Information Collection

Instrument 2 - Participant Exit Survey

IC 236137 under ICR 202209-0970-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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 2_SRAE HS Exit Survey_0825_clean.docx	Other-High School Exit Survey
Instrument 2_SRAE HS Exit Survey_0825_clean.docx	Other-High School Exit Survey
Instrument 2a_SRAE MS Exit Survey_0825_clean.docx	Other-Middle School Exit Survey
Instrument 2a_SRAE MS Exit Survey_0825_clean.docx	Other-Middle School Exit Survey
Instrument 2b_SRAE IMPACT HS Exit Survey_110321_clean.docx	Other-High School Exit Survey (Short
Instrument 2b_SRAE IMPACT HS Exit Survey_110321_clean.docx	Other-High School Exit Survey (Short
Instrument 2c_SRAE IMPACT MS Exit Survey_110321_clean.docx	Other-Middle School Exit Survey (Sho
Instrument 2c_SRAE IMPACT MS Exit Survey_110321_clean.docx	Other-Middle School Exit Survey (Sho

IC Title:

Instrument 2 - Participant Exit 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 Exit Survey	Instrument 2_SRAE HS Exit Survey_0825_clean.docx	Yes	Yes	Fillable Fileable
Other-Middle School Exit Survey	Instrument 2a_SRAE MS Exit Survey_0825_clean.docx	Yes	Yes	Fillable Fileable
Other-High School Exit Survey (Short Version)	Instrument 2b_SRAE IMPACT HS Exit Survey_110321_clean.docx	Yes	Yes	Fillable Fileable
Other-Middle School Exit Survey (Short Version)	Instrument 2c_SRAE IMPACT MS Exit 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: 1,113,358

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	Previously Approved
Annual Number of Responses for this IC	371,116	83,608	287,508
Annual IC Time Burden (Hours)	61,866	13,938	47,928
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.