Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
NHHSP Acceptance/Verification of Good Standing Report Unchanged 40 10 0 Form and Instruction 4C
NHHSP Authorization to Release Information Unchanged 200 50 0 Form and Instruction 4B
NHHSP Change in Program Curriculum Form Unchanged 40 10 0 Form and Instruction 4E
NHHSP Graduation Documentation Form Unchanged 40 10 0 Form and Instruction 4F
NHHSP Letters of Reccomendation Unchanged 400 100 0 Form and Instruction 4G
NHHSP Scholar Enrollment Verification Form Unchanged 160 80 0 Form and Instruction 4D
NHSC S2S LRP - Essay Unchanged 348 348 0 Form and Instruction 2C
NHSC S2S LRP - Proof of Citizenship Unchanged 348 35 0 Form and Instruction 1B
NHSC SP - Essay Unchanged 3100 3100 0 Form and Instruction 1D
NHSC SP - Proof of Citizenship Unchanged 3100 620 0 Form and Instruction 1C
NHSC SP Authorization to Release Information Unchanged 3100 310 0 Form and Instruction 1E
NHSC SP Awardees Schools – Post Graduate Training Verification Form Unchanged 383 192 0 Form and Instruction 2B
NHSC SP Awardees Schools – Data Collection Worksheet Unchanged 550 550 0 Form and Instruction 2A
NHSC SP Awardees Schools – In-School Verification Form Unchanged 5100 510 0 Form and Instruction 2C
NHSC SP Letters of Recommendation Unchanged 6200 6200 0 Form and Instruction 1B
NHSC SP – Acceptance/Verification of Good Standing Report Unchanged 3100 775 0 Form and Instruction 1F
NHSC SP – Verification of Vulnerable Background Unchanged 615 154 0 Form and Instruction 1G
NHSC Scholarship Program Application Modified 3100 6200 0 Form and Instruction 1A
NHSC Students to Service Repayment Program Application Modified 348 696 0 Form and Instruction 3-1
Native Hawaiian Health Scholarship Program Application Unchanged 200 400 0 Form and Instruction 4A
S2S LRP – Authorization to Release Information Unchanged 348 35 0 Form and Instruction 3E
S2S LRP - Letters of Recommendation Unchanged 348 696 0 Form and Instruction 3D-Instructions
Form and Instruction 3D-Preceptor
S2S LRP - Verification of Vulnerable Background Unchanged 115 29 0 Form and Instruction 3G
S2S LRP – Acceptance/Verification of Good Standing Report Unchanged 348 87 0 Form and Instruction 3D
Total burden requested under this ICR: 31631 21197 0  
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