Information Collection

The Nursing Scholarship Program

IC 43610 under ICR 201504-0915-002 · OMB 0915-0301.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form 1
Eligible Application The Nursing Scholarship Program
Form and Instruction
Form 2
NCSP APG The Nursing Scholarship Program
Form and Instruction
Form 3
Graduation Close Out Form The Nursing Scholarship Program
Form and Instruction
Form 4
Confirmation of Interest Form The Nursing Scholarship Program
Form and Instruction
Form 5
Contract The Nursing Scholarship Program
Form and Instruction
Form 6
DCW The Nursing Scholarship Program
Form and Instruction
Form 7
School Enrollment Verification Form The Nursing Scholarship Program
Form and Instruction
Form 8
Initial Employment Verification Form The Nursing Scholarship Program
Form and Instruction
Form 9
Participant Service Verification The Nursing Scholarship Program
Form and Instruction
1 Eligible Application
Attachment B-Eligible Application screenshots .pdf
Form and Instruction
2 NCSP APG
Attachment C-NCSP APG.docx
Form and Instruction
3 Graduation Close Out Form
Attachment D-Graduation Close Out Form.docx
Form and Instruction
4 Confirmation of Interest Form
Attachment E-Confirmation of Interest Form Screenshots.docx
Form and Instruction
5 Contract
Attachment F-Contract.pdf
Form and Instruction
6 DCW
Attachment G-DCW Screen shot.docx
Form and Instruction
7 School Enrollment Verification Form
Attachment H-School Enrollment Verification Form.pdf
Form and Instruction
8 Initial Employment Verification Form
Attachment I-Initial Employment Verification Form.pdf
Form and Instruction
9 Participant Service Verification
Attachment J-Employer -Participant Service Verification Screenshots .pdf
Form and Instruction
Attachment A - Nursing Legislation.pdf
Nursing Legislation
IC Document

Information Collection (IC) Details

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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 1 Yes Yes Fillable Fileable
Form and Instruction 2 Yes Yes Fillable Fileable
Form and Instruction 3 Yes Yes Fillable Fileable
Form and Instruction 4 Yes Yes Fillable Fileable
Form and Instruction 5 Yes Yes Fillable Fileable
Form and Instruction 6 Yes Yes Fillable Fileable
Form and Instruction 7 Yes Yes Fillable Fileable
Form and Instruction 8 Yes Yes Fillable Fileable
Form and Instruction 9 Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 8,050 0 2,350 0 0 5,700
Annual IC Time Burden (Hours) 6,891 0 -3,309 0 0 10,200
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
Nursing Legislation 06/21/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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