Information Collection

BIRCWH Principal Investigator, Mentor, and Scholar Satisfaction Surveys

IC 217155 under ICR 201410-0925-002 · OMB 0925-0643.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0643 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 BIRCWH Principal Investigator, Mentor, and Scholar Satisfaction Surveys	Form and Instruction
1 Scholars Survey Attachment_A.1_NICHD_BIRCWH_Scholars_Survey_0925-0643.pdf	Form and Instruction
2 Mentors Survey Attachment_A.2_NICHD_BIRCWH_Mentors_Survey_0925-0643.pdf	Form and Instruction
3 PI Survey Attachment A.3__NICHD_BIRCWH_PI_Survey_0925-0643.pdf	Form and Instruction
Fast-track template_NICHD_BIRCWH_0925-0643_revised.docx Fast-Track Template	IC Document
Attachment_A.4_NICHD_BIRCWH_Email_Invite & Reminders_0925-0643.docx Survey Invitations	IC Document

IC Title:

BIRCWH Principal Investigator, Mentor, and Scholar Satisfaction Surveys

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Scholars Survey	Attachment_A.1_NICHD_BIRCWH_Scholars_Survey_0925-0643.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	2	Mentors Survey	Attachment_A.2_NICHD_BIRCWH_Mentors_Survey_0925-0643.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	3	PI Survey	Attachment A.3__NICHD_BIRCWH_PI_Survey_0925-0643.pdf	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,970

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,970	2,970
Annual IC Time Burden (Hours)	990	990
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast-Track Template	Fast-track template_NICHD_BIRCWH_0925-0643_revised.docx	06/22/2015
Survey Invitations	Attachment_A.4_NICHD_BIRCWH_Email_Invite & Reminders_0925-0643.docx	06/22/2015

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