Online Application (OA)

United States Coast Guard Academy Introduction Mission Program Application and Supplemental Forms

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1625-0121 can be found here:

Documents and Forms

Document Name Document Type
1625-0121 Instr_r0_2017.doc Instruction
1625-0121_AIM Application_Registration.pdf Other-Online AIM Application
USCGA-AIM3 AIM Medical History and Clearance From AIM Medical History and Clearance rev 1_29_15.pdf Form
USCGA-AIM2 AIM Scholarship Request Form AIM Scholarship Request.pdf Form
USCGA-AIM1 AIM Travel Update Form AIM Travel Update Form.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Online Application (OA)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			1625-0121 Instr_r0_2017.doc	Yes	Yes	Printable Only
Other-Online AIM Application			1625-0121_AIM Application_Registration.pdf	Yes	Yes	Fillable Fileable
Form	USCGA-AIM3	AIM Medical History and Clearance From	AIM Medical History and Clearance rev 1_29_15.pdf	Yes	Yes	Fillable Fileable Signable
Form	USCGA-AIM2	AIM Scholarship Request Form	AIM Scholarship Request.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	USCGA-AIM1	AIM Travel Update Form	AIM Travel Update Form.pdf	Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Water Transportation

Privacy Act System of Records
Title: Privacy Act of 1974; Department of Homeland Security United States Coast Guard DHS/USCG -- 027 Recruiting FIles	FR Citation: 76 FR 49494

Number of Respondents: 2,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	6,000	6,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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