Information Collection

Voluntary Student Engagement Form

IC 213417 under ICR 201408-1800-002 · OMB 1800-0011.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1800-0011 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
ED Voluntary Student Engagement Form 10-1-2014.doc	Other-Form
Student Engagement Form 9-12-2014_Generic Clearance OMB Template Instrument.docx Template Justification	IC Document

IC Title:

Voluntary Student Engagement Form

Agency IC Tracking Number:

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
Other-Form			ED Voluntary Student Engagement Form 10-1-2014.doc		No		Paper Only

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

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	300	300
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Template Justification	Student Engagement Form 9-12-2014_Generic Clearance OMB Template Instrument.docx	10/07/2014

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