Post-Participation Survey

National Learning Community for HIV CBO Leadership Evaluation

Documents and Forms

Document Name Document Type
Form 0920- Post-Participation Survey Form
0920- National Learning Community for HIV CBO Leadership Post- Att 8_Post-Participation Survey.docx Form
Att 9_Screenshots of Post-Participation Survey.docx Screenshots of Post-Participation Survey IC Document
Att 7_Email invitation for Post-Participation Survey.docx Email invitation _Post-Participation Survey IC Document
Att 10_Email reminder for Post-Participation Survey.docx Email reminder_Post-Participation Survey (Completion) IC Document

Information Collection (IC) Details

IC Title:	Post-Participation Survey	Agency IC Tracking Number:	0920-21EL

Is this a Common Form? No		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	0920-	National Learning Community for HIV CBO Leadership Post-Participation Survey	Att 8_Post-Participation Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: 09-20-0161 Records of Health Professionals in Disease Prevention and Control Training Programs	FR Citation: 83 FR 6591

Number of Respondents: 270	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	270	270
Annual IC Time Burden (Hours)	41	41
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Screenshots of Post-Participation Survey	Att 9_Screenshots of Post-Participation Survey.docx	11/03/2021
Email invitation _Post-Participation Survey	Att 7_Email invitation for Post-Participation Survey.docx	11/03/2021
Email reminder_Post-Participation Survey (Completion)	Att 10_Email reminder for Post-Participation Survey.docx	11/03/2021

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