Information Collection

Students enrolled in Workforce program(webbased student baseline survey)

IC 195738 under ICR 201208-0955-007 · OMB 0955-0007.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0990-Attachment 1 - Web Based Student SurveyITHealthcare.doc	Other-survey

IC Title:

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
Other-survey			0990-Attachment 1 - Web Based Student SurveyITHealthcare.doc		No	No	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,233

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,233	1,233
Annual IC Time Burden (Hours)	411	411
Annual IC Cost Burden (Dollars)	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.