NIH Office of Intramural Training & Education Application (OD)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 SIP	Form and Instruction	Removed	Available
Form 17 Survey - Optional Statistics	Form and Instruction	New	Available
Form 16 Evaluation-Letter of Recommendations	Form and Instruction	New	Available
Form 15 GPP Interview Experience Survey	Form and Instruction	New	Available
Form 14 GPP Registration	Form and Instruction	New	Available
Form 13 GPP Application	Form and Instruction	New	Available
Form 12 PBT Academy Training Program	Form and Instruction	New	Available
Form 10 UGSP Evaluation Scholar Payback Period	Form and Instruction	New	Available
Form 9 UGSP Scholar Contract	Form and Instruction	New	Available
Form 8 UGSP Deferment Form	Form and Instruction	New	Available
Form 8 UGSP Deferment Form	Form and Instruction	New	Available
Form 7 UGSP Renewal Application	Form and Instruction	New	Available
Form 6 UGSP Certification Exceptional Financial Need	Form and Instruction	New	Available
Form 6 UGSP Certification Exceptional Financial Need	Form and Instruction	New	Available
Form 5 UGSP Application	Form and Instruction	New	Available
Form 4 NAVW-NIH Visit Week Application	Form and Instruction	New	Available
Form 3 HiSTEP-High School Scientific Training Enrichment Program - Contact Information	Form and Instruction	New	Available
Form 2 SIP- Amgen Scholars at NIH - Supplement Application	Form and Instruction	New	Available
Form 1 SIP Summer Internship Program	Form and Instruction	New	Available
Form 2 VisitWeekNIH - Recommendation	Form and Instruction	Removed	Available
Form 1 VisitWeekNIH - Application	Form and Instruction	Removed	Available
Form 1 NIH Amgen Supplemental Questions	Form and Instruction	Removed	Available
Form 12 GPP Interview Experience	Form and Instruction	Removed	Available
Form 11 Time to Complete	Form and Instruction	Removed	Available
Form 10 Optional Information	Form and Instruction	Removed	Available
Form 16 Recommendation Letters	Form and Instruction	Removed	Available
Form 14 Deferment Form	Form and Instruction	Removed	Available
Form 14 Deferment Form	Form and Instruction	Removed	Available
Form 13 Certificate Form	Form and Instruction	Removed	Available
Form 13 Certification Form	Form and Instruction	Removed	Available
Form 9 Alumni Database	Form and Instruction	Removed	Available
Form 8 UGSP	Form and Instruction	Removed	Available
Form 7 NGSRC	Form and Instruction	Removed	Available
Form 6c GPPc	Form and Instruction	Removed	Available
Form 6b GPPb	Form and Instruction	Removed	Available
Form 6a GPPa	Form and Instruction	Removed	Available
Form 6c GPPc	Form and Instruction	Removed	Available
Form 6b GPPb	Form and Instruction	Removed	Available
Form 6a GPPa	Form and Instruction	Removed	Available
Form 5 TTP	Form and Instruction	Removed	Available
Form 4 CCSEP	Form and Instruction	Removed	Available
Form 3 PBTP	Form and Instruction	Removed	Available
Form 2 BESIP	Form and Instruction	Removed	Available
OITE 30 day FRN 2016-10994.pdf	Supplementary Document	Uploaded 2016-05-11	Repair queued
Form19-PrivacyImpactAssessment.pdf	Supplementary Document	Uploaded 2016-05-11	Available
Form18-PrivacyActApplicability.pdf	Supplementary Document	Uploaded 2016-05-11	Available
OMB15-SupportingStatement-SemiFinal.pdf	Supporting Statement A	Uploaded 2016-05-11	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
43627	Summer Internship Program Biomedical Research (SIP)	Form and Instruction	Removed	SIP
221480	Survey - Optional Statistics (Majority of Programs; 25% Response Rate)	Form and Instruction	New	Survey - Optional Statistics
221479	Evaluation - Recommendation Letters for Prospective Students	Form and Instruction	New	Evaluation-Letter of Recommendations
221478	Graduate Partnerships Program Interview Experience Survey (60% Response Rate)	Form and Instruction	New	GPP Interview Experience Survey
221477	Graduate Partnerships Program Registration	Form and Instruction	New	GPP Registration
221476	Graduate Partnerships Program Application	Form and Instruction	New	GPP Application
221475	NIH Academy Training Program Supplemental Application	Form and Instruction	New	PBT Academy Training Program
221474	Postbaccalaureate/Technical Training Program Application		New
221473	Undergraduate Scholarship Program Evaluation of Scholar PayBack Period	Form and Instruction	New	UGSP Evaluation Scholar Payback Period
221472	Undergraduate Scholarship Program Scholar Contract	Form and Instruction	New	UGSP Scholar Contract
221471	Undergraduate Scholarship Program Deferment Form (Completed by University Staff))	Form and Instruction	New	UGSP Deferment Form
221470	Undergraduate Scholarship Program Deferment Form (Completed by UGSP Scholar)	Form and Instruction	New	UGSP Deferment Form
221469	Undergraduate Scholarship Program (UGSP) Renewal Application	Form and Instruction	New	UGSP Renewal Application
221467	Undergraduate Scholarship Program -Certificate of Exceptional Financial Need (Completed by University Staff)t)	Form and Instruction	New	UGSP Certification Exceptional Financial Need
221465	Undergraduate Scholarship Program -Certificate of Exceptional Financial Need (Completed by Applicant)	Form and Instruction	New	UGSP Certification Exceptional Financial Need
221464	Undergraduate Scholarship Program (UGSP) Application	Form and Instruction	New	UGSP Application
221463	NIH Visit Week - Application	Form and Instruction	New	NAVW-NIH Visit Week Application
221462	High School Scientifc Training & Enrichment Program - Contact Information	Form and Instruction	New	HiSTEP-High School Scientific Training Enrichment Program - Contact Information
221456	Amgen Scholars at NIH Program - Supplemental Application	Form and Instruction	New	SIP- Amgen Scholars at NIH - Supplement Application
221455	Summer Internship Program Application	Form and Instruction	New	SIP Summer Internship Program
214751	VisitWeekNIH - Recommendation	Form and Instruction	Removed	VisitWeekNIH - Recommendation
214750	VisitWeekNIH - Application	Form and Instruction	Removed	VisitWeekNIH - Application
213919	NIH-Amgen Supplemental Questions	Form and Instruction	Removed	NIH Amgen Supplemental Questions
207796	GPP Interview Experience	Form and Instruction	Removed	GPP Interview Experience
207795	Time to Complete Application Form	Form and Instruction	Removed	Time to Complete
207794	Survey Race-Ethnicity-Gender-Birth Year	Form and Instruction	Removed	Optional Information
207793	Reference Recommendation Letters for All Programs	Form and Instruction	Removed	Recommendation Letters
207792	UGSP - Deferment Form (Completed by University Staff)	Form and Instruction	Removed	Deferment Form
207791	UGSP - Deferment Form (Completed by Applicant)	Form and Instruction	Removed	Deferment Form
207790	UGSP - Certificate of Eligibility (Completed by University Staff)	Form and Instruction	Removed	Certificate Form
207789	UGSP - Certificate of Eligibility (Completed by Applicant)	Form and Instruction	Removed	Certification Form
207788	Alumni Database	Form and Instruction	Removed	Alumni Database
207787	Undergraduate Scholarship Program (UGSP)	Form and Instruction	Removed	UGSP
207786	National Graduate Student research Conference (NGSRC)	Form and Instruction	Removed	NGSRC
207785	Graduate Partnerships Program (GPP) - Application (Select Institutional Partnerships and Individual)	Form and Instruction	Removed	GPPc
207785	Graduate Partnerships Program (GPP) - Application (Select Institutional Partnerships and Individual)	Form and Instruction	Removed	GPPb
207785	Graduate Partnerships Program (GPP) - Application (Select Institutional Partnerships and Individual)	Form and Instruction	Removed	GPPa
207784	Graduate Partnerships Program (GPP) - Application (Select Institutional Partnerships)	Form and Instruction	Removed	GPPc
207784	Graduate Partnerships Program (GPP) - Application (Select Institutional Partnerships)	Form and Instruction	Removed	GPPb
207784	Graduate Partnerships Program (GPP) - Application (Select Institutional Partnerships)	Form and Instruction	Removed	GPPa
207783	Technical Training Program (PBT)	Form and Instruction	Removed	TTP
207782	Community College Summer Enrichment Program (CCSEP)	Form and Instruction	Removed	CCSEP
207781	Post-baccalaureate Training Program (PBT)	Form and Instruction	Removed	PBTP
200079	Biomedical Engineering Summer Intership Program (BESIP)	Form and Instruction	Removed	BESIP

ICR Details

OMB Control No: 0925-0299	ICR Reference No: 201605-0925-001
Status: Historical Active	Previous ICR Reference No: 201501-0925-006
Agency/Subagency: HHS/NIH	Agency Tracking No: 19980
Title: NIH Office of Intramural Training & Education Application (OD)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/24/2016
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/12/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2019	36 Months From Approved	08/31/2016
Responses	36,691	0	39,910
Time Burden (Hours)	16,334	0	18,414
Cost Burden (Dollars)	0	0	0

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Abstract: The Office of Intramural Training & Education (OITE) administers a variety of programs and initiatives to recruit pre-college through post-doctoral educational level individuals into the National Institutes of Health Intramural Research Program (NIH-IRP) to facilitate develop into future biomedical scientists. To identify qualified prospective students, the OITE has developed an application that contains the following target areas of assessment: personal information, eligibility criteria, contact information, student identification number, training program selection, scientific discipline interests, educational history, standardized examination scores, reference information, resume components, employment history, employment interests, dissertation research details, letters of recommendation, financial aid history, sensitive data, future networking contact, travel information, as well as feedback questions about interviews and application submission experiences. NIH investigators directly involved in the evaluation of prospective trainees will use information contained in the application.

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Authorizing Statute(s): US Code: 42 USC Sect. 241 and 282(b)(13) Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 69685	11/10/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 28880	05/10/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 19

table that charts list of burden

IC Title	Form No.	Form Name
NIH-Amgen Supplemental Questions	1	NIH Amgen Supplemental Questions
Alumni Database	9	Alumni Database
Amgen Scholars at NIH Program - Supplemental Application	2	SIP- Amgen Scholars at NIH - Supplement Application
Biomedical Engineering Summer Intership Program (BESIP)	2	BESIP
Community College Summer Enrichment Program (CCSEP)	4	CCSEP
Evaluation - Recommendation Letters for Prospective Students	16	Evaluation-Letter of Recommendations
GPP Interview Experience	12	GPP Interview Experience
Graduate Partnerships Program (GPP) - Application (Select Institutional Partnerships and Individual)	6a, 6b, 6c	GPPa ,   GPPb ,   GPPc
Graduate Partnerships Program (GPP) - Application (Select Institutional Partnerships)	6b, 6a, 6c	GPPa ,   GPPb ,   GPPc
Graduate Partnerships Program Application	13	GPP Application
Graduate Partnerships Program Interview Experience Survey (60% Response Rate)	15	GPP Interview Experience Survey
Graduate Partnerships Program Registration	14	GPP Registration
High School Scientifc Training & Enrichment Program - Contact Information	3	HiSTEP-High School Scientific Training Enrichment Program - Contact Information
NIH Academy Training Program Supplemental Application	12	PBT Academy Training Program
NIH Visit Week - Application	4	NAVW-NIH Visit Week Application
National Graduate Student research Conference (NGSRC)	7	NGSRC
Post-baccalaureate Training Program (PBT)	3	PBTP
Postbaccalaureate/Technical Training Program Application	11
Reference Recommendation Letters for All Programs	16	Recommendation Letters
Summer Internship Program Application	1	SIP Summer Internship Program
Summer Internship Program Biomedical Research (SIP)	1	SIP
Survey - Optional Statistics (Majority of Programs; 25% Response Rate)	17	Survey - Optional Statistics
Survey Race-Ethnicity-Gender-Birth Year	10	Optional Information
Technical Training Program (PBT)	5	TTP
Time to Complete Application Form	11	Time to Complete
UGSP - Certificate of Eligibility (Completed by Applicant)	13	Certification Form
UGSP - Certificate of Eligibility (Completed by University Staff)	13	Certificate Form
UGSP - Deferment Form (Completed by Applicant)	14	Deferment Form
UGSP - Deferment Form (Completed by University Staff)	14	Deferment Form
Undergraduate Scholarship Program (UGSP)	8	UGSP
Undergraduate Scholarship Program (UGSP) Application	5	UGSP Application
Undergraduate Scholarship Program (UGSP) Renewal Application	7	UGSP Renewal Application
Undergraduate Scholarship Program -Certificate of Exceptional Financial Need (Completed by Applicant)	6	UGSP Certification Exceptional Financial Need
Undergraduate Scholarship Program -Certificate of Exceptional Financial Need (Completed by University Staff)t)	6	UGSP Certification Exceptional Financial Need
Undergraduate Scholarship Program Deferment Form (Completed by UGSP Scholar)	8	UGSP Deferment Form
Undergraduate Scholarship Program Deferment Form (Completed by University Staff))	8	UGSP Deferment Form
Undergraduate Scholarship Program Evaluation of Scholar PayBack Period	10	UGSP Evaluation Scholar Payback Period
Undergraduate Scholarship Program Scholar Contract	9	UGSP Scholar Contract
VisitWeekNIH - Application	1	VisitWeekNIH - Application
VisitWeekNIH - Recommendation	2	VisitWeekNIH - Recommendation

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	36,691	39,910	0	-3,219	0	0
Annual Time Burden (Hours)	16,334	18,414	0	-2,080	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Revision

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Annual Cost to Federal Government: $419,964

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 05/12/2016

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