View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Work Experience Program Participant Questionnaire	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Web Survey			0704-STEM_Survey_Full Instrument_7.7.2023.docx		Yes	Yes	Fillable Fileable
Other-Intro and Agency Disclosure Notice			0704-STEM_Intro and ADN Preview.pdf		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

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

Documents for IC

Title	Document	Date Uploaded
Survey in Qualtrics	0704-STEM_Survey_Look and Feel in Qualtrics_4.26.2022.docx	06/03/2022

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.