Information Collection

National Environmental Public Health Internship Program (NEPHIP) Outcome Assessment

IC 236778 under ICR 201608-0920-018 · OMB 0920-1163.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1163 Assessment Instrument Web version National Environmental Public Health Internship Program (NEPHIP) Outcome Assessment	Form and Instruction
0920-1163 Assessment Instrument Web version 2_Attachment_A_NEPHIPAssessmentInstrument_WebVersion_revised.pdf	Form and Instruction
1_GenIC_NEPHIPAssessment.docx GenIC Assessment Template	IC Document
3_Attachment_B_NEPHIPAssessmentInstrument_WordVersion.docx Assessment Instrument Word version	IC Document
4_Attachment_C_NEPHIPAssessment_Announcement.docx Announcement	IC Document
5_Attachment_D_NEPHIPAssessment_EmailInvitation.docx Email Invitation	IC Document
6_Attachment_E_NEPHIPAssessment_ReminderEmail1.docx Reminder Email 1	IC Document
7_Attachment_F_NEPHIPAssessment_ReminderEmail2.docx Reminder Email 2	IC Document
8_Attachment_G_NEPHIPAssessment_ReminderEmail3.docx Reminder Email 3	IC Document
9_Attachment_H_NEPHIPAssessment_HSRdetermination_revised.pdf HSR Determination	IC Document

IC Title:

National Environmental Public Health Internship Program (NEPHIP) Outcome Assessment

Agency IC Tracking Number:

0920-1163-19BKN

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-1163	Assessment Instrument Web version	2_Attachment_A_NEPHIPAssessmentInstrument_WebVersion_revised.pdf		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 128

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	128	128
Annual IC Time Burden (Hours)	21	21
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
GenIC Assessment Template	1_GenIC_NEPHIPAssessment.docx	07/01/2019
Assessment Instrument Word version	3_Attachment_B_NEPHIPAssessmentInstrument_WordVersion.docx	07/01/2019
Announcement	4_Attachment_C_NEPHIPAssessment_Announcement.docx	07/01/2019
Email Invitation	5_Attachment_D_NEPHIPAssessment_EmailInvitation.docx	07/01/2019
Reminder Email 1	6_Attachment_E_NEPHIPAssessment_ReminderEmail1.docx	07/01/2019
Reminder Email 2	7_Attachment_F_NEPHIPAssessment_ReminderEmail2.docx	07/01/2019
Reminder Email 3	8_Attachment_G_NEPHIPAssessment_ReminderEmail3.docx	07/01/2019
HSR Determination	9_Attachment_H_NEPHIPAssessment_HSRdetermination_revised.pdf	07/01/2019

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