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⚠️ Notice: This information collection may be referencing outdated material.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

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	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

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 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

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.