National Health Service Corps Scholar/Students to Service Travel Request Worksheet

OMB 0915-0278

Clinicians participating in the HRSA National Health Service Corps (NHSC) Scholarship Program (SP) and the Students to Service (S2S) Loan Repayment Program (LRP) use the online Travel Request Worksheet to receive travel funds from the Federal Government to perform pre-employment interviews at sites on the Health Workforce Connector. The Travel Request Worksheet is also used to initiate the relocation process after a NHSC scholar or S2S participant has successfully been matched to an approved practice site.

The latest form for National Health Service Corps Scholar/Students to Service Travel Request Worksheet expires 2022-02-28 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 1 NHSC Travel Request Worksheet Form
Supporting Statement - NHSC Travel Request Worksheet - Final Draft v.2.docx Supporting Statement A
NHSC Travel Request Worksheet Form

All Historical Document Collections

202403-0915-001 Approved without change	Revision of a currently approved collection	2024-03-07
202110-0915-002 Approved without change	Extension without change of a currently approved collection	2021-10-19
201812-0915-003 Approved without change	Extension without change of a currently approved collection	2019-01-31
201512-0915-001 Approved without change	Extension without change of a currently approved collection	2015-12-04
201301-0915-001 Approved without change	Revision of a currently approved collection	2013-01-03
200912-0915-002 Approved without change	Extension without change of a currently approved collection	2009-12-11
200610-0915-001 Approved without change	Extension without change of a currently approved collection	2006-10-20
200307-0915-007 Approved without change	Existing collection in use without an OMB Control Number	2003-07-31