OMB control number

Application for Participation in the IHS Scholarship Program

OMB 0917-0006 · HHS/IHS.

OMB 0917-0006

The IHS Scholarship Program offers qualified American Indian and Alaska Native health profession students a unique opportunity to establish an educational foundation as they prepare to pursue a career in Indian health. Each scholarship (Preparatory, Pre-Graduate and health professions) is defined by applicant and degree program eligibility and provides generous financial aid packages (information available at www.ihs.gov/scholarship). The ultimate goal of the program is to develop health care providers and the next leaders of Indian health communities. Since IHS began providing scholarship support to American Indian and Alaska Native students to pursue health profession careers in 1978, the program has grown to support, educate and place health care professionals within medically underserved Indian health programs throughout the continental United States and Alaska. Today, nearly 7,000 American Indian and Alaska Native students have received scholarship awards and many have committed to serving their health profession careers at IHS; some have even returned to serve their own Tribal communities.

The latest form for Application for Participation in the IHS Scholarship Program expires 2027-01-31 and is listed under ICR 202310-0917-001.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form IHS-856-13 Notification of Impending Graduation	Form and Instruction
Form IHS 818 Health Professions Contract	Form
Form IHS-817 Scholarship Program Agreement	Form
Form IHS-856-23 Request for Credit Validation	Form
Form IHS-856-22 Change of Name or Address	Form
Form IHS-856-21 Summer School Request	Form
Form IHS-856-19 Lost Stipend Payment	Form
Form IHS-856-16 Annual Status Report	Form
Form IHS-856-15 Placement Update	Form
Form IHS-856-14 Notification of Deferment Program	Form
Form IHS-856-13 Notice of Impending Graduation	Form
Form IHS-856-12 Preferred Placement	Form
Form HS-856-11 Request for Approval of Deferment	Form
Form IHS-856-10 Change of Status	Form
Form IHS-856-9 Notification of Academic Problem	Form
Form IHS-856-8 Recipient's Initial Program Progress Report	Form
Form IHS-856-7 Verification of Acceptance or Decline of Award	Form
Supporting Statement for IHS Scholarship Program FINAL 10.30.23.docx	Supporting Statement A
Notification of Impending Graduation	Form and Instruction
IHS Scholarship Program Application	Other-Web Site Apps
Health Professions Contract	Form
Scholarship Program Agreement	Form
Request for Credit Validation	Form
Change of Name or Address	Form
Summer School Request	Form
Lost Stipend Payment	Form
Annual Status Report	Form
Placement Update	Form
Notification of Deferment Program	Form
Notice of Impending Graduation	Form
Preferred Placement	Form
Request for Approval of Deferment	Form
Change of Status	Form
Notification of Academic Problem	Form
Recipient's Initial Program Progress Report	Form
Verification of Acceptance or Decline of Award	Form

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
202310-0917-001	Revision of a currently approved collection	2023-10-31	Approved with change
202003-0917-001	Revision of a currently approved collection	2020-03-30	Approved with change
201609-0917-001	Revision of a currently approved collection	2016-09-22	Approved with change
201308-0917-001	Revision of a currently approved collection	2013-08-23	Approved without change
201006-0917-001	Revision of a currently approved collection	2010-06-02	Approved without change
200801-0917-002	Reinstatement without change of a previously approved collection	2008-01-31	Approved without change
200405-0917-001	Revision of a currently approved collection	2004-05-14	Approved without change
200111-0917-002	Reinstatement with change of a previously approved collection	2001-11-30	Approved without change
199805-0917-001	No material or nonsubstantive change to a currently approved collection	1998-05-19	Approved without change
199802-0917-002	Extension without change of a currently approved collection	1998-02-23	Approved without change
199410-0917-001	Reinstatement without change of a previously approved collection	1994-10-27	Approved without change
199104-0917-002	Revision of a currently approved collection	1991-04-05	Approved without change
198906-0917-001	No material or nonsubstantive change to a currently approved collection	1989-06-15	Approved with change
198904-0917-002	No material or nonsubstantive change to a currently approved collection	1989-04-10	Approved with change
198806-0917-004	Reinstatement with change of a previously approved collection	1988-06-10	Approved without change

OMB Details

Verification of Acceptance or Decline of Award

Federal Enterprise Architecture: Education - Higher Education

Information collection instruments
Form	Name	Electronic access	Type
Form IHS-856-7	Verification of Acceptance or Decline of Award	Fillable Fileable	Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.