Information Collection

Instrument 2 - Participant Exit Survey

IC 236137 under ICR 202512-0970-004 · OMB 0970-0536.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument 2a (Current) Participant Exit Survey for high school and older youth.docx	Other-Current Participant Exit Surve
Instrument 2a (Current) Participant Exit Survey for high school and older youth.docx	Other-Current Participant Exit Surve
Instrument 2a (Implement 2026) Participant Exit Survey for high school and older youth_clean.docx	Other-2026 Participant Exit Survey f
Instrument 2a (Implement 2026) Participant Exit Survey for high school and older youth_clean.docx	Other-2026 Participant Exit Survey f
Instrument 2b (Current) Participant Exit Survey for middle school youth.docx	Other-Current Participant Exit Surve
Instrument 2b (Current) Participant Exit Survey for middle school youth.docx	Other-Current Participant Exit Surve
Instrument 2b (Implement 2026) Participant Exit Survey for middle school youth_clean.docx	Other-2026 Participant Exit Survey f
Instrument 2b (Implement 2026) Participant Exit Survey for middle school youth_clean.docx	Other-2026 Participant Exit Survey f

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Current Participant Exit Survey for high school and older youth	Yes	Yes	Fillable Fileable
Other-2026 Participant Exit Survey for high school and older youth	Yes	Yes	Fillable Fileable
Other-Current Participant Exit Survey for middle school youth	Yes	Yes	Fillable Fileable
Other-2026 Participant Exit Survey for middle school youth	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 491,124

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	Previously Approved
Annual Number of Responses for this IC	163,706	-207,410	371,116
Annual IC Time Burden (Hours)	20,469	-41,397	61,866
Annual IC Cost Burden (Dollars)	0	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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