OMB No. 1290-XXXX
Exp. Date XX/XX/2021
OMB Package
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. Public reporting burden for this collection of information is estimated to average 15 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The obligation to respond to this collection is voluntary. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Chiefevaluationoffice@DOL.gov and reference the 0MB Control Number 1290-XXXX. Comments can also be mailed to: U.S. Department of Labor, Chief Evaluation Office, 200 Constitution Ave., NW, S-2312, Washington, DC 20210. Note: Please do not return the completed record to the email or mailing address.
One Record per Employer – Maintained by Demonstration Site
Field Name |
Type |
Length |
Response Category/Sample Entry |
Potential Source of Data |
Note |
Unique Tracking System Employer ID# |
N |
6 |
853 |
Employer Tracking System (Automatically Generated) |
|
Employer FEIN |
N |
9 |
99-9999999 |
D&B |
D&B has this variable on estimated 2/3 of firms; may be necessary to contact firms to obtain FEIN when it is missing from D&B) |
DUNS Number |
N |
9 |
999999999 |
D&B |
The numeric value assigned by D&B to uniquely identify the company. |
Employer Name |
Text |
26 |
Capital Enterprises, Inc. |
D&B |
A firm is a business organization consisting of one or more domestic establishments that were specified under common ownership or control. The firm and the establishment are the same for single-establishment firms. |
Employer Address |
Text |
30 |
493 East Main Street |
D&B |
|
Employer City |
Text |
15 |
San Francisco |
D&B |
|
Employer State |
N |
2 |
CA |
D&B |
|
Employer Zip |
N |
5 |
94110 |
D&B |
|
Employer Phone |
N |
10 |
408-555-1234 |
D&B |
|
Employer Website |
Text |
26 |
D&B |
|
|
Contact Person |
Text |
26 |
George Wilson |
D&B |
|
Contact Person Phone |
N |
10 |
408-555-2222 |
D&B |
|
Contact Person E-mail |
Text |
30 |
gwilson@capitalenterprises.com |
D&B |
|
Location Types |
N |
1 |
1=Headquarters 2=Single Location 3=Branch |
D&B |
|
Subsidiary |
N |
1 |
1=Yes 2=No |
D&B |
|
Parent DUNS |
N |
9 |
999999999 |
D&B |
The numeric value assigned by D&B to uniquely identify the company. |
Parent Name |
Text |
26 |
Capital Parent, Inc. |
D&B |
|
Year Established |
N |
4 |
1984 |
D&B |
|
SIC Division |
N |
1 |
A=Agric, Forestry, Fishing C=Construction D=Manufacturing E=Transp. Comm.& Util. F=Wholesale Trade G=Retail Trade H=Fin, Insur. & RE I=Services J=Public Admin. |
|
|
SIC 8-Digit Code |
N |
8 |
503101100 (e.g., Building Materials Exterior) |
D&B |
|
Employer North America Industry Classification System (NAICS) Code |
N |
6 |
423310 (Lumber-Plywood-Millwork and Wood Panel Merchant Wholesaler) |
D&B |
|
Line of Business |
Text |
26 |
Wholesale Lumber/Plywood/Millwork |
D&B |
|
Revenue (US Dollars, millions) |
N |
6 |
$6.2 million |
D&B |
|
Revenue Growth (%) |
N |
4 |
2.2% |
D&B |
|
Net Income (US Dollars, millions) |
N |
6 |
$5.4 million |
D&B |
|
Income Growth (%) |
N |
4 |
2.4% |
D&B |
|
Total Employees |
N |
8 |
265 |
D&B |
|
Employee Growth (%) |
N |
4 |
2.2% |
D&B |
|
Employees at this Location |
N |
8 |
265 |
D&B |
|
Total Assets (US Dollars, millions) |
N |
6 |
$12.4 million |
D&B |
|
Market Value (US Dollars, millions) |
N |
6 |
$21.1 million |
D&B |
|
Random Assignment (RA) Date |
Date |
8 |
MM-DD-YYYY |
Employer Tracking System (Automatically Generated) |
Automatically generated by the Tracking System |
Random Assignment Group Assignment |
N |
1 |
0=Control 1= Treatment Group #1 2= Treatment Group #2 |
Employer Tracking System (Automatically Generated) |
Automatically generated by the Tracking System; could be as many arms as appropriate/desired. For example, Treatment Group #1 could be received marketing letter; Treatment Group #2 could be received intensive marketing services. |
Whether Employer Had AAI Apprenticeship Program at Time of Random Assignment |
N |
1 |
1=Yes 2=No |
QPR |
|
Number of AAI Apprentices Active at Time of Random Assignment |
N |
7 |
35 (Apprenticeship slots) |
QPR |
|
Number of New AAI Apprentices Added in Full Year Prior to Random Assignment |
N |
7 |
24 (Apprenticeship slots) |
QPR |
|
Employer Provided with Recruitment/Marketing Letter |
N |
1 |
1=Yes 2=No |
Employer Tracking System (Automatically Generated or collected/entered by Demo Site Staff) |
Employer Tracking System could potentially produce tracking system letter. If mailing is done by grantee, this field would confirm that in fact letter was sent out to employer (note: potentially, this field is not needed if we assume being assigned to treatment group means employer received letter). |
Number of Total Recruitment/Marketing/Service Contacts with Employer |
N |
3 |
8 (contacts) |
Collected/entered by Demo Site Staff |
This field could be rolled up from relational database log of contacts/services received (see below) or entered by site recruitment staff when employer exits initiative. |
Type of Service Ever Received #1 - Information and encouragement to establish apprenticeship programs |
N |
1 |
1=Yes 2=No |
Collected/entered by Demo Site Staff |
This field could be rolled up from relational database log of contacts/services received (see below) or entered by site recruitment staff when employer exits initiative. |
Type of Service Ever Received #2 - Help with apprenticeship program design |
N |
1 |
1=Yes 2=No |
Collected/entered by Demo Site Staff |
This field could be rolled up from relational database log of contacts/services received (see below) or entered by site recruitment staff when employer exits initiative. |
Type of Service Ever Received #3 - Help with apprenticeship registration |
N |
1 |
1=Yes 2=No |
Collected/entered by Demo Site Staff |
This field could be rolled up from relational database log of contacts/services received (see below) or entered by site recruitment staff when employer exits initiative. |
Type of Service Ever Received #4 – Other Type of Assistance |
N |
1 |
1=Yes 2=No |
Collected/entered by Demo Site Staff |
This field could be rolled up from relational database log of contacts/services received (see below) or entered by site recruitment staff when employer exits initiative. Additional service types could be added. |
Narrative Description of the Type of Service Ever Received #4 – Other Type of Assistance |
Text |
50 |
Example – Connected firm with employer association that provided TA on apprenticeship formation. |
Collected/entered by Demo Site Staff |
Optional field to provide additional information on preceding data element. |
Number of Total Minutes of Recruitment/Marketing/Services Received by Employer |
N |
4 |
26 (hours of service) |
Collected/entered by Demo Site Staff |
This field could be rolled up from relational database log of contacts/services received (see below) or entered by site recruitment staff when employer exits initiative. |
Outcome #1 – Employer Created New AAI Apprenticeship Program(s) at 1 Year After Random Assignment |
N |
1 |
1=Yes 2=No
|
QPR |
Follow-up outcomes could be collected at multiple points (1, 2, 3, etc. years after RA). Match would be made (visually or automatically) with QPR data. Additional data items could be added to system to capture breakdown by type of apprenticeship program. |
Outcome #2 – Employer Expanded Existing AAI Apprenticeship Program(s) at 1 Year After Random Assignment |
N |
1 |
1=Yes 2=No
|
QPR |
Follow-up outcomes could be collected at multiple points (1, 2, 3, etc. years after RA). Match would be made (visually or automatically) with QPR data. Additional data items could be added to system to capture breakdown by type of apprenticeship program. |
Outcome #3 – Number of Apprentices Enrolled in AAI Apprenticeship Program(s) at Employer at 1 Year After Random Assignment |
N |
5 |
85 (apprenticeships) |
QPR |
Follow-up outcomes could be collected at multiple points (1, 2, 3, etc. years after RA). Match would be made (visually or automatically) with QPR data. Additional data items could be added to system to capture breakdown by type of apprenticeship program. |
Outcome #4 – Total Number of New Apprentices Added to AAI Apprenticeship Program(s) at Employer during Full Year Since Random Assignment |
N |
5 |
130 (apprenticeships) |
QPR |
Follow-up outcomes could be collected at multiple points (1, 2, 3, etc. years after RA). Match would be made (visually or automatically) with QPR data. Additional data items could be added to system to capture breakdown by type of apprenticeship program. |
Outcome #5 – Total Number of AAI Apprenticeship Completions in AAI Apprenticeship Program(s) at One Year After Random Assignment |
N |
5 |
65 (apprenticeships) |
QPR |
Follow-up outcomes could be collected at multiple points (1, 2, 3, etc. years after RA). Match would be made (visually or automatically) with QPR data. Additional data items could be added to system to capture breakdown by type of apprenticeship program. |
Intermediate Outcome #1 – Employer Contacted Demonstration Staff After Receipt of Letter for More Information/Assistance in Year After RA |
N |
1 |
1=Yes 2=No
|
Collected/entered by Demo Site Staff |
Optional field -- measure could be collected at multiple points (1, 2, 3, etc. years after RA). Follow-up contact by demonstration site staff to employer to collect data would be necessary. |
Intermediate Outcome #2 – Employer Expressed Interest in Establishing/Expanding Apprenticeship Program in Year After RA |
N |
1 |
1=Yes 2=No
|
Collected/entered by Demo Site Staff |
Optional field -- measure could be collected at multiple points (1, 2, 3, etc. years after RA). Follow-up contact by demonstration site staff to employer to collect data would be necessary. |
Intermediate Outcome #3 – Employer Submitted Registration Paperwork for Apprenticeship Program in Year After RA |
N |
1 |
1=Yes 2=No
|
Collected/entered by Demo Site Staff |
Optional field -- measure could be collected at multiple points (1, 2, 3, etc. years after RA). Follow-up contact by demonstration site staff to employer to collect data would be necessary. |
Intermediate Outcome #4 – Employer Successfully Registers Apprenticeship Program in Year After RA |
N |
1 |
1=Yes 2=No
|
Collected/entered by Demo Site Staff |
Optional field -- measure could be collected at multiple points (1, 2, 3, etc. years after RA). Follow-up contact by demonstration site staff to employer to collect data would be necessary. |
Optional Relational Data Base Maintained by Demonstration Site Staff to Track Each Employer Contact and Service Delivered [This is not necessarily needed, but would provide log of each contact/service received by each employer in the demonstration. Multiple records would be kept for each employer with one record created for each contact or service delivery by demonstration site staff. Information from this data system could potentially be rolled up to service tracking data items in the Employer Tracking System.
Field Name |
Type |
Length |
Response Category/Sample Entry |
Potential Source of Data (Other than Directly from Employer) |
Note |
Unique Tracking System Employer ID# |
N |
6 |
853 |
Employer Tracking System (Automatically Generated) |
Would be already generated by system; demo staff would link transaction to this system generated ID. |
Date of Employer Contact/Service Receipt |
Date |
8 |
MM-DD-YYYY |
Collected/entered by Demo Site Staff |
|
Method of Employer Contact |
N |
1 |
1=Telephone call 2=Email 3=Letter 4=In-person (one-on-one meeting) 5=In-person (group meeting/workshop) 6=Webinar 7=Other |
Collected/entered by Demo Site Staff |
|
Type of Service Delivered During Contact |
N |
2 |
1=Information/encouragement to establish apprenticeship program 2=Help with apprenticeship program design 3=Help with apprenticeship registration 4=Help with…[Other types of assistance] |
Collected/entered by Demo Site Staff |
|
Number of Minutes Involved in Contact/Service Delivery |
N |
4 |
15 minutes |
Collected/entered by Demo Site Staff |
|
Outcome/Results of Contact/Service Delivery |
Text |
40 |
Narrative |
Collected/entered by Demo Site Staff |
|
OMB Package, Appendix B8
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | John Trutko |
File Modified | 0000-00-00 |
File Created | 2021-01-20 |