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NYCALC Student Medical Information (Form 3-2525)
Native Youth Climate Adaptation and Leadership Congress
OMB: 1018-0176
IC ID: 242613
OMB.report
DOI/FWS
OMB 1018-0176
ICR 202306-1018-001
IC 242613
( )
Documents and Forms
Document Name
Document Type
Form 3-2525
NYCALC Student Medical Information (Form 3-2525)
Form
3-2525 Native Youth Climate Adaptation and Leadership Congress
Form 3-2525 NYCALC Student Medical Information Form Ver 06-2020.docx
www.nycalc.org
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
NYCALC Student Medical Information (Form 3-2525)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
3-2525
Native Youth Climate Adaptation and Leadership Congress - Student Medical Information
Form 3-2525 NYCALC Student Medical Information Form Ver 06-2020.docx
https://www.nycalc.org
Yes
Yes
Fillable Fileable Signable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Natural Resources
Subfunction:
Conservation, Marine and Land Management
Privacy Act System of Records
Title:
DOI-16, DOI Learn (Department-wide Learning Management System)
FR Citation:
83 FR 50682
Number of Respondents:
100
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
100
0
0
0
0
100
Annual IC Time Burden (Hours)
50
0
0
0
0
50
Annual IC Cost Burden (Dollars)
0
0
0
0
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.