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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Voluntary Student Engagement Form	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection 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 %

	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

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.