NIH Office of Intramural Training & Education Application (OD)

Forms and Documents

Document Name	Status
Form 1 Summer Internship Program Biomedical Research (SIP) Form and Instruction	Removed
Form 17 Survey - Optional Statistics (Majority of Programs; 25% Response Rate) Form and Instruction	New
Form 16 Evaluation - Recommendation Letters for Prospective Students Form and Instruction	New
Form 15 Graduate Partnerships Program Interview Experience Survey (60% Response Rate) Form and Instruction	New
Form 14 Graduate Partnerships Program Registration Form and Instruction	New
Form 13 Graduate Partnerships Program Application Form and Instruction	New
Form 12 NIH Academy Training Program Supplemental Application Form and Instruction	New
Form 10 Undergraduate Scholarship Program Evaluation of Scholar PayBack Period Form and Instruction	New
Form 9 Undergraduate Scholarship Program Scholar Contract Form and Instruction	New
Form 8 Undergraduate Scholarship Program Deferment Form (Completed by University Staff)) Form and Instruction	New
Form 8 Undergraduate Scholarship Program Deferment Form (Completed by UGSP Scholar) Form and Instruction	New
Form 7 Undergraduate Scholarship Program (UGSP) Renewal Application Form and Instruction	New
Form 6 Undergraduate Scholarship Program -Certificate of Exceptional Financial Need (Completed by University Staff)t) Form and Instruction	New
Form 6 Undergraduate Scholarship Program -Certificate of Exceptional Financial Need (Completed by Applicant) Form and Instruction	New
Form 5 Undergraduate Scholarship Program (UGSP) Application Form and Instruction	New
Form 4 NIH Visit Week - Application Form and Instruction	New
Form 3 High School Scientifc Training & Enrichment Program - Contact Information Form and Instruction	New
Form 2 Amgen Scholars at NIH Program - Supplemental Application Form and Instruction	New
Form 1 Summer Internship Program Application Form and Instruction	New
Form 2 VisitWeekNIH - Recommendation Form and Instruction	Removed
Form 1 VisitWeekNIH - Application Form and Instruction	Removed
Form 1 NIH-Amgen Supplemental Questions Form and Instruction	Removed
Form 12 GPP Interview Experience Form and Instruction	Removed
Form 11 Time to Complete Application Form Form and Instruction	Removed
Form 10 Survey Race-Ethnicity-Gender-Birth Year Form and Instruction	Removed
Form 16 Reference Recommendation Letters for All Programs Form and Instruction	Removed
Form 14 UGSP - Deferment Form (Completed by University Staff) Form and Instruction	Removed
Form 14 UGSP - Deferment Form (Completed by Applicant) Form and Instruction	Removed
Form 13 UGSP - Certificate of Eligibility (Completed by University Staff) Form and Instruction	Removed
Form 13 UGSP - Certificate of Eligibility (Completed by Applicant) Form and Instruction	Removed
Form 9 Alumni Database Form and Instruction	Removed
Form 8 Undergraduate Scholarship Program (UGSP) Form and Instruction	Removed
Form 7 National Graduate Student research Conference (NGSRC) Form and Instruction	Removed
Form 6a Graduate Partnerships Program (GPP) - Application (Select Institutional Partnerships and Individual) Form and Instruction	Removed
Form 6a Graduate Partnerships Program (GPP) - Application (Select Institutional Partnerships) Form and Instruction	Removed
Form 5 Technical Training Program (PBT) Form and Instruction	Removed
Form 4 Community College Summer Enrichment Program (CCSEP) Form and Instruction	Removed
Form 3 Post-baccalaureate Training Program (PBT) Form and Instruction	Removed
Form 2 Biomedical Engineering Summer Intership Program (BESIP) Form and Instruction	Removed
OITE 30 day FRN 2016-10994.pdf Supplementary Document	2016-05-11
Form19-PrivacyImpactAssessment.pdf Supplementary Document	2016-05-11
Form18-PrivacyActApplicability.pdf Supplementary Document	2016-05-11
OMB15-SupportingStatement-SemiFinal.pdf Supporting Statement A	2016-05-11

IC Document Collections

IC ID	Document Title	Status
43627	Summer Internship Program Biomedical Research (SIP) Form and Instruction	Removed
221480	Survey - Optional Statistics (Majority of Programs; 25% Response Rate) Form and Instruction	New
221479	Evaluation - Recommendation Letters for Prospective Students Form and Instruction	New
221478	Graduate Partnerships Program Interview Experience Survey (60% Response Rate) Form and Instruction	New
221477	Graduate Partnerships Program Registration Form and Instruction	New
221476	Graduate Partnerships Program Application Form and Instruction	New
221475	NIH Academy Training Program Supplemental Application Form and Instruction	New
221474	Postbaccalaureate/Technical Training Program Application	New
221473	Undergraduate Scholarship Program Evaluation of Scholar PayBack Period Form and Instruction	New
221472	Undergraduate Scholarship Program Scholar Contract Form and Instruction	New
221471	Undergraduate Scholarship Program Deferment Form (Completed by University Staff)) Form and Instruction	New
221470	Undergraduate Scholarship Program Deferment Form (Completed by UGSP Scholar) Form and Instruction	New
221469	Undergraduate Scholarship Program (UGSP) Renewal Application Form and Instruction	New
221467	Undergraduate Scholarship Program -Certificate of Exceptional Financial Need (Completed by University Staff)t) Form and Instruction	New
221465	Undergraduate Scholarship Program -Certificate of Exceptional Financial Need (Completed by Applicant) Form and Instruction	New
221464	Undergraduate Scholarship Program (UGSP) Application Form and Instruction	New
221463	NIH Visit Week - Application Form and Instruction	New
221462	High School Scientifc Training & Enrichment Program - Contact Information Form and Instruction	New
221456	Amgen Scholars at NIH Program - Supplemental Application Form and Instruction	New
221455	Summer Internship Program Application Form and Instruction	New
214751	VisitWeekNIH - Recommendation Form and Instruction	Removed
214750	VisitWeekNIH - Application Form and Instruction	Removed
213919	NIH-Amgen Supplemental Questions Form and Instruction	Removed
207796	GPP Interview Experience Form and Instruction	Removed
207795	Time to Complete Application Form Form and Instruction	Removed
207794	Survey Race-Ethnicity-Gender-Birth Year Form and Instruction	Removed
207793	Reference Recommendation Letters for All Programs Form and Instruction	Removed
207792	UGSP - Deferment Form (Completed by University Staff) Form and Instruction	Removed
207791	UGSP - Deferment Form (Completed by Applicant) Form and Instruction	Removed
207790	UGSP - Certificate of Eligibility (Completed by University Staff) Form and Instruction	Removed
207789	UGSP - Certificate of Eligibility (Completed by Applicant) Form and Instruction	Removed
207788	Alumni Database Form and Instruction	Removed
207787	Undergraduate Scholarship Program (UGSP) Form and Instruction	Removed
207786	National Graduate Student research Conference (NGSRC) Form and Instruction	Removed
207785	Graduate Partnerships Program (GPP) - Application (Select Institutional Partnerships and Individual) Form and Instruction	Removed
207784	Graduate Partnerships Program (GPP) - Application (Select Institutional Partnerships) Form and Instruction	Removed
207783	Technical Training Program (PBT) Form and Instruction	Removed
207782	Community College Summer Enrichment Program (CCSEP) Form and Instruction	Removed
207781	Post-baccalaureate Training Program (PBT) Form and Instruction	Removed
200079	Biomedical Engineering Summer Intership Program (BESIP) Form and Instruction	Removed

ICR Details

OMB Control No: 0925-0299	ICR Reference No: 201605-0925-001
Status: Historical Active	Previous ICR Reference No: 201501-0925-006
Agency/Subagency: HHS/NIH	Agency Tracking No: 19980
Title: NIH Office of Intramural Training & Education Application (OD)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/24/2016
	Date Received in OIRA: 05/12/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2019	36 Months From Approved	08/31/2016
Responses	36,691	0	39,910
Time Burden (Hours)	16,334	0	18,414
Cost Burden (Dollars)	0	0	0

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Abstract: The Office of Intramural Training & Education (OITE) administers a variety of programs and initiatives to recruit pre-college through post-doctoral educational level individuals into the National Institutes of Health Intramural Research Program (NIH-IRP) to facilitate develop into future biomedical scientists. To identify qualified prospective students, the OITE has developed an application that contains the following target areas of assessment: personal information, eligibility criteria, contact information, student identification number, training program selection, scientific discipline interests, educational history, standardized examination scores, reference information, resume components, employment history, employment interests, dissertation research details, letters of recommendation, financial aid history, sensitive data, future networking contact, travel information, as well as feedback questions about interviews and application submission experiences. NIH investigators directly involved in the evaluation of prospective trainees will use information contained in the application.

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Authorizing Statute(s): US Code: 42 USC Sect. 241 and 282(b)(13) Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 69685	11/10/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 28880	05/10/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 19

IC Title	Form No.	Form Name
Undergraduate Scholarship Program Deferment Form (Completed by University Staff))	8	UGSP Deferment Form
Undergraduate Scholarship Program Scholar Contract	9	UGSP Scholar Contract
Undergraduate Scholarship Program Evaluation of Scholar PayBack Period	10	UGSP Evaluation Scholar Payback Period
Postbaccalaureate/Technical Training Program Application	11
Graduate Partnerships Program Application	13	GPP Application
Graduate Partnerships Program Registration	14	GPP Registration
Graduate Partnerships Program Interview Experience Survey (60% Response Rate)	15	GPP Interview Experience Survey
Evaluation - Recommendation Letters for Prospective Students	16	Evaluation-Letter of Recommendations
Survey - Optional Statistics (Majority of Programs; 25% Response Rate)	17	Survey - Optional Statistics
Undergraduate Scholarship Program -Certificate of Exceptional Financial Need (Completed by Applicant)	6	UGSP Certification Exceptional Financial Need
Undergraduate Scholarship Program -Certificate of Exceptional Financial Need (Completed by University Staff)t)	6	UGSP Certification Exceptional Financial Need
Undergraduate Scholarship Program (UGSP) Renewal Application	7	UGSP Renewal Application
Undergraduate Scholarship Program Deferment Form (Completed by UGSP Scholar)	8	UGSP Deferment Form
Summer Internship Program Biomedical Research (SIP)	1	SIP
Biomedical Engineering Summer Intership Program (BESIP)	2	BESIP
Post-baccalaureate Training Program (PBT)	3	PBTP
Community College Summer Enrichment Program (CCSEP)	4	CCSEP
Technical Training Program (PBT)	5	TTP
Graduate Partnerships Program (GPP) - Application (Select Institutional Partnerships)	6b, 6a, 6c	GPPa ,   GPPb ,   GPPc
Graduate Partnerships Program (GPP) - Application (Select Institutional Partnerships and Individual)	6a, 6b, 6c	GPPa ,   GPPb ,   GPPc
National Graduate Student research Conference (NGSRC)	7	NGSRC
Undergraduate Scholarship Program (UGSP)	8	UGSP
Alumni Database	9	Alumni Database
UGSP - Certificate of Eligibility (Completed by Applicant)	13	Certification Form
UGSP - Certificate of Eligibility (Completed by University Staff)	13	Certificate Form
UGSP - Deferment Form (Completed by Applicant)	14	Deferment Form
UGSP - Deferment Form (Completed by University Staff)	14	Deferment Form
Reference Recommendation Letters for All Programs	16	Recommendation Letters
Survey Race-Ethnicity-Gender-Birth Year	10	Optional Information
Time to Complete Application Form	11	Time to Complete
High School Scientifc Training & Enrichment Program - Contact Information	3	HiSTEP-High School Scientific Training Enrichment Program - Contact Information
NIH Academy Training Program Supplemental Application	12	PBT Academy Training Program
GPP Interview Experience	12	GPP Interview Experience
NIH-Amgen Supplemental Questions	1	NIH Amgen Supplemental Questions
VisitWeekNIH - Application	1	VisitWeekNIH - Application
VisitWeekNIH - Recommendation	2	VisitWeekNIH - Recommendation
Summer Internship Program Application	1	SIP Summer Internship Program
Amgen Scholars at NIH Program - Supplemental Application	2	SIP- Amgen Scholars at NIH - Supplement Application
NIH Visit Week - Application	4	NAVW-NIH Visit Week Application
Undergraduate Scholarship Program (UGSP) Application	5	UGSP Application

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	36,691	39,910	0	-3,219	0	0
Annual Time Burden (Hours)	16,334	18,414	0	-2,080	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Revision

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Annual Cost to Federal Government: $419,964

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 05/12/2016

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