4 Alabama Outreach Required Form

OMB # 0925-0701
Expiration Date: 07/31/2017

Safe Sleep Outreach Required Forms Checklist for
Closing Meeting
Please bring all of these items to the closing meeting on August 4, 2017. Use this
checklist to make sure you have all of the required items.
Public reporting burden for this collection of information is estimated to average 1 minute per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining
the data needed, and completing and reviewing the collection of information. An agency may not conduct
or sponsor, and a person is not required to respond to, a collection of information unless it displays a
currently valid OMB control number. Send comments regarding this burden estimate or any other aspect
of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance
Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0701). Do not
return the completed form to this address.

______ Completed Sign-In Sheets
______ Completed Safe Sleep Outreach Project Assessment Forms from event attendees
______ Completed Safe Sleep Outreach Project Activity Tracking Form
______ Signed Photo/Video Release Forms

All Sign-In Sheets, Activity Tracking Forms, and Project Assessment Forms
must be turned in at the Closing Meeting on August 4, 2017.