ETA 9192 Annual Center Academic Programs Review and Planning

U.S. Department Labor

Employment and Training Administration

OMB Control No. 1205-0219
Expiration Date: xx/xx/xxxx

Annual Center Academic Programs Review and Planning Report
Reporting Period Start (MM/YY):

Reporting Period End (MM/YY):

Center Name:

Center ID (XXXXXX):

Center Contact Name:

Center Contact Email:

Center Contact Job Title:

Center Contact Phone:

Center Director Name:

Email:

Phone:

High School Equivalency (HSE) Testing
1. HSE testing option(s) currently available to center (select all that apply):
□ General Educational Development (GED®)
□ High School Equivalency Test (HiSETTM)
HSE Testing for Students who Separated from Center
2. Main factors determining when your center’s students are academically prepared to take an HSE test(s)
(select all that apply):
□ TABE test scores (Please specify): _____________
□ HSE-prep course summative exams or assessments
□ Official HSE Practice Test scores
□ Instructor recommendation
□ Academic manager recommendation
□ Certain amount of time elapsing (Please specify): _____________
□ There is no criterion; all students are considered academically prepared to take HSE tests
□ Other (Please specify): _________________________________________
3. Approximate number of separated students who were academically prepared to take each HSE test:
GED® ____________
HiSETTM ____________
4. Main reason(s) students who separated and were academically prepared to take the GED did not take the
test (select all that apply):
□ Not applicable (all separated students who were academically prepared to take the GED took the GED)
□ State had not started offering GED testing
□ Local GED testing site(s) had not started offering GED testing
□ Testing site(s) offering GED are located too far away from our center
□ Testing site(s) had limited slots or scheduling challenges
□ Our center decided not to prepare students for the GED during that time
□ Our center decided to prepare students for a different HSE test during that time
□ Our center decided to prepare students for obtaining HSDs instead of HSEs during that time
□ Other (Please specify): ______________________________________________________

ETA-9192 (Rev. X/X/20XX)

OMB Control No. 1205-0219
Expiration Date: xx/xx/xxxx

5. Main reason(s) students who separated and were academically prepared to take the HiSET did not take the
test (select all that apply):
□ Not applicable (all separated students who were academically prepared to take the HiSET took the HiSET)
□ State had not started offering HiSET testing
□ Local HiSET testing site(s) had not started offering HiSET testing
□ Testing site(s) offering HiSET are located too far away from our center
□ Testing site(s) had limited slots or scheduling challenges
□ Our center decided not to prepare students for the HiSET during that time
□ Our center decided to prepare students for a different HSE test during that time
□ Our center decided to prepare students for obtaining HSDs instead of HSEs during that time
□ Other (Please specify): ______________________________________________________
On-Center HSE Testing Sites/Availability
6a. GED currently offered on-center:
7a. HiSET currently offered on-center:
□ Yes □ No
□ Yes □ No
6b. Number of days each month GED testing
7b. Number of days each month HiSET testing
typically offered on-center: ________________
typically offered on-center: _________________
6c. Number of testing seats (slots) typically available 7c. Number of testing seats (slots) typically available to
to students each time GED offered on-center:
students each time HiSET offered on-center:
___________
___________
6d. GED testing format(s) available:
7d. HiSET testing format(s) available:
□ Not Applicable
□ Not Applicable
□ Computer-based only
□ Computer-based only
□ Paper-based only
□ Paper-based only
□ Both computer- and paper-based
□ Both computer- and paper-based
Off-Center HSE Testing Sites/Availability
8. Total number of off-center HSE testing sites available to your center: ______________________
9a. Off-Center Testing Site #1:
Name: _________________
State: __________________
9b. HSE test(s) offered at site:
□ GED®
□ HiSETTM
9c. Number of days each month
site offers:
GED testing: ___________
HiSET testing: __________
9d. Number of testing seats (slots)
typically available to students
each time HSE testing offered:
___________

10a. Off-Center Testing Site #2:
Name: _________________
State: __________________
10b. HSE test(s) offered at site:
□ GED®
□ HiSETTM
10c. Number of days each month
site offers:
GED testing: ___________
HiSET testing: __________
10d. Number of testing seats (slots)
typically available to students each
time HSE testing offered:
___________

11a. Off-Center Testing Site #3:
Name: _________________
State: __________________
11b. HSE test(s) offered at site:
□ GED®
□ HiSETTM
11c. Number of days each month
site offers:
GED testing: ___________
HiSET testing: __________
11d. Number of testing seats
(slots) typically available to
students each time HSE testing
offered: ___________

9e. HSE testing format(s)
available:
□ Computer-based only
□ Paper-based only
□ Both computer- and paperbased
9f. Sufficient HSE testing
availability:
□ Yes □ No

10e. HSE testing format(s)
available:
□ Computer-based only
□ Paper-based only
□ Both computer- and paper-based

11e. HSE testing format(s)
available:
□ Computer-based only
□ Paper-based only
□ Both computer- and paper-based

10f. Sufficient HSE testing
availability:
□ Yes □ No

11f. Sufficient HSE testing
availability:
□ Yes □ No
ETA-9192 (Rev. X/X/20XX)

OMB Control No. 1205-0219
Expiration Date: xx/xx/xxxx

12. Number of testing seats (slots) usually available
for your students each month across all on- and offcenter HSE testing sites:
____________________________________

13. Combined on- and off-center HSE testing
availability sufficient:
□ Yes □ No

Local (Traditional) HSD Programs
14. State-sanctioned HSD by
15. Accredited online HSD programs used:
completing a local HSD program:
□ None/not applicable
□ Yes □ No
□ New Learning Resources Online: North New Summit School
□ Penn Foster
□ James Madison Online High School (offered through Ashworth College)
□ Other: ______________________________
16. Recent changes in online
HSD programs available:
_________________________
_________________________
_________________________
_________________________

17. Anticipated upcoming changes
to online HSD programs available:
_________________________
_________________________
_________________________
_________________________

18. Barriers to adding new online
HSD programs:
_________________________
_________________________
_________________________
_________________________

Online HSD Programs
19. State-accredited HSD by
completing an online HSD
program:
□ Yes □ No
21. Recent changes in local
(partnership) HSD programs
available:
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________

20. Types of HSD programs used:
□ Center-based high school program
□ Local HSD program (on- or off-center)
□ Not applicable
22. Anticipated upcoming changes
23. Barriers to developing new
to local HSD programs available:
partnerships for local HSD
programs:
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________

HSD Program Experiences for Separated Students
24. Main factors determining when students are academically prepared to enroll in an HSD program (select all
that apply):
□ TABE test scores (Please specify): _____________
□ HSD-provider stipulations
□ Instructor recommendation
□ Academic manager recommendation
□ Certain amount of time elapsing (Please specify): _____________
□ Students are enrolled in HSD programs when they enter the Career Development Period
□ Other (Please specify): _________________________________________

ETA-9192 (Rev. X/X/20XX)

OMB Control No. 1205-0219
Expiration Date: xx/xx/xxxx

25. Number of students
academically prepared to enroll in
accredited, state-sanctioned,
center-operated HSD program:
_____________________

26. Number of students
academically prepared to enroll in
accredited local HSD partnership
program(s):
_____________________

27. Number of students
academically prepared to enroll in
accredited online HSD program(s):
_____________________

General High School Program Information
28. State awards HSD if HSE passed:
□ Yes, automatically
□ Yes, but there was a request process
□ Yes, but there were additional requirements
□ No
29. Percentage of HSE attainments
30. Completions documented in CIS as:
converted into HSDs:
□ HSE certificates □ HSDs □ HSE certificates promoted to HSDs
______________%
Future Plans/Strategies/Approaches for HSD Programs and HSE Testing:
31. HSE Testing (select all that
32. Online HSD Programs (select
33. Local HSD Programs (select all
apply):
all that apply):
that apply):
□ No plans to start offering
□ No plans to start offering
□ No plans to start offering
□ Plan to start offering
□ Plan to start offering
□ Plan to start offering
□ Plan to stop offering
□ Plan to stop offering
□ Plan to stop offering
□ Plan to offer additional option(s) □ Plan to offer additional option(s)
□ Plan to offer additional option(s)
□ Plan to offer fewer (but at least
□ Plan to offer fewer (but at least
□ Plan to offer fewer (but at least
one)
one)
one)
Additional Factors That May Impact Student Performance
34. Number of Current LEP or
35. Number of Current Students
ELL Students:
Enrolled in or Completed an
________________
ESL/ESOL/ELL class:
______________
37. Main Barriers: Achieving Literacy Gains:
___________________________________

36. Number of Current Students
with a Documented Disability:
_________

38. Main Barriers: Achieving Numeracy Gains:
___________________________________

39. Main reason(s) center stops administering TABE test to a student:
□ Attainment of 1 EFL gain
□ Attainment of the EFL 5 on Reading and the EFL 6 on Math
□ Attainment of a different EFL gain (Please specify EFL gain and explain
rationale):_______________________
□ Attainment of a perfect score
□ Attainment of another EFL (Please specify EFL and explain rationale):_______________________
□ Attainment of an individualized EFL that aligns with a student’s specific career goal (Please explain):
___________________
□ Students are never exempt from follow-up TABE testing
40. Attainment of specific TABE
score requirement for graduation:
□ Yes □ No

40a. Specific TABE score:
_____________________

40b. Rationale for specific TABE
score:
_________________________

ETA-9192 (Rev. X/X/20XX)

OMB Control No. 1205-0219
Expiration Date: xx/xx/xxxx

Student Driver’s License (DL) Attainment
41. Driver’s licenses used
42. Number of students at entry with:
for identification during
No Driver’s License/License never
Outreach and Admissions
issued_________
(OA) process:
Valid Driver’s License _________
Driver’s License Expired _______
□ Yes □ No
Driver’s License Suspended _____
Driver’s License Revoked _______
Learner’s Permit ___________
State ID only ___________

43. Number of students at exit with:
No Driver’s License/License never
issued_________
Valid Driver’s License _________
Driver’s License Expired _______
Driver’s License Suspended _____
Driver’s License Revoked _______
Learner’s Permit ___________
State ID only ___________

44. Number of students who
earned learner permits during
enrollment ____________

45. Number of students who
earned driver’s license on-center
during enrollment _______

46. Number of students who
earned driver’s license off-center
during enrollment _______

47. Number of driver’s education
instructors available to center
_______________

48. Number of vehicles available
for behind-the-wheel instruction
_________________

49. Number of driving simulators
available _________________

50. Types of outstanding
student fines required to be
paid prior to obtaining
driver’s license
______________________
______________________
______________________

51. Types of required
fees related to obtaining
driver’s license
____________________
____________________
____________________

52. Overall barriers to
implementing Driver’s
License program:
□ State requirements
□ Funding
□ Resources
□ Staffing
□ Other barriers
______________

53. Overall barriers to
maintaining Driver’s
License program:
□ State requirements
□ Funding
□ Resources
□ Staffing
□ Other barriers
______________

54. Describe the main barriers to creating a Driver’s License program on center for the purpose of assisting
students to attain a driver’s license or learner’s permit
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
55. Describe the main barriers to operating/maintaining a Driver’s License program on center for the purpose
of assisting students to attain a driver’s license or learner’s permit
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
56. Center Operator-Specific Requirements for Student Entry into Driver’s Education Program:
□ Yes – Specify:_____________________________________________
□ No
Registered Apprenticeship Program (RAP) Opportunities
57a. Registered
57b. Registered
57c. Registered
Apprenticeship (RA) Apprenticeship (RA) Apprenticeship (RA)
Written Partnership
Written Partnership
Written Partnership
Agreement #1:
Agreement #2:
Agreement #3:

57d. Registered
Apprenticeship (RA)
Written Partnership
Agreement #4:

57e. Registered
Apprenticeship
(RA) Written
Partnership
Agreement #5:

ETA-9192 (Rev. X/X/20XX)

OMB Control No. 1205-0219
Expiration Date: xx/xx/xxxx

RA Partner Name:
___________
Agreement Start
Date
(MM/DD/YYYY):
_____________
Agreement Type:
_____________

RA Partner Name:
___________
Agreement Start
Date
(MM/DD/YYYY):
_____________
Agreement Type:
_____________

RA Partner Name:
___________
Agreement Start
Date
(MM/DD/YYYY):
_____________
Agreement Type:
_____________

RA Partner Name:
____________
Agreement Start
Date
(MM/DD/YYYY):
____________
Agreement Type:
_____________

RA Partner
Name:
_____________
Agreement Start
Date
(MM/DD/YYYY):
______________
Agreement Type:
______________

58. Center’s CTT Programs Available to Students that Lead to RAs or are RA Industries:
□ Advanced Manufacturing RA → Name of Relevant CTT Program(s) ____________________________
□ Construction RA → Name of Relevant CTT Program(s) ______________________________________
□ Energy RA → Name of Relevant CTT Program(s) ___________________________________________
□ Financial Services RA → Name of Relevant CTT Program(s) __________________________________
□ Healthcare RA → Name of Relevant CTT Program(s) ________________________________________
□ Hospitality RA → Name of Relevant CTT Program(s) _________________________________________
□ Information Technology RA → Name of Relevant CTT Program(s) _______________________________
□ Telecommunications RA → Name of Relevant CTT Program(s) _________________________________
□ Transportation RA → Name of Relevant CTT Program(s) ______________________________________
59. Describe your state’s requirements that serve as barriers to creating/maintaining RAs and RA industry
partnerships:
_______________________________________________________________________________________
_______________________________________________________________________________________
60. Describe county/local requirements that serve as barriers to creating/maintaining RAs and RA industry
partnerships:
_______________________________________________________________________________________
_______________________________________________________________________________________

Impacts of Distance Learning: Learning Gains
61. Describe barriers to TABE testing and academic instruction for the purpose of attaining TABE EFL gains
for students participating in distance learning.

Impacts of Distance Learning: HSD/HSE Attainment
62. Describe barriers to academic instruction and HSD or HSE program availability, access and ability to
complete the program for the purpose of attaining an HSD or its recognized equivalent for students
participating in distance learning.
ETA-9192 (Rev. X/X/20XX)

OMB Control No. 1205-0219
Expiration Date: xx/xx/xxxx

Impacts of Distance Learning: Career Technical Training (CTT) and Primary IRC Attainment
63. Describe barriers to technical training instruction, completion of the associated eTAR components, and
attainment of associated primary Industry Recognized Credential(s) (IRCs) for students participating in
distance learning.

Resumption of Center Enrollments/On-Center Operations
64. Describe barriers faced by students returning to center from distance learning to successful completion of
academic and/or training-related credentials and attainment of learning gains.

Privacy Act Notice:
All request for personal information about students must be treated as requests under the Freedom of Information Act and the Privacy Act of 1974, and handled pursuant 29
CFR Parts 70 and 70a and 45 CFR Parts 160 and 164.
Public Burden Statement:
Persons are not required to respond to this collection of information unless it displays a currently valid OMB control number. Respondents' obligation to complete this form is
required to obtain or retain benefits (P.L. 113-128). Public reporting burden is estimated to average 90 minutes per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of Information. Send comments regarding this burden
estimate to the U.S. Department of Labor, Division of Adult Services, Room S-4209, Washington, D.C. 20210 (Paperwork Reduction Project 1205-0025). Please do not submit
ETA-9192(Rev. X/X/20XX)
completed forms to this address.

ETA-9192 (Rev. X/X/20XX)

OMB Control No. 1205-0219
Expiration Date: xx/xx/xxxx

ETA-9192– Annual Center Academic Programs Review and Planning Report

Purpose: The ETA is requesting clearance to collect, annually, information from centers on their
current and future plans for academic programs related to both attaining learning gains and
completing an academic credential. This form will collect information that cannot be captured through
existing data systems or other sources. The information collected will allow Job Corps to better
understand the academic landscape, including barriers to academic credential attainments, academic
instructional needs, requirements and barriers around TABE testing used for attaining Educational
Functional Level gains reported under WIOA, and future planning needs around attainment of High
School Diploma credentials or recognized equivalents. No individual student-level data will be
collected; all data will be aggregated or at the center-level.
General Instructions:
Please complete this form using information from the most current full calendar year and future plans
for the upcoming program year.

ETA-9192 (Rev. X/X/20XX)