Information Collection

Application for Participation in the National Health Service Corps Scholarship Program

IC 6375 under ICR 200702-0915-003 · OMB 0915-0146.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0146 can be found here:

Documents and Forms

Document Name Document Type
Form nhsc 0146 Application for Participation in the National Health Service Corps Scholarship Program Form
nhsc 0146 nhsc scholarship application 0146 scholarship form.pdf Form
0146 bulletin 07.doc Bulletin IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Participation in the National Health Service Corps Scholarship Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	nhsc 0146	nhsc scholarship application	0146 scholarship form.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title: Public Health Service National Health Service Corps Scholarship/Loan Repayment Participants Records System	FR Citation: 58 FR 12968

Number of Respondents: 1,800	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,800	-1,300	3,100
Annual IC Time Burden (Hours)	1,950	-1,150	3,100
Annual IC Cost Burden (Dollars)	0	-8,000	8,000

Documents for IC

Title	Document	Date Uploaded
Bulletin	0146 bulletin 07.doc

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.