|
|
|
|
|
|
|
|
|
|
OMB Approval 1293-0014 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Expires 9/30/2019 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Public Burden Statement - 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 valid OMB control number for this information collection is 1293-0014. The time required to complete this information collection is 1 hour per response, including the time to review instructions, search existing data sources, gather the data needed, and complete and review the information collection. The obligation to respond is required to obtain or retain a benefit (38 U.S.C. 2021 and 2023). If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Labor, Veterans' Employment and Training Service, 200 Constitution Avenue, N.W., Washington D.C. 20210. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Attachment B |
|
|
|
|
|
|
|
|
|
|
|
United States Department of Labor |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Veterans' Employment and Training Service |
|
|
|
|
|
|
Competitve Grants Planned Goals Chart |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
PLEASE NOTE: Use the "Tab" key to navigate. Incorrect entries appear in a red font. |
|
|
For the below homeless veteran subgroups, enter the planned percentage of total enrollments to be served as stated in your application narrative. |
% of Total Planned Enrollments |
|
|
|
|
|
|
|
Applicant Name |
|
|
Period of Performance: |
|
|
Chronically Homeless Veteran |
0% |
|
|
|
|
|
|
|
Enter Name |
|
Enter Period of Performance |
|
Female Homeless Veteran |
0% |
|
|
|
|
|
|
|
Name of Project |
|
|
Funding Amount: |
|
|
Homeless Veteran with Family |
0% |
|
|
|
|
|
|
|
Enter Name of the Project |
|
Enter Amount |
|
IVTP Eligible |
0% |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
If applicable, enter data for the follow-up periods covered by your grant. |
|
|
|
|
|
|
|
|
Core Operation Year Goals (Not Cumulative) |
90 day F/U |
180 day F/U |
270 day F/U |
365 day Final |
|
|
|
|
|
|
1. |
Planned Performance |
Jul-Sep |
Oct-Dec |
Jan-Mar |
Apr-Jun |
Total |
|
|
|
|
|
a. |
# of Eligibility Assessments |
0 |
0 |
0 |
0 |
|
|
|
|
0 |
|
|
|
|
|
b. |
# of Participants Enrolled |
0 |
0 |
0 |
0 |
|
|
|
|
0 |
|
|
|
|
0 |
c. |
# Placed in Trans.or Perm Housing |
0 |
0 |
0 |
0 |
|
|
|
|
0 |
|
|
|
|
|
d. |
# Referred to VA for Benefits |
0 |
0 |
0 |
0 |
|
|
|
|
0 |
|
|
|
|
|
e. |
# Placed into Employment (cannot be greater than # exits) |
0 |
0 |
0 |
0 |
|
0 |
|
|
|
|
0 |
f. |
Average Hourly Wage at Placement |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
|
|
|
$0.00 |
|
|
|
|
$0.00 |
g. |
Placement Rate Overall (calculated: 1e/1j=rate) |
0.0% |
0.0% |
0.0% |
0.0% |
Don't forget to enter the planned overall placement rate for the chronically homeless |
0% |
|
|
|
|
0.00 |
h. |
Placement Rate for the Chronically Homeless (a subset of 1g) |
0.0% |
0.0% |
0.0% |
0.0% |
0% |
|
|
|
|
0.00 |
i. |
Cost Per Placement (calculated: 1e/4d=cost) |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
|
|
|
|
#DIV/0! |
j. |
# of Exiters |
0 |
0 |
0 |
0 |
|
|
|
|
0 |
|
|
|
|
|
m. |
# Earned Wages in the 2nd Full Quarter After Exit |
|
|
0 |
0 |
0 |
0 |
|
|
0 |
|
|
|
|
|
n. |
Employment Rate in the 2nd Quarter After Exit (calc.) |
|
|
0.0% |
0.0% |
0.0% |
0.0% |
|
|
0.0% |
|
|
|
|
0.0% |
o. |
# Earned Wages in the 4th Full Quarter After Exit |
|
|
|
|
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
p. |
Employment Rate in the 4th Quarter After Exit (calc.) |
|
|
|
|
0.0% |
0.0% |
0.0% |
0.0% |
0.0% |
|
|
|
|
0.0% |
q. |
Median Quarterly Earnings in the 2nd Qtr. After Exit |
|
|
$0.00 |
$0.00 |
$0.00 |
$0.00 |
Don't forget to enter overall >>> |
|
$0.00 |
|
|
|
|
$0.00 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
2. |
Planned Training Activities |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
a. |
Unduplicated Count of Those Trained by the Quarter the Participant First Received Training |
0 |
0 |
0 |
0 |
|
|
|
|
0 |
|
|
|
|
|
b. |
% of Participants Trained (calculated cumulative percentage) |
0.0% |
0.0% |
0.0% |
0.0% |
|
|
|
|
0% |
|
|
|
|
|
c. |
Class-Room-Training |
0 |
0 |
0 |
0 |
|
|
|
|
0 |
|
|
|
|
|
d. |
On-the-Job Training |
0 |
0 |
0 |
0 |
|
|
|
|
0 |
|
|
|
|
|
e. |
Occupational Skills Training |
0 |
0 |
0 |
0 |
|
|
|
|
0 |
|
|
|
|
|
f. |
Apprenticeship Training |
0 |
0 |
0 |
0 |
|
|
|
|
0 |
|
|
|
|
|
g. |
Upgrading and Retraining |
0 |
0 |
0 |
0 |
|
|
|
|
0 |
|
|
|
|
|
h. |
Other Training |
0 |
0 |
0 |
0 |
|
|
|
|
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
3. |
Planned Supportive Services |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
a. |
Job Search Assistance |
0 |
0 |
0 |
0 |
|
|
|
|
0 |
|
|
|
|
|
b. |
Life Skills and Money Management |
0 |
0 |
0 |
0 |
|
|
|
|
0 |
|
|
|
|
|
c. |
Counseling/Vocational Guidance |
0 |
0 |
0 |
0 |
|
|
|
|
0 |
|
|
|
|
|
d. |
Job Club Workshops |
0 |
0 |
0 |
0 |
|
|
|
|
0 |
|
|
|
|
|
e. |
Compensated Work Therapy |
0 |
0 |
0 |
0 |
|
|
|
|
0 |
|
|
|
|
|
f. |
Tools/Fees/Specific Work Clothing/Boots |
0 |
0 |
0 |
0 |
|
|
|
|
0 |
|
|
|
|
|
g. |
Other Supportive Services |
0 |
0 |
0 |
0 |
|
|
|
|
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
4. |
Planned Expenditures |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
a. |
Participant Services |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
|
|
|
|
$0.00 |
|
|
|
|
$0.00 |
b. |
Admin Costs |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
|
|
|
|
$0.00 |
|
|
|
|
$0.00 |
c. |
Stand Down (requires prior approval from the Grant Officer) |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
|
|
|
|
$0.00 |
|
|
|
|
$0.00 |
d. |
Total Expenditures (calculated) |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
|
|
|
|
$0.00 |
|
|
|
|
$0.00 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
VETS-700 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|