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Youth Participant Monthly Report 

Participant first and last names and Date of Birth are required for submission.

Course of Action: Program Elements Needed to Achieve Goals

Youth are required to have access to all fourteen WIOA Youth program elements.  Please select elements based on needs identified on the participant's objective assessment.

Improving Educational Achievement

Start Date

Successful Completion:

Project End Date

Actual End Date

Start Date

Successful Completion:

Project End Date

Actual End Date

Start Date

Successful Completion:

Project End Date

Actual End Date

Preparing for and Succeeding in Employment

Start Date

Successful Completion:

Project End Date

Actual End Date

Start Date

Successful Completion:

Project End Date

Actual End Date

Start Date

Successful Completion:

Project End Date

Actual End Date

Start Date

Successful Completion:

Project End Date

Actual End Date

Start Date

Successful Completion:

Project End Date

Actual End Date

Supporting Youth

Start Date

Successful Completion:

Project End Date

Actual End Date

Start Date

Successful Completion:

Project End Date

Actual End Date

Start Date

Successful Completion:

Project End Date

Actual End Date

Start Date

Successful Completion:

Project End Date

Actual End Date

Developing the Potential of Young Adults as Citizens & Leaders

Start Date

Successful Completion:

Project End Date

Actual End Date

Start Date

Successful Completion:

Project End Date

Actual End Date

Please answer the following questions:
Employment Rate/Median Earnings

Has the participant entered employment?

If yes, please enter:

Since the time of the last monthly report, is the participants still employed?

Education

Is the participant currently attending high school or a GED program?

Has the participant enrolled in college/university?

If yes, please enter:

Is the participant currently enrolled in an occupational skills training program that leads to a postsecondary credential?

Since the time of the last monthly report, is the participant still attending school/training?

Credential Attainment and Measurable Skills Gains

For participants who are currently enrolled in occupational skills training that leads to a recognized postsecondary credential, did the participant receive a satisfactory or better progress report towards established milestones (e.g. passage of an exam or class)? 

For participants who are currently enrolled in occupational skills training that leads to a postsecondary credential, has the participant obtained a diploma, degree or certificate? 

If yes, please enter:

Work Experience

Is the youth participating in a work experience?

Is the participant enrolled in an internship or on-the job training program?* 

Did the participant receive a satisfactory or better progress report towards established milestones (refer to training plan)?

An error occurred. Please make sure you filled out all required fields.

Your report was submitted successfully.

HempsteadWorks Career Center

50 Clinton St.

Suite 400

Hempstead, NY 11550

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TEL: 516-485-5000

TTY: 1-800-662-1220

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The Workforce Innovation and Opportunity Act financially assisted program is an equal opportunity employer / program. Auxiliary aids and services are available upon request to individuals with disabilities. To request reasonable accommodation, please call our Disability Resources Coordinator at (516) 485-5000 ext. 1113.

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A service of the Town of Hempstead/City of Long Beach Workforce Development Board

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