Online Survey for Point of Contact of Host Institutions

Process Evaluation of the NIH Director's Early Independence Award Program (EIA)

Documents and Forms

Document Name Document Type
Form Attachment 8 Online Survey for Point of Contact of Host Institutions Form
Attachment 8 Screenshots of the Online POC EIA Host Survey Screenshots Online Survey Point of Contact Host Institution.pdf Form
Attachment B.2.2 - Protocols Online Survey POC Host Institution.doc On-line Survey Protocols IC Document
Attachment 8 Proposed Final Online Survey Point of Contact Host Institution.doc Attachment 8: Word vesion of the POC EIA Host Survey IC Document

Information Collection (IC) Details

IC Title:	Online Survey for Point of Contact of Host Institutions	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	Attachment 8	Screenshots of the Online POC EIA Host Survey	Screenshots Online Survey Point of Contact Host Institution.pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	40	16	24
Annual IC Time Burden (Hours)	13	-11	24
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
On-line Survey Protocols	Attachment B.2.2 - Protocols Online Survey POC Host Institution.doc	09/26/2012
Attachment 8: Word vesion of the POC EIA Host Survey	Attachment 8 Proposed Final Online Survey Point of Contact Host Institution.doc	08/16/2013

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