[NCHS] NCHS Data Detectives Camp 2023-2025

[NCHS] Youth Outreach Generic Clearance for the National Center for Health Statistics

Documents and Forms

Document Name Document Type
[NCHS] NCHS Data Detectives Camp 2023-2025 Form and Instruction
Camper Application Form Att A Camper Application Form 03032023.docx Form and Instruction
Parent Application Form Att B Parent Application Form 03032023.docx Form and Instruction
Teacher Recommendation Att C Teacher Recommendation 03032023.docx Form and Instruction
Camper Information/Registration Form (in-person) Att D Registration Form IN-PERSON 03032023.docx Form and Instruction
Camper Information/Registration Form (virtual) Att E Registration Form VIRTUAL 03032023.docx Form and Instruction
Parent Evaluation Form Att F Parent Eval Form 03032023.docx Form and Instruction
Student Evaluation Form Att G Student Eval Form 03032023.docx Form and Instruction
GenIC Supporting Statement 03092023v2.docx SSA (Project description and burden estimation) IC Document
Att H NCHS_DataDetectiveCamp_Memo_HumanSubj_rev02_07_23_signed.pdf CDC Determination: IRB Approval is Not Required IC Document

Information Collection (IC) Details

IC Title:	[NCHS] NCHS Data Detectives Camp 2023-2025	Agency IC Tracking Number:	0920-1185-23DG

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	None	Camper Application Form	Att A Camper Application Form 03032023.docx	Yes	Yes	Fillable Fileable
Form and Instruction	None	Parent Application Form	Att B Parent Application Form 03032023.docx	Yes	Yes	Fillable Fileable
Form and Instruction	None	Teacher Recommendation	Att C Teacher Recommendation 03032023.docx	Yes	Yes	Fillable Fileable
Form and Instruction	None	Camper Information/Registration Form (in-person)	Att D Registration Form IN-PERSON 03032023.docx	No		Paper Only
Form and Instruction	None	Camper Information/Registration Form (virtual)	Att E Registration Form VIRTUAL 03032023.docx	Yes	Yes	Fillable Fileable
Form and Instruction	None	Parent Evaluation Form	Att F Parent Eval Form 03032023.docx	Yes	Yes	Fillable Fileable
Form and Instruction	None	Student Evaluation Form	Att G Student Eval Form 03032023.docx	Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records
Title: 09-20-0169, Users of Health Statistics	FR Citation: 51 FR 42371

Number of Respondents: 2,140	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,140	2,140
Annual IC Time Burden (Hours)	853	853
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SSA (Project description and burden estimation)	GenIC Supporting Statement 03092023v2.docx	03/09/2023
CDC Determination: IRB Approval is Not Required	Att H NCHS_DataDetectiveCamp_Memo_HumanSubj_rev02_07_23_signed.pdf	03/09/2023

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