DPRP Confirmation Email

Att 4D DPRP Confirmation Email.docx

CDC Diabetes Prevention Recognition Program (DPRP)

DPRP Confirmation Email

OMB: 0920-0909

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Application Received Confirmation Email

Subject line: Diabetes Prevention Recognition Program Application Received

Email Body

Thank you for your application to the Diabetes Prevention Recognition Program (DPRP). If you indicated that you will be using either the 2012 National Diabetes Prevention Program Curriculum or the PreventT2 Curriculum, you will be notified within 15 working days regarding the outcome of your application.

If you indicated that you will be using an alternate curriculum and you submitted your full, yearlong alternate curriculum with your application, you will be notified within 4-6 weeks by the DPRP regarding the outcome.

The information that you provided in your application is reproduced below. If you wish to correct an error or withdraw your application, or if you have any other questions about your application or the DPRP, please contact the Recognition Program staff at [email protected].

Your DPRP Application Information:

Submission ID:

1. Type of Application:

2. Organization Code: * Assigned Code Not Provided

3. Organization Name:

4. Delivery Mode

5. Class Type

6. Physical Address:

7. Mailing Address:

8. Web Address:

9. Organization Phone Number:

8. Organization Type

9. Program Coordinator’s Name:

10. Program Coordinator’s Title:

11. Program Coordinator’s E-mail:

12. Program Coordinator’s Phone Number:

13. Program Coordinator’s Fax Number:

14. Lifestyle Coach Training Entity:

15. Data Preparer Name:

16. Data Preparer Title:

17. Data Preparer Email Address:

18. Data Preparer Phone Number:

19. Data Preparer Fax Number (if applicable):

20. Curriculum:

21. Electronic Signature:

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorThomas, Darlene (CDC/ONDIEH/NCCDPHP)
File Modified0000-00-00
File Created2021-01-21

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