Category 2 Measueres (6 measures)

Pregnancy Assistance Fund (PAF) Performance Measures Collection

0990-0416_Attachment D_Forms_Category 2 _PAF PM Renewal_0990_0416

Category 2 Measueres (6 measures)

OMB: 0990-0416

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OMB #:0990-0416

Expiration Date: xx/xx/xxxx

Attachment D: Form for Category 2 Grantee Programs (Grantees Working with High Schools or Community Service Centers)



2.1 What is the number of expectant and parenting participants by their high school enrollment status?

Indicate the number for each category below.

a) Enrolled, Freshman

b) Enrolled, Sophomore

c) Enrolled, Junior

d) Enrolled, Senior

e) Preparing for General Education Diploma (GED)

f) Not enrolled in high school or preparing for the GED

2.2 How many expectant and parenting high school students served dropped out of high school during the school year?

2.3 How many expectant and parenting students served who were high school seniors at enrollment or at the beginning of the program year that graduated from high school at the end of the school year?

2.4 How many expectant and parenting participants passed the GED exam during the program year?


2.5 How many expectant and parenting participants who either graduated from high school or obtained a GED that are accepted into an IHE?

2.6 How many parenting participants 19 years and younger reported a new pregnancy during the program year?


According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0990-0416. The time required to complete this information collection is estimated to average 9 hours per respondent, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services, OS/OCIO/PRA, 200 Independence Ave., S.W., Suite 336-E, Washington D.C. 20201, Attention: PRA Reports Clearance Officer


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AuthorTara Rice
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