Information Collection

Student Survey

IC 206589 under ICR 201304-0935-001 · OMB 0935-0210.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form #2 Student Survey	Form and Instruction
Form #2 Student Survey Attachment A -- Student_Survey.docx	Form and Instruction
Attachment B -- Invitation Email for Student Survey.docx Attachment B -- Invitation Email for Student Survey	IC Document

IC Title:

Student Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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	Form #2	Student Survey	Attachment A -- Student_Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,800

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,800	1,800
Annual IC Time Burden (Hours)	300	300
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment B -- Invitation Email for Student Survey	Attachment B -- Invitation Email for Student Survey.docx	04/15/2013

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