Application for Participation in the IHS Scholarship Program

ICR 202003-0917-001

OMB: 0917-0006

Federal Form Document

ICR Details
0917-0006 202003-0917-001
Active 201609-0917-001
HHS/IHS 19731
Application for Participation in the IHS Scholarship Program
Revision of a currently approved collection   No
Regular
Approved with change 10/01/2020
Retrieve Notice of Action (NOA) 03/30/2020
  Inventory as of this Action Requested Previously Approved
10/31/2023 36 Months From Approved 09/30/2020
3,275 0 12,580
1,286 0 4,340
0 0 0

The IHS Scholarship Program offers qualified American Indian and Alaska Native health profession students a unique opportunity to establish an educational foundation as they prepare to pursue a career in Indian health. Each scholarship (Preparatory, Pre-Graduate and health professions) is defined by applicant and degree program eligibility and provides generous financial aid packages (information available at www.ihs.gov/scholarship). The ultimate goal of the program is to develop health care providers and the next leaders of Indian health communities. Since IHS began providing scholarship support to American Indian and Alaska Native students to pursue health profession careers in 1978, the program has grown to support, educate and place health care professionals within medically underserved Indian health programs throughout the continental United States and Alaska. Today, nearly 7,000 American Indian and Alaska Native students have received scholarship awards and many have committed to serving their health profession careers at IHS; some have even returned to serve their own Tribal communities.

PL: Pub.L. 94 - 437 522 Name of Law: Indian Health Care Improvement
  
None

Not associated with rulemaking

  84 FR 68938 12/17/2019
85 FR 16636 03/24/2020
No

17
IC Title Form No. Form Name
Notification of Academic Problem IHS-856-9 Notification of Academic Problem
Annual Status Report IHS-856-16 Annual Status Report
Summer School Request IHS-856-21 Summer School Request
Lost Stipend Payment IHS-856-19 Lost Stipend Payment
Change of Name or Address IHS-856-22 Change of Name or Address
Request for Credit Validation IHS-856-23 Request for Credit Validation
Delinquent Federal Debt IHS-856-5 Delinquent Federal Debt
Extern Site Preference Request IHS-856-17 Extern Site Preference Request
Request for Extern Travel Reimbursement IHS-856-18 Request for Extern Travel Reimbursement
Faculty/Advisor Evaluation IHS-856-24 Faculty-Advisor Evaluation
Faculty/Employer Evaluation IHS-856-3 Faculty/Employer Evaluation
Placement Update IHS-856-15 Placement Update
Notification of Deferment Program IHS-856-14 Notification of Deferment Program
Notice of Impending Graduation IHS-856-13 Notice of Impending Graduation
Preferred Placement IHS-856-12 Preferred Placement
Request for Approval of Deferment HS-856-11 Request for Approval of Deferment
Change of Status IHS-856-10 Change of Status
Recipient's Initial Program Progress Report ihs-856-8 Recipient's Initial Program Progress Report
Health Professions Contract IHS 818 Contract
Scholarship Program Agreement IHS-817 Scholarship Program Agreement
Verification of Acceptance or Decline of Award IHS-856-7 Verification of Acceptance or Decline of Award
Course Curriculum Verification IHS-856-6 Course Curriculum Verification
IHS Scholarship Program Application

  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 3,275 12,580 0 145 -9,450 0
Annual Time Burden (Hours) 1,286 4,340 0 751 -3,805 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Changing Forms
The online application process decreased the number of scholars completing hard copy forms IHS-856-3, IHS-856-5, and IHS-856-6. While IHS has incorporated these forms in the online application process (i.e., forms IHS- 856-3, IHS-856-5 and IHS-856-6) the applicants still need to provide this information as part of the online, electronic application.

$145,223
No
    Yes
    Yes
No
No
No
No
Evonne Bennett-Barnes 301 443-4750 evonne.bennett-barnes@ihs.gov

  No

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.
03/30/2020


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