KSC COVID-19 Vaccine Scheduling Application

Documents and Forms

Document Name Document Type
COVID Vaccine Registration Screenshots.docx www.eventbrite.com/e/ksc-vaccines-tickets-145860565879?utm_source=eventbrite&utm_medium=ebcampaigns&utm_campaign=664102& Other-Registration
COVID Vaccine Registration Screenshots.docx www.eventbrite.com/e/ksc-vaccines-tickets-145860565879?utm_source=eventbrite&utm_medium=ebcampaigns&utm_campaign=664102& Other-Registration
COVID19 Vaccine Registration Text.xlsx www.eventbrite.com/e/ksc-vaccines-tickets-145860565879?utm_source=eventbrite&utm_medium=ebcampaigns&utm_campaign=664102& Other-Registration
COVID19 Vaccine Registration Text.xlsx www.eventbrite.com/e/ksc-vaccines-tickets-145860565879?utm_source=eventbrite&utm_medium=ebcampaigns&utm_campaign=664102& Other-Registration

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	KSC COVID-19 Vaccine Scheduling Application	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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
Other-Registration			COVID Vaccine Registration Screenshots.docx	https://www.eventbrite.com/e/ksc-vaccines-tickets-145860565879?utm_source=eventbrite&utm_medium=ebcampaigns&utm_campaign=664102&aff=odeccpebemailcampaigns&utm_term=ctabutton&mipa=ABIdvVtH9fW-G04EiIbcEtREKUZT8-UkeLTYSj7LJHU-B0BR2dmnhy6bvgYyWj5wR3sJuRflZUJ8KMlDrULmaAK4f91HPxX_3K-AtJZDy8Tjqcc-b70SJwK-xMx8lZSYhehD5IyeQE4hUmFkFQt7W2eRGRhQPj_rzraw5uBVh-3XeQJPHEFeVp7FybWKNBBCfREYeLvsv8qPoeoOB0REHeoMNRjAUNcSCBXK1OvKt80AjB22c8on8PqkncKOG3S15pXSrOaZHeebRmK-xgg_RDrcWS2MW5pE4A#tickets	Yes	Yes	Fillable Fileable
Other-Registration			COVID19 Vaccine Registration Text.xlsx	https://www.eventbrite.com/e/ksc-vaccines-tickets-145860565879?utm_source=eventbrite&utm_medium=ebcampaigns&utm_campaign=664102&aff=odeccpebemailcampaigns&utm_term=ctabutton&mipa=ABIdvVtH9fW-G04EiIbcEtREKUZT8-UkeLTYSj7LJHU-B0BR2dmnhy6bvgYyWj5wR3sJuRflZUJ8KMlDrULmaAK4f91HPxX_3K-AtJZDy8Tjqcc-b70SJwK-xMx8lZSYhehD5IyeQE4hUmFkFQt7W2eRGRhQPj_rzraw5uBVh-3XeQJPHEFeVp7FybWKNBBCfREYeLvsv8qPoeoOB0REHeoMNRjAUNcSCBXK1OvKt80AjB22c8on8PqkncKOG3S15pXSrOaZHeebRmK-xgg_RDrcWS2MW5pE4A#tickets	Yes	Yes	Fillable Fileable

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records
Title: 10HIMS NASA Health Information Management System	FR Citation: 85 FR 79224

Number of Respondents: 3,336	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,336	3,336
Annual IC Time Burden (Hours)	278	278
Annual IC Cost Burden (Dollars)	11,076	11,076

Documents for IC

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.