PDG B-5 Individual Session Annual Convening Survey

Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery

PDG B-5 Individual Session Annual Convening Survey

OMB: 0970-0401

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All-Grantee Convening - Individual Session Survey

Thank you for attending this session at the PDG B-5 TA Center Virtual All Grantee Convening. Your thoughts and suggestions are important for future conferences. Your individual responses will be kept private. Only aggregate information will be shared with the convening organizers, presenters, the Center’s leadership and funders. This should take you about 1 minute to complete. Thank you for taking the time to complete this feedback form! 



    1. Rate the quality of the information (and resources, if applicable) provided.

  • Excellent 

  • Good

  • Poor

  • Very poor

    1. Rate the relevance of the information (and resources, if applicable) to your state:

  • Very relevant

  • Somewhat relevant

  • Not relevant

  • Not at all relevant

    1. Rate the usefulness of the information (and resources, if applicable) provided: 

  • Very useful

  • Somewhat useful

  • Not useful

  • Not at all useful

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PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to gather feedback from participants at the PDG B-5 Annual All-Grantee Convening. Public reporting burden for this collection of information is estimated to average 1 minute per respondent, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This collection of information is voluntary. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. The OMB # for this collection is 0970-0401 and the expiration date is 05/31/2021. If you have any comments on this collection of information, please contact Paula Bendl Smith ([email protected]).





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AuthorSara Thayer
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File Created2021-05-10

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