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Participant Data, Participant Burden

ICR 201409-1205-004 · OMB 1205-0464 · Object 55657104.

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Record metadata
File Type	application/vnd.ms-excel
File Title	Participant Data, Participant Burden
Last Modified By	Calc
File Modified	2015-07-20
File Created	2026-09-13
Conversion State	complete

Extracted Text

YouthBuild Data Elements - July 2015
No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

SECTION I - INDIVIDUAL INFORMATION
SECTION I.A - IDENTIFYING AND DEMOGRAPHIC INFORMATION
Record the unique identification number assigned to the individual. At a minimum, this
1 Social Security
Number
identifier for a person must be the same for every period of participation in the program.

VALID VALUES

XXXXXXXXX
(No hyphens)

2
3

Date of Birth
Gender

Record the individual's date of birth.
Indicate the participant's gender by select Male or Female
Leave blank if the individual does not wish to disclose his/her gender.

Ethnicity Hispanic/
Latino

Indicate the participant's ethnicity by selecting Yes or No.
Leave blank if the participant does not disclose his/her ethnicity.

American Indian or
Alaskan Native

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

MM/DD/YYYY
1 = Male
2 = Female
Blank = no self-disclosure
1 = Yes
2 = No
Blank = no self-disclosure
1 = Yes
Blank = not reported

Leave blank if the participant is not American Indian or Alaska Native or refused to
report on this element.
6

Asian

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

1 = Yes
Blank = not reported

Leave blank if the participant is not Asian or refused to report on this element.

1 of 65

No.
7

DATA ELEMENT
NAME
Black or African
American

DATA ELEMENT DEFINITIONS/INSTRUCTIONS
Indicate whether the participant is Black or African American by selecting Yes or Not
Reported.

VALID VALUES
1 = Yes
Blank = not reported

Leave blank if the participant is not Black or African American or refused to report on
this element.
8

Hawaiian Native or
other Pacific Islander

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

White

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

1 = Yes
Blank = not reported

Leave blank if the participant is not White or refused to report on this element.

2 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

SECTION I.B - ENROLLMENT INFORMATION
Enter a cohort ID for participant. This identifier is required and consists of the three
10 Cohort Identifier
7 alphanumeric
character month abbrevation and a four digit year and is used to group particular students
together for the purposes of reporting. For example, all of the participants who enter the
program in the October 2008 will have a cohort designation of OCT2008 them from a
cohort beginning in January 2009 which would have a cohort identifier of JAN2009.
11

Team Identifier

If desired, enter the team number that the participant will be assigned to. The team
identifier can be up to 5 alphanumeric characters and might be used to divide a cohort
into two or more teams.

5 alphanumeric

HUD or DOL
Participant

Enter 1 if this is a DOL supported participant; this indicates the funding stream that
supports the participant.

1 = Yes

Marital status

Enter the participants marital status at time of enrollment

Children

Children living with
participant

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

2
= No
1 = Married
2 = Single
3 = Divorced
4 = Widowed
5 = Separated
6 = Domestic Partnership
7 = Not Reported

3 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

Other dependents
Enter the number of dependents other than children living with the participant.
living with participant

Highest Grade
Completed

VALID VALUES
00

Use the appropriate code to record the highest school grade completed by the individual. 00 = No school grades completed
01 - 12 = Number of
Record 87 if the individual completed the 12th grade and attained a high school diploma. elementary/secondary school
Record 88 if the individual completed the 12th grade and attained a GED or equivalent. grades completed
Record 89 if the individual with a disability received a certificate of
13-15 = Number of college, or
attendance/completion.
full-time technical or vocational
Record 90 if the individual attained other post-secondary degree or certification.
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 = Attained Certificate of
Attendance/Completion
90 = Attained Other PostSecondary degree or Certificate

4 of 65

No.

DATA ELEMENT
NAME

Foster Youth

Select Yes if the individual is a person who is or is aging out of the foster care system.
Select No if the individual does not meet the conditions described above.

1 = Yes
2 = No

Migrant Youth

Select Yes if the individual is the youth is a migrant worker or is a member of a migrant
family.
Select No if the individual does not meet the conditions described above.

1 = Yes
2 = No

Low Income Family

Select Yes if the individual is the youth is a member of a low income family. The
definition of “low-income family” is taken directly from the United States Housing Act
of 1937 (42 U.S.C. 1437a(b)(2)) which states:
“The term ‘low-income families’ means those families whose incomes do not exceed 80
per centum of the median income for the area, as determined by the Secretary with
adjustments for smaller and larger families, except that the Secretary may establish
income ceilings higher or lower than 80 per centum of the median for the area on the
basis of the Secretary's findings that such variations are necessary because of prevailing
levels of construction costs or unusually high or low family incomes.”

1 = Yes
2 = No

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

Select No if the individual does not meet the conditions described above.

Youth Offender

Select Yes if the individual has been convicted of a crime by the juvenile justice system. 1 = Yes
Select No if the individual does not meet the conditions described above.
2 = No

5 of 65

No.

DATA ELEMENT
NAME

Adult Offender

High School Drop-Out Select Yes if the individual is the youth is a high school drop-out.
Select No if the individual does not meet the conditions described above.

1 = Yes
2 = No

Basic Skills Deficient Select Yes if the individual is the youth is basic skills deficient. Basic skills deficient is
defined as an the individual who computes or solves problems, reads, writes, or speaks
English at or below the eighth grade level or is unable to compute or solve problems,
read, write, or speak English at a level necessary to function on the job, in the
individual’s family, or in society. This can be measured using recognized assessments
(i.e., TABE or CASAS)
Select No if the individual does not meet the conditions described above.

1 = Yes
2 = No

Child of Incarcerated
Parent or Legal
Guardian

1 = Yes
2 = No

DATA ELEMENT DEFINITIONS/INSTRUCTIONS
Select Yes if the individual has been convicted of a crime by the adult correctional
system. Select No if the individual does not meet the conditions described above.

Select Yes if either of the youth's parents or legal guardian is incarcerated at the time of
the youth's enrollment into the YouthBuild program.
Select No if the individual does not meet the conditions described above.

VALID VALUES
1 = Yes
2 = No

6 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

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

Individual with a
Disability

Select Yes if the individual indicates that he/she has any "disability," as defined in
1 = Yes
Section 3 of the Americans with Disabilities Act of 1990 (42 U.S.C. 12102), as amended 2 = No
by the Americans with Disabilities Act Amendments Act of 2008 (ADAAA). Under that Blank = no self-identification
definition, a "disability" is a physical or mental impairment that substantially limits one
or more of the person's major life activities: and an individual with a disability is an
individual who has such a disability, has a record of such a disability, or is regarded as
having such a disability. (For definitions and examples of "physical or mental
impairment" and "major life activities," see Section 4 of the ADAAA).
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.

Health Issues

Select Yes, Significant 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 mental/physical health issues.

1 = Yes, significant health issues
2 = No significant health issues
Blank = no self-identification

Otherwise, select No significant health issues.
Leave blank if the individual does not wish to self-identify.

7 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

Employment Status at Record Employed if the participant is a person, at enrollment, who either (a) worked
1 = Employed
Enrollment
more than 15 hours per week as a paid employee, (b) did any work at all in his or her
2 = Employed, but Received
own business, profession, or farm, (c) worked 15 hours or more as unpaid worker in an Notice of Termination of
enterprise operated by a member of the family, or (d) is one who was not working, but
Employment or Military
has a job or business from which he or she was temporarily absent because of illness, bad Separation
weather, vacation, labor-management dispute, or personal reasons, whether or not paid
3 = Not Employed
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.

Occupation at
Enrollment

From the drop-down box select the participants occupation at enrollment.
Leave blank if the participant is not employed at enrollment.

8 of 65

No.
31

DATA ELEMENT
NAME
Hours Worked at
Enrollment

DATA ELEMENT DEFINITIONS/INSTRUCTIONS
Enter the average hours per week that the participant works at the above occupation.

VALID VALUES
00
Blank = not employed

Leave blank if the participant is not employed at participation.
32

Average Hourly Wage Enter the participant's average hourly wage at the above occupation.
at Enrollment
Leave blank if the participant is not employed at participation.

00.00
Blank = not employed

Start Date for Job at
Enrollment

MM/DD/YYYY
Blank = not employed

Enter the date on which the participant began to work at the above job.
Leave blank if the participant is not employed at participation.

9 of 65

No.
34

DATA ELEMENT
NAME
Housing Status at
Enrollment

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

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.

1 = Own/rent apartment, room, or
house
2 = Staying at someone's
Select Staying at someone's apartment, room, or house (Stable) if, at enrollment, the apartment, room, or house
individual is living in an apartment, room, or house that somebody else owns or rents and (Stable)
if the person is not at risk of being displaced from this housing, i.e the housing situation 3 = Halfway house/ transitional
is long-term.
house
4 = Residential treatment
Select Halfway house/transitional house if, at enrollment, the individual is living in a
5 = Homeless
residence designed to assist persons as they re-enter society and learn to adapt to
6 = Staying at someone's
independent living after having been in prison.
apartment, room, or house
(Unstable)
Select Residential treatment if, at enrollment, the individual lives in a residential
7 = Group Home
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 may regularly stay at a
publicly or privately operated shelter for temporary acommodation; 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.

Program Referral
Source

Select Staying at someone's apartment, room, or house if, at enrollment, the
individual is living in an apartment, room, or house that somebody else owns or rents and
Enter
how theisparticipant
was referred
to from
the YouthBuild
program.
Pull down
menu iswill Text
if the person
at risk of being
displaced
this housing,
i.e the housing
situation
include
juvenile justice, workforce system, school counselor, or other. This is an
short-term.
optional field.
10 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

Post-Release Status at Select parole if the participant is on parole on the date of participation.
Enrollment
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.

Mandated
participation

VALID VALUES
1 = Parole
2 = Probation
3 = Other Criminal Justice/Court
Supervision
4 = None

Select Yes if participation in the YB program is mandated by a criminal justice agency or 1 = Yes
agent as a condition of parole, probation, or other supervision.
2 = No
Select No if participation in the YB program is not mandated by a criminal justice agency
or agent

11 of 65

DATA ELEMENT
NAME
No.
DATA ELEMENT DEFINITIONS/INSTRUCTIONS
SECTION II - PROGRAM ACTIVITIES AND SERVICES INFORMATION
SECTION II.A - PROGRAM PARTICIPATION DATA
Record the date on which the individual begins receiving his/her first service funded by
38 Date of Program
Enrollment
the program following a determination of eligibility to participate in the program.

VALID VALUES

MM/DD/YYYY

This date will be entered by program staff
39

Date of Exit

Record the date on which the last service funded by the program or a partner program
MM/DD/YYYY
(excluding supportive services) is received by the participant or the date of incarceration
or when the participant completes the program, whichever occurs first.
This is a "hard exit" entered by program staff; it is not automatically generated by the
system.

40
41

Successful Exit
Prerelease Contact

Select Yes if the participant has successfully exited the program; Select No if the
participant exited the program unsuccessfully

1 = Yes
2

= No
Select Yes if the DoL grantee had any contact with the participant prior to registration in 1 = Yes
the program.
2 = No
Select No if the DoL grantee did not have any contact with the participant prior to
registration in the program.

12 of 65

No.
42

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

Other Reasons for Exit Select Health/Medical if the participant is receiving medical treatment that precludes
02 = Health/Medical
(at time of exit or
entry into unsubsidized employment or continued participation in the program. Does
03 = Deceased
during 3-quarter
not include temporary conditions expected to last for less than 90 days.
04 = Family Care
measurement period
05 = Reservists Called to Active
following the quarter Select Deceased if the participant was found to be deceased or no longer living.
Duty
of exit)
Blank = none of the above
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.
Select Reservists Called to Active Duty if the participant is a reservist who is called to
active duty for at least 90 days.
Leave blank if the none of the above reasons apply.

13 of 65

DATA ELEMENT
NAME
No.
DATA ELEMENT DEFINITIONS/INSTRUCTIONS
SECTION II.B - SERVICES AND OTHER RELATED ASSISTANCE DATA
Education Activities
Enter the date on which the participant started math/reading remediation.
44 Date Entered
Math/Reading
Remediation
Math/Reading remediation consists of classroom instruction designed to improve a
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.

VALID VALUES

MM/DD/YYYY

Expected Completion Enter the date on which the participant is expected to complete math/reading
Date of Math/Reading Remediation.
Remediation

MM/DD/YYYY

Date Ended
Math/Reading
Remediation

Enter the date on which the participant exited math/reading remediation.

MM/DD/YYYY

Completed
Math/Reading
Remediation

Select Yes if the participant successfully completed math/reading remediation.

1 = Yes
2 = No

Date Entered GED
Preparation

Enter the date on which the participant started GED preparation.

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

MM/DD/YYYY

GED preparation is an activity intended to prepare an participant for passing the GED
examination.

14 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

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

MM/DD/YYYY

Date Ended GED
Preparation

Enter the date on which the participant exits GED preparation.

MM/DD/YYYY

Completed GED
Preparation

Select Yes if the participant successfully completed GED preparation

1 = Yes
2 = No

Select No if the participant did not successfully complete GED preparation.
52

Date Entered Other
Education Activities

Enter the date on which the participant started other education activities .

MM/DD/YYYY

Type of Other
Education Activities

Specify the type of other education activities .

Text

Expected Completion Enter the date on which the participant is expected to complete other education
Date of Other
activities .
Education Activities

MM/DD/YYYY

Date Ended Other
Education Activities

Enter the date on which the participant exits other education activities .

MM/DD/YYYY

Date Entered High
School Diploma
Program

Enter the date on which the participant entered high school diploma program

MM/DD/YYYY

15 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

Expected Completion Enter the date on which the participant is expected to earn their high school diploma.
Date of High School
Diploma Program

MM/DD/YYYY

Date Ended High
School Diploma
Program

Enter the date on which the participant exits the high school diploma program.

MM/DD/YYYY

Completed High
School Diploma
Program

Select Yes if the participant successfully completed a high school diploma program

1 = Yes
2 = No

Select No if the participant did not successfully complete a high school diploma program

16 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

Education or Job Training Activities
60

Date Entered
Vocational/
Occupational Skills
Training Services

Enter the date on which the participant started vocational/occupational skills training.

MM/DD/YYYY

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.

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

MM/DD/YYYY

Date Entered
Vocational/
Occupational Skills
Training Services

MM/DD/YYYY

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.

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

MM/DD/YYYY

17 of 65

No.
64

DATA ELEMENT
NAME
Date Entered PreApprenticeship
Program

DATA ELEMENT DEFINITIONS/INSTRUCTIONS
Enter the date on which the participant started a pre-apprenticeship program

VALID VALUES
MM/DD/YYYY

A pre-apprenticeship program means an organized plan under which apprenticeship
candidates will be selected for a short (a few weeks) intensified training period in a
school or training center, with the intent to place them into regular apprenticeship upon
completion or soon after completion of pre-apprenticeship.

Expected Completion Enter the date on which the participant is expected to complete pre-apprenticeship
Date of Preprogram .
Apprenticeship
Program

MM/DD/YYYY

Date Ended PreApprenticeship
Program

Enter the date on which the participant exits pre-apprenticeship program.

MM/DD/YYYY

Completed PreApprenticeship
Program

Select Yes if the participant successfully completed pre-apprenticeship program

1 = Yes
2 = No

Select No if the participant did not successfully complete pre-apprenticeship program.

18 of 65

No.
68

DATA ELEMENT
NAME
Date Entered On the
Job Training (OJT)

DATA ELEMENT DEFINITIONS/INSTRUCTIONS
Enter the date on which the participant started on-the-job training (OJT).

VALID VALUES
MM/DD/YYYY

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.

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

Date Entered On the
Job Training (OJT)

Enter the date on which the participant started on-the-job training (OJT).

MM/DD/YYYY

19 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

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

Date Entered On the
Job Training (OJT)

Enter the date on which the participant started on-the-job training (OJT).

MM/DD/YYYY

Date Entered Other
Job Training
Activities

Enter the date on which the participant started other Job Training activities .

MM/DD/YYYY

Type of Other Job
Training Activities

Specify the type of other Job Training activities .

Text

Expected Completion Enter the date on which the participant is expected to complete other job training
Date of Other Job
activities .
Training Activities

MM/DD/YYYY

Date Ended Other Job Enter the date on which the participant exits other education activities .
Training Activities

MM/DD/YYYY

20 of 65

DATA ELEMENT
NAME
No.
DATA ELEMENT DEFINITIONS/INSTRUCTIONS
Workforce Preparation Activities
Enter the date on which the participant started subsidized employment.
77 Date Entered
Subsidized
Employment

VALID VALUES
MM/DD/YYYY

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

MM/DD/YYYY

Date Ended
Subsidized
Employment

MM/DD/YYYY

Completed Subsidized Select Yes if the participant successfully completed subsidized employment.
Employment
Select No if the participant did not successfully complete subsidized employment.

1 = Yes
2 = No

Date Entered
Internship

MM/DD/YYYY

Enter the date on which the participant exited subsidized employment.

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.

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

MM/DD/YYYY

Date Ended Internship Enter the date on which the participant exits internship.

MM/DD/YYYY

21 of 65

No.

DATA ELEMENT
NAME

Completed Internship Select Yes if the participant successfully completed internship

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES
1 = Yes
2 = No

Select No if the participant did not successfully complete internship.
85

Date Entered
Workforce
Information Services

Enter the date on which the participant started workforce information services.

MM/DD/YYYY

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; shortand 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.

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

MM/DD/YYYY

Date Ended
Workforce
Information Services

MM/DD/YYYY

Enter the date on which the participant exits workforce information services.

22 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

Completed Workforce Select Yes if the participant successfully completed workforce information services
Information Services
Select No if the participant did not successfully complete workforce information
services.

1 = Yes
2 = No

Date Entered Work
Readiness Training

MM/DD/YYYY

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.

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

MM/DD/YYYY

Date Ended Work
Readiness Training

MM/DD/YYYY

Enter the date on which the participant exits work readiness training.

23 of 65

No.
92

DATA ELEMENT
NAME
Completed Work
Readiness Training

DATA ELEMENT DEFINITIONS/INSTRUCTIONS
Select Yes if the participant successfully completed work readiness training

VALID VALUES
1 = Yes
2 = No

Select No if the participant did not successfully complete work readiness training.
93

Date Entered
Career/Life Skills
Counseling

Enter the date on which the participant started career/life skills counseling.

MM/DD/YYYY

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

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

MM/DD/YYYY

Date Ended
Career/Life Skills
Counseling

Enter the date on which the participant exits career/life skills counseling.

MM/DD/YYYY

Completed
Career/Life Skills
Counseling

Select Yes if the participant successfully completed career/life skills counseling

1 = Yes
2 = No

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

Date Entered Other
Enter the date on which the participant started other workforce preparation activities.
Workforce Preparation
Activities

MM/DD/YYYY

24 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

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

Text

Expected Completion Enter the date on which the participant is expected to complete other workforce
Date of Other
preparation activities.
Workforce Preparation
Activities

MM/DD/YYYY

Enter the date on which the participant exits other workforce preparation activities.
100 Date Ended Other
Workforce Preparation
Activities

MM/DD/YYYY

Select Yes if the participant successfully completed other workforce preparation
101 Completed Other
Workforce Preparation activities
Activities
Select No if the participant did not successfully complete other workforce preparation
activities.

1 = Yes
2 = No

25 of 65

DATA ELEMENT
NAME
No.
DATA ELEMENT DEFINITIONS/INSTRUCTIONS
Community Involvement and Leadership Development Activities
Enter the date on which the participant started community service.
102 Date Entered
Community Service
Community service is an activity in which the participants perform volunteer work that
benefits the community

VALID VALUES
MM/DD/YYYY

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

MM/DD/YYYY

104 Date Ended
Community Service

Enter the date on which the participant exits community service.

MM/DD/YYYY

105 Completed
Community Service

Select Yes if the participant successfully completed community service

1 = Yes
2 = No

Select No if the participant did not successfully complete community service.
Enter the date on which the participant started other community involvement activities.
106 Date Entered Other
Community
Involvement Activities

MM/DD/YYYY

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

Text

26 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

108 Expected Completion Enter the date on which the participant is expected to complete other community
Date of Other
involvement activities.
Community
Involvement Activities

MM/DD/YYYY

Enter the date on which the participant exits other community involvement activities.
109 Date Ended Other
Community
Involvement Activities

MM/DD/YYYY

Select Yes if the participant successfully completed other community involvement
110 Completed Other
Community
activities.
Involvement Activities
Select No if the participant did not successfully complete other community involvement
activities.

1 = Yes
2 = No

111 Date Entered
Leadership
Development
Activities

MM/DD/YYYY

Enter the date on which the participant started leadership development activities.
Leadership development activities may include participation on youth advisory board,
[provide other examples]

112 Expected Completion Enter the date on which the participant is expected to complete leadership development
Date of Leadership
activities
Development
Activities

MM/DD/YYYY

27 of 65

No.

DATA ELEMENT
NAME

113 Date Ended
Leadership
Development
Activities

DATA ELEMENT DEFINITIONS/INSTRUCTIONS
Enter the date on which the participant exits leadership development activities.

VALID VALUES
MM/DD/YYYY

114 Completed Leadership Select Yes if the participant successfully completed leadership development activities.
Development
Select No if the participant did not successfully complete leadership development
Activities
activities.

1 = Yes
2 = No

Enter the date on which the participant started receiving post-secondary exploration and
115 Date Entered Post
Secondary Exploration planning services.
Postand Planning
secondary exploration and planning servicesmay include college tours, assistance with
college applications, financial and scholarship applications, college preparation classes
on time management, study skills, etc.
116 Expected Completion Enter the date on which the participant is expected to complete post-secondary
Date of Postexploration and planning activities.
Secondary Exploration
and Planning Services

MM/DD/YYYY

28 of 65

No.

DATA ELEMENT
NAME

117 Date Ended Post
Secondary Planning
and Exploration
Activities

DATA ELEMENT DEFINITIONS/INSTRUCTIONS
Enter the date on which the participant exits post secondary panning and exploration
activities

118 Received Educational Record 1 if the participant received educational achievement services. Educational
Achievement Services achievement services include, but are not limited to, tutoring, time management skills,
and study skills training
Record 2 if the individual did not receive any of the services described above.

VALID VALUES
MM/DD/YYYY

1 = Yes
2 = No

29 of 65

DATA ELEMENT
NAME
No.
DATA ELEMENT DEFINITIONS/INSTRUCTIONS
VALID VALUES
Mentoring Activities
Enter the date on which the participant started mentoring activities.
119 Date Entered
MM/DD/YYYY
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.

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

MM/DD/YYYY

121 Date Ended Mentoring Enter the date on which the participant exits mentoring activities.
Activities

MM/DD/YYYY

122 Completed Mentoring Select Yes if the participant successfully completed mentoring activities
Activities
Select No if the participant did not successfully complete mentoring activities.

1 = Yes
2 = No

30 of 65

DATA ELEMENT
NAME
No.
DATA ELEMENT DEFINITIONS/INSTRUCTIONS
Health Services
Enter the date on which the participant started substance abuse treatment.
123 Date Entered
Substance Abuse
Treatment
124 Provider Type

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

VALID VALUES
MM/DD/YYYY

1 = Faith-based Provider
2 = Community-based Provider
3 = Public Provider

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

MM/DD/YYYY

126 Date Ended Substance Enter the date on which the participant exited substance abuse treatment
Abuse Treatment

MM/DD/YYYY

127 Completed Substance Select Yes if the participant successfully completed substance abuse treatment.
Abuse Treatment
Select No if the participant did not successfully complete substance abuse treatment.

1 =Yes
2 = No

31 of 65

No.

DATA ELEMENT
NAME

128 Date Entered Mental
Health Treatment

DATA ELEMENT DEFINITIONS/INSTRUCTIONS
Enter the date on which the participant started mental health treatment.

VALID VALUES
MM/DD/YYYY

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

MM/DD/YYYY

130 Date Ended Mental
Health Treatment

Enter the date on which the participant exited mental health treatment

MM/DD/YYYY

131 Completed Mental
Health Treatment

Select Yes if the participant successfully completed mental health treatment.

1 =Yes
2 = No

Select No if the participant did not successfully complete mental health treatment.
132 Date Entered
Emergency Medical
Care

Enter the date on which the participant started emergency medical care.

MM/DD/YYYY

133 Expected Completion Enter the date on which the participant is expected to complete emergency medical care. MM/DD/YYYY
Date of Emergency
Medical Care
134 Date Ended
Emergency Medical
Care

Enter the date on which the participant exited emergency medical care

MM/DD/YYYY

32 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

135 Completed Emergency Select Yes if the participant successfully completed emergency medical care.
Medical Care
Select No if the participant did not successfully complete emergency medical care.

1 =Yes
2 = No

136 Date Entered NonEmergency Medical
Care

MM/DD/YYYY

Enter the date on which the participant started non-emergency medical care.

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

MM/DD/YYYY

138 Date Ended NonEmergency Medical
Care

Enter the date on which the participant exited non-emergency medical care

MM/DD/YYYY

139 Completed NonEmergency Medical
Care

Select Yes if the participant successfully completed non-emergency medical care.

1 =Yes
2 = No

140 Date Entered
Pregnancy Leave

Enter the date on which the participant started pregancy leave.

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

141 Expected Completion Enter the date on which the participant is expected to complete Pregnancy Leave.
Date Pregnancy Leave

MM/DD/YYYY
MM/DD/YYYY

33 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

142 Date Ended Pregnancy Enter the date on which the participant exited Pregnancy Leave
Leave

MM/DD/YYYY

143 Completed Pregnancy Select Yes if the participant successfully completed Pregnancy Leave.
Leave
Select No if the participant did not successfully complete Pregnancy Leave.

1 =Yes
2 = No

144 Date Entered Other Enter the date on which the participant started other health services.
Health Services

MM/DD/YYYY

145 Expected
Completion Date of
Other Health
Services

Enter the date on which the participant is expected to complete other health
services.

MM/DD/YYYY

146 Date Ended Other
Health Services

Enter the date on which the participant exited other health services

MM/DD/YYYY

147 Completed Other
Health Services

Select Yes if the participant successfully completed other health services.

1 =Yes
2 = No

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

34 of 65

DATA ELEMENT
NAME
No.
DATA ELEMENT DEFINITIONS/INSTRUCTIONS
Supportive Services
148 Date Entered
Enter the date on which the participant started transportation services.
Transportation
Transportation services include assistance or cash paid to participants for the
Services
purpose of transportation.

VALID VALUES
MM/DD/YYYY

149 Date Ended
Transportation
Services

Enter the date on which the participant exits transportation services.

MM/DD/YYYY

150 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

151 Date Ended Child
Care Services

Enter the date on which the participant exits child care services.

MM/DD/YYYY

152 Date Entered Follow- Enter the date on which the participant started other follow-up services.
up Services
Other follow-up services are on-going mentoring that occurs after exit.

MM/DD/YYYY

153 Date Ended Follow-up Enter the last date on which the participant received follow-up services.
Services
Enter the date on which the participant started other supportive services. Other
154 Date Entered Other
Supportive Services
supportive services includes all supportive services not listed above.
Enter the date on which the participant exits other supportive services.
155 Date Ended Other
Supportive Services

MM/DD/YYYY
MM/DD/YYYY
MM/DD/YYYY

35 of 65

DATA ELEMENT
NAME
No.
DATA ELEMENT DEFINITIONS/INSTRUCTIONS
SECTION III - PROGRAM OUTCOMES INFORMATION
SECTION III.A - FOLLOW-UP
SECTION III.B - SHORT-TERM OUTCOME STATUS
156 Date of Initial
Enter the date on which the participant started the initial unsubsidized employment
Placement Into
Unsubsidized
Employment

VALID VALUES

MM/DD/YYYY

Enter the employer's name for the participant's initial placement into unsubsidized
157 Employer Name for
Initial Placement Into employment.
Unsubsidized
Employment

Text

158 Employer Contact for Enter the contact information for the employer for the participant's placement into
Initial Placement Into unsubsidized employment.
Unsubsidized
Employment

Text

159 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

160 Hourly Wage at
Placement for Initial
Placement into
Unsubsidized
Employment

Enter the hourly wage for the initial unsubsidized unemployment at placement.

00.00

36 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

Enter the number of hours worked during the first full week for the initial job placement. 00
161 Number of Hours
Worked During the 1st Please round up to the nearest hour.
Full Week in Initial
Placement into
Unsubsidized
Employment.
162 Benefits for Initial
Placement into
Unsubsidized
Employment

Enter the type of employment benefits (i.e., vacation and sick leave, health insurance,
tuition reimbursement, etc.) for this placement. 0 = no benefits; 1 = partial benefits; 2 =
full benefits.

0 = no benefits
1 = partial benefits
2 = full benefits

163 Date of Placement
Into Unsubsidized
Employment #2

Enter the date on which the participant started the unsubsidized employment.

MM/DD/YYYY

164 Employer Name for
Placement Into
Unsubsidized
Employment #2

Enter the employer's name for the participant's placement into unsubsidized employment. Text

165 Employer Contact for Enter the contact information for the employer for the participant's placement into
Placement Into
unsubsidized employment.
Unsubsidized
Employment #2

Text

166 Last Date of
Employment for
Placement into
Unsubsidized
Employment #2

MM/DD/YYYY

Enter the last date on which the participant worked for the employer.

37 of 65

No.

DATA ELEMENT
NAME

167 Hourly Wage at
Placement for
Placement into
Unsubsidized
Employment #2

DATA ELEMENT DEFINITIONS/INSTRUCTIONS
Enter the hourly wage for the unsubsidized unemployment at placement.

VALID VALUES
00.00

Enter the number of hours worked during the first full week for the placement into
168 Number of Hours
Worked During the 1st unsubsidized employment. Please round up to the nearest hour.
Full Week in
Placement into
Unsubsidized
Employment #2

169 Benefits for Placement Enter the type of employment benefits (i.e., vacation and sick leave, health insurance,
into Unsubsidized
tuition reimbursement, etc.) for this placement. 0 = no benefits; 1 = partial benefits; 2 =
Employment #2
full benefits.

0 = no benefits
1 = partial benefits
2 = full benefits

170 Repeat Fields 154 to
160 for Additional
Jobs

Grantees must be able to collect the above job information for as many jobs as the
participant has.

171 Initial Conviction

If the participant has never been previously convicted but is convicted after enrolling in
the program please select yes to record

1 = Yes

172 Date Initial Arrest

Enter the date on which the participant was convicted.

MM/DD/YYYY

38 of 65

No.

DATA ELEMENT
NAME

173 Re-Arrested/ ReIncarcerated

DATA ELEMENT DEFINITIONS/INSTRUCTIONS
Select the appropriate choice from below:
Re-arrested for a new crime if 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.)

VALID VALUES
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

Select No if none of the above conditions apply.
This field repeats as needed.

174 Date Re-Arrested/ Re- Enter the date on which the participant was re-arrested for a new crime or re-incarcerated MM/DD/YYYY
Incarcerated
for a violation of parole or probation.
This field repeats as needed for repeated.
175 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

176 Date Entered PostSecondary Education

Enter the date on which the participant enrolled in post-secondary education during
program participation..

MM/DD/YYYY
Blank = did not enter postsecondary education

Leave blank if the participant does not enter post-secondary education during program
participation.

39 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

177 Date Entered
Registered
Apprenticeship
Program

Enter the date on which the participant enrolled in registered apprenticeship during
program participation.

MM/DD/YYYY
Blank = did not enter postsecondary education

178 Employer Name for
Placement Into
Registered
Apprenticeship
Program

Enter the employer's name for the participant's placement into a registered apprenticeship Text
.

Leave blank if the participant does not enter a registered apprenticeship program during
program participation.

179 Employer Contact for Enter the contact information for the employer for the participant's placement into a
Placement Into
registered apprenticeship
Registered
Apprenticeship
Program

Text

180 Last Date of
Employment for
Placement into
Registered
Apprenticeship
Program

Enter the last date on which the participant worked for the employer.

MM/DD/YYYY

181 Hourly Wage at
Placement for
Placement into
Registered
Apprenticeship
Program

Enter the hourly wage for the registered apprenticeship at placement.

00.00

40 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

Enter the number of hours worked during the first full week for the placement into a
182 Number of Hours
Worked During the 1st registered apprenticeship. Please round up to the nearest hour.
Full Week in
Placement into
Registered
Apprenticeship
Program

183 Attained Driver's
License

1 = Yes

Select Yes if the participant earned driver's license otherwise leave blank

41 of 65

DATA ELEMENT
NAME
No.
DATA ELEMENT DEFINITIONS/INSTRUCTIONS
VALID VALUES
SECTION III.C - POST-PROGRAM EMPLOYMENT AND JOB RETENTION DATA
Select Yes if the participant was employed in the first quarter after the quarter of exit.
1 = Yes
184 Employed in 1st
Quarter After Exit
Select No if the participant was not employed in the first quarter after the quarter of exit. 2 = No
Quarter

185 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.

42 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

186 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.

MM/DD/YYYY

187 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 1 = Yes
earnings information for the 1st quarter after the exit quarter.
2 = No

Repeat for each follow-up attempt.

Enter No if the grantee did not successfully contact the participant to collect this
information.
Repeat for each follow-up attempt.

188 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

43 of 65

No.

DATA ELEMENT
NAME

189 Type of Employment
Match 2nd Quarter
After Exit Quarter

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

Use the appropriate code to identify the method used in determining the individual's
1 = UI Wage Records (In-State &
employment status in the second quarter following the quarter of exit. If the individual is WRIS)
found in more than once source of employment, record the data source for which the
2 = Federal Employment Records
individual's earnings are greatest.
(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.

Enter the number of hours worked in the first full week of employment during the 2nd
190 Hours Worked First
Full Week for the 2nd quarter after the exit quarter. Please round up to the nearest hour.
Quarter After the Exit
Quarter.

Enter the hourly wage for the job listed in the above element for in the first full week of
191 Hourly Wages First
Full Week of Work
employment during the 2nd quarter after the exit quarter.
for the 2nd Quarter
After the Exit Quarter

00.00

44 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

192 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 postprogram.

MM/DD/YYYY

193 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 1 = Yes
earnings information for the 2nd quarter after the exit quarter.
2 = No

Repeat for each follow-up attempt.

Enter no if the grantee did not successfully contact the participant to collect this
information.
Repeat for each follow-up attempt.

194 Employed in 3rd
Quarter After Exit
Quarter

Select Yes if the participant was employed in the third quarter after the quarter of exit.
1 = Yes
Select No if the participant was not employed in the third quarter after the quarter of exit. 2 = No

45 of 65

No.

DATA ELEMENT
NAME

195 Type of Employment
Match 3rd Quarter
After Exit Quarter

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

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.

Enter the number of hours worked in the first full week of employment during the 3rd
196 Hours Worked First
Full Week for the 3rd quarter after the exit quarter. Please round up to the nearest hour.
Quarter After the Exit
Quarter.

197 Hourly Wages First
Full Week of Work
for the 3rd quarter
after the exit quarter

00.00

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.

46 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

198 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 postprogram.

MM/DD/YYYY

199 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 1 = Yes
earnings information for the 3rd quarter after the exit quarter.
2 = No

Repeat for each follow-up attempt.

Enter No if the grantee did not successfully contact the participant to collect this
information.
Repeat for each follow-up attempt.

200 Employed in 4th
Quarter After Exit
Quarter

Select Yes if the participant was employed in the first quarter after the quarter of exit.
1 = Yes
Select No if the participant was not employed in the first quarter after the quarter of exit. 2 = No

47 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

201 Type of Employment
Match 4th Quarter
After Exit Quarter

202 Date of Follow-up for
4th 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.

MM/DD/YYYY

Repeat for each follow-up attempt.

48 of 65

No.

DATA ELEMENT
NAME

203 Successful Follow-up
for 4th Quarter After
the Exit Quarter
Employment and
Wage Information

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

Enter Yes if the grantee successfully contacted the participant to collect employment and 1 = Yes
earnings information for the 1st quarter after the exit quarter.
2 = No
Enter No if the grantee did not successfully contact the participant to collect this
information.
Repeat for each follow-up attempt.

49 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

SECTION III.D - POST-PROGRAM WAGE DATA
These fields are to be used for wage record data only.
204 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

205 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

206 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

207 Wages 4th 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

50 of 65

DATA ELEMENT
NAME
No.
DATA ELEMENT DEFINITIONS/INSTRUCTIONS
SECTION III.E - POST-PROGRAM POST-SECONDARY EDUCATION OR TRAINING
Select Yes if the participant was enrolled in post-secondary education or training in the
208 Enrolled in PostSecondary Education first quarter after the quarter of exit.
or Training in 1st
Select No if the participant was not enrolled in post-secondary education or training in
Quarter After Exit
the first quarter after the quarter of exit.
Quarter
209 Type of PostSecondary Education
or Training 1st
Quarter After Exit
Quarter

VALID VALUES
1 = Yes
2 = No

Enter the type of post-secondary education or training that the participant is enrolled in. 1 = Community College, AA
Advanced Training/Occupational Skills Training – To count as a placement for
degree track
the Youth Common Measures, advanced training constitutes an organized program of
2 = Community College,
study that provides specific vocational skills that lead to proficiency in performing actual Certificate track
tasks and technical functions required by certain occupational fields at entry,
3 = 4 Year College
intermediate, or advanced levels. Such training should: (1) be outcome-oriented and
4 = Long Term Occupational Skill
focused on a long-term goal as specified in the Individual Service Strategy, (2) be long- Training
term in nature and commence upon program exit rather than being short-term training
Blank = Not Enrolled in postthat is part of services received while enrolled in ETA-funded youth programs, and (3)
secondary education or training
result in attainment of a certificate (as defined below under this attachment).

51 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

210 Date of Follow-up for
1st Quarter After the
Exit Quarter PostSecondary Education
or Training

Enter the date on which the grantee attempted to contact the participant to obtain
information on enrollment in post-secondary education or training for the 1st quarter
after the exit quarter post-program.

211 Successful Follow-up
for 1st Quarter After
the Exit Quarter
Enrollment in PostSecondary Education
or Training

Enter Yes if the grantee successfully contacted the participant to collect information on
enrollment in post-secondary education or training for the 1st quarter after the exit
quarter.

VALID VALUES
MM/DD/YYYY

Repeat for each follow-up attempt.

1 = Yes
2 = No

Enter No if the grantee did not successfully contact the participant to collect this
information.
Repeat for each follow-up attempt.

212 Enrolled in PostSecondary Education
or Training in 2nd
Quarter After Exit
Quarter

Select Yes if the participant was enrolled in post-secondary education or training in the
second quarter after the quarter of exit.
Select No if the participant was not enrolled in post-secondary education or training in
the second quarter after the quarter of exit.

1 = Yes
2 = No

52 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

213 Type of PostSecondary Education
or Training 2nd
Quarter After Exit
Quarter

Enter the type of post-secondary education or training that the participant is enrolled in.

1 = Community College, AA
degree track
2 = Community College,
Certificate track
3 = 4 Year College
4 = Long Term Occupational Skill
Training
Blank = Not Enrolled in postsecondary education or training

214 Date of Follow-up for
2nd Quarter After the
Exit Quarter
Enrollment in PostSecondary Education
or Training

Enter the date on which the grantee attempted to contact the participant to obtain
information on enrollment in post-secondary education or training for the 2nd quarter
after the exit quarter post-program.

MM/DD/YYYY

215 Successful Follow-up
for 3rd Quarter After
the Exit Quarter
Enrollment in PostSecondary Education
or Training

Enter Yes if the grantee successfully contacted the participant to collect information on
enrollment in post-secondary education or training for the 3rd quarter after the exit
quarter.

Repeat for each follow-up attempt.

1 = Yes
2 = No

Enter No if the grantee did not successfully contact the participant to collect this
information.
Repeat for each follow-up attempt.

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No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

216 Enrolled in PostSecondary Education
or Training in 2nd
Quarter After Exit
Quarter

Select Yes if the participant was enrolled in post-secondary education or training in the
third quarter after the quarter of exit.
Select No if the participant was not enrolled in post-secondary education or training in
the third quarter after the quarter of exit.

1 = Yes
2 = No

217 Type of PostSecondary Education
or Training 3rd
Quarter After Exit
Quarter

Enter the type of post-secondary education or training that the participant is enrolled in.

218 Date of Follow-up for
3rd Quarter After the
Exit Quarter
Enrollment in PostSecondary Education
or Training

Enter the date on which the grantee attempted to contact the participant to obtain
information on enrollment in post-secondary education or training for the 3rd quarter
after the exit quarter post-program.

MM/DD/YYYY

Repeat for each follow-up attempt.

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No.

DATA ELEMENT
NAME

219 Successful Follow-up
for 3rd Quarter After
the Exit Quarter
Enrollment in PostSecondary Education
or Training

DATA ELEMENT DEFINITIONS/INSTRUCTIONS
Enter Yes if the grantee successfully contacted the participant to collect information on
enrollment in post-secondary education or training for the 3rd quarter after the exit
quarter.

VALID VALUES
1 = Yes
2 = No

Enter No if the grantee did not successfully contact the participant to collect this
information.
Repeat for each follow-up attempt.

220 Enrolled in PostSecondary Education
or Training in 4th
Quarter After Exit
Quarter

Select Yes if the participant was enrolled in post-secondary education or training in the
fourth quarter after the quarter of exit.
Select No if the participant was not enrolled in post-secondary education or training in
the fourth quarter after the quarter of exit.

1 = Yes
2 = No

221 Type of PostSecondary Education
or Training 4th
Quarter After Exit
Quarter

Enter the type of post-secondary education or training that the participant is enrolled in.

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No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

222 Date of Follow-up for
4th Quarter After the
Exit Quarter
Enrollment in PostSecondary Education
or Training

Enter the date on which the grantee attempted to contact the participant to obtain
information on enrollment in post-secondary education or training for the 4th quarter
after the exit quarter post-program.

223 Successful Follow-up
for 4th Quarter After
the Exit Quarter
Enrollment in PostSecondary Education
or Training

Enter Yes if the grantee successfully contacted the participant to collect information on
enrollment in post-secondary education or training for the 1st quarter after the exit
quarter.

VALID VALUES
MM/DD/YYYY

Repeat for each follow-up attempt.

1 = Yes
2 = No

Enter No if the grantee did not successfully contact the participant to collect this
information.
Repeat for each follow-up attempt.

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No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

SECTION III.F- EDUCATION AND CREDENTIAL DATA
Select attained a secondary school diploma individual attained a secondary school
1 = Attained a secondary school
224 Attained Diploma,
GED, or Certificate #1 (high school) diploma recognized by the State.
(high school) diploma.
Select attained a GED or high school equivalency diploma if the individual attained a 2 = Attained a GED or high
GED or high school equivalency diploma recognized by the State.
school equivalency diploma.
Select attained a certificate in recognition of attainment of technical or occupational 3 = Attained a certificate in
skills if the individual attained a certificate in recognition of attainment of technical or
recognition of attainment of
occupational skills.
technical or occupational skills.
Select did not attain a diploma, GED, or certificate if the individual did not attain a
4 = Did not attain a diploma,
diploma, GED, or certificate.
GED, or certificate.

225 Date Attained Degree Record the date on which the individual attained a diploma, GED, or certificate.
or Certificate #1
Leave "blank" if the individual did not attain a diploma, GED, or certificate.

MM/DD/YYYY
Blank = did not attain diploma,
GED, or certificate

226 Specify the Name of
Certificate #1

Text
Blank = no certificate achieved

Specify the name of the first certificate achieved.
Leave blank if no certificate was achieved.

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No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

Select attained a secondary school diploma individual attained a secondary school
1 = Attained a secondary school
227 Attained Diploma,
GED, or Certificate #2 (high school) diploma recognized by the State.
(high school) diploma.
Select attained a GED or high school equivalency diploma if the individual attained a 2 = Attained a GED or high
GED or high school equivalency diploma recognized by the State.
school equivalency diploma.
Select attained a certificate in recognition of attainment of technical or occupational 3 = Attained a certificate in
skills if the individual attained a certificate in recognition of attainment of technical or
recognition of attainment of
occupational skills.
technical or occupational skills.
Select did not attain a diploma, GED, or certificate if the individual did not attain a
4 = Did not attain a diploma,
diploma, GED, or certificate.
GED, or certificate

228 Date Attained Degree Record the date on which the individual attained a diploma, GED, or certificate.
or Certificate #2
Leave "blank" if the individual did not attain a diploma, GED, or certificate.

MM/DD/YYYY
Blank = did not attain diploma,
GED, or certificate

229 Specify the Name of
Certificate #2

Text
Blank = no certificate achieved

Specify the name of the second certificate achieved.
Leave blank if no certificate was achieved.

58 of 65

DATA ELEMENT
NAME
No.
DATA ELEMENT DEFINITIONS/INSTRUCTIONS
SECTION III.G - ADDITIONAL LITERACY AND NUMERACY ASSESSMENT DATA
Record 1 if the participant was assessed using approved tests for Adult Basic Education
230 Category of
Assessment
(ABE)
Record 2 if the participant was assessed using approved tests for English-As-A-Second
Language (ESL)
Record 0 or leave "blank" if the individual was not assessed in literacy or numeracy.

VALID VALUES
1 = ABE
2 = ESL

231 Type of Assessment
Test

Use the appropriate code to record the type of assessment test that was administered to
the youth participant.
Record 0 or leave "blank" if the individual was not assessed in literacy or numeracy.

1 = TABE 7-8, 9-10
2 = CASAS
3 = ABLE
4 = WorkKeys
5 = SPL
6 = BEST
7 = BEST Plus
8 = Other Approved Assessment
Tool

232 Functional Area

Use the appropriate code for the functional area of the assessment test that was
administered to the youth participant.
Record 0 or leave "blank" if the individual was not assessed in literacy or numeracy.

1 = Reading
2 = Writing
3 = Language
4 = Mathematics
5 = Speaking
6 = Oral
7 = Other Literacy Functional
Area
8 = Other Numeracy Functional
Area

233 Date Administered
Pre-Test

Record the date on which the pre-assessment test was administered to the youth
participant.
Leave "blank" if the individual was not assessed in literacy or numeracy.

YYYYMMDD

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No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

234 Pre-Test Score

Record the raw scale score achieved by the youth participant on the pre-assessment test.
Record 000 or leave "blank" if the individual was not assessed in literacy or numeracy.

000

235 Educational
Functioning Level

Record the educational functioning level that is associated with the youth participant's
raw scale score.
Record 0 or leave "blank" if the individual was not assessed in literacy or numeracy.

1 = Beginning ABE/ESL Literacy
2 = Beginning ABE/ESL Basic
Education
3 = Low Intermediate ABE/ESL
Education
4 = High Intermediate ABE/ESL
Education
5 = Low Adult Secondary
Education/Advanced ESL
6 = High Adult Secondary
Education/Advanced ESL

236 Date Administered
Post-Test #1

Record the date on which the post-test was administered to the youth during his/her first YYYYMMDD
year of participation in the program. If multiple post-tests were administered, record the
most recent date on which the functional area post-test was administered.
Leave "blank" if the youth did not receive a post-test during his/her first year of
participation in the program.

237 Post-Test Score #1

Record the raw scale score achieved by the youth participant.
Record 000 or leave "blank" if the youth did not receive a post-test during his/her first
year of participation in the program.

000

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No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

Record the educational functioning level that is associated with the youth participant's
238 Educational
Functioning Level #1 raw scale score.
Record 0 or leave "blank" if the youth did not receive a post-test during his/her first year
of participation in the program.

VALID VALUES
1 = Beginning ESL Literacy
2 = Low Beginning ESL Basic
Education
3 = Beginning ABE
Literacy/High Beginning ESL
Literacy
4 = ABE: Beginning Basic
Educationor ESL: Low
Intermediate ESL
5 = ABE:Low Intermediate Basic
Education or ESL: High
Intermediate ESL
6 = ABE: High Intermediate
Basic Education or Advanced
ESL
7=
ABE: Low Adult Secondary
Education or ESL: Exit ESL
8= ABE: High Adult Secondary
Education (Not Basic Skills
Deficient)

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No.

DATA ELEMENT
NAME

239 Date Administered
Post-Test #2

DATA ELEMENT DEFINITIONS/INSTRUCTIONS
Record the date on which the post-test was administered to the youth during his/her
second year of participation in the program. If multiple post-tests were administered,
record the most recent date on which the functional area post-test was administered.
Leave "blank" if the youth did not receive a post-test during his/her second year of
participation in the program.

VALID VALUES
YYYYMMDD

Additional Note: For WIASRD Elements #710-712, these fields are only reported for
youth who remain basic skills deficient and continue to participate in the program for a
second full year. At the completion of the second year, the individual should be posttested and the information reported in these fields. To determine an increase of one or
more levels, the individual's post-test scores from the second year in the program will be
compared to the scores from the test that was administered at the latest point during the
first year.

240 Post-Test Score #2

Record the raw scale score achieved by the youth participant.
000
Record 000 or leave "blank" if the youth did not receive a post-test during his/her second
year of participation in the program.

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No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

Record the educational functioning level that is associated with the youth participant's
241 Educational
Functioning Level #2 raw scale score.
Record 0 or leave "blank" if the youth did not receive a post-test during his/her second
year of participation in the program.

242 Date Administered
Post-Test #3

VALID VALUES
1 = Beginning ABE/ESL Literacy
2 = Beginning ABE/ESL Basic
Education
3 = Low Intermediate ABE/ESL
Education
4 = High Intermediate ABE/ESL
Education
5 = Low Adult Secondary
Education/Advanced ESL
6 = High Adult Secondary
Education/Advanced ESL

Record the date on which the post-test was administered to the youth during his/her third YYYYMMDD
year of participation in the program. If multiple post-tests were administered, record the
most recent date on which the functional area post-test was administered.
Leave "blank" if the youth did not receive a post-test during his/her third year of
participation in the program.
Additional Note: For WIASRD Elements #713-715, these fields are only reported for
youth who remain basic skills deficient and continue to participate in the program for a
third full year. At the completion of the third year, the individual should be post-tested
and the information reported in these fields. To determine an increase of one or more
levels, the individual's post-test scores from the third year in the program will be
compared to the scores from the test that was administered at the completion of the
second year.

63 of 65

No.

DATA ELEMENT
NAME

243 Post-Test Score #3

DATA ELEMENT DEFINITIONS/INSTRUCTIONS
Record the raw scale score achieved by the youth participant.
Record 000 or leave "blank" if the youth did not receive a post-test during his/her third
year of participation in the program.

VALID VALUES
000

Record the educational functioning level that is associated with the youth participant's
1 = Beginning ABE/ESL Literacy
244 Educational
Functioning Level #3 raw scale score.
2 = Beginning ABE/ESL Basic
Record 0 or leave "blank" if the youth did not receive a post-test during his/her third year Education
of participation in the program.
3 = Low Intermediate ABE/ESL
Education
4 = High Intermediate ABE/ESL
Education
5 = Low Adult Secondary
Education/Advanced ESL
6 = High Adult Secondary
Education/Advanced ESL

64 of 65

No.

DATA ELEMENT
NAME

DATA ELEMENT DEFINITIONS/INSTRUCTIONS

VALID VALUES

The collection of ABE/ESL assessment data for youth who are basic skills deficient is
245 Information on
Additional Functional organized according to the Type of Assessment Test and Functional Area, providing
Areas
space for the collection of up to 3 annual post-test scores in each functional area.
Additional space has been provided on the record layout so that information on youth
achievement in more than one functional area (e.g., reading, mathematics) can be
reported as needed to fully reflect progress toward literacy or numeracy gains. For
example, if the youth is assessed using TABE 9-10 in Reading and Math, data elements
702-715 will be used to track achievement in the Reading functional area (if necessary,
for up to 3 full years) and then repeat to track achievement in the Math functional area (if
necessary, for up to 3 full years) using the additional spaces 716-729 provided on the
record layout.

65 of 65