Attachment B H 1B Standardized Quarterly Performance Report

STANDARDIZED QUARTERLY PERFORMANCE PROGRESS REPORT Employment and Training Administration H-1B TECHNICAL SKILLS TRAINING GRANTS and H-1B JOBS AND INNOVATION ACCELERATOR CHALLENGE GRANTS Quarterly Report Form OMB No. 1205-0 NEW
A. GRANTEE IDENTIFYING INFORMATION
1. Grantee Name:
2. Grant Number:
3. Program/Project Name:
4. Grantee Address: City: __________________________________________ State: ______________________________________ Zip Code: ____________
5. Report Quarter End Date: mm/dd/yyyy
6. Report Due Date: mm/dd/yyyy
Performance Items		Previous Quarter (A)	Current Quarter (B)	Cumulative Grant-to-Date (C)
B. GRANT SUMMARY INFORMATION
1. Total Exiters
2. Total Participants Served
3. New Participants Served
C. PARTICIPANT SUMMARY INFORMATION
Gender	1a. Male
	1b. Female
Ethnicity/Race	2a. Hispanic/Latino
	2b. American Indian or Alaskan Native
	2c. Asian
	2d. Black or African American
	2e. Native Hawaiian or Other Pacific Islander
	2f. White
	2g. More Than One Race
Other Demographics	3a. Eligible Veterans
	3b. Individuals with a Disability
	3c. Employed Individuals
	3d. Unemployed Individuals
	3e. Dislocated Workers
	3f. Long-term Unemployed
Education Level	4a. High School Graduate or Equivalent
	4b. 1 - 4 Years or More of College, or Full-time Technical or Vocational School
	4c. Associates Diploma or Degree
	4d. Bachelor's Degree or Equivalent
	4e. Advanced Degree Beyond Bachelor's
D. PROGRAM SERVICES
Training Indicators	1. Number Began Receiving Education/Job Training Activities
	2. Number Participated On-the-Job Training Activities
	3a. Number Participated in Classroom Occupational Training Activities
	3b. Number Participated in Contextualized Training Activities
	3c. Number Participated in Distance Learning Activities
	3d. Number Participated in Customized Training Activities
	3di. Number Participated in Incumbent Worker Training Activities
	4. Number Completed Education/Job Training Activities
	5. Number Completed On-the-Job Training Activities
E. PROGRAM OUTCOMES - PERFORMANCE INDICATORS
Education Outcomes	1. Number Completed Program Activities and Obtained a Credential
	2. Total Number of Credentials Received
Employment Outcomes	3. Number Entered Unsubsidized Employment
	3a. Number Entered Unsubsidized Training-Related Employment
	3b. Number Retained Employment
Incumbent Worker Outcomes	4a. Total Number of Employed Retained Current Position with Current Employer
	4b. Total Number of Employed that Advanced into New Position with Current Employer
F. COMMON PERFORMANCE MEASURES
1. Entered Employment Rate
2. Employment Retention
3. Average Earnings
G. REPORT CERTIFICATION/ADDITIONAL COMMENTS
1. Report Comments/Narrative: Attach a separate document that provides a discussion of the grant narrative items outlined in the reporting instructions found in the accompanying DOL H-1B Quarterly Performance Handbook.
2. Name of Grantee Certifying Official/Title:		3. Telephone Number:
4. Email Address:
Persons are not required to respond unless this form displays a currently valid OMB number. Obligation to respond is required to obtain or retain benefits (Workforce Investment Act [Section 185(a)(2)]. Public reporting burden for this collection of information, which is to assist with planning and program management and to meet Congressional and statutory requirements, averages 10 hours per record, including time to review instructions, search existing data sources, gather and maintain the data needed, and complete and review the collection of information. Send comments regarding this burden estimate to the U.S. Department of Labor, ETA, Room C-4518, 200 Constitution Avenue, NW, Washington, DC 20210-0001
DOL, ETA Internal Use Only
Additional Comments:
Regional Federal Project Officer:
National Program Office Notes: