Information Collection

Student Vaccination Certification and Testing Consent

IC 249488 under ICR 202207-1205-003 · OMB 1205-0548.

Documents and Forms

Document Name Document Type
Form ETA 9197 Student Vaccination Certification and Testing Consent Form
ETA 9197 Job Corps COVID-19 Symptom Tracker and Attestation Form 9197 071222 clean.docx Form
ETA 9197 Job Corps COVID-19 Symptom Tracker and Attestation Form 9197 071222 clean.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Student Vaccination Certification and Testing Consent	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	ETA 9197	Job Corps COVID-19 Symptom Tracker and Attestation	Form 9197 071222 clean.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title: DOL/GOVT-2 Job Corps Student Records	FR Citation: 81 FR 25765

Number of Respondents: 20,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

	Requested	Previously Approved
Annual Number of Responses for this IC	80,000	80,000
Annual IC Time Burden (Hours)	26,400	26,400
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.