HPP Mentor Demographics Survey

OMB Control Number 0648-0568, expires XX/XX/20XX

HPP Mentor Demographics Survey
As part of NOAA Education efforts to enhance the Hollings Prep Program (HPP), an evaluation
of the three-year HPP pilot is being undertaken. You are being asked to complete a short
survey. Your responses are appreciated, and will be used in the evaluation of HPP meeting its
diversity goals. Thank you for your participation.
1. First and last name

🔽

2. Line office

National Environmental Satellite, Data, and Information Service (NESDIS)
National Marine Fisheries Service (NMFS)
National Ocean Service (NOS)
National Weather Service (NWS)
Office of Marine & Aviation Operations (OMAO)
Office of Oceanic & Atmospheric Research (OAR)

3. What year(s) did you serve as an HPP mentor? Select all that apply.
2019
2020
2021
4. Which categories best describe you? Select all that apply.
❏ Black or African American
❏ White
❏ Asian
❏ American Indian or Alaska Native
❏ Native Hawaiian or Pacific Islander
❏ Other
❏ Decline to answer
5. Are you Hispanic or Latino?
❏ Yes
❏ No
❏ Decline to answer
6. Gender:
Female
Male

Other
Decline to answer

Public Burden Statement
A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be
subject to a penalty for failure to comply with an information collection subject to the requirements of the Paperwork
Reduction Act of 1995 unless the information collection has a currently valid OMB Control Number. The approved
OMB Control Number for this information collection is 0648-0568. Without this approval, we could not conduct this
survey. Public reporting for this information collection is estimated to be approximately 5 minutes per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the information collection. All responses to this information collection are
voluntary. Send comments regarding this burden estimate or any other aspect of this information collection, including
suggestions for reducing this burden to the NOAA Office of Education, Natasha White, Natasha.White@noaa.gov.
Privacy Act Statement
Authority: The collection of this information is authorized under 5 U.S.C. 301, Departmental Regulations and 15
U.S.C. 1512, Powers and duties of Department.
Purpose: NOAA’s Office of Education proposes to collect contact information and associated background information
of undergraduate and graduate students, as well as recent graduates, for the purpose of tracking scholarship
recipients’ academic progress, making annual financial awards, and tracking graduate studies and career progress.
Demographic information will be used to measure the success of stated Diversity, Equity, Inclusion, and Justice
(DEIJ) goals only. This information will not be used to determine program eligibility.
NOAA Routine Uses: NOAA will use this information to evaluate and assess student data and information for the
purpose of selecting successful candidates for scholarships, fellowships and internships, generating internal NOAA
reports, and articles to demonstrate the success of its program.
Disclosure of this information is permitted under the Privacy Act of 1974 (5 U.S.C. Section 552a) to be shared among
NOAA staff for work-related purposes. Disclosure of this information is also subject to all of the published routine
uses as identified in the Privacy Act System of Records Notice Commerce/NOAA-14, Office of Education,
Educational Partnership Program (EPP/MSI); Ernest F. Hollings Undergraduate Scholarship Program and National
Marine Fisheries Service Recruitment, Training, and Research Program.
Obligation to Respond: Furnishing this information is voluntary; however, failure to provide information may prevent
consideration of your application for the program.