Date of this Submission (MM/DD/YYYY): 10/04/05
NASA Center: Johnson Space Center
Application Name: Education and Training Cooperative
Is this application or information collection new or is an existing one being modified?
New
Does this application collect, maintain, and/or disseminate information in identifiable form (IIF)?
Contact information for potential respondent population is in identifiable form (IIF).
The Education and Training Cooperative application collects, maintains, and disseminates information in identifiable format.
Mission Program/Project Supported: AE Education Office
Identifying Numbers (Use N/A, where appropriate)
Privacy Act System of Records Number: 10-SPER
OMB Information Collection Approval Number and Expiration Date:
Other Identifying Number(s):
Description
1. Provide an overview of the application and indicate the legislation authorizing this activity.
The system is used by USRA to work cooperatively with the NASA Johnson Space Center (JSC) in managing the cooperative agreement for a work/study opportunity for disadvantaged students or students in need of encouragement and positive, nurturing role models. The system collects information on applicants necessary for screening and employment purposes.
2. Describe the information the agency will collect, maintain, or disseminate and how the agency will use the information. In this description, indicate whether the information contains IIF and whether submission is voluntary or mandatory.
The system collects and uses the following information:Students Names (IIF-Mandatory) – used to identify the students throughout the program.
Date of Birth (IFF-Mandatory – used to verify that students are eligible to participate in the program
Social Security Number - (IIF-Mandatory) – used for employment purposes
Mailing Address - (IIF-Mandatory) – used for employment purposes and send program related material to participants.
Phone Numbers - (IIF-Mandatory) – used for employment purposes and emergency contact when students are working on-site.
Medical Notes – (IIF – Optional) – used to ensure the well-being of the students while they are working on-site.
Email Address – (IIF – Optional) – used to contact students during the pre-employment process and maintain contact with alumni.
Education Records - (IIF-Mandatory) – used to ensure that students are academically eligible to participate in the program.
Financial Account Information – (IIF- Optional) – used for employment payroll purposes.
3. Explain how the IIF collected, maintained, and/or disseminated is the minimum necessary to accomplish the purpose for this effort.
All the collected information stated above is necessary for the successful administration of the program.
4. Explain why the IIF is being collected, maintained, or disseminated.
Explained in question number 2.
5. Identify with whom the agency will share the IIF.
USRA shares IIF with USRA Headquarters office in Columbia, Maryland strictly for employment purposes. USRA does not share IIF with anyone outside of this organization.
6. Describe how the IIF will be obtained, from whom it will be collected, what the suppliers of information and the subjects will be told about the information collection, and how this message will be conveyed to them (e.g., written notice, electronic notice if a Web-based collection, etc.). Describe any opportunities for consent provided to individuals regarding what information is collected and how the information will be shared.
The IIF is obtained through online and paper forms from college and/or university students who wish to participate in the Work-Study program. Applicants are given a written copy of the USRA Privacy Policy and told how their IIF will be used during the employment process.
7. State wheather personal information will be collected from children under age 13 on the Internet and, if so, how parental or guardian approval will be obtained. (Reference: Children's Online Privacy Protection Act of 1998).
No information is collected from children under the age of 13.
8. Describe how the IIF will be secured.
All access to IIF is SSL secure and has a password protected connection.
9. Describe plans for retention and destruction of IIF.
All electronic IIF is stored in a secure manner. Once the data has been deemed unnecessary to maintain, it will be destroyed.
10. Identify whether a system of records is being created under section 552a of the Title 5, United States Code (the Privacy Act), or identify the existing Privacy Act system of records notice under which the records will be maintained.
The system is covered under 10-SPER.
Identify a point of contact to whom a member of the public can address questions concerning this information system and the privacy concerns associated with it: Barbara Hammond|
Signature on File Janelle Holt NASA Cognizant Official/Title Date 1/15/06 Concur: Signature on File Herbert J. Babineaux, Jr. JSC Privacy Act Manager Date ________________ Concur: Signature on File Patti F. Stockman NASA Privacy Act Officer Date 3/29/2006 |
Concur: Signature on File Jean E. Carter JSC Chief Information Officer Date 1/16/2006 Approved for Publication: Signature on File Patricia L. Dunnington Chief Information Officer Date 3/30/2006 |