Global Edits 
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				Duplicate Detection 
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				A. If multiple records
				have the same birth date and name (Fields 1 and 2), then no
				record can have a Field 46  (Date of Participation) or a Field 47
				(Date or Exit) between the Date of Program Participation and the
				Date of Exit plus 90 days of any other record with the same
				Individual Identifier. 
 
B. If multiple records have the
				same Individual Identifier, then only the record with the most
				recent Date of Participation can have a blank Date of Exit. 
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				Age 
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				A.  Must be greater than
				or equal to 18 and less than or equal to 100 years old at Date of
				Participation.  Age = DATE OF PARTICIPATION minus DATE OF BIRTH 
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				SECTION I - INDIVIDUAL
				INFORMATION 
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				SECTION I.A -
				IDENTIFYING AND DEMOGRAPHIC INFORMATION 
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				1 
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				Date of Birth 
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				Record the individual's
				date of birth. 
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				MM/DD/YYYY 
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				2 
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				Name 
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				Record the individual’s
				first name, last name, and middle initial (optional). 
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				Text Box 
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				Middle Initial Field
				should be optional.  First and last name are required.  Mark
				these with a red asterisk. 
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				3 
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				Eligibility Type 
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				Indicate the eligibility
				type by selecting Ex-Offender or Non-Custodial Parent. 
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				1 = Ex-Offender 
				2
				= Non-Custodial Parent 
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				Field is required, but may
				select more than one option. 
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				4 
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				Gender 
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				Indicate the participant's
				gender by selecting Male or Female. 
 
Leave
				blank if the individual does not wish to disclose his/her gender. 
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				1 = Male 
2 =
				Female 
Blank = no self-disclosure 
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				5 
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				Ethnicity Hispanic/ Latino 
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				Indicate the participant's
				ethnicity by selecting yes or no.  
 
Leave
				blank if the participant does not disclose his/her ethnicity. 
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				1 = Yes 
2 = No 
Blank
				= no self-disclosure 
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				6 
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				American Indian or Alaska
				Native 
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				Select yes if the
				participant is American Indian or Alaska Native. 
				 
Leave
				blank if the participant is not American Indian or Alaska Native
				or refused to report on this element. 
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				1 = Yes 
Blank = not
				reported 
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				7 
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				Asian 
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				Select yes if the
				participant is Asian. 
				 
Leave
				blank if the participant is not Asian or refused to report on
				this element. 
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				1 = Yes 
Blank = not
				reported 
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				8 
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				Black or African American 
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				Select yes if the
				participant is Black or African American. 
				 
				 
Leave
				blank if the participant is not Black or African American or
				refused to report on this element. 
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				1 = Yes 
Blank = not
				reported 
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				9 
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				Hawaiian Native or other
				Pacific Islander 
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				Select yes if the
				participant is a Hawaiian Native or other Pacific Islander. 
				 
Leave
				blank if the participant is not a Hawaiian Native or other
				Pacific Islander or refused to report on this element. 
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				1 = Yes 
Blank = not
				reported 
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				10 
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				White 
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				Select yes if the
				participant is White. 
				 
Leave
				blank if the participant is not White or refused to report on
				this element. 
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				1 = Yes 
Blank = not
				reported 
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				SECTION I.B -
				ENROLLMENT INFORMATION 
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				11 
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				Primary Language 
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				Specify language spoken
				most often. 
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				1 = English 
				2
				= Spanish 
				3
				= Other 
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				If other, grantee must
				specify language in text box 
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				12 
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				Marital status 
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				Enter the participant’s
				marital status at time of enrollment. 
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				1 = Married 
2 =
				Single 
3 = Divorced 
4 = Widowed 
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				13 
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				Lives with Participant 
				 
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				Indicate the living
				situation from the dropdown menu, selecting all that apply. 
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				1 = Alone 
				2
				= Wife 
				3
				= Girlfriend 
				4
				= Parent/Stepparent 
				5
				= Friend(s) 
				6
				= Grandparent 
				7
				= Own Child(ren) 
				8
				= Other Child(ren) 
				9
				= Sister/Brother 
				10
				= Other Relative 
				11=
				Other Non-Relative 
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				Grantee must have ability
				to select multiple categories from dropdown menu 
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				16 
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				Highest School Grade
				Completed 
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				Use the appropriate code
				to record the highest school grade completed by the individual. 
				 
 
Record 87 if the individual completed the 12th
				grade and attained a high school diploma. 
 
				 
				Record
				88 if the individual completed the 12th grade and attained a
				GED or equivalent. 
 
				 
				Record
				89 if the individual with a disability received a certificate
				of attendance/completion.  
 
				 
				Record
				90 if the individual attained other post-secondary degree or
				certification.     
				 
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				00 = No school grades
				completed 
01 - 12 = Number of elementary/secondary school
				grades completed 
13-15 = Number of college, or full-time
				technical or vocational school years completed 
16 =
				Bachelor's degree or equivalent 
17 = Education beyond the
				Bachelor's degree 
87 = Attained High School Diploma 
88
				= Attained GED or Equivalent 
89 = Attained Certificate of
				Attendance/Completion 
90 = Attained Other Post-Secondary
				degree or Certificate 
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				17 
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				Occupational Training
				Certification 
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				Select yes or no 
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				1 = Yes 
				2
				= No 
				 
				 
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				If yes, a text box is
				required, describing the certificate(s) attained 
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				18 
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				Eligible Veteran Status 
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				Select yes, <= 180
				days if the individual is a person who served in the active
				U.S. military, naval, or air service for a period of less than or
				equal to 180 days, and who was discharged or released from such
				service under conditions other than dishonorable. 
				 
				 
				 
				Select
				yes, eligible veteran if the individual served on active
				duty for a period of more than 180 days and was discharged or
				released with other than a dishonorable discharge; or was
				discharged or released because of a service connected disability;
				or as a member of a reserve component under an order to
				active duty pursuant to section 167 (a), (d), or, (g), 673 (a) of
				Title 10, U.S.C., served on active duty during a period of war or
				in a campaign or expedition for which a campaign badge is
				authorized and was discharged or released from such duty with
				other than a dishonorable discharge.  
				 
				 
				 
				Select
				yes, other eligible person if the individual is a person
				who is (a) the spouse of any person who died on active duty or of
				a service-connected disability, (b) the spouse of any member of
				the Armed Forces serving on active duty who at the time of
				application for assistance under this part, is listed, pursuant
				to 38 U.S.C 101 and the regulations issued thereunder, by the
				Secretary concerned, in one or more of the following categories
				and has been so listed for more than 90 days: (i) missing in
				action; (ii) captured in the line of duty by a hostile force; or
				(iii) forcibly detained or interned in the line of duty by a
				foreign government or power; or (c) the spouse of any person who
				has a total disability permanent in nature resulting from a
				service-connected disability or the spouse of a veteran who died
				while a disability so evaluated was in existence.  
				 
				 
				 
				Select
				no if the individual does not meet any one of the
				conditions described above. 
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				1 = Yes, <= 180 days 
				 
				2
				= Yes, Eligible Veteran 
				 
				3
				= Yes, Other Eligible Person 
				 
				4
				= No 
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				19 
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				Limited English Proficient 
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				Select yes if the
				individual is a person who has limited ability in speaking,
				reading, writing or understanding the English language and: (a)
				whose native language is a language other than English, or (b)
				who lives in a family or community environment where a language
				other than English is the dominant language.  
 
				 
				Select
				no if the individual does not meet the conditions described
				above. 
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				1 = Yes 
2 = No 
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				20 
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				Individual with a
				Disability 
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				Select yes if the
				individual indicates that he/she has any "disability,"
				as defined in Section 3(2)(a) of the Americans with Disabilities
				Act of 1990 (42 U.S.C. 12102).  Under that definition, a
				"disability" is a physical or mental impairment that
				substantially limits one or more of the person's major life
				activities.  (For definitions and examples of "physical or
				mental impairment" and "major life activities,"
				see paragraphs (1) and (2) of the definition of the term
				"disability" in 29 CFR 37.4, the definition section of
				the WIA non-discrimination regulations.) 
 
				 
				Select
				no if the individual indicates that he/she does not have a
				disability that meets the definition. 
 
				 
				Leave
				blank if the individual does not wish to self-identify. 
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				1 = Yes 
2 = No 
Blank
				= no self-identification 
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				21 
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				Employment History 
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				Select yes or no
				as to whether participant has ever been employed. 
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				1 = Yes 
				2
				= No 
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				22 
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				Employment Retention
				History 
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				Select yes or no
				as to whether participant has ever worked for the same employer
				for six months or more. 
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				1 = Yes 
				2
				= No 
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				23 
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				Employment Status at
				Intake 
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				Record Employed if
				the participant is a person who either: (a) did any work at all
				as a paid employee, (b) did any work at all in his or her own
				business, profession, or farm, (c) worked 15 hours or more as an
				unpaid worker in an enterprise operated by a member of the
				family, or (d) is one who was not working, but has a job or
				business from which he or she was temporarily absent because of
				illness, bad weather, vacation, labor-management dispute, or
				personal reasons, whether or not paid by the employer for
				time-off, and whether or not seeking another job.  
 
				 
				Record
				Employed, but Received Notice of Termination of Employment or
				Military Separation if the participant is a person who,
				although employed, either: (a) has received a notice of
				termination of employment or the employer has issued a Worker
				Adjustment and Retraining Notification (WARN) or other notice
				that the facility or enterprise will close, or (b) is currently
				on active military duty and has been provided with a
				firm date of separation from military service.   
 
				 
				Record
				Not Employed if the individual does not meet any one of
				the conditions described above. 
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				1 = Employed 
2 =
				Employed, but Received Notice of Termination of Employment or
				Military Separation 
3 = Not Employed 
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				A. Must be 1 or 2 if Field
				24 (Occupation at Intake) is >0. 
B. Must be 1 or 2 if
				Field 25 (Hours Worked at Intake) is >0. 
C. Must be 1 or
				2 if Field 26 (Earnings at Intake) is >0. 
D. Must be 1 or
				2 if Field 27 (Start Date for Job at Intake) is not blank. 
E.
				 Must be completed within two weeks of opening the record. 
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				24 
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				Occupation at Intake 
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				Record the 8-digit
				occupational code that best describes the individual's employment
				at enrollment using the O*Net Version 4.0 (or later versions)
				classification system. 
 
Leave blank if the participant
				is not employed at participation. 
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				00000000 
Blank or
				00000000 = unavailable or unknown 
(No hyphens or periods) 
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				25 
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				Hours Worked at Intake 
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				Enter the average hours
				per week that the participant works at the above occupation. 
				Leave blank if the participant is not employed at participation. 
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				00Blank = not employed 
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				A. Must be greater than 0
				if Field 23 (Employment Status at Intake) is 1 or 2. 
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				26 
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				Average Hourly Wage at
				Intake 
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				Enter the participant's
				average hourly wage at the above occupation. 
 
Leave
				blank if the participant is not employed at participation. 
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				00.00 
Blank = not
				employed 
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				A. Must be greater than 0
				if Field 23 (Employment Status at Intake) is 1 or 2. 
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				27 
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				Start Date for Job at
				Intake 
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				Enter the date on which
				the participant began to work at the above job. 
 
Leave
				blank if the participant is not employed at participation. 
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				MM/DD/YYYY 
Blank =
				not employed 
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				A. Must not be blank if
				Field 23 (Employment Status at Intake) is 1 or 2. 
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				28 
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				Housing Status at
				Enrollment 
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				Select Own/Rent
				Apartment, Room, or House if, at enrollment, the individual
				is living in an apartment, room, or house that he/she owns or
				rents.  
				 
				 
				 
				Select
				Staying at someone's apartment, room, or house (Stable)
				if, at enrollment, the individual is living in an apartment,
				room, or house that somebody else owns or rents and if the person
				is not at risk of being displaced from this housing, i.e the
				housing situation is long-term. 
				 
				 
				Select
				Halfway house/transitional house if, at enrollment, the
				individual is living in a residence designed to assist persons as
				they re-enter society and learn to adapt to independent living
				after having been in prison. 
				 
				 
				Select
				Residential treatment if, at enrollment, the individual
				lives in a residential treatment center.  A residential treatment
				center is a group home that provides room and board, and provides
				specialized treatment or rehabilitation persons with emotional,
				psychological, or developmental problems as well as chemical
				dependencies. 
				 
				 
				Select
				Homeless if, at enrollment, the individual lacks a fixed,
				regular, adequate night time residence.  This definition includes
				any individual who has a primary night time residence that is a
				publicly or privately operated shelter for temporary
				accommodation; an institution providing temporary residence for
				individuals intended to be institutionalized; or a public or
				private place not designated for or ordinarily used as a regular
				sleeping accommodation for human beings.  This definition does
				not include an individual imprisoned or detained under an Act of
				Congress or state law.  An individual who may be sleeping in a
				temporary accommodation while away from home should not, as a
				result of that alone, be recorded as homeless.  
				 
				 
				 
				Select
				Staying at someone's apartment, room, or house (Unstable)
				if, at enrollment, the individual is living in an apartment,
				room, or house that somebody else owns or rents and if the person
				is at risk of being displaced from this housing, i.e. the housing
				situation is short-term. 
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				1 = Own/rent apartment,
				room, or house 
				2
				= Staying at someone's apartment, room, or house (Stable) 
				3
				= Halfway house/ transitional house 
				4
				= Residential treatment 
				5
				= Homeless 
				6
				= Staying at someone's apartment, room, or house (Unstable) 
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				A.  Must be completed
				within two weeks of opening the record. 
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				29 
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				Alcohol Abuse/ Drug Use at
				Intake 
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				Select prior to
				incarceration if the individual used illegal drugs or abused
				legal drugs or alcohol within 3 months prior to incarceration. 
 
				 
				Select
				prior to enrollment if the individual used illegal drugs or
				abused legal drugs or alcohol 3 months prior to
				enrollment. 
Select both if the individual used illegal drugs
				or abused legal drugs or alcohol within 3 months prior to
				incarceration and 3 months prior to enrollment. 
 
				 
				Select
				no if the individual did not use illegal drugs or abuse
				alcohol 3 months prior to incarceration or 3 month prior to
				enrollment. 
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				1 = Prior to enrollment 
2
				= No 
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				A.  Must be completed
				within two weeks of opening the record. 
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				30 
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				Alcohol Abuse/Drug Abuse
				Treatment at Intake 
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				Select yes or no
				as to whether participant is in substance abuse treatment at
				intake. 
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				1 = Yes 
				2
				= No 
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				If participant answers
				yes, select yes or no as to whether treatment is court-mandated
				or a requirement of probation/parole based on participant’s
				answer to first question. 
				 
				 
				1
				= Yes 
				2
				= No 
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				31 
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				Family Support 
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				Select any of the
				categories that apply in terms of the participant’s
				response to area where family are able to assist. 
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				1 = Place to Live 
				2
				= Job 
				3
				= Substance Abuse Treatment 
				4
				= Transportation 
				5
				= Financial Support 
				6
				= None 
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				32 
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				Public Assistance at
				Enrollment 
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				Indicate the following
				sources of other public assistance that the recipient was
				receiving at enrollment. 
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				1 = Social Security
				Insurance (SSI) or Social Security Disability (SSD) 
2 =
				Temporary Assistance for Needy Families (TANF) 
3 = Welfare
				for single adults or general assistance (GA) 
4 =
				Unemployment insurance 
5 = Food stamps 
6 = Division of
				AIDS Services Income Support (DAS) 
7 = Other government
				sources  
8 = No Benefits 
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				33 
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				Referral Source 
			 | 
			
				Enter the name of the
				organization or individual who referred the applicant to the ETJD
				program. 
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				Text 
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				 This field is
				optional. 
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				SECTION I.C -
				INFORMATION ON INCARCERATION 
This information is collected
				at enrollment for ex-offender participants only 
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				34 
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				Post-Release Status at
				Intake 
			 | 
			
				Select parole if
				the participant is on parole on the date of participation. 
 
				 
				Select
				probation if the participant is on probation on the date
				of participation. 
 
				 
				Select
				other criminal justice/court supervision if the
				participant is on post-release supervision other than parole or
				probation on the date of participation. 
 
				 
				Select
				none if the participant is not on any form of post-release
				supervision. 
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				1 = Parole 
2 =
				Probation 
3 = Other Criminal Justice/Court Supervision 
4
				= None 
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				35 
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				Mandated participation 
			 | 
			
				Select yes if
				participation in the ETJD program is mandated by a criminal
				justice agency or agent 
 
Select no if
				participation in the ETJD program is not mandated by a criminal
				justice agency or agent 
			 | 
			
				1 = Yes 
2 = No 
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				36 
			 | 
			
				Criminal Justice System
				Identifier 
			 | 
			
				Enter the individual's
				unique criminal justice system identifier that was assigned to
				the individual while in most recent incarceration. 
			 | 
			
				Text 
			 | 
			
				  
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				37 
			 | 
			
				Type of Criminal Justice
				Identifier 
			 | 
			
				Select the appropriate
				type of criminal justice identifier used in Field 36. 
			 | 
			
				1 = Federal ID 
2 =
				State CJ record ID 
3 = State prison ID 
4 = State
				parole/ probation agency ID 
5 = Local probation agency ID 
6
				= Local jail ID 
7 = Other 
			 | 
			
				A.  Must not be null if
				Field 36 (Criminal Justice System Identifier) is not null. 
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				38 
			 | 
			
				Specify Other Criminal
				Justice Identifier 
			 | 
			
				Specify the type of
				criminal justice identifier if other was selected in Field 37. 
			 | 
			
				Text 
			 | 
			
				A. Must not be blank if
				Field 37 (Type of Criminal Justice Identifier) is 7. 
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				39 
			 | 
			
				Employment Status at
				Incarceration 
			 | 
			
				Prior to the most recent
				incarceration, indicate whether the individual was employed
				within two weeks of arrest. 
			 | 
			
				1 = Employed full-time 
2
				= Employed part-time  
3 = Not employed 
			 | 
			
				  
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				40 
			 | 
			
				Date of Incarceration for
				Most Recent Crime Prior to Participation 
			 | 
			
				Enter the date on which
				the participant was incarcerated for the most recent crime
				committed prior to participation. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be less than Field
				41 (Date of Release for Most Recent Crime Prior to
				Participation). 
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				41 
			 | 
			
				Date of Release for Most
				Recent Crime Prior to Participation 
			 | 
			
				Enter the date on which
				the participant was most recently released from prison prior to
				participation. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be less than Field
				62 (Date of Program Participation). 
 
B.  Must be
				completed within two weeks of opening the record. 
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				42 
			 | 
			
				Institution 
			 | 
			
				Enter the name of the
				institution at which the participant was incarcerated most
				recently prior to enrollment. 
			 | 
			
				Text 
			 | 
			
				  
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				43 
			 | 
			
				Type of Institution 
			 | 
			
				Select the type of
				institution at which the participant was incarcerated most
				recently prior to enrollment 
			 | 
			
				1 = Federal prison 
2
				= State prison 
3 = County/city jail 
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				44 
			 | 
			
				Total Time Incarcerated 
			 | 
			
				Enter the total number of
				years and months that the participant has been incarcerated
				during his/her lifetime. 
			 | 
			
				YY/MM 
			 | 
			
				A.  Must be completed
				within two weeks of opening the record. 
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				45 
			 | 
			
				Property Crime 
			 | 
			
				Select the appropriate
				type(s) of property crime for the participant's most recent
				conviction.  Property crimes include, but are not limited to,
				burglary, larceny, motor vehicle theft, and receiving stolen
				property.If a participant was convicted for more than one type of
				offense, select all appropriate offenses.  Leave blank if the
				participant's most recent conviction was not for a property
				crime. 
			 | 
			
				1 = Burglary 
				2
				= Larceny 
				3
				= Motor vehicle theft 
				4
				= Receiving stolen property 
				5
				= Other property crime 
				Blank
				= not a property crime 
			 | 
			
				A.  Must be completed
				within two weeks of opening the record. 
			 | 
		
		
			
				46 
			 | 
			
				Type of Other Property
				Crime 
			 | 
			
				Specify the other property
				crime. 
 
Leave blank if the participant’s most
				recent conviction did not include other property crimes. 
			 | 
			
				Text 
Blank = did not
				include other property crime 
			 | 
			
				A. Must not be blank if
				Field 45 (Property Crime) is 5. 
 
B.  Must be completed
				within two weeks of opening the record. 
			 | 
		
		
			
				47 
			 | 
			
				Drug Crime 
			 | 
			
				Select the appropriate
				type(s) of drug crime for the participant's most recent
				conviction.  Drug crimes include, but are not limited to,
				possession of a controlled substance, traffic in a controlled
				substance, and possession of drug paraphernalia. 
 
If a
				participant was convicted for more than one type of offense,
				select all applicable offenses. 
 
Leave blank if the
				participant's most recent conviction was not for a drug crime. 
			 | 
			
				1 = Possession of a
				controlled substance 
2 = Traffic in a controlled substance 
3
				= Possession of drug paraphernalia 
4 = Other drug
				crime 
Blank = not a drug crime 
			 | 
			
				A.  Must be completed
				within two weeks of opening the record. 
			 | 
		
		
			
				48 
			 | 
			
				Type of Other Drug Crime 
			 | 
			
				Specify the other drug
				crime. 
 
Leave blank if the participant's most recent
				conviction did not include other drug crimes. 
			 | 
			
				Text 
Blank = did not
				include other drug crime 
			 | 
			
				A. Must not be blank if
				Field 40 (Drug Crimes) is 4. 
 
B.  Must be completed
				within two weeks of opening the record. 
			 | 
		
		
			
				49 
			 | 
			
				Public Order Offenses 
			 | 
			
				Select the appropriate
				type(s) of public order offenses for the participant's most
				recent conviction.  Public order offenses include, but are not
				limited to, commercial vice, gambling, animal cruelty, and
				driving while intoxicated. 
 
If a participant was
				convicted for more than one type of offense, select all
				appropriate offenses. 
 
Leave blank if the participant's
				most recent conviction was not for a public order offense. 
			 | 
			
				1 = Commercial vice 
2
				= Gambling 
3 = Animal cruelty 
4 = Driving while
				intoxicated 
5 = Other public order offense 
Blank = not
				a public order offense 
			 | 
			
				A.  Must be completed
				within two weeks of opening the record. 
			 | 
		
		
			
				50 
			 | 
			
				Type of Other Public Order
				Offenses 
			 | 
			
				Specify the other public
				order offense.  Leave blank if the participant's most recent
				conviction did not include other public order offenses. 
			 | 
			
				Text 
				Blank
				= did not include other public order offense 
			 | 
			
				A. Must not be blank if
				Field 49 (Public Order Offenses) is 5. 
				 
				 
				B.
				 Must be completed within two weeks of opening the record. 
			 | 
		
		
			
				51 
			 | 
			
				Other Offenses 
			 | 
			
				Select yes if the
				participant's most recent conviction was for any offense not
				included in property, drug, or public order offenses. 
			 | 
			
				1 = Yes 
2 = No 
			 | 
			
				A.  Must be completed
				within two weeks of opening the record. 
			 | 
		
		
			
				52 
			 | 
			
				Type of Other Offenses 
			 | 
			
				Specify the other
				offenses. 
 
Leave blank if the participant's most recent
				conviction did not include other offenses. 
			 | 
			
				Text 
Blank = did not
				include other offenses 
			 | 
			
				A. Must not be blank if
				Field 51 (Other Offenses) is 1. 
 
B.  Must be completed
				within two weeks of opening the record. 
			 | 
		
		
			
				SECTION 1.D.
				INFORMATION ON CHILD SUPPORT 
				This
				information is collected at enrollment for both non-custodial
				parent and ex-offender participants 
			 | 
		
		
			
				53 
			 | 
			
				Number of Children Under
				Age 19 
			 | 
			
				Select the appropriate
				number from the dropdown box 
			 | 
			
				Drop down box containing
				numbers from 0 to 10 
			 | 
			
				 
				 
			 | 
		
		
			
				54 
			 | 
			
				Age of Each Child Under
				Age 19 
			 | 
			
				Fill in appropriate text
				boxes with age of each child. 
				 
			 | 
			
				Text 
			 | 
			
				
					
						
							Automatically
							create number of text boxes that corresponds to number of
							children selected in Field 53 (Number of Children Under Age
							19) 
						 
					 
				 
				
				 
				 
				
				0 = no text boxes 
				
				1 = 1 text box 
				
				2 = 2 text boxes 
				Etc. 
			 | 
		
		
			
				55 
			 | 
			
				Number of Children Under
				Age 19 that Live with Participant 
			 | 
			
				Select the appropriate
				number from the dropdown box 
			 | 
			
				Drop down box containing
				numbers from 0 to 10 
			 | 
			
				 
				 
			 | 
		
		
			
				56 
			 | 
			
				Formal Child Support Order
				in Place 
			 | 
			
				Does the individual have
				one or more current child support order(s) in place? This is an
				order that was established through the formal child support
				system (either a court or a state or county agency). 
			 | 
			
				Select Yes or No 
			 | 
			
				 
				 
			 | 
		
		
			
				57 
			 | 
			
				Number of Child Support
				Enforcement Cases 
			 | 
			
				Select the appropriate
				number from the dropdown box 
			 | 
			
				Drop down box containing
				numbers from 0 to 10 
			 | 
			
				If yes to Field 56 (Formal
				Child Support Order in Place), then Field 57 cannot be 0 
				 
				
				 
				 
			 | 
		
		
			
				58 
			 | 
			
				Number of Children for
				Each Child Support Enforcement Case 
			 | 
			
				Specify the number of
				children for whom the individual is obligated to pay child
				support for each case. 
			 | 
			
				For Case 1, select number
				from drop down; for Case 2, select number, etc. 
			 | 
			
				If yes to Field 56 (Formal
				Child Support Order in Place), then Field 51 must be filled out. 
				 
				 
				For
				the number selected in Field 57 (Number of Child Support
				Enforcement Cases), a separate drop down box should appear until
				the total of the number in Field 57 
				 
			 | 
		
		
			
				59 
			 | 
			
				Child Support Case Numbers 
			 | 
			
				Specify the case numbers
				for each Child Support Enforcement Case 
			 | 
			
				Text Boxes up to the total
				number selected in Field 57 (Number of Child Support Enforcement
				Cases) 
			 | 
			
				optional 
			 | 
		
		
			
				60 
			 | 
			
				Order Amount for Each Case 
			 | 
			
				
					Specify the monetary
					value of the order amount 
				 
				 
				 
				
					
					Specify the payment
					period for collection 
				 
				
				 
				 
				
					Specify
					whether payment includes arrearages or only current payment due 
				 
			 | 
			
				
					Text box 
				 
				 
				 
				
					
					Dropdown menu – 
					 
				 
				1
				= weekly 
				2=
				monthly 
				3
				= other 
				 
				 
				C.
				 Select Yes or No 
			 | 
			
				If
				yes to Field 56, this Field must be filled out.  Order amount
				information fields should be provided up to the maximum number of
				child support cases stated in Field 57 (Number of Child Support
				Enforcement Cases). 
			 | 
		
		
			
				61 
			 | 
			
				Date of Most Recent
				Visitation with Focal Child 
			 | 
			
				Specify most recent date
				of visit with focal child 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				 
				 
			 | 
		
		
			
				SECTION
				II - PROGRAM ACTIVITIES AND SERVICES INFORMATION 
			 | 
			
				 
				 
			 | 
		
		
			
				SECTION II.A - PROGRAM
				PARTICIPATION DATA 
			 | 
			
				  
			 | 
		
		
			
				62 
			 | 
			
				Date of Program
				Participation 
			 | 
			
				Record the date on which
				the individual begins receiving his/her first service funded by
				the program following a determination of eligibility to
				participate in the program.   
 
This date will be
				auto-generated by the system to be the date on which assessment
				information is submitted. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. This date will be
				auto-generated by the system to be the date on which assessment
				information is submitted. 
			 | 
		
		
			
				63 
			 | 
			
				Date of Exit 
			 | 
			
				Record the date on which
				the last service funded by the program or a partner program
				(excluding supportive services) is received by the participant or
				the date of incarceration, whichever occurs first. 
 
Once
				a participant has not received any services funded by the program
				(excluding supportive services) or a partner program for 90
				consecutive calendar days has no planned gap in service, and is
				not scheduled for future services, the date of exit is applied
				retroactively to the last day on which the individual received a
				service funded by the program or a partner program. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. This date will be
				auto-generated by the system to be the date on which the
				individual receives his/her last service. 
			 | 
		
		
			
				64 
			 | 
			
				Reason for Leaving Initial
				Placement in Unsubsidized Employment 
			 | 
			
				Indicate the reason why
				the individual left the job of initial placement. 
			 | 
			
				1 = Reincarcerated 
2
				= Quit 
3 = Laid off 
4 = Fired 
5 = Temporary or
				seasonal job ended 
6 = Other 
			 | 
			
				 
				 
			 | 
		
		
			
				65 
			 | 
			
				Prerelease Contact 
			 | 
			
				Select yes if the
				DOL grantee had any contact with the participant prior to
				registration in the program. 
 
Select no if the
				DOL grantee did not have any contact with the participant prior
				to registration in the program. 
			 | 
			
				1 = Yes 
2 = No 
			 | 
			
				  
			 | 
		
		
			
				66 
			 | 
			
				Other Reasons for Exit (at
				time of exit or during three-quarter measurement period following
				the quarter of exit) 
			 | 
			
				Select Health/Medical
				if the participant is receiving medical treatment that precludes
				entry into unsubsidized employment or continued participation in
				the program.    Does not include temporary conditions expected to
				last for less than 90 days. 
				 
				 
				Select
				Deceased if the participant was found to be deceased or no
				longer living. 
				 
				 
				Select
				Family Care if the participant is providing care for a
				family member that precludes entry into unsubsidized employment
				or continued participation in the program.  Does not include
				temporary conditions expected to last for less than 90 days.  
				 
				 
				 
				Select
				Reservists Called to Active Duty if the participant is a
				reservist who is called to active duty for at least 90 days.  
				 
				 
				 
				Leave
				blank if none of the above reasons apply. 
			 | 
			
				02 = Health/Medical 
				03
				= Deceased 
				04
				= Family Care 
				05
				= Reservists Called to Active Duty 
				Blank
				= none of the above 
			 | 
			
				A. Must be blank if Field
				63 (Date of Exit) is blank. 
			 | 
		
		
			
				SECTION II.B - SERVICES
				AND OTHER RELATED ASSISTANCE DATA 
			 | 
			
				  
			 | 
		
		
			
				Education or Job
				Training Activities 
			 | 
			
				  
			 | 
		
		
			
				67 
			 | 
			
				Date Entered Math/Reading
				Remediation 
			 | 
			
				Enter the date on which
				the participant  started math/reading remediation.  
				 
 
Math/reading remediation consists of classroom
				instruction designed to improve a participant’s reading
				and/or math skills for those participants who are determined to
				be basic literacy skills deficient.  Basic education skills
				include reading comprehension, math computation, writing,
				speaking, listening, problem solving, reasoning, and the capacity
				to use these skills.  
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				  
			 | 
		
		
			
				68 
			 | 
			
				Expected Completion Date
				of Math/Reading Remediation 
			 | 
			
				Enter the date on which
				the participant is expected to complete math/reading remediation. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 67 (Date Entered Math/Reading
				Remediation) 
			 | 
		
		
			
				69 
			 | 
			
				Date of Last Math/Reading
				Remediation Services During the Month 
			 | 
			
				Enter the last date during
				the month in which the participant received math/remediation
				services.  
				 
				 
				 
				Note:
				This field must repeat for every month in which the participant
				receives math/remediation services. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 67 (Date Entered Math/Reading
				Remediation) 
			 | 
		
		
			
				70 
			 | 
			
				Date Ended Math/Reading
				Remediation 
			 | 
			
				Enter the date on which
				the participant exited math/reading remediation.   
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 67 (Date Entered Math/Reading
				Remediation). 
				 
 
				 
			 | 
		
		
			
				71 
			 | 
			
				Completed Math/Reading
				Remediation 
			 | 
			
				Select yes if the
				participant successfully completed math/reading remediation.  
				 
 
Select no if the participant did not
				successfully complete math/reading remediation.   
				 
			 | 
			
				1 = Yes 
2 = No 
			 | 
			
				A. Must not be blank if
				Field 70 (Date Ended Math/Reading Remediation) is a valid date. 
			 | 
		
		
			
				72 
			 | 
			
				Date Entered GED
				Preparation 
			 | 
			
				Enter the date on which
				the participant started GED preparation.   
 
GED
				preparation is an activity intended to prepare a participant for
				passing the GED examination. 
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				  
			 | 
		
		
			
				73 
			 | 
			
				Expected Completion Date
				of GED Preparation 
			 | 
			
				Enter the date on which
				the participant is expected to complete GED preparation.  
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 72 (Date Entered GED Preparation). 
			 | 
		
		
			
				74 
			 | 
			
				Date of Last GED
				Preparation Services During the Month 
			 | 
			
				Enter the last date during
				the month in which the participant received GED preparation
				services.   
 
Note:  This field must repeat for every
				month in which the participant receives GED preparation services. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 72 (Date Entered GED Preparation). 
			 | 
		
		
			
				75 
			 | 
			
				Date Ended GED Preparation 
			 | 
			
				Enter the date on which
				the participant exits GED preparation.  
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 72 (Date Entered GED Preparation). 
				 
 
				 
			 | 
		
		
			
				76 
			 | 
			
				Completed GED Preparation 
			 | 
			
				Select yes if the
				participant successfully completed GED preparation. 
 
Select
				no if the participant did not successfully complete GED
				preparation. 
			 | 
			
				1 = Yes 
2 = No 
			 | 
			
				A. Must not be blank if
				Field 75 (Date Ended GED Preparation) is a valid date. 
			 | 
		
		
			
				77 
			 | 
			
				Date Entered Vocational/
				Occupational Skills Training Services 
			 | 
			
				Enter the date on which
				the participant started vocational/occupational skills training. 
				  
 
Vocational/ occupational skills training is a type
				of long-term occupational training consisting of specific
				classroom and work-based study in a specific occupation leading
				to a degree or certificate. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				  
			 | 
		
		
			
				78 
			 | 
			
				Expected Completion Date
				of Vocational/ Occupational Skills Training Services 
			 | 
			
				Enter the date on which
				the participant is expected to complete vocational/occupational
				skills training.   
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 77 (Date Entered Vocational/
				Occupational Skills Training Services). 
			 | 
		
		
			
				79 
			 | 
			
				Date of Last Vocational/
				Occupational Skills Training Services During the Month 
			 | 
			
				Enter the last date during
				the month in which the participant received
				vocational/occupational skills training services.   
 
Note:
				 This field must repeat for every month in which the participant
				receives vocational/occupational skills training services. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 77 (Date Entered Vocational/
				Occupational Skills Training Services). 
			 | 
		
		
			
				80 
			 | 
			
				Date Ended Vocational/
				Occupational Skills Training Services 
			 | 
			
				Enter the date on which
				the participant exited vocational/occupational skills training.  
				
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 77 (Date Entered Vocational/
				Occupational Skills Training Services). 
				 
 
				 
			 | 
		
		
			
				81 
			 | 
			
				Completed Vocational/
				Occupational Skills Training Services 
			 | 
			
				Select yes if the
				participant successfully completed vocational/occupational skills
				training. 
 
Select no if the participant did not
				successfully complete vocational/ occupational skills training. 
			 | 
			
				1 = Yes 
2 = No 
			 | 
			
				A. Must not be blank if
				Field 80 (Date Ended Vocational/ Occupational Skills Training
				Services) is a valid date. 
			 | 
		
		
			
				82 
			 | 
			
				Expected Duration of
				Vocational/ Occupational Skills Training 
			 | 
			
				Select the duration of the
				vocational/occupational skills training program that the
				participant has entered. 
			 | 
			
				1 = 5 or fewer hours per
				week 
2 = 6 to 15 hours per week 
3 = 16 to 25 hours per
				week 
4 = 25 or more hours per week 
			 | 
			
				A. Must not be blank if
				Field 77 (Date Entered Vocational/ Occupational Skills Training
				Services) is a valid date. 
			 | 
		
		
			
				83 
			 | 
			
				Expected Cost of
				Vocational/ Occupational Skills Training 
			 | 
			
				Enter the expected cost of
				the vocational/occupational skills training program that the
				participant has entered. 
			 | 
			
				0000.00 
			 | 
			
				A. Must not be blank if
				Field 61 (Date Entered Vocational/ Occupational Skills Training
				Services) is a valid date. 
			 | 
		
		
			
				84 
			 | 
			
				Date Entered On- the-Job
				Training (OJT) 
			 | 
			
				Enter the date on which
				the participant started on-the-job training (OJT).   
 
OJT
				is training provided by an employer that pays the participant
				while the participant is engaged in productive work.  The job
				provides knowledge or skills essential to the full and adequate
				performance of the job, provides reimbursement to the employer of
				up to 50% of the wage rate of the participant, and is limited in
				duration to a period appropriate to the occupation for which the
				participant is being trained. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				  
			 | 
		
		
			
				85 
			 | 
			
				Expected Completion Date
				of On-the-Job Training (OJT) 
			 | 
			
				Enter the date on which
				the participant is expected to complete on-the-job training
				(OJT).  
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 84 (Date Entered On-the-Job
				Training). 
			 | 
		
		
			
				86 
			 | 
			
				Date of Last On-the-Job
				Training (OJT) Services During the Month 
			 | 
			
				Enter the last date during
				the month in which the participant received on-the-job training
				(OJT) services.   
 
Note: This field must repeat for
				every month in which the participant receives on-the-job training
				(OJT) services. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 84 (Date Entered On-the-Job
				Training). 
			 | 
		
		
			
				87 
			 | 
			
				Date Ended On-the-Job
				Training (OJT) 
			 | 
			
				Enter the date on which
				the participant exited on-the-job training (OJT).  
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 84 (Date Entered On-the-Job
				Training). 
				 
 
				 
			 | 
		
		
			
				88 
			 | 
			
				Completed On-the-Job
				Training (OJT) 
			 | 
			
				Select yes if the
				participant successfully completed OJT. 
 
Select no
				if the participant did not successfully complete OJT. 
			 | 
			
				1 =Yes 
2 = No 
			 | 
			
				A. Must not be blank if
				Field 87 (Date Ended On-the-Job Training) is a valid date. 
			 | 
		
		
			
				89 
			 | 
			
				Date Entered Other
				Education or Job Training Activities 
			 | 
			
				Enter the date on which
				the participant started other education or job training
				activities.  
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				  
			 | 
		
		
			
				90 
			 | 
			
				Type of Other Education or
				Job Training Activities 
			 | 
			
				Specify the type of other
				education or job training activities.  
				 
			 | 
			
				Text 
			 | 
			
				A. Must not be blank if
				Field 89 (Date Entered Other Education or Job Training
				Activities) is a valid date. 
			 | 
		
		
			
				91 
			 | 
			
				Expected Completion Date
				of Other Education or Job Training Activities 
			 | 
			
				Enter the date on which
				the participant is expected to complete other education or job
				training activities.  
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must not be blank if
				Field 89 (Date Entered Other Education or Job Training
				Activities) is a valid date. 
			 | 
		
		
			
				92 
			 | 
			
				Date of Last Other
				Education or Job Training Activities Services During the Month 
			 | 
			
				Enter the last date during
				the month in which the participant received other education or
				job training activities services.   
 
Note: This field
				must repeat for every month in which the participant receives
				other education or job training activities services. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must not be blank if
				Field 89 (Date Entered Other Education or Job Training
				Activities) is a valid date. 
			 | 
		
		
			
				93 
			 | 
			
				Date Ended Other Education
				or Job Training Activities 
			 | 
			
				Enter the date on which
				the participant exits other education or job training activities.
				
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 89 (Date Entered Other Education
				or Job Training Activities). 
			 | 
		
		
			
				94 
			 | 
			
				Completed Other Education
				or Job Training Activities 
			 | 
			
				Select yes if the
				participant successfully completed other education or job
				training activities. 
 
Select no if the
				participant did not successfully complete other education or job
				training activities. 
			 | 
			
				1 = Yes 
2 = No 
			 | 
			
				A. Must not be blank if
				Field 93 (Date Ended Other Education or Job Training Activities)
				is a valid date. 
			 | 
		
		
			
				Workforce Preparation
				Activities 
			 | 
			
				  
			 | 
		
		
			
				95 
			 | 
			
				Date Entered Subsidized
				Employment 
			 | 
			
				Enter the date on which
				the participant started subsidized employment.  
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				  
			 | 
		
		
			
				96 
			 | 
			
				Expected Completion Date
				of Subsidized Employment 
			 | 
			
				Enter the date on which
				the participant is expected to complete subsidized employment.  
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 95 (Date Entered Subsidized
				Employment). 
			 | 
		
		
			
				97 
			 | 
			
				Date of Last Subsidized
				Employment Services During the Month 
			 | 
			
				Enter the last date during
				the month in which the participant received subsidized employment
				services.   
 
Note: This field must repeat for every
				month in which the participant receives subsidized employment
				services. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 95 (Date Entered Subsidized
				Employment). 
			 | 
		
		
			
				98 
			 | 
			
				Date Ended Subsidized
				Employment 
			 | 
			
				Enter the date on which
				the participant exited subsidized employment.  
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 95 (Date Entered Subsidized
				Employment). 
 
				 
			 | 
		
		
			
				99 
			 | 
			
				Completed Subsidized
				Employment 
			 | 
			
				Select yes if the
				participant successfully completed subsidized employment. 
				 
				 
				Select
				no if the participant did not successfully complete
				subsidized employment. 
			 | 
			
				1 = Yes 
				2
				= No 
			 | 
			
				A. Must not be blank if
				Field 98 (Date Ended Subsidized Employment) is a valid date. 
			 | 
		
		
			
				100 
			 | 
			
				Date Entered Internship 
			 | 
			
				Enter the date on which
				the participant started internship.   
 
Internship
				consists of on-site work experience designed to improve an
				enrollee’s occupational skills and readiness for the world
				of work.   
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				  
			 | 
		
		
			
				101 
			 | 
			
				Expected Completion Date
				of Internship 
			 | 
			
				Enter the date on which
				the participant is expected to complete internship.  
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 100 (Date Entered Internship). 
			 | 
		
		
			
				102 
			 | 
			
				Date of Last Internship
				During the Month 
			 | 
			
				Enter the last date during
				the month in which the participant participated in an
				internship. 
 
Note: This field must repeat for every
				month in which the participant is in the internship. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 100 (Date Entered Internship). 
			 | 
		
		
			
				103 
			 | 
			
				Date Ended Internship 
			 | 
			
				Enter the date on which
				the participant exits internship. 
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 84 (Date Entered Internship). 
B.
				Must not be blank if Field 88 is 1. 
			 | 
		
		
			
				104 
			 | 
			
				Completed Internship 
			 | 
			
				Select yes if the
				participant successfully completed internshipSelect no if the
				participant did not successfully complete internship. 
			 | 
			
				1 = Yes2 = No 
			 | 
			
				A. Must not be blank if
				Field 87 (Date Ended Internship) is a valid date. 
			 | 
		
		
			
				105 
			 | 
			
				Date Entered Workforce
				Information Services 
			 | 
			
				Enter the date on which
				the participant started workforce information services. 
				 
 
Workforce information services include, but are not
				limited to, providing information on state and local labor market
				conditions; industries, occupations and characteristics of the
				workforce; area business identified skills needs; employer wage
				and benefit trends; short- and long-term industry and
				occupational projections; worker supply and demand; and job
				vacancies survey results.  Workforce information also includes
				local employment dynamics information such as workforce
				availability; business turnover rates; job creation; job
				destruction; new hire rates, worker residency, commuting pattern
				information; and the identification of high-growth and
				high-demand industries. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				  
			 | 
		
		
			
				106 
			 | 
			
				Expected Completion Date
				of Workforce Information Services 
			 | 
			
				Enter the date on which
				the participant is expected to complete workforce information
				services.  
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 105 (Date Entered Workforce
				Information Services). 
			 | 
		
		
			
				107 
			 | 
			
				Date of Last Workforce
				Information Services  During the Month 
			 | 
			
				Enter the last date during
				the month in which the participant received workforce information
				services.   
 
Note: This field must repeat for every
				month in which the participant receives workforce information
				services. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 105 (Date Entered Workforce
				Information Services). 
			 | 
		
		
			
				108 
			 | 
			
				Date Ended Workforce
				Information Services 
			 | 
			
				Enter the date on which
				the participant exits workforce information services. 
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 105 (Date Entered Workforce
				Information Services). 
			 | 
		
		
			
				109 
			 | 
			
				Completed Workforce
				Information Services 
			 | 
			
				Select yes if the
				participant successfully completed workforce information
				services. 
 
Select no if the participant did not
				successfully complete workforce information services. 
			 | 
			
				1 = Yes 
2 = No 
			 | 
			
				A. Must not be blank if
				Field 108 (Date Ended Workforce Information Services) is a valid
				date. 
			 | 
		
		
			
				110 
			 | 
			
				Date Entered Training 
			 | 
			
				Enter the date on which
				the participant started any training program.  
				 
			 | 
			
				MM/DD/YYYY 
				1
				= Orientation 
				2
				= Life Skills 
				3
				= Pre-employment Class 
				4
				= Vocational/ Occupational Skills 
				5
				= On-the-Job Training 
				6
				= Internship 
				7
				= Parenting Class 
				8
				= Other 
				 
				 
			 | 
			
				If a date is provided, a
				selection must be made from the dropdown for the type of training
				program. 
				 
				 
				For
				values 5 and 6, employer must be provided in a text box.  For
				value 8, the type of class should be described in a text box. 
			 | 
		
		
			
				111 
			 | 
			
				Completion Date of
				Training 
			 | 
			
				Enter the date on which
				the participant completed the training.  
				 
			 | 
			
				MM/DD/YYYY 
				1
				= Orientation 
				2
				= Life Skills 
				3
				= Pre-employment Class 
				4
				= Vocational/ Occupational Skills 
				5
				= On-the-Job Training 
				6
				= Internship 
				7
				= Parenting Class 
				8
				= Other 
				Yes/No 
				 
				 
				 
				 
			 | 
			
				If a date is provided, a
				selection must be made from the dropdown for the type of training
				program. 
				 
				 
				For
				values 5 and 6, employer must be provided in a text box.  For
				value 8, the type of class should be described in a text box. 
				 
				 
				Grantee
				must select yes or no as to whether a certificate was provided
				from the training.  If yes, a text box should be filled out
				providing the certificate name. 
			 | 
		
		
			
				112 
			 | 
			
				Date Entered Work
				Readiness Training Services 
				 
			 | 
			
				Enter the date on which
				the participant started work readiness training services. 
				 
				 
				Work
				readiness training includes world of work awareness, labor market
				knowledge, occupational information, values clarification and
				personal understanding, career planning and decision-making, and
				job search techniques (resumes, interviews, applications, and
				follow-up letters).  It also includes positive work habits,
				attitudes, and behavior such as punctuality, regular attendance,
				presenting a neat appearance, getting along and working well with
				others, exhibiting good conduct, following instructions and
				completing tasks, accepting constructive criticism from
				supervisors and co-workers, showing initiative and reliability,
				and assuming the responsibilities involved in maintaining a job. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				 
				 
			 | 
		
		
			
				113 
			 | 
			
				Date of Last Work
				Readiness Training Services During the Month 
			 | 
			
				Enter the last date during
				the month in which the participant received work readiness
				training services.  
				 
				 
				 
				Note:
				This field must repeat for every month in which the participant
				receives work readiness training services. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 112 (Date Entered Work Readiness
				Training Services). 
			 | 
		
		
			
				114 
			 | 
			
				Date Ended Work Readiness
				Training Services 
			 | 
			
				Enter the date on which
				the participant exits work readiness training services. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 112 (Date Entered Work Readiness
				Training.) 
 
				 
			 | 
		
		
			
				115 
			 | 
			
				Completed Work Readiness
				Training 
			 | 
			
				Select yes if the
				participant successfully completed work readiness
				training. 
 
Select no if the participant did not
				successfully complete work readiness training. 
			 | 
			
				1 = Yes 
2 = No 
			 | 
			
				A. Must not be blank if
				Field 114 (Date Ended Work Readiness Training Services) is a
				valid date. 
			 | 
		
		
			
				116 
			 | 
			
				Date Entered Career/Life
				Skills Counseling 
			 | 
			
				Enter the date on which
				the participant started career/life skills counseling. 
				 
 
Career/Life skills counseling is any formal
				counseling provided on a specific life skill or related to career
				guidance. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				  
			 | 
		
		
			
				117 
			 | 
			
				Expected Completion Date
				of Career/Life Skills Counseling 
			 | 
			
				Enter the date on which
				the participant is expected to complete career/life skills
				counseling.  
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 116 (Date Entered Career/Life
				Skills Counseling). 
			 | 
		
		
			
				118 
			 | 
			
				Date of Last Career/Life
				Skills Counseling Services During the Month 
			 | 
			
				Enter the last date during
				the month in which the participant received career/life skills
				counseling services.   
 
Note: This field must repeat
				for every month in which the participant receives career/life
				skills counseling services. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 116 (Date Entered Career/Life
				Skills Counseling). 
			 | 
		
		
			
				119 
			 | 
			
				Date Ended Career/Life
				Skills Counseling 
			 | 
			
				Enter the date on which
				the participant exits career/life skills counseling. 
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 116 (Date Entered Career/Life
				Skills Counseling). 
 
				 
			 | 
		
		
			
				120 
			 | 
			
				Completed Career/Life
				Skills Counseling 
			 | 
			
				Select yes if the
				participant successfully completed career/life skills
				counseling 
 
Select no if the participant did not
				successfully complete career/life skills counseling. 
			 | 
			
				1 = Yes 
2 = No 
			 | 
			
				A. Must not be blank if
				Field 119 (Date Ended Career/Life Skills Counseling) is a valid
				date. 
			 | 
		
		
			
				121 
			 | 
			
				Date Entered Other
				Workforce Preparation Activities 
			 | 
			
				Enter the date on which
				the participant started other workforce preparation activities.  
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				  
			 | 
		
		
			
				122 
			 | 
			
				Type of Other Workforce
				Preparation Activities 
			 | 
			
				Specify the type of other
				workforce preparation activities.  
				 
			 | 
			
				Text 
			 | 
			
				A. Must not be blank if
				Field 121 (Date Entered Other Workforce Preparation Activities)
				is a valid date. 
			 | 
		
		
			
				123 
			 | 
			
				Expected Completion Date
				of Other Workforce Preparation Activities 
			 | 
			
				Enter the date on which
				the participant is expected to complete other workforce
				preparation activities.  
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must not be blank if
				Field 121 (Date Entered Other Workforce Preparation Activities)
				is a valid date. 
			 | 
		
		
			
				124 
			 | 
			
				Date of Last Other
				Workforce Preparation Activities Services During the Month 
			 | 
			
				Enter the last date during
				the month in which the participant received other workforce
				preparation activities services.   
 
Note: This field
				must repeat for every month in which the participant receives
				other workforce preparation activities services. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must not be blank if
				Field 121 (Date Entered Other Workforce Preparation Activities)
				is a valid date. 
			 | 
		
		
			
				125 
			 | 
			
				Date Ended Other Workforce
				Preparation Activities 
			 | 
			
				Enter the date on which
				the participant exits other workforce preparation activities. 
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 121 (Date Entered Other Workforce
				Preparation Activities). 
			 | 
		
		
			
				126 
			 | 
			
				Completed Other Workforce
				Preparation Activities 
			 | 
			
				Select yes if the
				participant successfully completed other workforce preparation
				activities 
 
Select no if the participant did not
				successfully complete other workforce preparation activities. 
			 | 
			
				1 = Yes 
2 = No 
			 | 
			
				A. Must not be blank if
				Field 125 (Date Ended Other Workforce Preparation Activities) is
				a valid date. 
			 | 
		
		
			
				Community Involvement
				Activities 
			 | 
			
				  
			 | 
		
		
			
				127 
			 | 
			
				Date Entered Community
				Service 
			 | 
			
				Enter the date on which
				the participant started community service.   
 
Community
				service is an activity in which the participants perform
				volunteer work that benefits the community. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				  
			 | 
		
		
			
				128 
			 | 
			
				Expected Completion Date
				of Community Service 
			 | 
			
				Enter the date on which
				the participant is expected to complete community service.  
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 127 (Date Entered Community
				Service). 
			 | 
		
		
			
				129 
			 | 
			
				Date of Last Community
				Service During the Month 
			 | 
			
				Enter the last date during
				the month in which the participant received community service
				services.   
 
Note: This field must repeat for every
				month in which the participant receives community service
				services. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 127 (Date Entered Community
				Service). 
			 | 
		
		
			
				130 
			 | 
			
				Date Ended Community
				Service 
			 | 
			
				Enter the date on which
				the participant exits community service. 
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 127 (Date Entered Community
				Service). 
 
				 
			 | 
		
		
			
				131 
			 | 
			
				Completed Community
				Service 
			 | 
			
				Select yes if the
				participant successfully completed community service. 
				 
				 
				Select
				no if the participant did not successfully complete
				community service. 
			 | 
			
				1 = Yes 
				2
				= No 
			 | 
			
				A. Must not be blank if
				Field 130 (Date Ended Community Service) is a valid date. 
			 | 
		
		
			
				132 
			 | 
			
				Date Entered Other
				Community Involvement Activities 
			 | 
			
				Enter the date on which
				the participant started other community service.  
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				  
			 | 
		
		
			
				133 
			 | 
			
				Type of Other Community
				Involvement Activities 
			 | 
			
				Specify the type of other
				community service.  
				 
			 | 
			
				Text 
			 | 
			
				A. Must not be blank if
				Field 132 (Date Entered Other Community Involvement Activities)
				is a valid date. 
			 | 
		
		
			
				134 
			 | 
			
				Expected Completion Date
				of Other Community Involvement Activities 
			 | 
			
				Enter the date on which
				the participant is expected to complete community service.  
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 132 (Date Entered Other Community
				Involvement Activities). 
			 | 
		
		
			
				135 
			 | 
			
				Date of Last Other
				Community Service Services During the Month 
			 | 
			
				Enter the last date during
				the month in which the participant received other community
				service services.   
 
Note: This Field must repeat for
				every month in which the participant receives other community
				service services. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 132 (Date Entered Other Community
				Involvement Activities). 
			 | 
		
		
			
				136 
			 | 
			
				Date Ended Other Community
				Involvement Activities 
			 | 
			
				Enter the date on which
				the participant exits community service. 
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 132 (Date Entered Other Community
				Involvement Activities). 
 
				 
			 | 
		
		
			
				137 
			 | 
			
				Completed Other Community
				Involvement Activities 
			 | 
			
				Select yes if the
				participant successfully completed community service. 
				 
				 
				Select
				no if the participant did not successfully complete
				community service. 
			 | 
			
				1 = Yes 
				2
				= No 
			 | 
			
				A. Must not be blank if
				Field 136 (Date Ended Other Community Involvement Activities) is
				a valid date. 
			 | 
		
		
			
				Mentoring Activities 
			 | 
			
				  
			 | 
		
		
			
				138 
			 | 
			
				Date Entered Mentoring
				Activities 
			 | 
			
				Enter the date on which
				the participant started mentoring activities.   
 
Mentoring
				is a sustained relationship between a mentor and participant,
				whether one on one or in a group setting.  Through continued
				involvement, a mentor offers support and guidance in the
				individual’s development to become a responsible member of
				the community.  A variety of approaches may be used such as
				coaching, training, discussion, and counseling. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				  
			 | 
		
		
			
				139 
			 | 
			
				Expected Completion Date
				of Mentoring Activities 
			 | 
			
				Enter the date on which
				the participant is expected to complete mentoring activities.  
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 138 (Date Entered Mentoring
				Activities). 
			 | 
		
		
			
				140 
			 | 
			
				Date of Last Mentoring
				Activities Services During the Month 
			 | 
			
				Enter the last date during
				the month in which the participant received mentoring activities
				services.   
 
Note: This field must repeat for every
				month in which the participant receives mentoring activities
				services. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 138 (Date Entered Mentoring
				Activities). 
			 | 
		
		
			
				141 
			 | 
			
				Date Ended Mentoring
				Activities 
			 | 
			
				Enter the date on which
				the participant exits mentoring activities. 
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 138 (Date Entered Mentoring
				Activities). 
 
				 
			 | 
		
		
			
				142 
			 | 
			
				Completed Mentoring
				Activities 
			 | 
			
				Select yes if the
				participant successfully completed mentoring activities 
 
Select
				no if the participant did not successfully complete
				mentoring activities. 
			 | 
			
				1 = Yes 
2 = No 
			 | 
			
				A. Must not be blank if
				Field 141 (Date Ended Mentoring Activities) is a valid date. 
			 | 
		
		
			
				Supportive Services 
			 | 
			
				  
			 | 
		
		
			
				143 
			 | 
			
				Date Entered
				Transportation Services 
			 | 
			
				Enter the date on which
				the participant started transportation services.  
				 
				 
				 
				Transportation
				services include assistance or cash paid to participants for the
				purpose of transportation. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				  
			 | 
		
		
			
				144 
			 | 
			
				Date of Last
				Transportation Services  During the Month 
			 | 
			
				Enter the last date during
				the month in which the participant received transportation
				services.   
 
Note: This field must repeat for every
				month in which the participant receives transportation services. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 143 (Date Entered Transportation
				Services). 
			 | 
		
		
			
				145 
			 | 
			
				Date Ended Transportation
				Services 
			 | 
			
				Enter the date on which
				the participant exits transportation services. 
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 143 (Date Entered Transportation
				Services). 
			 | 
		
		
			
				146 
			 | 
			
				Date Entered Child Care
				Services 
			 | 
			
				Enter the date on which
				the participant started child care services.  
				 
				 
				 
				Child
				care services provide participants during program participation
				with child care that can be inside or outside the home, as well
				as after-school programs.  It usually includes supervision and
				shelter. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				  
			 | 
		
		
			
				147 
			 | 
			
				Date of Last Child Care
				Services  During the Month 
			 | 
			
				Enter the last date during
				the month in which the participant received child care services. 
				 
 
Note: This field must repeat for every month in which
				the participant receives child care services. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 146 (Date Entered Child Care
				Services). 
			 | 
		
		
			
				148 
			 | 
			
				Date Ended Child Care
				Services 
			 | 
			
				Enter the date on which
				the participant exits child care services. 
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 146 (Date Entered Child Care
				Services). 
			 | 
		
		
			
				149 
			 | 
			
				Date of Supportive Service
				Payment 
			 | 
			
				Enter the date on which
				the participant received a supportive service payment.   
 
 
				 
			 | 
			
				MM/DD/YYYY 
				$XXX.XX 
				1
				= Child Care 
				2
				= Housing 
				3
				= Clothing 
				4
				= Food 
				 
				5
				= Transportation 
				6
				= Other 
			 | 
			
				If date is entered, a
				monetary value must be entered and a type of service payment must
				be selected from a dropdown menu.  If other is selected, the text
				box must be used to describe other service payment. 
				 
				 
				The
				system must allow for separate instances of supportive service
				payments and should not overwrite previous entries. 
				 
				 
			 | 
		
		
			
				150 
			 | 
			
				Date Entered Follow-up
				Mentoring Services 
			 | 
			
				Enter the date on which
				the participant started follow-up mentoring services. 
 
Follow-up
				mentoring services are on-going mentoring that occurs after exit. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				  
			 | 
		
		
			
				151 
			 | 
			
				Last Date of Follow-up
				Mentoring Services During Month 
			 | 
			
				Enter the last date during
				the month in which the participant received follow-up mentoring
				services. 
 
Note: This field must repeat for every month
				in which the participant receives follow-up mentoring services. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 150 (Date Entered Follow-up
				Mentoring Services). 
			 | 
		
		
			
				152 
			 | 
			
				Date Ended Follow-up
				Mentoring Services 
			 | 
			
				Enter the last date on
				which the participant received follow-up mentoring services. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 150 (Date Entered Follow-up
				Mentoring Services). 
			 | 
		
		
			
				153 
			 | 
			
				Date Entered Other
				Follow-up Services 
			 | 
			
				Enter the date on which
				the participant started other follow-up services. 
 
Other
				follow-up services are on-going supportive services that occur
				after exit. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				  
			 | 
		
		
			
				154 
			 | 
			
				Last Date of Other
				Follow-up Services During Month 
			 | 
			
				Enter the last date during
				the month in which the participant received other follow-up
				services. 
 
Note: This field must repeat for every month
				in which the participant receives other follow-up services. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 153 (Date Entered Other Follow-up
				Services). 
			 | 
		
		
			
				155 
			 | 
			
				Date Ended Other Follow-up
				Services 
			 | 
			
				Enter the last date on
				which the participant received other follow-up services. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 153 (Date Entered Other Follow-up
				Services). 
			 | 
		
		
			
				156 
			 | 
			
				Date Entered Other
				Supportive Services 
			 | 
			
				Enter the date on which
				the participant started other supportive services.  
				 
				 
				 
				Other
				supportive services include supportive services not listed above. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				  
			 | 
		
		
			
				157 
			 | 
			
				Date of Last Other
				Supportive Services  During the Month 
			 | 
			
				Enter the last date during
				the month in which the participant received other supportive
				services .   
 
Note: This field must repeat for every
				month in which the participant receives other supportive
				services. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 156 (Date Entered Other Supportive
				Services). 
			 | 
		
		
			
				158 
			 | 
			
				Date Ended Other
				Supportive Services 
			 | 
			
				Enter the date on which
				the participant exits other supportive services. 
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 156 (Date Entered Other Supportive
				Services). 
			 | 
		
		
			
				159 
			 | 
			
				Date Entered Substance
				Abuse/Mental Health Treatment 
			 | 
			
				Enter the date on which
				the participant entered substance abuse or mental health
				treatment. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				If date is not blank, a
				text box must be filled out containing the name of the provider
				of treatment services 
			 | 
		
		
			
				160 
				 
			 | 
			
				Date Completed Substance
				Abuse/Mental Health Treatment 
			 | 
			
				Enter the date on which
				the participant completed substance abuse or mental health
				treatment. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 159 (Date Entered Substance
				Abuse/Mental Health Treatment). 
			 | 
		
		
			
				Case Management
				Services 
			 | 
		
		
			
				161 
			 | 
			
				Date Staff Contact/Meeting
				Occurred 
			 | 
			
				Enter the date on which
				the participant met with Case Manager or other staff and type of
				staff. 
			 | 
			
				MM/DD/YYYY 
				1
				= Case Manager 
				2
				= Job Developer/Coach 
				3
				= Transitional Job Coordinator 
				4
				= Other 
			 | 
			
				If other is selected, type
				of staff should be indicated in a text box. 
				 
				 
				The
				system must allow for separate instances of staff meetings and
				should not overwrite previous entries. 
				 
				 
				This
				service should be considered a supportive service, rather than a
				core service. 
				 
				 
			 | 
		
		
			
				Parenting/Child Support
				Services 
			 | 
		
		
			
				162 
			 | 
			
				Child Support Order
				Assistance 
			 | 
			
				Enter the date on which
				the participant received child support order assistance. 
				 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				The system must allow for
				separate instances of child support assistance and should not
				overwrite previous entries. 
				 
				 
			 | 
		
		
			
				163 
			 | 
			
				Child Support Order
				Modification 
			 | 
			
				Enter the date on which
				the participant was granted a Child Support Order Modification. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				The system must allow for
				separate instances of child support order modification and should
				not overwrite previous entries. 
				 
				 
			 | 
		
		
			
				164 
			 | 
			
				Child Support Payment 
			 | 
			
				Enter the date on which
				the participant provided payment of a child support order and the
				amount of the payment. 
			 | 
			
				MM/DD/YYYY 
				$0000.00 
			 | 
			
				The system must allow for
				separate instances of child support and should not overwrite
				previous entries. 
				 
				 
			 | 
		
		
			
				165 
			 | 
			
				Child Support General
				Assistance 
			 | 
			
				Enter the date on which
				the participant received general (non-order) child support
				assistance. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				The system must allow for
				separate instances of child support assistance and should not
				overwrite previous entries. 
			 | 
		
		
			
				166 
			 | 
			
				Child Visitation
				Assistance 
			 | 
			
				Enter the date on which
				the participant received assistance with child visitation. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				The system must allow for
				separate instances of child visitation assistance and should not
				overwrite previous entries. 
			 | 
		
		
			
				167 
			 | 
			
				Parenting Class 
			 | 
			
				Enter the date on which
				the participant attended parenting class. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				The system must allow for
				separate instances of parenting class and should not overwrite
				previous entries. 
			 | 
		
		
			
				SECTION
				III – TRANSITIONAL JOB PLACEMENT 
			 | 
		
		
			
				168 
			 | 
			
				Work Dates and Placement 
			 | 
			
				Enter the start date and
				end dates of work in a pay period.  
				 
				 
				 
				Enter
				the location of the transitional job placement. 
				 
				 
				Enter
				the type of placement: 
				1
				= Grant Program/Worksite 
				2
				= Private Sector Subsidized 
			 | 
			
				Start date of pay period 
				MM/DD/YYYY 
				End
				date of pay period 
				MM/DD/YYYY 
				Text
				Box 
			 | 
			
				 
				 
			 | 
		
		
			
				169 
			 | 
			
				Transitional Job Pay Date 
			 | 
			
				Enter the date of paycheck
				for each pay period 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				 
				 
			 | 
		
		
			
				170 
			 | 
			
				Transitional Job Hours
				Worked 
			 | 
			
				Enter the number of hours
				worked in each pay period 
			 | 
			
				00 
			 | 
			
				 
				 
			 | 
		
		
			
				171 
			 | 
			
				Amount of Pay Check 
			 | 
			
				Enter the value of the
				paycheck for each pay period 
			 | 
			
				$00.00 
			 | 
			
				 
				 
			 | 
		
		
			
				SECTION
				IV - PROGRAM OUTCOMES INFORMATION 
			 | 
			
				  
			 | 
		
		
			
				SECTION IV.A -
				FOLLOW-UP 
			 | 
			
				  
			 | 
		
		
			
				172 
			 | 
			
				Date of Follow-up 
			 | 
			
				Enter the date on which
				the grantee attempted to contact the participant to obtain
				post-program follow-up information, such as post-program
				employment and earnings information. 
 
Repeat for each
				follow-up attempt. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 63 (Date of Exit). 
			 | 
		
		
			
				173 
			 | 
			
				Successful Follow-up 
			 | 
			
				Enter yes if the
				grantee successfully contacted the participant to collect
				follow-up information. 
 
Enter no if the grantee
				did not successfully contact the participant to collect follow-up
				information. 
 
Repeat for each follow-up attempt. 
			 | 
			
				1 = Yes 
2 = No 
			 | 
			
				A. Must be 1 or 2 if Field
				172 (Date of Follow-up) has a valid date. 
			 | 
		
		
			
				SECTION IV.B -
				SHORT-TERM OUTCOME STATUS 
			 | 
			
				  
			 | 
		
		
			
				174 
			 | 
			
				Alcohol Abuse/ Drug Use at
				6 Months 
			 | 
			
				Select yes if the
				individual used illegal drugs or abused legal drugs or alcohol
				within six months after enrollment. 
 
Select no
				if the individual did not use illegal drugs or abuse legal drugs
				or alcohol within six months after enrollment. 
			 | 
			
				1 = Yes 
2 = No 
			 | 
			
				A. Must be 1 or 2 if Field
				29 (Alcohol Abuse/ Drug Use at Intake) is 1, 2, or 3. 
			 | 
		
		
			
				175 
			 | 
			
				Housing Status at 6 Months 
			 | 
			
				Select Own/Rent
				Apartment, Room, Or House if, six months after enrollment,
				the individual is living in an apartment, room, or house that
				he/she owns or rents. 
 
Select Staying at someone's
				apartment, room, or house (Stable) if, six months after
				enrollment, the individual is living in an apartment, room, or
				house that somebody else owns or rents and if the person is not
				at risk of being displaced from this housing, i.e. the housing
				situation is long-term. 
 
Select Halfway
				house/transitional house if, six months after enrollment, the
				individual is living in a residence designed to assist persons as
				they re-enter society and learn to adapt to independent living
				after having been in prison. 
 
Select Residential
				treatment if, six months after enrollment, the individual
				lives in a residential treatment center.  A residential treatment
				center is a group home that provides room and board, and provides
				specialized treatment or rehabilitation persons with emotional,
				psychological, or developmental problems as well as chemical
				dependencies. 
 
Select Homeless if, six months
				after enrollment, the individual lacks a fixed, regular, adequate
				night time residence.  This definition includes any 
individual
				who has a primary night time residence that is a publicly or
				privately operated shelter for temporary accommodation; an
				institution providing temporary residence for individuals
				intended to be institutionalized; 
				 
			 | 
			
				1 = Own/rent apartment,
				room, or house 
2 = Staying at someone's apartment, room, or
				house (Stable) 
3 = Halfway house/ transitional house 
4
				= Residential Treatment 
5 = Homeless 
6 = Staying at
				someone's apartment, room, or house (Unstable) 
			 | 
			
				  
			 | 
		
		
			
				 
				 
			 | 
			
				 
				 
			 | 
			
				or a public or private
				place not designated for or ordinarily used as a regular sleeping
				accommodation for human beings.  This definition does not include
				an individual imprisoned or detained under an Act of Congress or
				state law.  An individual who may be sleeping in a temporary
				accommodation while away from home should not, as a result of
				that alone, be recorded as homeless.   
 
Select Staying
				at someone's apartment, room, or house (Unstable) if, six
				months after enrollment, the individual is living in an
				apartment, room, or house that somebody else owns or rents and if
				the person is at risk of being displaced from this housing, i.e.
				the housing situation is short-term. 
			 | 
			
				 
				 
			 | 
			
				 
				 
			 | 
		
		
			
				176 
			 | 
			
				Date of Initial Placement
				Into Unsubsidized Employment 
			 | 
			
				Enter the date on which
				the participant started the initial unsubsidized employment. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				  
			 | 
		
		
			
				177 
			 | 
			
				Employer Name for Initial
				Placement Into Unsubsidized Employment 
			 | 
			
				Enter the employer's name
				for the participant's initial placement into unsubsidized
				employment. 
			 | 
			
				Text 
			 | 
			
				A. Must not be blank if
				Field 176 (Date of Initial Placement Into Unsubsidized
				Employment) has a valid date. 
			 | 
		
		
			
				178 
			 | 
			
				Employer Contact for
				Initial Placement Into Unsubsidized Employment 
			 | 
			
				Enter the contact
				information for the employer for the participant's placement into
				unsubsidized employment. 
			 | 
			
				Text 
			 | 
			
				  
			 | 
		
		
			
				179 
			 | 
			
				Last Date of Employment
				for Initial Placement into Unsubsidized Employment 
			 | 
			
				Enter the last date on
				which the participant worked for the employer. 
				 
				 
				Enter
				the reason for placement end date. 
			 | 
			
				MM/DD/YYYY 
				 
				 
				1
				= Quit 
				2
				= Laid Off 
				3
				= Terminated 
				4
				= Temporary/Seasonal 
				5
				= Incarcerated 
				6
				= Other 
			 | 
			
				A. Must be blank or
				greater than or equal to Field 176 (Date of Initial Placement
				Into Unsubsidized Employment). 
			 | 
		
		
			
				180 
			 | 
			
				Hourly Wage at Placement
				for Initial Placement into Unsubsidized Employment 
			 | 
			
				Enter the hourly wage for
				the initial unsubsidized employment at placement. 
			 | 
			
				00.00 
			 | 
			
				A. Must be greater than 0
				if Field 176 (Date of Initial Placement Into Unsubsidized
				Employment) has a valid date. 
			 | 
		
		
			
				181 
			 | 
			
				Number of Hours Worked
				During the 1st Full Week in Initial Placement into Unsubsidized
				Employment. 
			 | 
			
				Enter the number of hours
				worked during the first full week for the initial job placement. 
			 | 
			
				00 
			 | 
			
				A. Must be greater than 0
				if Field 176 (Date of Initial Placement Into Unsubsidized
				Employment) has a valid date. 
			 | 
		
		
			
				182 
			 | 
			
				Repeat Fields 176 to 181
				for Additional Jobs 
			 | 
			
				Grantees must be able to
				collect the above job information for as many jobs as the
				participant has. 
			 | 
			
				  
			 | 
			
				Same edits as for Fields
				176 to 181. 
			 | 
		
		
			
				183 
			 | 
			
				Re-Arrested/
				Re-Incarcerated 
			 | 
			
				Select Re-arrested for
				a new crime if the participant is arrested for a new
				crime. 
 
Select Re-incarcerated for a revocation of
				the parole or probation order for violations of terms of sentence
				if the participant violates parole or probation. 
 
Select
				Otherwise violated the terms and conditions of their sentence
				if the participant violates his/her parole or probation and is
				not re-incarcerated. (Note: This option does not count towards
				the recidivism rate.) 
 
Leave blank if none of
				the above apply. 
 
This field repeats as needed. 
			 | 
			
				1 = Re-arrested for a new
				crime 
2 = Re- incarcerated for a revocation of the parole or
				probation order for violations of terms of sentence 
3 =
				Otherwise violated  the terms and conditions of their
				sentence 
Blank = none of the above 
			 | 
			
				  
			 | 
		
		
			
				184 
			 | 
			
				Date Re-Arrested/
				Re-Incarcerated 
				 
			 | 
			
				Enter the date on which
				the participant was re-arrested for a new crime or
				re-incarcerated for a violation of parole or probation. 
 
This
				field repeats as needed for repeated. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must not be blank if
				Field 183 (Re-Arrested/Re-Incarcerated) is 1 or 2. 
			 | 
		
		
			
				185 
			 | 
			
				Date Entered
				Post-Secondary Education 
			 | 
			
				Enter the date on which
				the participant enrolled in post-secondary education during
				program participation.. 
 
Leave blank if the participant
				does not enter post-secondary education during program
				participation. 
			 | 
			
				MM/DD/YYYY 
Blank =
				did not enter post-secondary education 
			 | 
			
				  
			 | 
		
		
			
				SECTION III.C -
				POST-PROGRAM EMPLOYMENT AND JOB RETENTION DATA 
			 | 
			
				  
			 | 
		
		
			
				186 
			 | 
			
				Employed in First Quarter
				After Exit Quarter 
			 | 
			
				Select yes if the
				participant was employed in the first quarter after the quarter
				of exit.  
				 
				 
Select
				no if the participant was not employed in the first
				quarter after the quarter of exit. 
			 | 
			
				1 = Yes 
2 = No 
			 | 
			
				A.  Must be blank if Field
				63 (Date of Exit) is blank. 
				 
B.
				 Must be 1 or 2 if Field 189 (Successful Follow-up for First
				Quarter After the Exit Quarter Employment and Wage Information)
				is 1. 
			 | 
		
		
			
				187 
			 | 
			
				Type of Employment Match
				First Quarter After Exit Quarter 
			 | 
			
				Use the appropriate code
				to identify the method used in determining the individual's
				employment status in the first quarter following the quarter of
				exit.  If the individual is found in more than once source of
				employment, record the data source for which the individual's
				earnings are greatest. 
			 | 
			
				1 = UI Wage Records
				(In-State and WRIS) 
2 = Federal Employment Records (OPM,
				USPS) 
3 = Military Employment Records (DOD) 
4 = Other
				Administrative Wage Records 
5 = Supplemental through case
				management, participant survey, and/or verification with the
				employer 
Blank = Not Employed. 
			 | 
			
				A.  If Field 186 (Employed
				in First Quarter after Exit Quarter) is 1, then this field will
				be auto-generated as 5 because of lack of wage records. 
 
B.
				 If Field 186 (Employed in First Quarter after Exit Quarter) is 2
				or blank, then this field will be auto-generated as blank. 
			 | 
		
		
			
				188 
			 | 
			
				Date of Follow-up for
				First Quarter After the Exit Quarter Employment and Wage
				Information 
			 | 
			
				Enter the date on which
				the grantee attempted to contact the participant or employer to
				obtain information on employment and earnings for the 1st quarter
				after the exit quarter post-program. 
 
Repeat for each
				follow-up attempt. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must not be blank if
				Field 186 (Employed in First Quarter After Exit Quarter) is 1. 
				 
B.
				Must not be blank if Field 189 (Successful Follow-up for First
				Quarter After the Exit Quarter Employment and Wage Information)
				is not blank. 
			 | 
		
		
			
				189 
			 | 
			
				Successful Follow-up for
				First Quarter After the Exit Quarter Employment and Wage
				Information 
			 | 
			
				Enter yes if the
				grantee successfully contacted the participant to collect
				employment and earnings information for the 1st quarter after the
				exit quarter. 
 
Enter no if the grantee did not
				successfully contact the participant to collect this
				information. 
 
Repeat for each follow-up attempt. 
			 | 
			
				1 = Yes 
2 = No 
			 | 
			
				A. Must not be blank if
				Field 188 (Date of Follow-up for First Quarter After the Exit
				Quarter Employment and Wage Information) is a valid date. 
			 | 
		
		
			
				190 
			 | 
			
				Retention Bonus/Incentive
				Payment 
			 | 
			
				Enter date and amount of
				any retention bonus or incentive payment. 
			 | 
			
				MM/DD/YY 
				$0000.00 
			 | 
			
				 
				 
			 | 
		
		
			
				191 
			 | 
			
				Employed in Second Quarter
				After Exit Quarter 
			 | 
			
				Select yes if the
				participant was employed in the second quarter after the quarter
				of exit.  
				 
				 
Select
				no if the participant was not employed in the second
				quarter after the quarter of exit. 
			 | 
			
				1 = Yes 
2 = No 
			 | 
			
				A.  Must be blank if Field
				63 (Date of Exit) is blank. 
				 
B.
				 Must be 1 or 2 if Field 189 (Successful Follow-up for First
				Quarter After the Exit Quarter Employment and Wage Information)
				is 1. 
			 | 
		
		
			
				192 
			 | 
			
				Type of Employment Match
				Second Quarter After Exit Quarter 
			 | 
			
				Use the appropriate code
				to identify the method used in determining the individual's
				employment status in the second quarter following the quarter of
				exit.  If the individual is found in more than once source of
				employment, record the data source for which the individual's
				earnings are greatest. 
			 | 
			
				1 = UI Wage Records
				(In-State and WRIS) 
2 = Federal Employment Records (OPM,
				USPS) 
3 = Military Employment Records (DOD) 
4 = Other
				Administrative Wage Records 
5 = Supplemental through case
				management, participant survey, and/or verification with the
				employer 
Blank = Not Employed. 
			 | 
			
				A.  If Field 191 (Employed
				in Second Quarter after Exit Quarter) is 1, then this field will
				be auto-generated as 5 because of lack of wage records. 
 
A.
				 If Field 191 (Employed in Second Quarter after Exit Quarter) is
				2 or blank, then this field will be auto-generated as blank. 
			 | 
		
		
			
				193 
			 | 
			
				Hours Worked First Full
				Week for the Second Quarter After the Exit Quarter. 
			 | 
			
				Enter the number of hours
				worked in the first full week of employment during the second
				quarter after the exit quarter. 
			 | 
			
				00 
			 | 
			
				A. Must be >0 if Field
				191 (Employed in Second Quarter After Exit Quarter) is 1. 
			 | 
		
		
			
				194 
			 | 
			
				Hourly Wages First  Full
				Week of Work for the Second Quarter After the Exit Quarter 
			 | 
			
				Enter the hourly wage for
				the job listed in the above element for in the first full week of
				employment during the second quarter after the exit quarter. 
			 | 
			
				00.00 
			 | 
			
				A. Must be >0 if Field
				191 (Employed in Second Quarter After Exit Quarter) is 1. 
			 | 
		
		
			
				195 
			 | 
			
				Date of Follow-up for
				Second Quarter After the Exit Quarter Employment and Wage
				Information 
			 | 
			
				Enter the date on which
				the grantee attempted to contact the participant to obtain
				information on employment and earnings for the second quarter
				after the exit quarter post-program. 
 
Repeat for each
				follow-up attempt. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must not be blank if
				Field 191 (Employed in Second Quarter After Exit Quarter) is 1. 
				 
B.
				Must not be blank if Field 196 (Successful Follow-up for Second
				Quarter After the Exit Quarter Employment and Wage Information)
				is 1. 
			 | 
		
		
			
				196 
			 | 
			
				Successful Follow-up for
				Second Quarter After the Exit Quarter Employment and Wage
				Information 
			 | 
			
				Enter yes if the
				grantee successfully contacted the participant to collect
				employment and earnings information for the 2nd quarter after the
				exit quarter. 
 
Enter no if the grantee did not
				successfully contact the participant to collect this
				information. 
 
Repeat for each follow-up attempt. 
			 | 
			
				1 = Yes 
2 = No 
			 | 
			
				A. Must not be blank if
				Field 195 (Date of Follow-up for Second Quarter After the Exit
				Quarter Employment and Wage Information) is a valid date. 
			 | 
		
		
			
				197 
			 | 
			
				Employed in Third Quarter
				After Exit Quarter 
			 | 
			
				Select yes if the
				participant was employed in the third quarter after the quarter
				of exit.  
				 
				 
Select
				no if the participant was not employed in the third
				quarter after the quarter of exit. 
			 | 
			
				1 = Yes 
2 = No 
			 | 
			
				A.  Must be blank if Field
				63 (Date of Exit) is blank. 
				 
B.
				 Must be 1 if Field 199 (Hours Worked First Full Week for the
				Third Quarter After the Exit Quarter) is > 0. 
			 | 
		
		
			
				198 
			 | 
			
				Type of Employment Match
				Third Quarter After Exit Quarter 
			 | 
			
				Use the appropriate code
				to identify the method used in determining the individual's
				employment status in the third quarter following the quarter of
				exit.  If the individual is found in more than once source of
				employment, record the data source for which the individual's
				earnings are greatest. 
			 | 
			
				1 = UI Wage Records
				(In-State and WRIS) 
2 = Federal Employment Records (OPM,
				USPS) 
3 = Military Employment Records (DOD) 
4 = Other
				Administrative Wage Records 
5 = Supplemental through case
				management, participant survey, and/or verification with the
				employer 
Blank = Not Employed. 
			 | 
			
				A.  If Field 197 (Employed
				in Third Quarter after Exit Quarter) is 1, then this field will
				be auto-generated as 5 because of lack of wage records. 
 
A.
				 If Field 197 (Employed in Third Quarter after Exit Quarter) is 2
				or blank, then this field will be auto-generated as blank. 
			 | 
		
		
			
				199 
			 | 
			
				Hours Worked First Full
				Week for the Third Quarter After the Exit Quarter 
			 | 
			
				Enter the number of hours
				worked in the first full week of employment during the third
				quarter after the exit quarter. 
			 | 
			
				00 
			 | 
			
				A. Must be >0 if Field
				197 (Employed in Third Quarter After Exit Quarter) is 1. 
			 | 
		
		
			
				200 
			 | 
			
				Hourly Wages First  Full
				Week of Work for the Third Quarter After the Exit Quarter 
			 | 
			
				Enter the hourly wage for
				the job listed in the above element for in the first full week of
				employment during the third quarter after the exit quarter. 
			 | 
			
				00.00 
			 | 
			
				A. Must be >0 if Field
				197 (Employed in Third Quarter After Exit Quarter) is 1. 
			 | 
		
		
			
				201 
			 | 
			
				Date of Follow-up for
				Third Quarter After the Exit Quarter Employment and Wage
				Information 
			 | 
			
				Enter the date on which
				the grantee attempted to contact the participant to obtain
				information on employment and earnings for the 3rd quarter after
				the exit quarter post-program. 
 
Repeat for each
				follow-up attempt. 
			 | 
			
				MM/DD/YYYY 
			 | 
			
				A. Must not be blank if
				Field 197 (Employed in Third Quarter After Exit Quarter) is 1. 
				 
B.
				Must not be blank if Field 202 (Successful Follow-up for Third
				Quarter After the Exit Quarter Employment and Wage Information)
				is 1. 
			 | 
		
		
			
				202 
			 | 
			
				Successful Follow-up for
				Third Quarter After the Exit Quarter Employment and Wage
				Information 
			 | 
			
				Enter yes if the
				grantee successfully contacted the participant to collect
				employment and earnings information for the 3rd quarter after the
				exit quarter. 
 
Enter no if the grantee did not
				successfully contact the participant to collect this
				information. 
 
Repeat for each follow-up attempt. 
			 | 
			
				1 = Yes 
2 = No 
			 | 
			
				A. Must not be blank if
				Field 201 (Date of Follow-up for Third Quarter After the Exit
				Quarter Employment and Wage Information) is a valid date. 
			 | 
		
		
			
				SECTION III.D -
				POST-PROGRAM WAGE DATA 
These Fields are to be used for wage
				record data only. 
			 | 
			
				  
			 | 
		
		
			
				203 
			 | 
			
				Wages First Quarter After
				Exit Quarter 
			 | 
			
				Record total earnings from
				wage records for the first quarter after the quarter of exit.  
				 
				 
Enter
				999999.99 if data is not yet available. 
			 | 
			
				000000.00 
			 | 
			
				A.  This field will not be
				included in the system until grantees obtain access to wage
				records. 
			 | 
		
		
			
				204 
			 | 
			
				Wages Second Quarter After
				Exit Quarter 
			 | 
			
				Record total earnings from
				wage records for the second quarter after the quarter of exit.  
				 
				 
Enter
				999999.99 if data is not yet available. 
			 | 
			
				000000.00 
			 | 
			
				A.  This field will not be
				included in the system until grantees obtain access to wage
				records. 
			 | 
		
		
			
				205 
			 | 
			
				Wages Third Quarter After
				Exit Quarter 
			 | 
			
				Record total earnings from
				wage records for the third quarter after the quarter of exit.  
				 
				 
Enter
				999999.99 if data is not yet available. 
			 | 
			
				000000.00 
			 | 
			
				A.  This field will not be
				included in the system until grantees obtain access to wage
				records. 
			 | 
		
		
			
				SECTION III.E -
				EDUCATION AND CREDENTIAL DATA 
			 | 
			
				  
			 | 
		
		
			
				206 
			 | 
			
				Attained Diploma, GED, or
				Certificate #1 
			 | 
			
				Select attained a
				secondary school diploma if the individual attained a
				secondary school (high school) diploma recognized by the state. 
				 
Select
				attained a GED or high school equivalency diploma if the
				individual attained a GED or high school equivalency diploma
				recognized by the state. 
				 
Select
				attained a certificate in recognition of attainment of
				technical or occupational skills if the individual attained a
				certificate in recognition of attainment of technical or
				occupational skills. 
				 
Select
				did not attain a diploma, GED, or certificate if the
				individual did not attain a diploma, GED, or certificate. 
			 | 
			
				1 = Attained a secondary
				school (high school)  diploma. 
2 = Attained a GED or high
				school equivalency diploma. 
3 = Attained a certificate in
				recognition of attainment of technical or occupational skills. 
4
				= Did not attain a diploma, GED, or certificate 
			 | 
			
				A. Must NOT be 1 or 2 if
				Field 16 (Highest School Grade Completed) is 16, 17, 87, 88, or
				90. 
			 | 
		
		
			
				207 
			 | 
			
				Date Attained Degree or
				Certificate #1 
			 | 
			
				Record the date on which
				the individual attained a diploma, GED, or certificate.   
 
Leave
				"blank" if the individual did not attain a diploma,
				GED, or certificate. 
			 | 
			
				MM/DD/YYYY 
Blank =
				did not attain diploma, GED, or certificate 
			 | 
			
				A. Must be greater than
				Field 62 (Date of Program Participation) if Field 206 (Attained
				Diploma, GED, or Certificate #1) is 1, 2, or 3. 
				 
B.
				 Must be blank if Field 206 is blank or 4. 
			 | 
		
		
			
				208 
			 | 
			
				Specify the Name of
				Certificate #1 
			 | 
			
				Specify the name of the
				first certificate achieved. 
 
Leave blank if no
				certificate was achieved. 
			 | 
			
				Text 
Blank = no
				certificate achieved 
			 | 
			
				A. Must not be blank if
				Field 206 (Attained Diploma, GED, or Certificate #1) is 3. 
			 | 
		
		
			
				209 
			 | 
			
				Attained Diploma, GED, or
				Certificate #2 
			 | 
			
				Select attained a
				secondary school diploma if the individual attained a
				secondary school (high school) diploma recognized by the state. 
				 
Select
				attained a GED or high school equivalency diploma if the
				individual attained a GED or high school equivalency diploma
				recognized by the state. 
				 
Select
				attained a certificate in recognition of attainment of
				technical or occupational skills if the individual attained a
				certificate in recognition of attainment of technical or
				occupational skills. 
				 
Select
				did not attain a diploma, GED, or certificate if the
				individual did not attain a diploma, GED, or certificate. 
			 | 
			
				 1 = Attained a secondary
				school (high school) diploma. 
2 = Attained a GED or high
				school equivalency diploma. 
3 = Attained a certificate in
				recognition of attainment of technical or occupational skills. 
4
				= Did not attain a diploma, GED, or certificate 
			 | 
			
				A. Must NOT be 1 or 2 if
				Field 16 (Highest School Grade Completed) is 16, 17, 87, 88, or
				90. 
			 | 
		
		
			
				210 
			 | 
			
				Date Attained Degree or
				Certificate #2 
			 | 
			
				Record the date on which
				the individual attained a diploma, GED, or certificate.   
 
Leave
				"blank" if the individual did not attain a diploma,
				GED, or certificate. 
			 | 
			
				MM/DD/YYYY 
Blank =
				did not attain diploma, GED, or certificate 
			 | 
			
				A. Must be greater than
				Field 62 (Date of Program Participation) if Field 209 (Attained
				Diploma, GED, or Certificate #2) is 1, 2, or 3. 
				 
B.
				 Must be blank if Field 206 is blank or 4. 
			 | 
		
		
			
				211 
			 | 
			
				Specify the Name of
				Certificate #2 
			 | 
			
				Specify the name of the
				second certificate achieved. 
 
Leave blank if no
				certificate was achieved. 
			 | 
			
				Text 
Blank = no
				certificate achieved 
			 | 
			
				A. Must not be blank if
				Field 209 (Attained Diploma, GED, or Certificate #2) is 1, 2, or
				3. 
			 |