Att 3_ECEO New Participant Registration Form 36.5

Application for Training

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0017 can be found here:

Documents and Forms

Document Name Document Type
Attachment4_TCEO New Participant Registration_OMB_0920-0017_02-05-2013.pdf Other-pdf

Information Collection (IC) Details

IC Title:	Att 3_ECEO New Participant Registration Form 36.5	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
Other-pdf			Attachment4_TCEO New Participant Registration_OMB_0920-0017_02-05-2013.pdf		Yes	Yes	Fillable Printable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title: 09-20-01610-Records of Health Professionals in Disease Prevention and Control Training Programs	FR Citation: 51 FR 42485

Number of Respondents: 200,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	200,000	125,000	75,000
Annual IC Time Burden (Hours)	16,667	10,417	6,250
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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