OMB
Control Number: 2900-0864
Expires
October 31, 2025
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[ ] VA Benefits and Services Course (Classes outlining the VA benefits and services available, how to use them, and how to apply. Course was previously known as VA Benefits I/II or VA Benefits & Services.)
[ ] Managing Your (MY) Transition (previously known as the Transition Overview and Resilient Transition)
[ ] Personal Financial Planning for Transition (e.g., financial readiness)
[ ] Military Occupational Classification “MOC” Crosswalk (e.g., helps you be more marketable in the civilian sector)
[ ] Department of Labor Employment Fundamentals of Career Transition (EFCT) (Previously DOL Employment Workshop)
[ ] None of the above – SKIP TO Q3
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Strongly disagree |
Disagree |
Neither agree nor disagree |
Agree |
Strongly agree |
Not applicable |
Overall, the program was beneficial in helping me gain the information and skills I needed to prepare me for my transition and post-military life. |
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Overall, the program enhanced my confidence in transition planning. |
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Overall, I used what I learned from the program during my transition. |
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I was given the time I needed during my military career to attend TAP courses. |
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My immediate leadership was supportive of my transition to civilian life (e.g., attending TAP courses, attaining Career Readiness Standards). |
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The process of transitioning from active duty was more challenging than I expected. |
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I am adjusting well at working towards my civilian goals (e.g., employment, education, and/or entrepreneurship goals). |
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TAP provided me with local resources or points of contact that prepared me to transition to the community where I [will live / lived] after separation. |
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The information provided during TAP assisted me in my transition to civilian employment. |
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[ ] Managing Your (MY) Education (Education Track, previously known as the Accessing Higher Education Track)
[ ] Entrepreneurship Track (e.g., SBA or “Boots to Business”)
[ ] Career Credential and Exploration (C2E) Vocational Track
[ ] Employment Track: DOL Employment Workshop (DOLEW)
[ ] None of the above
I took all or almost all in a traditional classroom setting
I took all or almost all virtually using the Instructor-led virtual courses
I took all or almost all virtually using the self-paced/web-based courses
I took a few of my modules/tracks in a classroom and a few virtually
Did not complete any modules
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Not useful at all |
Not very useful |
Neutral |
Somewhat useful |
Extremely useful |
Not applicable |
VA Benefits and Services Course |
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Career Technical Training Track (CT3, previously called CTT or sometimes “career training track”) |
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Transition Overview (e.g., Resilient Transitions) |
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Personal Financial Planning for Transition (e.g., financial readiness) |
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Military Occupational Classification Crosswalk “MOC” Crosswalk (e.g., helps you be more marketable in the civilian sector) |
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Department of Labor Employment Workshop (e.g., career development skills such as interviewing, networking, and writing resumes) |
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Accessing Higher Education Track |
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Entrepreneurship Track |
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____________________________________________
____________________________________________
____________________________________________
____________________________________________
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Strongly disagree |
Disagree |
Neither agree or disagree |
Agree |
Strongly agree |
Not applicable |
Me personally as a Veteran |
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My family |
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Strongly disagree |
Disagree |
Neither agree or disagree |
Agree |
Strongly agree |
Not applicable |
Apply for VA benefits |
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Prepare for potential impact to my economic well-being after my service |
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Prepare for changes in my personal life |
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Prevent potential homelessness |
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Obtain VA health care |
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Seek help for mental health concerns I might experience |
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No |
Yes, I've applied |
Yes, I plan to apply |
Not applicable |
Did not know about this benefit |
VA Disability Compensation |
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VA Education (e.g, post 9/11 GI Bill, Montgomery Bill, etc.) |
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VA Life Insurance (e.g., Veterans' Group Life Insurance) |
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VA Home Loans |
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VA Veteran Readiness and Employment (formerly known as Vocational Rehabilitation and Employment) |
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VA Health Care |
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VA Caregiver Program |
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[ ] Yes
[ ] No
11) If yes, what services were used?
Individual or group counseling
Family counseling
Employment assessment
VBA Benefits assistance
Medical screening/referral
Other_______
Prefer not to answer
Sometimes Servicemembers use a VA Benefits Advisor (VA Rep) for questions about benefits or career training.
Yes
No
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Unacceptable |
Needs Improvement |
Average |
Good |
Outstanding |
Not Applicable |
Knowledge of the VA Benefits Advisor |
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Information provided by the VA Benefits Advisor |
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Accessibility of the VA Benefits Advisor during your transition |
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Your overall experience with the VA Benefits Advisor |
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Extremely challenging |
Very challenging |
Moderately challenging |
A little challenging |
Not at all challenging |
Not applicable |
Prefer not to answer |
Managing expectations about the salary I can expect in a civilian job. |
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Knowing the steps in conducting a job search. |
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Understanding how my military experiences translate to civilian job requirements. |
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Adapting to differences between military and civilian workforce cultures, norms and behaviors |
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Interacting with civilians who are not familiar with the military. |
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Working with civilians who share different values from me. |
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Communicating in civilian terms rather than using military vocabulary and acronyms. |
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Learning to have a better work-life balance after the transition. |
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Missing the camaraderie and teamwork that was part of the military culture. |
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Working at a slower pace than when in the military. |
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Working at a faster pace than when in the military. |
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Yes, self-employed
Yes, work for a business, non-profit, or government agency (not self-employed)
No, I pursued education/training before starting work
No, I retired and chose not to pursue further employment
No, I wanted to work but could not find a job
No, I took extended time off (greater than 6 months, other than terminal leave) before starting work or school
No, other reason - Please specify (Required): _________________________________________________*
Prefer not to answer
Landed a job prior to separating
0-3 months after separating
More than 3 months but less than 6 months after separating
Between 6 months and 1 year after separating
More than 1 year after separating
Yes
No
Permanent
Temporary or Seasonal
Yes, I own my own company and have __________ employees excluding myself: _________________________________________________*
Yes, I have a side-business/hobby I use to supplement my income
Yes, I have taken tangible steps to start a business during the last 12 months (by myself or with others)
No
I work full-time (without an additional part-time job)
I work full time, and have an additional part time job
I don’t have a full-time job, I work part-time by choice
I work part-time at one job, but would like full-time employment
I work part-time at more than one job, but would like full-time employment
Number of jobs (Required): _________________________________________________*
Prefer not to answer
Yes
No
[ ] Higher pay
[ ] Better fit for my skills and abilities
[ ] Want a permanent position
[ ] Job satisfaction/better work environment
[ ] Something more interesting
[ ] More flexible schedule
[ ] Better training and educational opportunities
[ ] Better hours
[ ] Want more hours/full-time position
[ ] More opportunities for advancement
[ ] Shorter commute
[ ] Prefer not to answer
[ ] VA Health Care System (e.g., myHealtheVet.gov)
[ ] Department of Labor’s American Job Center
[ ] VA Benefits Website (e.g., eBenefits)
[ ] Commercial job site (e.g., Indeed, LinkedIn, etc.)
[ ] Other - Please specify (Required): _________________________________________________*
[ ] None
[ ] Prefer not to Answer
[ ] USAJOBS (e.g., federal jobs)
[ ] VA Veteran Readiness and Employment (formerly known as Vocational Rehabilitation and Employment)
[ ] Department of Labor’s American Job Center
[ ] U.S. Chamber of Commerce Foundation’s Hiring Our Heroes Fast Track
[ ] Commercial job site (e.g., Indeed, LinkedIn, etc.)
[ ] Private or non-profit sector (e.g., applying directly, through a recruiter, Veteran hiring initiative, etc.)
[ ] Other - Please specify (Required): _________________________________________________*
[ ] None of the above
High school equivalent (e.g., GED) or less
High school graduate
Trade/technical school
Some college
Associate degree (e.g., AA, AS)
4-year college degree (e.g., BA, AB, BS)
Master’s degree (e.g., MA, MS, MSW, MBA)
Professional degree (e.g., MD, DDS, DVM, LLB, JD)
Doctorate degree (e.g., PhD, EdD)
Prefer not to answer
[ ] Education at a college or university, full-time
[ ] Education at a college or university, part-time
[ ] Technical or vocational training/obtain license or certificate, full-time
[ ] Technical or vocational training/obtain license or certificate, part-time
[ ] Other - Please specify (Required): _________________________________________________*
[ ] No
[ ] 1 to 10
[ ] 11 to 20
[ ] 21 to 30
[ ] 31 to 40
[ ] 41 or more
[ ] Credits were not recorded
[ ] Did not complete any credits this year
[ ] Yes, apprenticeship
[ ] Yes, internship
[ ] No
[ ] Yes
[ ] No
________Student Loans
________GI Bill
________Working part-time or full-time
________Scholarship
________Money from other sources (e.g., parents, relatives, savings, etc.)
________Other (e.g., VR&E, Target Foundation, etc.)
________Prefer not to answer
[ ] None of the above
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Very dissatisfied |
Dissatisfied |
Neither satisfied nor dissatisfied |
Somewhat satisfied |
Very satisfied |
The quality of your education or training experience |
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The extent to which your education or training is advancing your career goals |
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Your learning environment (e.g., teachers and other students, educational setting) |
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Yes
No
Prefer not to answer
Yes
No
Prefer not to answer
Yes
No
Prefer not to answer
Yes
No
Prefer not to answer
Yes
No
Prefer not to answer
[ ] Employer-provided health insurance (could be from your current or former employer, a family member’s current or former employer, or a union)
[ ] A plan you purchased through a healthcare exchange (e.g., Healthcare.gov, State exchange, Affordable Care Act/ “Obamacare”, etc.)
[ ] TRICARE
[ ] VA
[ ] Medicaid
[ ] Medicare
[ ] Other government assisted health plan
[ ] Something Else - Please specify (Required): _________________________________________________*
[ ] None of the above
[ ] Prefer not to answer
Employer-provided health insurance (could be from your current or former employer, a family member’s current or former employer, or a union)
A plan you purchased through a healthcare exchange (e.g., Healthcare.gov, State exchange, Affordable Care Act/ “Obamacare”, etc.)
TRICARE
VA
Medicaid
Medicare
Other government assisted health plan
Something else - Please specify (Required): _________________________________________________*
Prefer not to answer
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Very dissatisfied |
Dissatisfied |
Neither satisfied nor dissatisfied |
Somewhat satisfied |
Very satisfied |
Your physical health |
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Your emotional/mental health |
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Your health care |
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Living with a domestic partner
Never married
Married-first and only marriage
Married-second or later marriage
Separated
Divorced
Widowed
Prefer not to answer
Currently in a relationship
Not currently in a relationship
Prefer not to answer
Yes
No
Prefer not to answer
Under 5 years old: _________________________________________________
Age 5 through 12 years old: _________________________________________________
Age 13 through 18 years old: _________________________________________________
Age 19 through 26 years old: _________________________________________________
27+ years old: _________________________________________________
Prefer not to answer:
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None |
One |
Two |
Three or Four |
Five to Eight |
Nine or more |
Prefer not to answer |
How many relatives do you see or hear from at least once a month? |
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How many relatives do you feel at ease with that you can talk about private matters? |
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How many relatives do you feel close to such that you could call on them for help? |
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None |
One |
Two |
Three or Four |
Five to Eight |
Nine or more |
Prefer not to answer |
How many of your friends do you see or hear from at least once a month? |
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How many friends do you feel at ease with that you can talk about private matters? |
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How many friends do you feel close to such that you could call on them for help? |
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Never |
Hardly Ever |
Some of the Time |
Often |
How often do you feel that you lack companionship? |
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How often do you feel left out? |
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How often do you feel isolated from others? |
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Yes
No
Prefer not to answer
Yes
No
Prefer not to answer
Yes
No
Prefer not to answer
Yes
No
Prefer not to answer
No, my household is not more than one month behind in debt payments
Yes, my household is over one month behind in debt payments
Not applicable- my household does not have any debt
Prefer not to answer
Yes
No
Prefer not to answer
Number of people (Required): _________________________________________________*
Prefer not to answer
Rent an apartment, house, or room
Own an apartment or house
Live with a friend or relative and not paying rent
Live in a dormitory at school
Live in a medical or assisted living facility, such as a hospital or rehab center
Live in transitional housing (e.g., a halfway house)
Live in a car, on the street, or in a homeless shelter
Somewhere else - Please specify (Required): _________________________________________________*
Prefer not to answer
56) During the past 12 months, how many months were you employed?
Months employed:
Was not employed at any time during the past 12 months
57) During the past 12 months, how much did you earn from all jobs or businesses before taxes and other deductions?
Yearly salary:
58) During the past 12 months, what was your gross income? (Your gross income includes income you received from all sources, before taxes, including earnings from a job, benefits received from government programs, and any retirement, pension, investing, or savings income that you receive regular payments from.)
59) During the past 12 months, what was your gross household income? (Your household income is the combined before-tax income of people who share their income and live in the same home. Typically, this would be you and your spouse.)
Yes
No
_________________________________________________
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No satisfaction at all (0) |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
Completely satisfied (10) |
Prefer not to answer |
Thinking about your own life and personal circumstances, how satisfied are you with your life as a whole? |
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How satisfied are with your standard of living? |
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How satisfied are you with your health? |
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How satisfied are you with what you are achieving in life? |
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How satisfied are you with your personal relationships? |
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How satisfied are you with how safe you feel? |
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How satisfied are you with feeling part of your community? |
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How satisfied are you with your future security? |
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Yes - If you would like to be contacted, please enter your preferred e-mail address, preferably a personal e-mail that will remain stable (e.g., john.doe@gmail.com):: _________________________________________________*
Yes - but I do not have an email address
No
____________________________________________
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File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Matthew Branner |
File Modified | 0000-00-00 |
File Created | 2023-07-29 |