obligation to respond to this collection is required to obtain or retain benefit (Workforce Investment Act Section 185(a)). Public reporting burden for this collection of information is estimated to average 17 hours per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Labor, Employment and Training Administration, Office of Workforce Investment, Attention: National Farmworker Jobs Program, 200 Constitution Avenue, N.W., Room C-4510, Washington, DC 20210 and reference OMB Control Number 1205-0425. (Paperwork Reduction Act Project 1205-0425).

Shape3 ETA 9095

Instructions for Completing NFJP Program Status Summary (PSS) Report

Part 1: Participant Data


General Instructions. The PSS is required to be electronically submitted on a quarterly basis, cumulative by the Program Year quarters (i.e., beginning July 1, October 1, January 1, and April

1). Reports are due no later than 45 days after the end of each reporting quarter (20 CFR

667.300(3)(d). Please submit via the Internet at www.etareports.doleta.gov.


a. Grantee Name and Address – NO ENTRY REQUIRED


b. Grant Number – NO ENTRY REQUIRED


c. Period of Grant – NO ENTRY REQUIRED


d. Reporting Period – NO ENTRY REQUIRED


Section I. Participation Summary


LINE I.A. Total Participants Served Enter in the column for the current reporting quarter (i.e. 1st quarter, 2nd quarter, 3rd quarter, or 4th quarter) the cumulative number of participants for the program year.


Participant is any individual who is determined eligible to participate in the program and receives a service funded by the program. Participant counts do not include individuals who only receive a determination of eligibility to participate in the program.


LINE I.A.1. New Participants – Enter in the column for the current reporting quarter the cumulative number of new participants for the program year.


LINE I.A.2. Participants Carried Over From Previous Program Year Enter in the column for the current reporting quarter the number of participants in the program on the last day of the previous program year whose participation continued in this program year. This number remains constant for the program year.


LINE I.B. Total Number of Participants Exiting Program Enter in the column for the current reporting quarter the cumulative number of participants who have exited the program during the program year.


Exit from the program occurs when a participant has not received any services funded by the program or a partner program for 90 consecutive calendar days and has no 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.



Section II. Participant Outcomes


Line II.A. Placed in Unsubsidized Employment Enter in the column for the current reporting quarter the cumulative number of participants placed in unsubsidized employment during the program year.


Line II.B. Completed Training Services – Enter in the column for the current reporting quarter the cumulative number of participants who completed at least one training service during the program year.


Section III. Total Current Participants (End-of- Period) – NO ENTRY REQUIRED


Section IV. Participant Enrollments in

Program Services


LINE IV.A. Core Services Enter in column B the column for the current reporting quarter the cumulative number of participants who received at least one core service during the program year. Core Services are identified in WIA Section 134(d)(2).


LINE IV.B. Intensive Services – Enter in

the column for the current reporting quarter the cumulative number of participants who received at least one intensive service during the program year. Intensive Services are identified in WIA Section 134(d)(3)(C) and 20 CFR Section 669.370.


LINE IV.C. Training Services – Enter in the column for the current reporting quarter the cumulative number of participants who received at least one training service during the program year. Training Services are identified in WIA Section 134(d)(4)(D) and Section 167(d) and 20 CFR Section 669.410.


LINE IV.D. Related Assistance Services (only)

Enter in the column for the current reporting quarter the cumulative number of participants who received one or more related assistance services only during the program year. Related Assistance services are identified in 20 CFR Section 669.430.














Part 2: Quarterly Narrative Progress Report



  1. Program Highlights and Accomplishments:


  1. Partnership Activities:


  1. Participant and Performance Outcomes:


  1. Key Issues and Challenges:


  1. Additional Information (Optional):







Instructions for Completing NFJP Program Status Summary (PSS) Report

Part 2: Quarterly Narrative Progress Report


In Part 2 of the PSS Report, grantees will provide a narrative progress report for grant activities for the quarter.


A. Program Highlights and Accomplishments – In this section, grantees should describe program highlights and accomplishments for the quarter. This section may also be used to share participant success stories.


B. Partnership Activities – In this section, grantees should describe key activities undertaken with partners in the quarter, including collaboration with existing partners and any efforts to develop new partnerships. Among other partnership activities, grantees should describe activities with the state’s American Job Centers (also known as One-Stop Career Centers).


C. Participant and Performance Outcomes – In this section, grantees should provide a brief summary of: 1) the grantee’s participant outcomes on the Program Status Summary Report (ETA Form 9095) for the quarter in comparison to the planned participant levels for the quarter on the Program Planning Summary Report (ETA Form 9094); and 2) the grantee’s performance outcomes for the common measures (entered employment, retention, and earnings) for the previous quarter in comparison to the program performance targets for the program year. If participant or performance outcome targets are not met, grantees should describe efforts already taken or strategies to be implemented to meet those outcomes. Grantees that have met or exceeded both participant and performance outcomes can include a short statement indicating this result.


D. Key Issues and Challenges – In this section, grantees should summarize any significant issues or challenges encountered, and describe any actions already taken or strategies to be implemented to address those issues or challenges. This section may be used to identify any technical assistance needs of the grantee.


E. Additional Information (Optional) – This section may be used by grantees to provide any additional information not provided in other sections of the quarterly narrative progress report.



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