Information Collection

CN Program Operators - State Agency Staff

IC 257719 under ICR 202211-0584-012 · OMB 0584-0678.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix A- Sample State Agency Letter -1.docx	Other-
Appendix A- Sample State Agency Letter -1.docx	Other-
Appendix B- Nomination Form -1.docx	Other-
Appendix B- Nomination Form -1.docx	Other-
Appendix C- Welcome Questions -1.docx	Other-
Appendix C- Welcome Questions -1.docx	Other-
Appendix D- Course Evaluation -1.docx	Other-
Appendix D- Course Evaluation -1.docx	Other-
Appendix E- Program Impact Evaluation- 1.docx	Other-
Appendix E- Program Impact Evaluation- 1.docx	Other-

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-	Yes	Yes	Fillable Printable
Other-	Yes	Yes	Fillable Printable
Other-	Yes	Yes	Fillable Printable
Other-	Yes	Yes	Fillable Printable
Other-	Yes	Yes	Fillable Printable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 130

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	264	264
Annual IC Time Burden (Hours)	44	44
Annual IC Cost Burden (Dollars)	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.

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