Information Collection

Student Safety Assessment Survey

IC 239906 under ICR 202002-1205-001 · OMB 1205-0542.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0542 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Student Safety Assessment English Script 031920.docx	Other-Survey
Student Safety Assessment Spanish Script 031920.docx	Other-Survey

IC Title:

Student Safety Assessment Survey

Agency IC Tracking Number:

Is this a Common Form? No

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-Survey			Student Safety Assessment English Script 031920.docx		Yes	Yes	Fillable Fileable
Other-Survey			Student Safety Assessment Spanish Script 031920.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title: Job Corps Student Records (DOL/GOVT-2)

FR Citation: 67 FR 16815

Number of Respondents: 11,663

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	139,956	139,956
Annual IC Time Burden (Hours)	34,989	34,989
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.