Information Collection

Faculty Interview and Email Request

IC 191869 under ICR 201001-0990-002 · OMB 0990-0357.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0990- (Dyad) FacultyEmailInvitationsAppendixC 1 A.doc	Other-Email Invitations
0990- (Dyad) FACULTY TELEPHONE RECRUITMENT SCRIPTAppendixC 2 A.doc	Other-Telephone recruitment
0990-(Dyad) FacultyInterviewProtocols 6AppendixB 3 A.doc	Other-Interview Protocols
0990- (Dyad)SampleConfirmationMessageAPPENDIX C 4.doc 0990- (Dyad)SampleConfirmationMessageAPPENDIX C 4	IC Document
0990- (Dyad) FacultyFrequentlyAskedQuestionAppendixC 5 A.doc Faculty Frequent questions	IC Document
0990- (Dyad) FacultyConsentFormsAPPENDIX C 6 A.doc Faculty-Consent Forms	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Email Invitations	0990- (Dyad) FacultyEmailInvitationsAppendixC 1 A.doc	Yes	Yes	Paper Only
Other-Telephone recruitment	0990- (Dyad) FACULTY TELEPHONE RECRUITMENT SCRIPTAppendixC 2 A.doc	No	No	Paper Only
Other-Interview Protocols	0990-(Dyad) FacultyInterviewProtocols 6AppendixB 3 A.doc	No	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
0990- (Dyad)SampleConfirmationMessageAPPENDIX C 4	0990- (Dyad)SampleConfirmationMessageAPPENDIX C 4.doc	12/22/2009
Faculty Frequent questions	0990- (Dyad) FacultyFrequentlyAskedQuestionAppendixC 5 A.doc	12/22/2009
Faculty-Consent Forms	0990- (Dyad) FacultyConsentFormsAPPENDIX C 6 A.doc	12/23/2009

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.