Division of Scientific Education and Professional Development (DSEPD) Pan-Fellowship Stakeholder Survey

Data Collection for CDC Fellowship Programs

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1163 can be found here:

Documents and Forms

Document Name Document Type
3_Attachment_B_FellowshipSurvey_WebVersion.pdf Other-WEB
2_Attachment_A_Fellowship_Survey_WordVersion.docx Other-WORD
4_Attachment_C_FellowshipSurvey_Announcement.docx Att C_Announcement IC Document
5_Attachment_D_FellowshipSurvey_EmailInvitation.docx Att D Email Invitation IC Document
6_Attachment_E_FellowshipSurvey_ReminderEmail1.docx Att E Reminder Email 1 IC Document
7_Attachment_F_FellowshipSurvey_ReminderEmail2.docx Att F Reminder Email 2 IC Document
8_Attachment_G_FellowshipSurvey_ReminderEmail3.docx Att G Reminder Email 3 IC Document
9_Attachment_H_FellowshipSurvey_SampleScript.docx Att H_Sample Script IC Document
10_AttachmentI_FellowshipSurvey_HSRdetermination.pdf Att I Determination IC Document
1_FellowshipSurvey_RequestGenIC.docx Request for Approval IC Document

Information Collection (IC) Details

IC Title:	Division of Scientific Education and Professional Development (DSEPD) Pan-Fellowship Stakeholder Survey	Agency IC Tracking Number:	17AGY

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
Other-WEB			3_Attachment_B_FellowshipSurvey_WebVersion.pdf		Yes	Yes	Fillable Fileable
Other-WORD			2_Attachment_A_Fellowship_Survey_WordVersion.docx		Yes	Yes	Paper Only

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 947	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	947	947
Annual IC Time Burden (Hours)	128	128
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Att C_Announcement	4_Attachment_C_FellowshipSurvey_Announcement.docx	04/27/2017
Att D Email Invitation	5_Attachment_D_FellowshipSurvey_EmailInvitation.docx	04/27/2017
Att E Reminder Email 1	6_Attachment_E_FellowshipSurvey_ReminderEmail1.docx	04/27/2017
Att F Reminder Email 2	7_Attachment_F_FellowshipSurvey_ReminderEmail2.docx	04/27/2017
Att G Reminder Email 3	8_Attachment_G_FellowshipSurvey_ReminderEmail3.docx	04/27/2017
Att H_Sample Script	9_Attachment_H_FellowshipSurvey_SampleScript.docx	04/27/2017
Att I Determination	10_AttachmentI_FellowshipSurvey_HSRdetermination.pdf	04/27/2017
Request for Approval	1_FellowshipSurvey_RequestGenIC.docx	04/28/2017

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