Information Collection

DCCPS Fellows Symposium Submission (NCI)

IC 236105 under ICR 201602-0925-001 · OMB 0925-0740.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0740 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 DCCPS Fellows Symposium Submission (NCI)	Form and Instruction
1 Registration and Abstract Submission Form screenshot Screen Shots Registration and Abstract Submission Form (1).docx	Form and Instruction
2 Mentor of the Year award form screenshot Screen Shots for Mentor of the Year award form.docx	Form and Instruction
DCCPS Fellows Symposium.docx DCCPS Fellows Symposium	IC Document
Email Invites.pdf email invite	IC Document

IC Title:

DCCPS Fellows Symposium Submission (NCI)

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Registration and Abstract Submission Form screenshot	Screen Shots Registration and Abstract Submission Form (1).docx		Yes	Yes	Fillable Fileable
Form and Instruction	2	Mentor of the Year award form screenshot	Screen Shots for Mentor of the Year award form.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	50	50
Annual IC Time Burden (Hours)	26	26
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
DCCPS Fellows Symposium	DCCPS Fellows Symposium.docx	05/15/2019
email invite	Email Invites.pdf	05/15/2019

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