Application for Participation in the National Health Service Corps Scholarship Program

Application for Participation in the National Health Service Corps Scholarship Program

OMB: 0915-0146

IC ID: 6375

Information Collection (IC) Details

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Application for Participation in the National Health Service Corps Scholarship Program
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 62.6

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1 1 0146 nhsc form 2007.pdf Yes Yes Fillable Fileable
Instruction 0146 Scholar Bulletin.doc Yes No Fillable Fileable

Health Health Care Services

Public Health Service National Health Service Corps Scholarship/Loan Repayment Participants Records System  58 FR 12968

1,800 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,800 0 -1,300 0 3,100 0
Annual IC Time Burden (Hours) 5,400 0 2,300 0 3,100 0
Annual IC Cost Burden (Dollars) 0 0 -8,000 0 8,000 0

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