DoD STEM Work Experience Program Participant Questionnaire

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
0704-0668 _SSA_9.22.2026 (1).docx	Supporting Statement A	Uploaded 2026-09-29	Available
0704-0668Invitation Email_08.31.2026.docx	Supplementary Document	Uploaded 2026-09-22	Available
0704-0668_Updated_Supporting_Statement_Part_B.docx	Supporting Statement B	Uploaded 2026-09-22	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
254017	Work Experience Program Participant Questionnaire	Other-Web Survey	Modified

ICR Details

OMB Control No: 0704-0668	ICR Reference No: 202608-0704-004
Status: Received in OIRA	Previous ICR Reference No: 202206-0704-002
Agency/Subagency: DOW/DODDEP	Agency Tracking No: 0704-STEM
Title: DoD STEM Work Experience Program Participant Questionnaire
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 09/30/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	09/30/2026
Responses	300	300
Time Burden (Hours)	75	75
Cost Burden (Dollars)	1,500	1,500

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Abstract: The information gathered through this survey will inform the Department of Defense (DoD) on the range of science, technology, engineering, and mathematics (STEM) education programs that can be considered work experience programs (WEPs) in that they have two components: (1) an experiential component where participants engage in meaningful work and (2) an educational component where they acquire skills or knowledge. This definition includes programs labeled as internships, apprenticeships, or related experiences, such as work-based learning, cooperative education, and postdoctoral positions.

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Authorizing Statute(s): US Code: 10 USC 2194 Name of Law: Education partnerships
   US Code: 10 USC 2195 Name of Law: Department of Defense cooperative education programs
   US Code: 10 USC 2192 Name of Law: Improvement of education in technical fields: general authority regarding education in science, math
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 35186	06/10/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 56432	09/02/2026
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Work Experience Program Participant Questionnaire

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ICR Summary of Burden

table that charts list of burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	300	300	0	0	0	0
Annual Time Burden (Hours)	75	75	0	0	0	0
Annual Cost Burden (Dollars)	1,500	1,500	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $5,250

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/30/2026

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