Information Collection

Crew Health and Performance Exploration Analog (CHAPEA) Crew Application

IC 277587 under ICR 202509-2700-004 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CHAPEA Mission 3 Screenshots.docx chapea.nasa.gov/	Other-CHAPEA Mission 3 Screenshots
CHAPEA Mission 3 Screenshots.docx chapea.nasa.gov/	Other-CHAPEA Mission 3 Screenshots
CHAPEA Mission 3 Text .docx	Other-CHAPEA Mission 3 Text
CHAPEA Mission 3 Text .docx	Other-CHAPEA Mission 3 Text
Qualifications and Application Process.docx www.nasa.gov/humans-in-space/chapea/participate/	Other-Qualifications and Application
Qualifications and Application Process.docx www.nasa.gov/humans-in-space/chapea/participate/	Other-Qualifications and Application
Recruiting.docx www.nasa.gov/humans-in-space/chapea/about-chapea/	Other-Recruiting
Recruiting.docx www.nasa.gov/humans-in-space/chapea/about-chapea/	Other-Recruiting

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-CHAPEA Mission 3 Screenshots	https://chapea.nasa.gov/	Yes	Yes	Fillable Fileable
Other-CHAPEA Mission 3 Text		Yes	Yes	Fillable Fileable
Other-Qualifications and Application Process	https://www.nasa.gov/humans-in-space/chapea/participate/	Yes	Yes	Fillable Fileable
Other-Recruiting	https://www.nasa.gov/humans-in-space/chapea/about-chapea/	Yes	Yes	Fillable Fileable

Line of Business: General Science and Innovation

Subfunction: Space Exploration and Innovation

Privacy Act System of Records

Title: Human Experimental and Research Data Records

FR Citation: 80 FR 68568

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)	1,500	1,500
Annual IC Cost Burden (Dollars)	63,680	63,680

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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