1 Schedule C

Schedule C: Services Report: Employment Services 45 CFR 400.154 (a)								Form ORR-6
Reporting Period:							Fiscal Year:
State:							Date:
Grant #:					Grant Name:
A. RCA Employment Data: Number of refugees between 18 and 65 who are not exempt under §400.76 and who reached the eight month time limit for RCA this trimester					1. Total Number		2. Grant Terminations due to income from employment prior to the eight month limit
B. Entered Employment and Cash Assistance Status				Time in U.S.		2. FT	3. PT	4. Grant Terminations
Participants by type		1. Total Number
a. RCA	1.			0 - 4 months
	2.			5 - 8 months
b. TANF	1.			0 - 12 months
	2.			> 12 months
c. Other CA	1.			0 - 12 months
	2.			> 12 months
d. No CA	1.			0 - 12 months
	2.			> 12 months
e. Total Caseload for Employment Services		0		TOTAL		0	0	0
C. Average Hourly Wage Employment Entry
D. Health Benefits Available
E. Employed 90 Days Later
a) RCA at entered employment
b) TANF at entered employment
c) Other CA at entered employment
d) No CA at entered employment
Total						0	0
Schedule C: Services Report: Employability Services, 45 CFR 400.154 (b) – (k)								Form ORR-6
Reporting Period:							Fiscal Year:
State:							Date:
Grant #:					Grant Name:
A. Active participants this period		Total		AGE		SERVICES
1. English Language Training		0		18-50	51 and over	Beginner	Intermediate	Other
0 - 12 mos in U.S.
> 12 mos in U.S.
2. On the Job Training		0		18-50	51 and over	0-30 days training	> 1 month training	> 3 months training
0 - 12 mos in U.S.
> 12 mos in U.S.
B. Completions (unduplicated)
3. Skills Training		0		18-50	51 and over	0-30 days training	> 1 month training	> 3 months training
0 - 12 mos in U.S.
> 12 mos in U.S.
B. Completions (unduplicated)
4. Case Management		0		18-50	51 and over	New case	Follow-up	Referred
0 - 12 mos in U.S.
> 12 mos in U.S.
5. Other Employability Services		0		Employability assessment	Child Care	Transportation	Interpreting & translation	EAD assistance
0 - 12 mos in U.S.
> 12 mos in U.S.