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NCI's Center for Cancer Training (CCT) Application Form for Graduate Student Recruitment Program (GSRP) (NCI)
Generic Clearance for Application Information for Fellowships, Internships, Training Programs, and Specialty Positions (NCI)
OMB: 0925-0761
IC ID: 238701
OMB.report
HHS/NIH
OMB 0925-0761
ICR 202004-0925-001
IC 238701
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0761 can be found here:
2022-05-31 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
NCI's Center for Cancer Training (CCT) Application Form for Graduate Student Recruitment Program (GSRP) (NCI)
Form and Instruction
1 Applicant application screenshot
Attachment 1 - Application Screenshots.pdf
Form and Instruction
2 Reference form screenshot
Attachment 2 - Reference Form Screenshots Aug 2019.pdf
Form and Instruction
Mini SSA CCT FINAL (2).docx
Mini SSA
IC Document
Attachment 3 - Emails to Applicant and Referee.pdf
Emails to applicant and referee
IC Document
Attachment 4 - PIA.pdf
PIA
IC Document
Attachment 5 - Privacy Act Memo.pdf
Privacy Act Memo
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
NCI's Center for Cancer Training (CCT) Application Form for Graduate Student Recruitment Program (GSRP) (NCI)
Agency IC Tracking Number:
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
1
Applicant application screenshot
Attachment 1 - Application Screenshots.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
2
Reference form screenshot
Attachment 2 - Reference Form Screenshots Aug 2019.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
400
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Requested
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
400
0
0
0
0
400
Annual IC Time Burden (Hours)
175
0
0
0
0
175
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Mini SSA
Mini SSA CCT FINAL (2).docx
11/25/2019
Emails to applicant and referee
Attachment 3 - Emails to Applicant and Referee.pdf
11/25/2019
PIA
Attachment 4 - PIA.pdf
11/25/2019
Privacy Act Memo
Attachment 5 - Privacy Act Memo.pdf
11/25/2019
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.