Information Collection

Student Outcome Survey Baseline

IC 201395 under ICR 201207-0920-010 · OMB 0920-0941.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0941 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Student Outcome Survey Baseline	Form and Instruction
1 Student Outcome Survey -- Baseline Atmt D Student Outcome Survey Baseline_11-21-11.docx	Form and Instruction
no number Student Baseline Outcome Survey Atmt_D_Student_Outcome_Survey_Baseline_corrected.doc	Form and Instruction

IC Title:

Student Outcome Survey Baseline

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Student Outcome Survey -- Baseline	Atmt D Student Outcome Survey Baseline_11-21-11.docx		No	No	Paper Only
Form and Instruction	no number	Student Baseline Outcome Survey	Atmt_D_Student_Outcome_Survey_Baseline_corrected.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 11,286

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	11,286	-3,762	15,048
Annual IC Time Burden (Hours)	8,465	-2,821	11,286
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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