CDC Undergraduate Public Health Scholars (CUPS) Program Assessment – Alumni 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⚠️ Notice: This information collection may be referencing outdated material.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
Form 0920-1163 CDC Undergraduate Public Health Scholars (CUPS) Program Assessment – Alumni Survey Form and Instruction
0920-1163 CUPS Alumni Assessment Survey CDC CUPS Alumni Assessment Final 20200504.docx Form and Instruction
CUPS Evaluation Survey invitation 20200501.docx CUPS Evaluation Survey invitation IC Document
Request for Approval - GenIC CUPS Student Follow-up Survey 20200505.docx Request for Approval Gen IC CUPS Student Follow-up Survey IC Document
Project Determination CUPS.docx Project Determination IC Document

Information Collection (IC) Details

IC Title:	CDC Undergraduate Public Health Scholars (CUPS) Program Assessment – Alumni Survey	Agency IC Tracking Number:

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
Form and Instruction	0920-1163	CUPS Alumni Assessment Survey	CDC CUPS Alumni Assessment Final 20200504.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,200	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	1,200	1,200
Annual IC Time Burden (Hours)	500	500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Project Determination	Project Determination CUPS.docx	03/24/2020
CUPS Evaluation Survey invitation	CUPS Evaluation Survey invitation 20200501.docx	05/04/2020
Request for Approval Gen IC CUPS Student Follow-up Survey	Request for Approval - GenIC CUPS Student Follow-up Survey 20200505.docx	05/05/2020

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