Application for Participation in the National Health Service Corps Scholarship Program

The National Health Service Corps Scholarship Program, Students to Service Loan Repayment Program, and the Native Hawaiian Health Scholarship Program

OMB: 0915-0146

IC ID: 6375

Information Collection (IC) Details

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Application for Participation in the National Health Service Corps Scholarship Program
 
No Unchanged
 
Required to Obtain or Retain Benefits
 
42 CFR 62.6

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 FY 2017 NHSC SP Application Content.pdf FY 2017 NHSC SP Application Content.pdf Yes Yes Fillable Fileable
Instruction NHSC SP FY 2017 Online Application User Guide.pdf Yes Yes Fillable Fileable

Health Health Care Services

Public Health Service National Health Service Corps Scholarship/Loan Repayment Participants Records System  58 FR 12968

1,800 0
   
Individuals or Households
 
   100 %

  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 1,800 0 0 0 0 1,800
Annual IC Time Burden (Hours) 3,600 0 0 0 0 3,600
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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