Information Collection

Nurse Corps Evaluation: Participant and Alumni Survey

IC 262067 under ICR 202309-0915-001 · OMB 0915-0393.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3 Nurse Corps Evaluation: Participant and Alumni Survey	Form and Instruction
Form 3 Nurse Corps Evaluation: Participant and Alumni Survey Nurse Corps Evaluation: Participant and Alumni Survey	Form and Instruction
Form 4 Outreach for Nurse Corps Evaluation: Participant and Alumni Survey Nurse Corps Evaluation: Participant and Alumni Survey	Form and Instruction
Form 5 INTRODUCTORY CALL SCRIPT FOR TELEPHONE ADMINISTRATION Nurse Corps Evaluation: Participant and Alumni Survey	Form and Instruction
3 Nurse Corps Evaluation: Participant and Alumni Survey Nurse Corps Participant and Alumni Survey.docx	Form and Instruction
3 Nurse Corps Evaluation: Participant and Alumni Survey Nurse Corps Participant and Alumni Survey.docx	Form and Instruction
4 Outreach for Nurse Corps Evaluation: Participant and Alu Outreach Materials for Participant and Alumni Survey.docx	Form and Instruction
4 Outreach for Nurse Corps Evaluation: Participant and Alu Outreach Materials for Participant and Alumni Survey.docx	Form and Instruction
5 INTRODUCTORY CALL SCRIPT FOR TELEPHONE ADMINISTRATION Telephone Follow-up Introduction.docx	Form and Instruction
5 INTRODUCTORY CALL SCRIPT FOR TELEPHONE ADMINISTRATION Telephone Follow-up Introduction.docx	Form and Instruction

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.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	3	Yes	Yes	Fillable Fileable
Form and Instruction	4	Yes	Yes	Fillable Fileable
Form and Instruction	5	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 7,302

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	7,302	7,302
Annual IC Time Burden (Hours)	3,067	3,067
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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