Information Collection

Pilot Testing Center for Cancer Training (CCT) Application Form for electronic Individual Development Plan (eIDP) (NCI)

IC 232709 under ICR 201605-0925-007 · OMB 0925-0046.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0046 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Initial Trainees screenshots Pilot Testing Center for Cancer Training (CCT) Application Form for electronic Individual Development Plan (eIDP) (NCI)	Form and Instruction
Form 2 Exit Survey Part 1 Alumni Pilot Testing Center for Cancer Training (CCT) Application Form for electronic Individual Development Plan (eIDP) (NCI)	Form and Instruction
Form 3 Exit Survey Part 2 - Feedback Pilot Testing Center for Cancer Training (CCT) Application Form for electronic Individual Development Plan (eIDP) (NCI)	Form and Instruction
Form 4 Pilot Feedback Survey 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

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:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Yes	Yes	Fillable Fileable
Form and Instruction	2	Yes	Yes	Fillable Fileable
Form and Instruction	3	Yes	Yes	Fillable Fileable
Form and Instruction	4	Yes	Yes	Fillable Fileable

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 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	726	726
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
1a Expanded Deliverable & Training Tab		08/17/2018
1b Expanded Career Goals & Career Training Tab		08/17/2018
Pilot Email Invitation		08/17/2018
Mini SSA		08/17/2018

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

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