Academic Partnerships to Improve Health (APIH) Program Training/Workshop Feedback Survey (January – June, 2019)

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1050 can be found here:

Documents and Forms

Document Name Document Type
Academic Partnerships to Improve Health (APIH) Program Training/Workshop Feedback Survey (January – June, 2019) Form
APIH Training Feedback Survey Attachment I APIH Training Feedback Survey.docx Form
APIH Training_Jan-June 2019_12-21.docx GENIC Template with Project Description IC Document
ATTA~J0Y.DOC Email Invitation for AACN Virtual Training Participants IC Document
ATTA~T52.DOC Email Invitation for ASPPH Virtual Training Participants IC Document

Information Collection (IC) Details

IC Title:	Academic Partnerships to Improve Health (APIH) Program Training/Workshop Feedback Survey (January – June, 2019)	Agency IC Tracking Number:	0920-19KB

IC Status: New

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	n/a	APIH Training Feedback Survey	Attachment I APIH Training Feedback Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 180	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 25 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	180	180
Annual IC Time Burden (Hours)	15	15
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
GENIC Template with Project Description	APIH Training_Jan-June 2019_12-21.docx	12/21/2018
Email Invitation for AACN Virtual Training Participants	ATTA~J0Y.DOC	12/21/2018
Email Invitation for ASPPH Virtual Training Participants	ATTA~T52.DOC	12/21/2018

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