YCC QPR Form

STANDARDIZED QUARTERLY PERFORMANCE PROGRESS REPORT Employment and Training Administration H-1B Youth Career Connect Quarterly Report Form OMB No. xxxx-xxxx Form No. ETA XXXX Expiration x/x/x
A. GRANTEE IDENTIFYING INFORMATION
1. Grantee Name:
2. Grant Number:
3. Program/Project Name:
4. Grantee Address: City: __________________________________________ State: ______________________________________ Zip Code: ____________
5. Grantee Target Industry(ies)/Occupation(s):
6. Report Quarter End Date: mm/dd/yyyy
7. Report Due Date: mm/dd/yyyy
Performance Items		Previous Quarter (A)	Current Quarter (B)	Program Year-to-Date (C)	Cumulative Grant-to-Date (D)	Grantee Target (E)
B. GRANT SUMMARY INFORMATION
1. New Participants Enrolled
2. Participants Receiving Program Services						na
3. Participants Completed Program						na
4. Participants Exited Program						na
C. PARTICIPANT SUMMARY INFORMATION
Gender	1a. Male					na
	1b. Female					na
Ethnicity/Race	2a. Hispanic/Latino					na
	2b. American Indian or Alaskan Native					na
	2c. Asian					na
	2d. Black or African American					na
	2e. Native Hawaiian or Other Pacific Islander					na
	2f. White					na
	2g. More Than One Race					na
Other Demographics	3a. Eligible Veterans					na
	3b. Individuals with a Disability					na
	3c. Homeless/Runaway					na
	3d. Offender					na
	3e. Low Income					na
	3f. Limited English Language Proficiency					na
	3g. Pregnant/Parenting Youth					na
	3h. Foster Youth					na
Grade At Time of Enrollment	4a. 9th Grade					na
	4b. 10th Grade					na
	4c. 11th Grade					na
D. PROGRAM SERVICES
Program Services	1. Number of Professional Development Activities Conducted					na
	2. Number of Students Participated in Career/Academic Counseling					na
	3. Number of Students Participated in Community Service Learning					na
	4. Number of Students Participated in Mentoring					na
	5. Number of Students Participated in Work Experience					na
	6. Number of Students Participated in Leadership Development					na
	7. Number of Students who Received Supportive Services					na
	8. Number of Students Participated in Internship					na
	9. Number of Students Participated in Employer Provided Services					na
	10. Number of Students Entered Industry-Specific YCC Courses					na
E. PARTICIPANT OUTCOMES
	E.i. Participant Activities
Program Outcomes	1. Number of Students who Entered Unsubsidized Employment					na
	2. Number of Students who Entered Training-Related Employment					na
	3. Number of Students who Entered Long-Term Occupational Skills Training					na
	4. Number of Students who Entered Post-Secondary Education					na
	5. Number of Students who Earned an Industry-Recognized Credential					na
	6. Number of Students who Earned a High School Diploma					na
	7. Number of Students who Entered Registered Apprenticeship					na
	E.ii. Completion Outcomes
	8. Number of Students who Completed Program and Entered Unsubsizdized Employment					na
	9. Number of Students who Completed Program and Entered Unsubsidized Training-Related Employment					na
	10. Number of Students who Completed Program and Entered Long-Term Occupational Skills Training					na
	11. Number of Students who Completed Program and Entered Post-Secondary Education					na
	12. Number of Students who Completed Program and Earned an Industry-Recognized Credential					na
	13. Number of Students who Completed Program and Earned a High School Diploma					na
	14. Number of Students who Completed Program and Entered Registered Apprenticeship					na
F. SHORT-TERM PERFORMANCE INDICATORS
Short-term Indicators	1. Enrollment Rate	na	na
	Numerator	na	na			na
	Denominator	na	na			na
	2. Attendance Rate
	Numerator					na
	Denominator					na
	3. Chronic Absence Rate
	Numerator					na
	Denominator					na
	4. Mentoring Rate
	Numerator					na
	Denominator					na
	5. Yearly Program Retention Rate	na	na
	Numerator	na	na			na
	Denominator	na	na			na
	6. Work Readiness Attainment Rate
	Numerator					na
	Denominator					na
	7. Internship Placement Rate
	Numerator					na
	Denominator					na
	8. Internship Completion Rate
	Numerator					na
	Denominator					na
	9. Post-Secondary Credit Attainment Rate
	Numerator					na
	Denominator					na
	10. Average Hours of Post-Secondary Credit
	Numerator					na
	Denominator					na
G. LONG-TERM PERFORMANCE INDICATORS
Long-term Indicators	1. Program Completion Rate	na	na
	Numerator	na	na			na
	Denominator	na	na			na
	2. High School Diploma Attainment Rate
	Numerator					na
	Denominator					na
	3. Industry-Recognized Credential Attainment Rate
	Numerator					na
	Denominator					na
	4. Diploma and Credential Attainment Rate
	Numerator					na
	Denominator					na
	5. Placement Rate
	Numerator					na
	Denominator					na
G. REPORT CERTIFICATION/ADDITIONAL COMMENTS
1. Report Comments/Narrative:
2. Name of Grantee Certifying Official/Title:		3. Telephone Number:
4. Email Address:
Persons are not required to respond unless this form displays a currently valid OMB number. Obligation to respond is required to obtain or retain benefits (Workforce Investment Act [Section 185(a)(2)]. Public reporting burden for this collection of information, which is to assist with planning and program management and to meet Congressional and statutory requirements, averages 2.66 hours per record, including time to review instructions, search existing data sources, gather and maintain the data needed, and complete and review the collection of information. Send comments regarding this burden estimate to the U.S. Department of Labor, ETA, Room C-4518, 200 Constitution Avenue, NW, Washington, DC 20210-0001
DOL, ETA Internal Use Only
Additional Comments:
Regional Federal Project Officer:
National Program Office: