Appendix D

OMB Control No. 1205-0426

Expiration Date 12/31/2022

Job Corps Data Collection Instrument

	Question by Question Justification
Content of Questions		Question	Rationale
		Numbers
Placement Reverification for Employers and Educational Institutions (EV & SV)
Verification of Employment		EV1 – EV7	These instruments include a series of
Verification of		SV1 – SV6	questions designed to reverify the student’s
School/Training Experience			initial job or school placement with
			employers and educational institutions.
			Questions are included to assess whether
			the student met the Job Corps definition of
			“being placed” for different placement
			categories, including: part- or full-time
			employment, school/training, job and
			college combination, or job
			placement. The purpose of the re-
			verification is to monitor the services
			provided by placement contractors to
			ensure that contract requirements are being
			met and students are receiving quality
			services. If responses to the reverification
			questions indicate that the placement may
			not have been valid, a “questionable
			placement” is identified. Such notations
			will be used to generate notices for
			the appropriate Job Corps office for final
			determination.

Appendix D: Verification for Employers and Educational Institutions Page 1 of 9

VERIFICATION OF SCHOOL/TRAINING PLACEMENT WITH SCHOOLS OR TRAINING PROGRAMS

PROGRAMMER: THIS SURVEY IS FOR STUDENTS WITH PLACEMENT STATUS (PLACED_ST) CODES 06, 07, 08, 09, 10, AND 12 WHO CANNOT BE LOCATED DURING THE CHECKPOINT.

May I speak with <NAME OF CONTACT PERSON>? My name is (INTERVIEWER’S NAME) with DIR. We work with Job Corps, a national training program for youth. Job Corps is assessing the effectiveness of its program by calling employers to verify employment of former Job Corps students. I am calling to verify the employment of <STUDENT’S NAME>. Persons are not required to respond to this collection of information unless it displays a current valid Office of Management and Budget Control number. Responding to this questionnaire is voluntary. The collection of this information has been approved under OMB control number 1205- 0426, expiration date 12/31/2022. On average, it takes about 10 minutes to complete this survey, including time for reviewing instructions, searching data sources, and completing and reviewing the information.

MUST READ BEFORE BEGINNING SURVEY:

Before we begin the survey, we must be sure that you clearly understand a few points.  Your participation in the survey is completely voluntary.  Job Corps has obtained approval to conduct the survey from the federal government’s Office of Management and Budget.  All information you provide will be held in the strictest confidence and used only to assess how well young people are doing since leaving Job Corps.  Responses to this data collection will be used only for program evaluation purposes. The reports prepared for this study will summarize findings across the sample and will not associate responses with a specific individual. We will not provide information that identifies you to anyone outside the study team, except as required by law. Your answers will not be shared with anyone outside of Job Corps in any manner that would enable someone to identify you.  You may refuse to answer any questions that you do not want to answer.  However, we hope that you will choose to answer as many questions as you can. This call may be monitored for quality assurance.

INTERVIEWER: SOME SCHOOLS HAVE A POLICY NOT TO VERIFY ENROLLMENT. OTHERS WILL ONLY VERIFY THAT A PERSON WAS ENROLLED AND WILL GIVE NO OTHER INFORMATION. IF YOU FIND THAT THIS IS THE CASE, MARK APPROPRIATE ANSWER IN SV1 AND GO TO THE END.

SV1. Our records show that (he/she/ <STUDENT’S NAME>) enrolled in <NAME OF SCHOOL/TRAINING PROGRAM> around <DT_REPORTED FOR SCHOOL>. Is that

	correct?
	1	YES		SET SCHOOL TO YES AND GO TO SV2.
	2	NO		GO TO PROGRAM CHECK
	-9	DON’T KNOW		GO TO END OF INTERVIEW SCRIPT
	3	WILL NOT VERIFY		GO TO END OF INTERVIEW SCRIPT
	4	WILL VERIFY ENROLLMENT		GO TO END OF INTERVIEW SCRIPT
		ONLY, NO OTHER INFORMATION
PROGRAM CHECK: SET QP REASON CODE TO QP_ SCH = 1 GO TO END OF INTERVIEW
SCRIPT.
SV2.	And did (he/she) enroll around <DT_REPORTED FOR SCHOOL>? INTERVIEWER: IF
	RESPONDENT ALREADY TOLD YOU STUDENT WAS ENROLLED AROUND THIS
	DATE, MARK “YES.”
	1	YES	SET SCHOOL TO YES AND GO TO PROGRAM CHECK
	2	NO	AFTER Q. SV3.
	-9	DON’T KNOW
SV3.	On what date did he/she enroll there? Your best estimate is fine here.
	ENTER DATE [DATE]
	-9	DON’ T KNOW

Appendix D: Verification for Employers and Educational Institutions Page 2 of 9

PROGRAM CHECK: THIS QUESTION ONLY FOR PLACE_ST = 08, 09 AND 12.
IF PLACE_ST IN (08,09,12) ASK Q. SV4, ELSE GO TO Q. SV5.
SV4.	And was (he/she) expected to attend school/this program at least 20 hours per week?

1	YES	GO TO END OF INTERVIEW SCRIPT
2	NO	GO TO PROGRAM CHECK
-9	DON’T KNOW

PROGRAM CHECK: SET QUESTIONABLE PLACEMENT REASON CODE. QP_SCH = 4.

DISPLAY QP MSG SCREEN AND THEN GO TO END OF INTERVIEW SCRIPT.

PROGRAMMER NOTE: THIS QUESTION FOR PLACE_ST CODE= 06, 07 COLLEGE

COMBINATION OR 10 COLLEGE ONLY

SV5. And our records show (he/she) registered for at least (6/9) credit hours around

<DT_REPORTED>. Is that correct?

1	YES	GO TO END OF INTERVIEW SCRIPT
2	NO	ASK Q. SV6
-9	DON’T KNOW	ASK Q. SV6
SV6. Was there any time when (he/she) was registered for at least (6/9) credit hours?
1	YES	GO TO END OF INTERVIEW OF INTERVIEW SCRIPT
2	NO	GO TO NEXT PROGRAM CHECK
-9	DON’T KNOW	GO TO NEXT PROGRAM CHECK

PROGRAM CHECK: IF PLACED_ST = 10 SET QP REASON CODE TO QP_SCH = 5. IF PLACED_ST = 06 OR 07 SET QP REASON CODE TO QP_SCH = 7. SHOW QP MSG SCREEN THEN DISPLAY END OF INTERVIEW SCRIPT.

END OF INTERVIEW:

That is all the information I need. Thank you for your time today.

Appendix D: Verification for Employers and Educational Institutions Page 3 of 9

RE-VERIFICATION OF STUDENT EMPLOYMENT WITH EMPLOYER

PROGRAMMER NOTE: THIS SURVEY IS FOR STUDENTS WITH PLACEMENT STATUS (PLACED_ST) CODES 01, 02, 03, 04, 05, 06, 07, OR 11 WHO CANNOT BE LOCATED FOR A STUDENT SURVEY FOR AN INITIAL SURVEY. IF PLACED_ST = 02 OR 04 DETERMINE WHICH WORK VARIABLE TO SET IN Q. EV1 AND Q. EV2.

May I speak with <NAME OF CONTACT PERSON>? My name is (INTERVIEWER’S NAME) with DIR. We work with Job Corps, a national training program for youth. Job Corps is assessing the effectiveness of its program by calling employers to verify employment of former Job Corps students. I am calling to verify the employment of <STUDENT’S NAME>. Persons are not required to respond to this collection of information unless it displays a current valid Office of Management and Budget Control number. Responding to this questionnaire is voluntary. The collection of this information has been approved under OMB control number 1205- 0426, expiration date 12/31/2022. On average, it takes about 10 minutes to complete this survey, including time for reviewing instructions, searching data sources, and completing and reviewing the information.

INTERVIEWER: SOME EMPLOYERS HAVE A POLICY NOT TO VERIFY EMPLOYMENT. OTHERS WILL ONLY VERIFY THAT A PERSON WORKED FOR THEIR COMPANY AND WILL GIVE NO ADDITIONAL INFORMATION. IF YOU FIND THAT IS THE CASE, MARK APPROPRIATE ANSWER IN Q. EV1 AND GO TO END OF INTERVIEW.

EV1.	Our records show <STUDENT’S NAME> was employed at <NAME OF EMPLOYER>. Is
	that correct? PROBE: Our records list (his/her) job as <JOB TITLE>.
	1	YES	SET WORK1 OR WORK2 TO YES AND GO
			TO Q. EV3
	2	NO	GO TO Q. EV2
	-9	DON=T KNOW	GO TO END OF INTERVIEW SCRIPT
	3	WILL NOT VERIFY EMPLOYMENT GO TO END OF INTERVIEW SCRIPT
	4	WILL VERIFY EMPLOYMENT	GO TO END OF INTERVIEW SCRIPT
		ONLY NO OTHER INFORMATION

EV2. So, you don’t have any record or recollection of <STUDENT’S NAME> working there around <DT_REPORTED>?

1	YES, WORKED THERE	SET WORK1 OR WORK2 TO YES AND GO
		TO Q. EV3
2	NO, DID NOT WORK THERE	SET WORK1 OR WORK2 TO NO AND GO
	DON=T KNOW	TO END OF INTERVIEW SCRIPT
-9		.................................... GO TO END OF
		INTERVIEW SCRIPT

Appendix D: Verification for Employers and Educational Institutions Page 4 of 9

EV3. INTERVIEWER: IF RESPONDENT ALREADY TOLD YOU STUDENT WORKED THERE AROUND THIS DATE, MARK “YES” AT Q. EV3 AND GO TO Q.EV5.

And did (he/she) begin working around <DT_REPORTED>?

	1	YES	GO TO Q. EV5
	2	NO	ASK Q. EV4
	-9	DON=T KNOW	ASK Q. EV4
EV4.	Approximately when did (he/she) begin working there? Your best estimate is fine here.
	ENTER DATE [DATE]
	-9	DON=T KNOW............

EV5. Our records also show (he/she) usually worked at least <HOURS> a week at that job. Is that correct?

1	YES	GO TO END OF INTERVIEW SCRIPT
2	NO
-9	DON=T KNOW

EV6. Did (STUDENT=S NAME) ever work there at least <HOURS> in a week?

1	YES	GO TO EV7
2	NO	GO TO NEXT PROGRAM CHECK
-9	DON=T KNOW	GO TO EV7

PROGRAM CHECK: SET QUESTIONABLE PLACEMENT REASON CODES. DISPLAY QP MSG SCREEN.

IF PLACED_ST = 01 SET QP_EM1 = 4 IF PLACED_ST = 03 SET QP_EM1 = 3 IF PLACED_ST = 06 SET QP_EM1 = 9 IF PLACED_ST = 07 SET QP_EM1 = 8

EV7. Did (he/she) earn at least $5.15 per hour when (he/she) first started that job?

1	YES	GO TO END OF INTERVIEW SCRIPT
0	NO	GO TO NEXT PROGRAM CHECK
-9	DON=T KNOW	GO TO END OF INTERVIEW SCRIPT

PROGRAM CHECK: SET QP REASON CODE TO QP_EM1 = 10. DISPLAY QP MSG SCREEN.

END OF INTERVIEW SCRIPT: That is all the information I need. Thank you for your help.

Appendix D: Verification for Employers and Educational Institutions Page 5 of 9

LETTER TO RE-VERIFY INITIAL EMPLOYMENT WITH EMPLOYERS

To Whom It May Concern:

Decision Information Resources, Inc. is a research and evaluation contractor with the U.S. Department of Labor’s Job Corps program. Job Corps is interested in assessing the effectiveness of the Job Corps placement program. We are following up on former students who were enrolled in the Job Corps program. Your responses are confidential, and we appreciate your time and assistance. Your participation is voluntary. Our records show that the person listed below may be a current or former employee of your company. We would like to verify employment for:

NAME: <NAME>

1. Our records show he/she was employed with your company. Is this correct? CIRCLE ONE.

YES NO

DON’T KNOW

2. And did his/her employment begin around <DATE>.

CIRCLE ONE.

YES PLEASE GO TO QUESTION 4.

NO DON’T KNOW

3. On what date did he/she begin working there?

ENTER DATE / / . DON’T KNOW

4. Did he/she work at least <HOURS> per week? CIRCLE ONE.

YES PLEASE GO TO Q. 6

NO DON’T KNOW

5. What are the most hours he/she worked per week?

ENTER HOURS DON’T KNOW

6. Did he/she earn at least $5.15 per hour when he/she first started that job? CIRCLE ONE.

YES NO

DON’T KNOW

Your signature: Job Title: Date:

Privacy Act Notice:

All request for personal information about students must be treated as requests under the Freedom of Information Act and the Privacy Act of 1974 and handled pursuant 29 CFR Parts 70 and 70a and 45 CFR Parts 160 and 164.

Public Burden Statement:

Persons are not required to respond to this collection of information unless it displays a currently valid OMB control number. Respondents' obligation to complete this form is required to obtain or retain benefits (P.L. 113-128). Public reporting burden is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering, and maintaining the data needed, and completing and reviewing the collection of Information. Send comments regarding this burden estimate to the U.S. Department of Labor, Division of Adult Services, Room S-4209, Washington, D.C. 20210 (Paperwork Reduction Project 1205-0025). Please do not submit completed forms to this address.

LETTER TO REVERIFY INITIAL PLACEMENT WITH HIGH SCHOOL

To Whom It May Concern:

Decision Information Resources, Inc is a research and evaluation contractor with the U.S. Department of Labor’s Job Corps program. Job Corps is interested in assessing the effectiveness of the Job Corps placement program. We are following up on former students who were enrolled in the Job Corps program. Your responses are confidential, and we appreciate your time and assistance. Your participation is voluntary. We understand that the person listed below may be a current or former student at your school. We would like to verify enrollment for:

NAME: <NAME>

1. Our records show he/she was enrolled at your school. Is this correct? CIRCLE ONE

YES NO

DON’T KNOW

2. And did his/her enrollment begin around <DATE>.

CIRCLE ONE.	PLEASE GO TO QUESTION 4.
YES
NO
DON’T KNOW

3. On what date did he/she enroll there?

ENTER DATE / / . DON’T KNOW

4. And was this school/training expected to last for at least one term? CIRCLE ONE.

YES NO

DON’T KNOW

Your signature: Job Title: Date:

Page 7 of 9

Privacy Act Notice:

All request for personal information about students must be treated as requests under the Freedom of Information Act and the Privacy Act of 1974 and handled pursuant 29 CFR Parts 70 and 70a and 45 CFR Parts 160 and 164.

Public Burden Statement:

Persons are not required to respond to this collection of information unless it displays a currently valid OMB control number. Respondents' obligation to complete this form is required to obtain or retain benefits (P.L. 113-128). Public reporting burden is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering, and maintaining the data needed, and completing and reviewing the collection of Information. Send comments regarding this burden estimate to the U.S. Department of Labor, Division of Adult Services, Room S-4209, Washington, D.C. 20210 (Paperwork Reduction Project 1205-0426). Please do not submit completed forms to this address.

LETTER TO REVERIFY INITIAL PLACEMENT WITH POST SECONDARY VOCATIONAL OR OTHER TRAINING PROGRAMS

To Whom It May Concern:

Decision Information Resources, Inc is a research and evaluation contractor with the U.S. Department of Labor’s Job Corps program. Job Corps is interested in assessing the effectiveness of the Job Corps placement program. We are following up on former students who were enrolled in the Job Corps program. Your responses are confidential, and we appreciate your time and assistance. Your participation is voluntary. We understand that the person listed below may be a current or former student at your school/training program. We would like to verify enrollment for:

NAME: <NAME>

1. Our records show he/she was enrolled at your school or training program. Is this correct? CIRCLE ONE.

YES NO

DON’T KNOW

2. And did his/her enrollment begin around <DATE>.

CIRCLE ONE.

YES PLEASE GO TO QUESTION 4.

NO DON’T KNOW

3. On what date did he/she enroll there?

ENTER DATE / / . DON’T KNOW

4. And was this student expected to attend at least 20 hours per week? CIRCLE ONE.

YES NO

DON’T KNOW

Your signature: Job Title: Date:

Page 8 of 9

Privacy Act Notice:

All request for personal information about students must be treated as requests under the Freedom of Information Act and the Privacy Act of 1974 and handled pursuant 29 CFR Parts 70 and 70a and 45 CFR Parts 160 and 164.

Public Burden Statement:

Persons are not required to respond to this collection of information unless it displays a currently valid OMB control number. Respondents' obligation to complete this form is required to obtain or retain benefits (P.L. 113-128). Public reporting burden is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of Information. Send comments regarding this burden estimate to the U.S. Department of Labor, Division of Adult Services, Room S-4209, Washington, D.C. 20210 (Paperwork Reduction Project 1205-0426). Please do not submit completed forms to this address.

LETTER TO REVERIFY INITIAL PLACEMENT AT COLLEGE

To Whom It May Concern:

Decision Information Resources, Inc is a research and evaluation contractor with the U.S. Department of Labor’s Job Corps program. Job Corps is interested in assessing the effectiveness of the Job Corps placement program. We are following up on former students who were enrolled in the Job Corps program. Your responses are confidential, and we appreciate your time and assistance. Your participation is voluntary. We understand that the person listed below may be a current or former student at your college. We would like to verify enrollment for:

NAME: <NAME>

1. Our records show he/she was enrolled in your college program. Is this correct? CIRCLE ONE.

YES NO

DON’T KNOW

2. And did his/her enrollment begin around <DATE>.

CIRCLE ONE.	PLEASE GO TO QUESTION 4.
YES
NO
DON’T KNOW

3. On what date did he/she enroll there?

5. ENTER DATE: / / . DON’T KNOW

4. And was this student registered for at least <HOURS> credit hours?

CIRCLE ONE. YES

NO DON’T KNOW

For how many credit hours did this student enroll?

6. ENTER HOURS: ________ DON’T KNOW

Your signature: Job Title: Date:

Page 9 of 9

Privacy Act Notice:

All request for personal information about students must be treated as requests under the Freedom of Information Act and the Privacy Act of 1974 and handled pursuant 29 CFR Parts 70 and 70a and 45 CFR Parts 160 and 164.

Public Burden Statement:

Persons are not required to respond to this collection of information unless it displays a currently valid OMB control number. Respondents' obligation to complete this form is required to obtain or retain benefits (P.L. 113-128). Public reporting burden is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering, and maintaining the data needed, and completing and reviewing the collection of Information. Send comments regarding this burden estimate to the U.S. Department of Labor, Division of Adult Services, Room S-4209, Washington, D.C. 20210 (Paperwork Reduction Project 1205-0426). Please do not submit completed forms to this address.