THIS FORM IS USED BY STATE GRANT YCC
CAMP DIRECTORS TO REPORT THE NUMBER OF ENROLLEES BY SEX, AGE, TYPE
OF CAMP, GRADE NO SCHOOL, FAMILY INCOME, POPULATION OF HOME TOWN,
AND RACE OR ETHNIC BACKGROUND. IT ALSO RECORDS THE NUMBER OF
ENROLLEES SEPARATED THE REASON FOR SEPARATION. INFORMATION IS USED
TO GAUGE THE EFFECTIVENESS OF YCC IN REACHING ALL GROUPS.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.