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Pilot Testing Center for Cancer Training (CCT) Application Form for electronic Individual Development Plan (eIDP) (NCI)
Formative Research, Pretesting, and Customer Satisfaction of NCI's Communication and Education Resources (NCI)
OMB: 0925-0046
IC ID: 232709
OMB.report
HHS/NIH
OMB 0925-0046
ICR 201605-0925-007
IC 232709
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0046 can be found here:
2022-10-25 - Extension without change of a currently approved collection
2019-07-30 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 2
Pilot Testing Center for Cancer Training (CCT) Application Form for electronic Individual Development Plan (eIDP) (NCI)
Form and Instruction
1 Initial Trainees screenshots
Att1-Initial-Trainees'-Screenshots-081318.pdf
Form and Instruction
2 Exit Survey Part 1 Alumni
Att2a-Exit Survey Part 1 - Alumni-081318_Revised.pdf
Form and Instruction
3 Exit Survey Part 2 - Feedback
Att2b-Exit Survey Part 2 - Feedback-081318_Revised.pdf
Form and Instruction
4 Pilot Feedback Survey
Att4-Pilot-Feedback-Survey-081518.pdf
Form and Instruction
Att1a-Expanded Deliverables & Trainings Tab-081318.pdf
1a Expanded Deliverable & Training Tab
IC Document
Att1b-Expanded Career Goals & Career Trainings Tab-081318.pdf
1b Expanded Career Goals & Career Training Tab
IC Document
Att4a-Pilot Email Invitation 081518.pdf
Pilot Email Invitation
IC Document
miniSSA-eIDP_081518.docx
Mini SSA
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Pilot Testing Center for Cancer Training (CCT) Application Form for electronic Individual Development Plan (eIDP) (NCI)
Agency IC Tracking Number:
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 and Instruction
2
Exit Survey Part 1 Alumni
Att2a-Exit Survey Part 1 - Alumni-081318_Revised.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
1
Initial Trainees screenshots
Att1-Initial-Trainees'-Screenshots-081318.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
3
Exit Survey Part 2 - Feedback
Att2b-Exit Survey Part 2 - Feedback-081318_Revised.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
4
Pilot Feedback Survey
Att4-Pilot-Feedback-Survey-081518.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
Clinical Research; Student Records, HHS/PHS/NIH/OD/OIR/OE
FR Citation:
67 FR 60742
Number of Respondents:
500
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
2,000
0
2,000
0
0
0
Annual IC Time Burden (Hours)
726
0
726
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
1a Expanded Deliverable & Training Tab
Att1a-Expanded Deliverables & Trainings Tab-081318.pdf
08/17/2018
1b Expanded Career Goals & Career Training Tab
Att1b-Expanded Career Goals & Career Trainings Tab-081318.pdf
08/17/2018
Pilot Email Invitation
Att4a-Pilot Email Invitation 081518.pdf
08/17/2018
Mini SSA
miniSSA-eIDP_081518.docx
08/17/2018
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.