Information Collection

Instrument 1 - Participant Entry Survey

IC 236136 under ICR 202110-0970-010 · OMB 0970-0536.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0536 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument 1_SRAE HS Entry Survey_0825_clean.docx	Other-High School Entry Survey
Instrument 1_SRAE HS Entry Survey_0825_clean.docx	Other-High School Entry Survey
Instrument 1a_SRAE MS Entry Survey_0825_clean.docx	Other-Middle School Entry Survey
Instrument 1a_SRAE MS Entry Survey_0825_clean.docx	Other-Middle School Entry Survey
Instrument 1b_SRAE IMPACT HS Entry Survey_0825_clean.docx	Other-High School Entry Survey (Shor
Instrument 1b_SRAE IMPACT HS Entry Survey_110321_clean.docx	Other-High School Entry Survey (Shor
Instrument 1c_SRAE IMPACT MS Entry Survey_0825_clean.docx	Other-Middle School Entry Survey (Sh
Instrument 1c_SRAE IMPACT MS Entry Survey_110321_clean.docx	Other-Middle School Entry Survey (Sh

IC Title:

Instrument 1 - Participant Entry Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-High School Entry Survey	Instrument 1_SRAE HS Entry Survey_0825_clean.docx	Yes	Yes	Fillable Fileable
Other-Middle School Entry Survey	Instrument 1a_SRAE MS Entry Survey_0825_clean.docx	Yes	Yes	Fillable Fileable
Other-High School Entry Survey (Short Version)	Instrument 1b_SRAE IMPACT HS Entry Survey_110321_clean.docx	Yes	Yes	Fillable Fileable
Other-Middle School Entry Survey (Short Version)	Instrument 1c_SRAE IMPACT MS Entry Survey_110321_clean.docx	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 359,385

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	359,385	-73,775	433,160
Annual IC Time Burden (Hours)	47,906	-9,834	57,740
Annual IC Cost Burden (Dollars)	0	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.