HOPWA Monthly Progress Report Worksheet
This worksheet is intended to help you collect project information needed to complete Exhibits B & C of the HOPWA Monthly Progress Report.
See Worksheet Instructions for directions on using this worksheet. Please keep a file of Aother information@ (item 14 below) to specify on the
monthly report. Names and personal data on participants must be kept confidential; a unique identifying code should be used to track
participants. For families, list the head of household first and aggregate family information following that entry. Other family members can be
sequentially listed to provide space for demographic information. Please use the codes as described on the following Worksheet Instructions for
items 5 to 12.
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14.
Participant=s Date Number of Number of Race Hispanic Age/Sex Gross Recent Date Reason Housing Housing Other Information
ID Code Entering Adults Children (A,B, /non- Monthly Living Leaving for Type/# of Assistance
Program residing w/ residing w/ etc.) Hispanic Income Situation Program Leaving Bedrooms Payment/
Participant Participant (H or N) # of
Abcd12345601 12/01/06 2 B N 000