Form 7 In-Service Verification Form

The Nursing Scholarship Program

In-Service Verification Form_Screenshot

In Service Verification Form

OMB: 0915-0301

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Public Burden Statement: The purpose of the Nurse Corps Scholarship Program
(Nurse Corps SP) is to provide scholarships to nursing students in exchange for a
minimum two-year full-time service commitment (or part-time equivalent), at an
eligible health care facility with a critical shortage of nurses. The information that
applicants supply is used to evaluate their eligibility, qualifications and to assess their
continued compliance with the applicable standards for participation in the Nurse
Corps SP. The OMB control number for this information collection is 0915-0301 and it
is valid until 05/31/2021. This information collection is voluntary. Public reporting
burden for this collection of information is estimated to average .8 hours per response,
including the time for reviewing instructions, searching existing data sources, and
completing and reviewing the collection of information. Send comments regarding this
burden estimate or any other aspect of this collection of information, including
suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers
Lane, Room 14N136B, Rockville, Maryland, 20857 or [email protected].


File Typeapplication/pdf
AuthorVossen-fidalgo, Elisangela (HRSA)
File Modified2020-02-14
File Created2020-01-23

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