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To clear entries from a drop down field, right click on the cell and select Clear Contents. This will remove all previously entered selections.


















































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































0 OMB Approval 1293-0014 | Expires XX/XX/XXXX












































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































0













































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































Applicant Name 0 Population Category














































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































0














































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































0



























































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































Expected # of Participants Served by Project Annually 0 Funding Request for each individual year of the grant (up to $600,000 each year.)*












































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































0 Year 1 Year 2 Year 3 Total Amount














































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































0


$0













































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































Name of Local American Job Center(s) (AJC) 0 *Applicants may receive a maximum amount of $600,000 per year, however, applicants may submit a lesser amount that aligns with their budget and budget narrative. The first year amount MUST match the SF-424, SF-424A, and budget narrative.














































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































0













































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































0 0 0 0 0













































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































Purpose of Project 0











































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































0












































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































Activities to be Funded by Grant 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
















































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































0














































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































Intended Beneficiaries of the Project
























































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































0














































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































Outcomes of the Project






















































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































0














































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































Key Partnerships














































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































Partnerships with other federal, state, or local programs. For example, do you partner with a CoC, Supportive Service for Veteran Families (SSVF) program, GPD, VASH, Veterans Affairs Community Employment Coordinator (CEC), Faith-based organizations, and any other external community 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4th State/Territory















































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































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Tribal Lands (if applicable) - Select all that apply












































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Enter the Congressional District of your home office. The home office is the main location where the program is administered. The home office is typically where the HVRP program manager, or equivalent, is assigned. This may be different from the address (corporate office location)used to identify the applicant organization in Block 8 of the SF-424. If your home office is the same as the address listed in Block 8 , repeat that information here and state the home and corporate office locations are the same.














































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































Congressional District of Home Office















































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































0














































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































CoC # (Refer to the 2022 HUD CoC Boundaries Map to confirm all of the CoCs in your proposed SDA) CoC Name Saturation Level of CoC 2022 PIT Counts Expected Number of Participants Served by the Project within this CoC in a 12-month period 0 Public Burden Statement - 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. The valid OMB control number for this information collection is 1293-0014. The time required to complete this information collection is 1 hour per response, including the time to review instructions, search existing data sources, gather the data needed, and complete and review the information collection. The obligation to respond is required to obtain or retain a benefit (38 U.S.C. 2021 and 2023). If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Labor, Veterans' Employment and Training Service, 200 Constitution Avenue, N.W., Washington, D.C. 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0












































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































Sheet 2: PY22 Outcomes by State

0 United States Department of Labor
Veterans' Employment & Training Service
PY22 HVRP Outcomes by State
0





























PY22 HVRP national outcomes can be found at: https://www.dol.gov/agencies/vets/programs/hvrp





Instructions: Complete the data fields within the Abstract Tab, and the cells within this tab will auto populate.





State Placement Rate Cost Per Placement Employment Rate 2QAE Median Earnings 2QAE Employment Rate 4QAE





















































0




















Sheet 3: Avg Hourly Wage at Placement

United States Department of Labor
Veterans' Employment & Training Service
Average Hourly Wage at Placement

Instructions: Complete the data fields within the Abstract Tab, and the cells within this tab will auto populate.



Data Source: Living Wage Calculator at https://livingwage.mit.edu


Primary State SDA Counties Average Living Wage for Primary State SDA

-
0
2nd State Secondary State
Living Wage
Secondary State SDA Counties Average Living Wage for Secondary State SDA

-
0
3rd State Tertiary State
Living Wage
Tertiary State SDA Counties Average Living Wage for Tertiary State SDA

-
0
4th State Quaternary State
Living Wage
Quaternary State SDA Counties Average Living Wage for Quaternary State SDA

-
0

Sheet 4: Planned Goals Chart


United States Department of Labor

Veterans' Employment & Training Service

OMB Approval 1293-0014 | Expires XX/XX/XXXX

VETS-700 Planned Goals Chart






















Applicant Name Primary 2nd 3rd 4th # of Participants Served by the Project Annually Average Living Wage of Primary State SDA Average Hourly Wage at Placement - % of Primary State SDA

State State State State < 90% 90% to 110% > 110%
s
0 0 0 0 0 - Select SDA Select SDA Select SDA
PoP Total Funding Amount Program Year 1 Program Year 2 Program Year 3
$0.00 $0.00 $0.00 $0.00














Instructions












Enter requested data in the yellow highlighted cells of the Planned Goals section below. Rows not highlighted in yellow are locked and cannot be edited.














0 Planned Goals Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Q9 Q10 Q11 Q12
re # of Participants Enrolled - Quarterly Goal












# of Participants Enrolled - Cumulative Goal
-Q4 must equal the # of Participants Served by the Project Annually.
-Q8 must equal the # of Participants Served by the Project Annually x 2.
-Q12 must equal the # of Participants Served by the Project Annually x 3.
0 0 0 0 0 0 0 0 0 0 0 0
Percentage of Enrollments Trained - Cumulative Goal
Minimum is 55%


Number of Enrollments with Training - Cumulative Goal
-Formula: Percentage of Enrollments Trained - Cumulative Goal x # of Participants Enrolled - Cumulative Goal
-This is the unduplicated count of participants enrolled who received training services across the PoP.
0 0 0 0 0 0 0 0 0 0 0 0
# of Participants Exited - Quarterly Goal
This cannot exceed the # of Participants Enrolled - Cumulative Goal for the quarter.













# of Participants Exited - Cumulative Goal
Q12 must equal the # of Participants Enrolled - Cumulative Goal Q12
0 0 0 0 0 0 0 0 0 0 0 0
# of Exited Participants Placed into Employment - Quarterly Goal
This cannot exceed the # of Participants Exited - Cumulative Goal for the quarter.













# of Exited Participants Placed into Employment - Cumulative Goal 0 0 0 0 0 0 0 0 0 0 0 0
Placement Rate - Quarterly Goal
Formula: # of Exited Participants Placed into Employment - Quarterly Goal / # of Participants Exited - Quarterly Goal.
0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
Placement Rate - Cumulative Goal
Formula: # of Exited Participants Placed into Employment - Cumulative Goal / # of Participants Exited - Cumulative Goal.
0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
Average Hourly Wage at Placement - Quarterly Goal



Average Hourly Wage at Placement - Cumulative Goal
-See bottom of form for formulas
$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Estimated Costs per Quarter $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Estimated Costs per Quarter - Cumulative $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Cost per Placement - Quarterly Goal
Formula: Estimated Costs per Quarter / # of Exited Participants Placed into Employment - Quarterly Goal
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Cost Per Placement - Cumulative Goal
-Maximum of $16,000 at Q12
-Formula: Estimated Costs per Quarter - Cumulative / # of Exited Participants Placed into Employment - Cumulative Goal
$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
# Earned Wages in the 2nd Qtr After Exit - Quarterly Goal
-The # Earned Wages in the 2nd Qtr After Exit - Quarterly Goal cannot exceed the # of Exited Participants Placed into Employment - Quarterly Goal two quarters prior.
-Example: # Earned Wages in the 2nd Qtr After Exit - Quarterly Goal Q6 must be less than or equal to the # of Exited Participants Placed into Employment - Quarterly Goal Q4.
N/A N/A










# Earned Wages in the 2nd Qtr After Exit - Cumulative Goal N/A N/A 0 0 0 0 0 0 0 0 0 0
Employment Rate in the 2nd Quarter After Exit - Quarterly Goal
Formula: # Earned Wages in the 2nd Qtr After Exit - Quarterly Goal / # of Exited Participants Placed into Employment - Quarterly Goal from the previous two qu
N/A N/A 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
Employment Rate in the 2nd Quarter After Exit - Cumulative Goal
Formula: # Earned Wages in the 2nd Qtr After Exit - Cumulative Goal / # of Exited Participants Placed into Employment - Cumulative Goal
N/A N/A 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
Estimated Average # of Hours Worked per Week for those that Earned Wages in the 2nd Qtr After Exit N/A N/A

Median Earnings in the 2nd Qtr After Exit - Quarterly Goal
Formula: (Average Hourly Wage at Placement - Quarterly Goal x Estimated Average # of Hours Worked per Week for those that Earned Wages in the 2nd Qtr After Exit) x 13 weeks in a quarter))
N/A N/A $0 $0 $0
Median Earnings 2nd Quarter After Exit - Cumulative Goal
-See bottom of form for formulas
N/A N/A $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
# Earned Wages in the 4th Qtr After Exit - Quarterly Goal
-The # Earned Wages in the 4th Qtr After Exit - Quarterly Goal cannot exceed the # of Exited Participants Placed into Employment - Quarterly Goal four quarters prior.
-Example: # Earned Wages in the 4th Qtr After Exit - Quarterly Goal Q8 must be less than or equal to the # of Exited Participants Placed into Employment - Quarterly Goal Q4.
N/A N/A N/A N/A








# Earned Wages in the 4th Qtr After Exit - Cumulative Goal N/A N/A N/A N/A 0 0 0 0 0 0 0 0
Employment Rate in the 4th Quarter After Exit - Quarterly Goal
Formula: # Earned Wages in the 4th Qtr After Exit - Quarterly Goal / # of Exited Participants Placed into Employment - Quarterly Goal
N/A N/A N/A N/A 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
Employment Rate in the 4th Quarter After Exit - Cumulative Goal
Formula: # Earned Wages in the 4th Qtr After Exit - Cumulative Goal / # of Exited Participants Placed into Employment - Cumulative Goal
N/A N/A N/A N/A 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
















Expected Outcomes & Outputs Scores by Indicator Scored Goal Points Awarded Scoring Criteria
Public Burden Statement - 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. The valid OMB control number for this information collection is 1293-0014. The time required to complete this information collection is 1 hour per response, including the time to review instructions, search existing data sources, gather the data needed, and complete and review the information collection. The obligation to respond is required to obtain or retain a benefit (38 U.S.C. 2021 and 2023). If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Labor, Veterans' Employment and Training Service, 200 Constitution Avenue, N.W., Washington, D.C. 20210.

0 1 0


Percentage of Enrollments Trained 0.0% 0 < 60.0% ≥ 60.0% and ≤ 80.0% > 80.0%


Placement Rate 0.0% 0 < 50.0% ≥ 50.0% and ≤ 90.0% > 90.0%


Average Hourly Wage at Placement $0.00 0 Select SDA Select SDA Select SDA


Cost per Placement $0 0 < $4,000 ≥ $4,000 and ≤ $12,000 > $12,000


Employment Rate 2nd Quarter After Exit 0.0% 0 < 35.0% ≥ 35.0% and ≤ 70.0% > 70.0%


Median Earnings 2nd Quarter After Exit $0 0 ˂ $5,000 ≥ $5,000 and ≤ $11,000 > $11,000


Employment Rate 4th Quarter After Exit 0.0% 0 < 20.0% ≥ 20.0% and ≤ 50.0% > 50.0%


Total Score 0





















Average Hourly Wage at Placement - Cumulative Goal
Formula for Quarters 1-4: the value entered for Average Hourly Wage at Placement - Quarterly Goal Q1-Q4
Formula for Quarters 5-12: (Average Hourly Wage at Placement - Quarterly Goal Q4 x # of Participants Placed into Employment - Cumulative Goal Q4) + (Average Hourly Wage at Placement - Quarterly Goal Q5 x # of Participants Placed into Employment - Quarterly Goal Q5) + (Average Hourly Wage at Placement - Quarterly Goal Q6 x # of Participants Placed into Employment - Quarterly Goal Q6) + (Average Hourly Wage at Placement - Quarterly Goal Q7 x # of Participants Placed into Employment - Quarterly Goal Q7) + (Average Hourly Wage at Placement - Quarterly Goal Q8 x # of Participants Placed into Employment - Quarterly Goal Q8) + (Average Hourly Wage at Placement - Quarterly Goal Q9 x # of Participants Placed into Employment - Quarterly Goal Q9) + (Average Hourly Wage at Placement - Quarterly Goal Q10 x # of Participants Placed into Employment - Quarterly Goal Q10) + (Average Hourly Wage at Placement - Quarterly Goal Q11 x # of Participants Placed into Employment - Quarterly Goal Q11) + (Average Hourly Wage at Placement - Quarterly Goal Q12 x # of Participants Placed into Employment - Quarterly Goal Q12).

















Median Earnings 2nd Quarter After Exit - Cumulative Goal
-Formula for Quarters 3-6: the value entered for Median Earnings 2nd Qtr After Exit - Quarterly Goal Q3-Q6
-Formula for Quarters 7-12: (Median Earnings 2nd Qtr After Exit - Quarterly Goal Q6 x # of Participants Placed into Employment - Cumulative Goal Q4 +(Median Earnings 2nd Qtr After Exit - Quarterly Goal Q7 x # of Participants Placed into Employment - Cumulative Goal Q5) + (Median Earnings 2nd Qtr After Exit - Quarterly Goal Q8 x # of Participants Placed into Employment - Quarterly Goal Q6) + (Median Earnings 2nd Qtr After Exit - Quarterly Goal Q9 x # of Participants Placed into Employment - Quarterly Goal Q7) + (Median Earnings 2nd Qtr After Exit - Quarterly Goal Q10 x # of Participants Placed into Employment - Quarterly Goal Q8) + (Median Earnings 2nd Qtr After Exit - Quarterly Goal Q11 x # of Participants Placed into Employment - Quarterly Goal Q9) + (Median Earnings 2nd Qtr After Exit - Quarterly Goal Q12 x # of Participants Placed into Employment - Quarterly Goal Q10).
















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File Modified0000-00-00
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