Job Corps Health Questionnaire

OMB 1205-0033

Information on the health status of an applicant to Job Corps is obtained when the applicant completes ETA 653 during an interview with the admissions counselor as part of the admissions process.

The latest form for Job Corps Health Questionnaire expires 2023-06-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form ETA 653 Job Corps Health Questionnaire Form and Instruction
Job Corps Appendix 601 - Student Rights to Privacy and Disclosure of Information.pdf Supplementary Document
1205-0033 Supporting Statement - clean 51223.docx Supporting Statement A
Job Corps Health Questionnaire Form and Instruction

All Historical Document Collections

202305-1205-001 Approved with change	Revision of a currently approved collection	2023-05-19
202003-1205-002 Approved with change	Revision of a currently approved collection	2020-05-04
201703-1205-001 Approved with change	Revision of a currently approved collection	2017-03-21
201306-1205-001 Approved without change	Revision of a currently approved collection	2014-01-28
201010-1205-010 Approved without change	Extension without change of a currently approved collection	2010-11-26
200706-1205-011 Approved with change	Revision of a currently approved collection	2007-06-28
200405-1205-001 Approved without change	Revision of a currently approved collection	2004-05-14
200010-1205-001 Approved without change	Reinstatement with change of a previously approved collection	2000-10-25
200008-1205-003 Withdrawn	Reinstatement with change of a previously approved collection	2000-08-17
199705-1205-005 Approved without change	No material or nonsubstantive change to a currently approved collection	1997-05-03
199611-1205-008 Approved without change	Reinstatement with change of a previously approved collection	1996-11-22
199306-1205-003 Approved without change	Extension without change of a currently approved collection	1993-06-18
199003-1205-002 Approved without change	Revision of a currently approved collection	1990-03-26
198910-1205-009 Approved without change	Revision of a currently approved collection	1989-10-30
198807-1205-007 Approved without change	Revision of a currently approved collection	1988-07-15
198705-1205-004 Approved without change	Revision of a currently approved collection	1987-05-07
198610-1205-005 Withdrawn and continue	Revision of a currently approved collection	1986-10-22
198605-1205-002 Approved without change	Extension without change of a currently approved collection	1986-05-27
198410-1205-001 Approved without change	Extension without change of a currently approved collection	1984-10-30
198209-1205-011 Approved without change	Reinstatement with change of a previously approved collection	1982-09-01
197709-1205-002 Approved without change	Revision of a currently approved collection	1977-09-22
197709-1205-001 Approved without change	Revision of a currently approved collection	1977-09-21
197703-1205-005 Approved without change	Extension without change of a currently approved collection	1977-03-02