Camper Application Form

Attachment A OMB No. 0920-1185

Expiration Date:  03/31/2026

National Center for Health Statistics

Data Detectives Summer Camp

From the Office of Management and Budget (OMB No. 0920-1185, Expiration Date: 03/31/2026):

NOTICE - Public reporting burden of this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: CDC/ATSDR Information Collection Review Office; 1600 Clifton Road, MS D-74, Atlanta, GA 30333, ATTN: PRA (0920-1185).

Assurance of Confidentiality - We take your privacy very seriously. All information that relates to or describes identifiable characteristics of individuals, a practice, or an establishment will be used only for statistical purposes. NCHS staff, contractors, and agents will not disclose or release responses in identifiable form without the consent of the individual or establishment in accordance with section 308(d) of the Public Health Service Act (42 U.S.C. 242m(d)) and the Confidential Information Protection and Statistical Efficiency Act of 2018 (CIPSEA Pub. L. No. 115-435, 132 Stat. 5529 § 302). In accordance with CIPSEA, every NCHS employee, contractor, and agent has taken an oath and is subject to a jail term of up to five years, a fine of up to $250,000, or both if he or she willfully discloses ANY identifiable information about you. In addition to the above cited laws, NCHS complies with the Federal Cybersecurity Enhancement Act of 2015 (6 U.S.C. §§ 151 and 151 note) which protects Federal information systems from cybersecurity risks by screening their networks.

Camper Application Form

Any information you provide to us is voluntary. We will maintain any information you provide in accordance with applicable federal laws.

Camper Information

______________________ ________________________ _________________________

Applicant’s last name Applicant’s first name Applicant’s middle initial

Gender: ____ Male ____ Female

Current grade level: ____ 5^th grade ____ 6^th grade

T-shirt size:

___ Youth small ___ Youth medium ___ Youth large ___ Youth X-large

___ Adult small ___ Adult medium ___ Adult large ___ Adult X-large

Camper Information

This section is to be completed by the camp applicant and not the parent or guardian.

Please rate your knowledge or understanding of the concepts below:
		Know It Well	Have Heard or Seen It		No Clue
Types of statistical data (e.g., numerical, categorical, ordinal)
Computing summary statistics (e.g., mean, median, mode)
Computing percentiles (e.g., lower quartile, 25th percentile)
Graphically presenting data
	Creating and interpreting box and whisker plots
	Creating and interpreting histograms
	Scatter plots
Bivariate associations
Interpreting two-way tables
Probability
Sampling variability
Drawing inferences about a population
Comparing populations

In a short paragraph, of 4 to 6 sentences (no more than 1000 characters), please tell us what is your favorite math concept, equation, or number? Why?

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