Information Collection

Participant Baseline Survey and Consent Form

IC 276094 under ICR 202507-1290-001 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
T2-2025-06 SCC4_Appendix B. Participant baseline survey and consent form_Spa_6-11 to DOL 7.11.25.docx www.SCCNationalEval.com/Baseline	Other-Survey
T2-2025-06 SCC4_Appendix B. Participant baseline survey and consent form_Spa_12.16.25_Clean.docx www.SCCNationalEval.com/Baseline	Other-Survey
T2-2025-06 SCC4_Appendix A. Participant baseline survey and consent form_Eng_6-11 to DOL 7.11.25 Clean.docx www.SCCNationalEval.com/Baseline	Other-Survey
T2-2025-06 SCC4_Appendix A. Participant baseline survey and consent form_Eng_12.16.25_Clean.docx www.SCCNationalEval.com/Baseline	Other-Survey
T2-2025-06 SCC4_Appendix C. Participant Study Intake Staff FAQ_6-11 to DOL 7.11.25.docx Participant Study Intake Staff FAQ	IC Document
T2-2025-06 SCC4_Appendix C. Participant Study Intake Staff FAQ_6-11 to DOL 7.11.25.docx Participant Study Intake Staff FAQ	IC Document
T2-2025-06 SCC4_Appendix O. Participant random assignment notification_Eng_6-11 to DOL 7.11.25.docx Participant random assignment notification_Eng_6-11	IC Document
T2-2025-06 SCC4_Appendix O. Participant random assignment notification_Eng_6-11 to DOL 7.11.25.docx Participant random assignment notification_Eng_6-11	IC Document
T2-2025-06 SCC4_Appendix P. Participant random assignment notification_Spa_6-11 to DOL 7.11.25.docx T2-2025-06 SCC4_Appendix O. Participant random assignment notification_Spa_6-11	IC Document
T2-2025-06 SCC4_Appendix P. Participant random assignment notification_Spa_6-11 to DOL 7.11.25.docx T2-2025-06 SCC4_Appendix O. Participant random assignment notification_Spa_6-11	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Participant Baseline Survey and Consent Form

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.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey				https://www.SCCNationalEval.com/Baseline	Yes	Yes	Fillable Fileable
Other-Survey				https://www.SCCNationalEval.com/Baseline	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,000

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	2,000	2,000
Annual IC Time Burden (Hours)	500	500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Participant Study Intake Staff FAQ		07/16/2025
Participant random assignment notification_Eng_6-11		07/16/2025
T2-2025-06 SCC4_Appendix O. Participant random assignment notification_Spa_6-11		07/16/2025

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

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