Information Collection

Work Experience Program Participant Questionnaire

IC 254017 under ICR 202206-0704-002 · OMB 0704-0668.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0704-STEM_Survey_Full Instrument_1.17.2023.docx idaorg.gov1.qualtrics.com/jfe/preview/previewId/066cc7dc-3aaf-4c2f-9651-64732bc9fda2/SV_5ATajOVyWZFiTXw?Q_CHL=preview&Q_	Other-Web Survey
0704-STEM_Survey_Full Instrument_7.7.2023.docx	Other-Web Survey
0704-STEM_Intro and ADN Preview.pdf	Other-Intro and Agency Disclosure No
0704-STEM_Intro and ADN Preview.pdf	Other-Intro and Agency Disclosure No
0704-STEM_Survey_Look and Feel in Qualtrics_4.26.2022.docx Survey in Qualtrics	IC Document
0704-STEM_Survey_Look and Feel in Qualtrics_4.26.2022.docx Survey in Qualtrics	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Web Survey			0704-STEM_Survey_Full Instrument_7.7.2023.docx		Yes	Yes	Fillable Fileable
Other-Intro and Agency Disclosure Notice			0704-STEM_Intro and ADN Preview.pdf		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	75	75
Annual IC Cost Burden (Dollars)	1,500	1,500

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Survey in Qualtrics	0704-STEM_Survey_Look and Feel in Qualtrics_4.26.2022.docx	06/03/2022

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.