Instructions For Form Hud-40201 - Youthbuild Participant Tracking Worksheet - 1997

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Instructions for Completing Youthbuild Participant Tracking Worksheet, Part 14
The Youthbuild Participant Tracking Worksheet, Part 14 must be
Section II: Participation Report
kept in your files. Section I (Entrance Report) is completed for each
This section is to be completed for each participant after program
participant entering the program. Section II (Participation Report)
entry.
provides a record of the services and training received by each
participant. Section III (Exit Report) is completed when participants
16. Educational and Support Services: The table includes a listing
complete or leave the program for whatever reason. In all cases, the
of 10 different services and blank column to be completed to show
full name and Social Security Number of each participant must be
the number of courses the participant completed or the services
provided in Section I to track the status of the participant.
used.
Section I:
Entrance Report (Complete this section when a
Description of Educational and Support Services:
participant enters the program.)
(a) Remedial/Basic Skills: These programs include all basic
1.
Participant Identification: Enter the last name, first name, and
education instruction in math, reading, and other functional skills not
middle initial of the person participating in the Youthbuild Program.
aimed at a high school diploma or GED. Specific types of programs
which should be considered in this category are basic literacy
2.
Social Security Number: Enter the SSN of the participant.
programs or Adult Basic Education (ABE) programs for adults with
3.
Date of Birth: Using the MM/DD/YY format, enter the date of
less than an 8th grade education.
birth of the participant.
(b) Bi-Lingual Skills: These programs include all basic educa-
4.
Date of Program Entry: Using the MM/DD/YY format, enter the
tional instruction in basic education and other functional skills such
date the participant entered the Youthbuild Program.
as English for Speakers of Other Languages (ESOL) or English as
a Second Language (ESL) which can be aimed at a high school
5.
Current Address: List the current address for the Youthbuild
diploma or GED.
participant including the street address, city, State, and zip code.
(c) High School/GED Courses: Adult secondary education
6.
Gender: Check the appropriate code to indicate whether the
programs, such as adult high schools (where those completing the
participant is male or female.
program receive a high school diploma) or General Education
Development (GED) classes administered by school districts and
7.
Race/Ethnicity:
Check the appropriate code indicating the
community-based organizations (aimed at receiving a high school
racial/ethnic background of the participant.
equivalency certificate).
8.
Highest Grade or Year of School Completed:
Check the
(d) Post Secondary Assistance: Programs for high school
appropriate code indicating the highest grade or year of school
graduates or participants with a GED to improve employability but
completed by the participant upon entry into the program.
not having a direct vocational or training emphasis. Courses at a
9.
Current Living Status: Check the appropriate code indicating
community, junior, or four-year college leading to a degree or
the participant’s current living arrangements.
general academic advancement are examples.
10. Current Employment Status:
Check the appropriate code
(e) Vocational Skills: Technical training in a vocational or trade
indicating whether the participant was currently employed, full/part-
school, vocational program of a community or junior college, or
time, or unemployed upon entry into the program.
work-site-based training. These programs are clearly targeted to
qualifying for a specific job (such as auto mechanics, heating/air
11. Current Hourly Wage Rate: If the participant was employed
conditioning repair) and may involve a certificate or similar credential
upon entry into the program, please list the hourly wage rate he/she
(such as a licensed practical nurse).
was receiving. If not working, please leave blank.
(f) Other Support Services: Other programs and services for
12. How many hours worked: If the participant was employed upon
participants with or without a GED to improve employability as well
entry into the program, please list his/her average number of hours
as family life, health, self esteem, etc. Course to obtain a valid
worked within a week in the current job. If the participant was not
driver’s license, or to improve familial communications are ex-
working, please leave blank.
amples.
13. Total Family Income: Please enter the total family income for
(g) Counseling: This may include a wide range of counseling
the participant. Total family income includes income received by all
services including drug and alcohol abuse, counseling in the areas
members of the family and includes incomes from all sources
of personal development, stress management, parenting and child
including wages/salaries, public assistance, Social Security and
development, counseling in homemaking, household management,
pensions.
and money management.
14. Source of Referral to the Program: If the participant entered the
(h) Leadership Skills: This may include any services to en-
program through a formal referral, please check the appropriate
hance or create leadership skills for the participant such as training
code indicating the source of the referral.
focusing on group skills, group dynamics, group motivation, etc.
15. How did the participant learn about Youthbuild? Please check
(i)
Job Interview Skills: This may include a wide range of
the appropriate code to indicate how the participant found out about
services focused on job interview techniques and skills to enhance
the program.
the participant’s employability.
(j)
Job Placement Skills: This may include a wide range of
Previous editions are obsolete
form HUD-40201 (7/97)

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