ORR-6 Annual Service Plan

Annual Service Plan

ORR-6 OMB Control No. 0970-0036 Expires xx-xx-xxxx

1. State/Grantee:

2. Fiscal Year:

3. Date:

4. Previous FFY Report (Program Participants) 45 CFR 400.154 and 45 CFR 400.155

Total FY Unduplicated

a) Employment

0

b) Employability assessment

0

c) On-the-job training

0

d) English language instruction

0

e) Vocational Training

0

f) Skills recertfication

0

g) Day care for children

0

h) Transportation

0

i) Translation and Interpreter Services

0

j) Case management

0

k) EAD assistance

0

l) Information and referral

0

m) Outreach services

0

n) Social adjustment

0

o) Citizenship and naturalization

0

5. Total Unduplicated

0

6. Previous FFY report services participation (45 CFR 400.154 and 45 CFR 400.155)

Total Number

a) Report number of service participants at the end of FFY who are 0-12 months since arrival in the US

b) Report number of service participants at the end of FFY who are 13-60 months since arrival in the US

7. Previous FFY set-aside programs services participation

RSI

SOR

Other

a) Report number of service participants at the end of FFY who are 0-12 months since arrival in the US

b) Report number of service participants at the end of FFY who are 13-60 months since arrival in the US

Plan for upcoming FY

9. Grant

10. Contracted Amount by Funding Source

11. Program Participants

12. Type of Agency and Percent of Funds

8. Description of State-provided or Contracted Services

0-12 Month

13-60 Month

Total Number

A. State or County

B. Mutual Assistance Association

C. Refugee Agency

D. Community College

E. Adult Basic Education

F. Non Profit Organization

G. School District

H. Area Agency on Aging

I. Other

J. Total

a. Employment Services

RSS

0

0%

b. English Language Instruction

RSS

0

0%

c. On-the-Job Training

RSS

0

0%

d. Vocational Training

RSS

0

0%

e. Other Services

RSS

0

0%

RSS-RSI

0

0%

RSS-SOR

0

0%

Misc.

0

0%