AENT Program Forms

Advanced Education Nursing Traineeship (AENT) Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0375 can be found here:

Documents and Forms

Document Name Document Type
Form 1A AENT Program Forms Form and Instruction
1A Rural Underserved or PH practice settings; Graduate data Table 1A Rural Underserved or PH Practice Settings Graduates .docx 4 dec 13.docx Form and Instruction
1B Rural Underserve or PH settings graduates supported with Table 1B Rural Underserved or PHealth Practice Settings Graduates Supported .docx 4 dec 13.docx Form and Instruction
2A 2a projected master degree and post nursing master stude Table 2 A Projected Masters Degree and Post Nursing Masters .docx 4 dec 13.docx Form and Instruction
2B 2b projected doctoral degree students with instructions Table 2B Projected Doctoral Degree Students with Instructions.docx 4 dec 13.docx Form and Instruction

Information Collection (IC) Details

IC Title:	AENT Program Forms	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1A	Rural Underserved or PH practice settings; Graduate data with instructions	Table 1A Rural Underserved or PH Practice Settings Graduates .docx 4 dec 13.docx	Yes	Yes	Fillable Fileable
Form and Instruction	1B	Rural Underserve or PH settings graduates supported with instructions	Table 1B Rural Underserved or PHealth Practice Settings Graduates Supported .docx 4 dec 13.docx	Yes	Yes	Fillable Fileable
Form and Instruction	2A	2a projected master degree and post nursing master students with instructions	Table 2 A Projected Masters Degree and Post Nursing Masters .docx 4 dec 13.docx	Yes	Yes	Fillable Fileable
Form and Instruction	2B	2b projected doctoral degree students with instructions	Table 2B Projected Doctoral Degree Students with Instructions.docx 4 dec 13.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: 70	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	70	70
Annual IC Time Burden (Hours)	882	882
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.