Enter a unique ID for the participant. Please do not use SSNs.
Participant ID (DO NOT USE SSN) |
You may use the first four letters of Last Name, followed by First/Middle Initials (e.g. Robert B. Johnson = JOHNRB) or you may assign another label that is not the actual full name of the particiant that will assist you in tracking the progress of the participant. This information feeds into the VETS-701C through VETS-701F worksheets.
Participant Name (Do not use Actual Full Names) |
Enter the date the participant first received qualified (i.e., not self-service, informational, or follow-up) grant-funded services or benefits. If this is an option year award and the first service occurred in a prior program year, enter that original date.
Service Start Date (YYYY/MM/DD)
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The date the participant was enrolled in Wagner-Peyser Act, Jobs for Veterans State Grant, and/or Workforce Innovation and Opportunity Act services via an American Job Center (AJC).
Date First Registered in American Job Center (AJC) (YYYY/MM/DD) |
The participant is co-enrolled in
Wagner-Peyser Act, Jobs for Veterans State Grant, and/or Workforce Innovation and Opportunity Act services via an American Job Center (AJC).
Co-Enrolled in American Job Center (AJC) (1=Yes, 0=No) |
Grant and per Diem (VA Transitional Housing).
Co-Enrolled in VA's Grant and Per Diem (GPD) (1=Yes, 0=No) |
Received a VA supported housing voucher through Veterans Affairs Supportive Housing (VASH) program.
Co-Enrolled in Veterans Affairs Supportive Housing (VASH) (1=Yes, 0=No) |
Supportive Services for Veteran Families (SSVF).
Co-Enrolled in Supportive Services for Veteran Families (SSVF) (1=Yes, 0=No) |
Receiving rental assistance from a SSVF provider.
Co-Enrolled in SSVF-Shallow Subsidy (1=Yes, 0=No) |
Federal Emergency Management Agency (FEMA).
Co-Enrolled in FEMA (1=Yes, 0=No) |
Native American Housing Assistance and Self-Determination Act.
Co-Enrolled in Native American Housing Assistance & Self-Determination Act (NAHASDA) (1=Yes, 0=No) |
VA's Homelessness Prevention & Rapid Re-Housing Program.
Co-Enrolled in VA's Homelessness Prevention and Rapid Re-Housing Program (HPRP) (1=Yes, 0=No) |
Record the final date the participant received funded services that are not self-service, information-only, or follow up services. Record this last date of receipt of services only if there are no future services, that are not self-service, information-only, or follow up services, planned from the program.
Service End Date (Leave Blank for Persons to be Carried Forward to a Subsequent Grant) (YYYY/MM/DD) |
Please indicate whether the participant was employed when they exited the program.
Placed in Employment (1=Yes, 0=No) |
If the participant is reported as employed, then please provide the Hourly Wage paid to the individual.
Hourly Wage at Placement
|
Please indicate the Gender of the participant.
Gender (1=Male, 2=Female) |
Please indicate if the participant is of Hispanic or Latino origin.
Ethnicity (1=Hispanic or Latino, 0=Not Hispanic or Latino) |
Enter Yes for a person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.
American Indian or Alaska Native (1=Yes, 0=No) |
Enter Yes for a person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
Asian (1=Yes, 0=No) |
Enter Yes for a person having origins in any of the black racial groups of Africa. Terms such as "Haitian" or "Negro" can be used in addition to "Black or African American."
Black or African American (1=Yes, 0=No) |
Enter Yes for a person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
Native Hawaiian or Other Pacific Islander (1=Yes, 0=No) |
Enter Yes for a person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
White (1=Yes, 0=No) |
Please indicate the age of the participant at the time the first program-funded service was rendered.
Age (at First Service) |
The date the veteran entered military service as indicated in the DD214.
Date Entered Military Service |
The date the veteran was discharged from military service as indicated in the DD214.
Date of Military Discharge |
Enter the Last Branch of Military Service.
Last Branch of Military Service |
Enter the Highest Education Level at the time the first service was rendered:
1 = Attained secondary school diploma
2 = Attained a secondary school equivalency
3 = The participant with a disability receives a certificate of attendance/completion as a result of successfully completing an Individualized Education Program (IEP)
4 = Completed one of more years of postsecondary education
5 = Attained a postsecondary technical or vocational certificate (non-degree)
6 = Attained an Associate's degree
7 = Attained a Bachelor's degree
8 = Attained a degree beyond a Bachelor's degree
0 = No Educational Level Completed
Highest Education Level (at First Service) |
An individual is at risk for homelessness when the individual lacks the resources and support networks needed to obtain housing. The risk must be real and imminent (within 60 days). In some sense, anyone living below the poverty level may be at risk of homelessness.
An individual may be either at risk for homelessness or homeless, but not both at once.
At Risk of Homelessness (1=Yes, 0=No) |
Is a veteran who is homeless, meaning:
1. A person who lacks a fixed, regular, and adequate nighttime residence;
2. A person living in a supervised public or privately operated shelter designed to provide temporary living arrangements;
3. A person who resided in a shelter or place not meant for human habitation and who is exiting an institution where he or she temporarily resided;
4. A person with a primary nighttime residence that is a public or private place not designed for or ordinarily used as a regular sleeping accommodation for human beings, including a car, park, abandoned building, bus or train station, airport, or camping ground;
5. An individual who will imminently lose his or her housing, has no subsequent residence identified, and who lacks the resources or support network needed to obtain other permanent housing;
6. Unaccompanied youth and homeless families with children and youth defined as homeless under other federal statutes who have experienced a long period without permanent housing; have experienced persistent instability as measured by frequent moves over such period; and can be expected to continue in such status for an extended period of time because of chronic disabilities, chronic physical health or mental health conditions, substance addiction, histories of domestic violence or childhood abuse, the presence of a child or youth with a disability, or multiple barriers to employment; or
7. An individual or family who is fleeing, or is attempting to flee, domestic violence, dating violence, sexual assault, stalking, or other dangerous or life-threatening conditions in the individual’s or family’s current housing situation, including where the health and safety of children are jeopardized, and who have no other residence and lack the resources or support network to obtain other permanent housing.
Homeless (1=Yes, 0=No) |
Select Yes if the individual is considered to be "chronically homeless" at the time of enrollment. A ‘‘chronically homeless’’ individual is defined to mean a homeless individual who has met the definition of homelessness continuously for at least 12 months, or on at least four separate occasions in the last 3 years, where the combined occasions total a length of time of at least 12 months.
Episodic Homelessness (1=Yes, 0=No) |
Please select Yes if the veteran is defined as homeless and has care of one or more minor dependents.
Homeless With Family (1=Yes, 0=No) |
Please select Yes if the veteran has been convicted as an adult and imprisoned under municipal, county, tribal, federal, or state law and who falls into one of the following categories:
• Category 1 – The veteran was released within the previous 12 months from a penal institution into homelessness and needs employment assistance;
• Category 2 – The veteran has been incarcerated for at least six months and is scheduled for release within six months with no known housing destination and needs employment assistance;
• Category 3 – The veteran was released within the previous 12 months from a penal institution into temporary or permanent housing, but is now at imminent risk of homelessness and needs employment assistance; or
• Category 4 – The veteran is a resident of an institution that provides long-term care for mental illness and is scheduled for release with no known housing destination and needs employment assistance.
IVTP Eligible (1=Yes, 0=No) |
Select Yes if the veteran who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Veterans Administration; or a person who was discharged or released from active duty because of a service-connected disability.
Disabled (1=Yes, 0=No) |
Please select Yes if the participant is:
• A veteran who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Department of Veterans Affairs for a disability:
(A) Rated at 30 percent or more, or
(B) Rated at 10 or 20 percent in the case of a veteran who has been determined to have a serious employment handicap; or
• A person who was discharged or released from active duty because of a service-connected disability.
Special Disabled (1=Yes, 0=No) |
Enter the date the individual first participated in on-the-job training (OJT). OJT is provided under a contract with an employer or registered apprenticeship program sponsor in the public, private non-profit, or private sector. Through the OJT contract, occupational training is provided for the participant by the employer in exchange for the reimbursement, typically up to 50 percent of the wage rate of the participant, for the extraordinary costs of providing the training and supervision related to the training.
Date First Provided On-the-Job Training |
Enter the date the individual last participated in on-the-job training (OJT). OJT is provided under a contract with an employer or registered apprenticeship program sponsor in the public, private non-profit, or private sector. Through the OJT contract, occupational training is provided for the participant by the employer in exchange for the reimbursement, typically up to 50 percent of the wage rate of the participant, for the extraordinary costs of providing the training and supervision related to the training.
Date Last Provided On-the-Job Training |
On-the-Job Training Type (1=Apprenticeship; 2=Not an Apprenticeship) |
Date First Provided Career Technical Training |
Date Last Provided Career Technical Training |
Enter the date the participant first received training that provides an individual with the knowledge and skills to start and grow a business.
Date First Provided Entrepreneurial Training |
Enter the date the participant last received training that provides an individual with the knowledge and skills to start and grow a business.
Date Last Provided Entrepreneurial Training |
Date First Provided Other Training |
Date Last Provided Other Training |
Enter the date the individual first participated in customized training. This type of training is designed to meet the specific requirements of an employer (including a group of employers); is conducted with a commitment by the employer to employ an individual upon successful completion of the training; and for which the employer pays a significant portion of the cost of training.
Date First Provided Customized Training |
Enter the date the individual last participated in customized training. This type of training is designed to meet the specific requirements of an employer (including a group of employers); is conducted with a commitment by the employer to employ an individual upon successful completion of the training; and for which the employer pays a significant portion of the cost of training.
Date Last Provided Customized Training |
Transitional housing means housing, the purpose of which is to facilitate the movement of individuals and families experiencing homelessness to permanent housing. [note: 42 USC 11360(29)] Permanent housing means community-based housing without a designated length of stay where an individual or family has a lease in accord with state and Federal law that is renewable and terminable only for cause, and includes home ownership.
Date Last Placed in Transitional or Permanent Housing |
Quarter Last Provided Employment Adjustment Services (Support Service Type) |
Enter the last quarter the participant received a staff-facilitated job search service that focuses on building practical skills, identifying and initiating employer contacts, and conducting successful interviews with employers. Various approaches may include job club participation, identifying personal strengths and goals, résumé application preparation, interviewing techniques, and receiving labor market information.
Quarter Last Provided Job Search Assistance (Support Service Type)
|
Quarter Last Provided Job Readiness Training (Support Service Type) |
Transitional Jobs:
(A) are time-limited work experiences that are subsidized
and are in the public, private, or nonprofit sectors
for individuals with barriers to employment who are chronically
unemployed or have an inconsistent work history;
(B) are combined with comprehensive employment and
supportive services; and
(C) are designed to assist individuals establish a work history, demonstrate success in the workplace, and develop the skills
that lead to entry into and retention in unsubsidized
employment.
Quarter Last Provided Transitional Job |
Quarter Last Provided Transportation (Support Service Type) |
Quarter Last Provided Child / Dependent Care (Support Service Type) |
Quarter Last Provided Educational Supplies & Fees (Support Service Type)
|
Quarter Last Provided Accommodations for Persons with Disabilities (Support Service Type) |
Quarter Last Provided Health Care Service (Support Service Type) |
Quarter Last Provided Work Attire / Tools / Equipment (Support Service Type) |
Quarter Last Provided Legal Aid Services (Support Service Type) |
Quarter Last Provided Drug & Alcohol Counseling (Support Service Type) |
Quarter Last Provided Temporary Shelter (Support Service Type) |
Financial literacy activities that may include:
(i) supporting the ability of participants to create
household budgets, initiate savings plans, and make
informed financial decisions;
(ii) supporting the ability to manage spending,
credit, and debt, including credit card debt, effectively;
(iii) increasing awareness of the availability, usage and
significance of credit reports and scores in
obtaining credit, and their effect on credit terms;
(iv) supporting the ability to understand, evaluate,
and compare financial products, services, and
opportunities; and
(v) supporting activities that address the particular
financial literacy needs of non-English speakers,
including providing the support through the development
and distribution of multilingual financial literacy
and education materials.
Quarter Last Provided Financial Counseling (Support Service Type) |
Quarter Last Provided Other Support Service (Support Service Type) |
Earned Wages in 1st Quarter After Exit (1=Yes, 0=No) |
Earned Wages in 2nd Quarter After Exit (1=Yes, 0=No) |
Hours Per Week in 2nd Quarter After Exit |
Average Wage in 2nd Quarter After Exit |
Earned Wages in 3rd Quarter After Exit (1=Yes, 0=No) |
Hours Per Week in 3rd Quarter After Exit |
Hourly Wage in 3rd Quarter After Exit |
Earned Wages in 4th Quarter After Exit (1=Yes, 0=No) |
Hours Worked Per Week in 4th Quarter After Exit |
Hourly Wage in 4th Quarter After Exit |
Enrollment Quarter |
Individuals actively enrolled on the last day of the period of performance for the prior grant AND whose enrollment was carried forward to the current grant. The same ID & Name from the prior grant should be reused.
Carry Over (1=Yes, 0=No) |
Exit Quarter (Use filter button to show Exited Participants by Quarter) |
Quarter Employed |
Multiracial (1=Yes, 0=No) |
Last Military Service (# Years Ago) |
Date Provided First Training Service
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Date Provided Last Training Service (unduplicated count)
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Earnings in 2nd Quarter After Exit |
Earnings for 3rd Quarter After Exit |
Employed All 3 Quarters After Exit (1=Yes, 0=No) |
2nd & 3rd Quarter Earnings for those Employed all 3 Quarters After Exit |