Form IA 7702 IA 7702 Version 1 - Statistical Report

IA Form 7702 OMB Control No. 1076-0135 (Version 1)

Expiration Date: mm/dd/yyyy

P.L. 102-477 DEMONSTRATION PROJECT -- STATISTICAL REPORT

Tribe: Name & Address	Report Period	ID Number
	From:
	To:

I. People Served/Outcomes (Employment & Training Services)	Number
A. Total Participants
B. Total Terminations
1. Entered Unsubsidized Employment
a. Long term TANF Recipients Entered Unsubsidized Employment
2. Completed Education/Training Objective
3. Completed Other Plan Objective
4. Other Terminations
C. Total Current Participants

II. Terminee Characteristics

Characteristic	Number	Characteristics	Number
Male		High School Grad/GED
Female		Post-High School
Youth (21 and under)		Barriers to Employment
Adults (22 and over)		BIA General Asst. Recipient
Dropouts		Veteran
Students		TANF Recipients
		Placements with duration of 90 days or more

III. Program Activities and Services

Activity	Number	Activity	Number
Classroom Training		Families Receiving Child Care
On-the-Job Training		Children Receiving Child Care
Supported Work Services		Ages 0 - 3 years
Supportive Services		Ages 4 - 5 years
Other Tribal Services		Ages 6 years and over

Name of Tribal Contact Person for This Report	Phone Number	Date

Instructions for Completing the

P.L. 102-477 Demonstration Project -- Statistical Report

The term “program” and P.L. 102-477 “project” are used interchangeably in the instructions that follow.

Identification Section

Provide the name and mailing address of the tribe, along with the report period and identifying number, if any, assigned by the relevant BIA grant awarding official.

I. People Served/Outcomes Section

This section covers both youth and adults receiving employment, training or education services. It does not include children provided with child care services.

A. For this report, a participant is a person determined to be eligible for participation in the tribe’s P.L. 102-477 project and who has begun to receive services, including formal assessment or employability planning services.

B. For purposes of this report, “termination” includes any participant who has completed his or her program of services under the P.L. 102-477 project. The information recorded regarding the outcome for such a terminee can be recorded at any point in the 90 day period following the person’s termination from the program.

(1) Entered total number of participants that have entered Unsubsidized Employment in any job placement in a position not supported with funds from the program and not part of a supported work assignment. It can include self-employment.

(a) A “Long term TANF participant entered unsubsidized employment” is a participant who has been determined eligible for TANF assistance at the time of entry into the program and received assistance for at least 30 months (whether or not consecutive).

(2) Completed Education/Training Objective is the termination of a person who does not enter unsubsidized employment, but does successfully complete one or more of the objectives in the person’s employability plan related to education or job-specific skill training.

(3) Completed Other Plan Objective is the termination of a person who does not enter unsubsidized employment and does not complete any education or training objectives, but who successfully completes one or more of the other objectives of their participation as specified in the person’s employability plan.

(4) Other Terminations are terminations which cannot be classified into either of the three other categories.

Items I.B.(1), I.B.(2), I.B.(3) and I.B.(4) must total the same number as in Line I.B. Items I.B. and I.C. must total the same number as in Line I.A.

II. Terminee Characteristics

This section is used to record the characteristics of those persons who terminated from the program during the report period.

- A “Dropout” is a person not attending school at the time of entry into the program and who does not have a high school diploma or GED.

- A “Student” is a person who does not have a high school diploma or GED, but who is attending school at the time of entry into the program.

- A “High School Graduate/GED” individual is one who, at the time of entry into the program, does have a high school diploma or GED, but who has not had any formal postsecondary education.

- A “Post-High School” person is one who, at the time of entry into the program, has had formal postsecondary education.

- “Barriers to employment” include a person’s situation as an ex-offender, a substance abuser, one with an intermittent work history, one with a history of dependence on public assistance or another type of condition which makes it unlikely that the person would be able to successfully compete for an employment opportunity against other applicants without such barriers.

- “Placements with duration of 90 days or more” include participants placed in unsubsidized employment lasting at 90 days or more.

The total number of persons in all of the educational categories will equal the total number of terminees.

III. Program Activities and Services Section

This section is used to record the services which all participants are receiving or have received during their participation in the program. A person may be counted once for each category of services they receive during the reporting period.

- “Classroom training” is any educational or vocational training service normally conducted in a formal classroom setting. It includes adult basic education, GED preparation, postsecondary education, vocational education and training in job-specific skills.

- “On-the-job training” is training conducted at a work site where the employer is reimbursed for such training through a formal contract with the program.

- “Supported work services” involve work experience and training at a work site where the employer is not reimbursed for such services through a formal contract with the program. This includes work experience where the participant is paid directly by the program, as well as unpaid work experience for persons on public assistance.

- “Supportive services” include such services as transportation, child care, work clothing and tools or similar services necessary to enable the participant to take part in the program, to seek employment or to adjust to a new job.

- “Other tribal services” are services provided other than those described above. One example of such services would be those provided through a Tribal Employment Rights Office.

- “Families receiving child care” is a count of the total number of family units provided with child care services which are funded through the tribes approved P.L. 102-477 budget.

- “Children receiving child care” is a count of the total number of such children served. The three age categories will add up to the total number of children shown receiving child care. These child care services include any such services provided through the program, regardless of whether the program’s P.L. 102-477 budget includes funds from formal child care programs, such as the Child Care Development Fund program. Note the requirement for additional details on child care described in the instructions for the narrative portion of the P.L. 102-477 report.

Paperwork Reduction Act Statement: The information being collected meets the requirements of Public Law 102-477 for program evaluation, compliance, audit and program planning and management purposes. The data collected is shared with all participating Federal agencies providing funds. The reports are used to monitor the progress of the grantees in delivering services to tribal members, to identify unmet needs, to identify any other problems, and to provide information to justify budget submissions by the three federal agencies involved. Only tribes who have voluntarily applied to participate in this project will submit the annual report. Response is required to obtain benefits of the program. This report takes about 16 hours to complete. An agency may not request or sponsor a collection of information, and a person is not required to respond to a request, if a valid OMB control number is not provided. Comments concerning this information collection can be sent to: Information Collection Clearance Officer, Office of Regulatory Affairs – Indian Affairs, 1849 C Street, NW, Mail Stop 3071, Washington, DC 20240. Please note: comments, names and addresses of commenters are available for public review during regular business hours. If you wish us to withhold this information, you must state that prominently at the beginning of your comment. We will honor your request to the extent allowable by law.

OMB Control No. 1076-0135

Expiration Date: mm/dd/yyyy

NOTE: IA Form 7702 will be obsolete starting Month, Date, 2017