OMB
Control Number 0920-0765 Fellowship Management System Change
Request
Attachment 3 – Activity Tracking Module
Screenshots
| Program | 
				Page/ | Requested Change | Screenshot | 
| EEP | 5.2-a | Change type: Question/Response option revision Handbook Acknowledgement (Required for all students): 
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| EEP | 5.2-a | Change type: Question/Response option revision 669A SWEP Volunteer Agreement (Required for all students): 
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| EEP | 5.2-a | Change type: Question/Response option revision 
 669C SWEP Statement of Duties Agreement (Required for all students): 
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| EEP | 5.2-a | Change type: Question/Response option revision Change to: 
 1438 SWEP E-QIP Initiation Form (Required for all students): 
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| EEP | 5.2-a | Change type: Question/Response option revision Change to: 
 Provided your SSN to EEP Program (Required for all students): 
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| EEP | 5.2-a | Change type: Question/Response option revision Change to: 
 Safety Survival Skills Exam (SSS): 
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| EEP | 5.2-a | Change type: Question/Response option revision Change to Security Awareness Training (SAT): 
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| EEP | 5.2-a | Change type: Response option revision Change to: Personnel security background investigation completed by Office of Safety, Security, and Asset Management (OSSAM): 
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| EEP | 5.2-a | Change type: Response option revision Change to: Fingerprinting: 
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| EEP | 5.3-c | Change type: Response option revision Change to: Principles of Epidemiology for Public Health Practice Course (See program handbook) (Optional for all students): 
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| EEP | 5.3-c | Change type: Question deletion REMOVE ActivEpi Course (See program handbook) (Optional for all students): Completed | N/A – Field will be removed for EEP Activity Tracking. | 
| EEP | 5.3-c | Change type: Question deletion REMOVE Online Public Health Ethics Course (See program handbook) (Optional for all students): Completed | N/A – Field will be removed for EEP Activity Tracking. | 
| EEP | 5.3-c | Change type: Response option revision Return CDC SmartCard to Supervisor (Required for CDC-based students): 
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| EEP | 5.3-c | Change type: Response option revision Return computer and all other equipment provided: 
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| EEP | 7.1.1.1.a | Change type: Question addition Add new question: How would you describe your connection with other EEP students following the orientation? [MULTIPLE CHOICE] (very connected, somewhat connected, a little connected, not at all connected) | 
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| EEP | 7.1.1.4.a | Change type: Question addition Questions currently listed on screenshot should apply to All Students. Please combine current All Students and CDC Students Only sections into a single All Students section. | Screenshots remain the same as what is current in eFMS 2.0 OMB package. | 
| EEP | 7.1.1.4.a | Change type: Response option revision Change to: Did you receive your computer? 
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| EEP | 7.1.1.4.a | Change type: Response option revision Change to: When do you expect to receive your computer? 
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| EEP | 7.1.1.4.a | Change type: Response option revision Change to: Did you receive your SmartCard? 
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| EEP | 7.1.1.4.a | Change type: Response option revision Change to: When do you expect to receive your SmartCard? 
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| EEP | 7.1.1.4.a | Change type: Instructional text revision Below “Please confirm that the email provided in your Profile is current and permanent,” add a new section for “Orientation Travel”. This section should only be completed by students not based in Atlanta for EEP. | 
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| EEP | 7.1.1.4.a | Change type: Question addition In Orientation Travel section, add: What went well during the travel planning process? [OPEN ENDED] | 
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| EEP | 7.1.1.4.a | Change type: Question addition In Orientation Travel section, add: Please describe what could be improved for future EEP students traveling to and staying in Atlanta during orientation. [OPEN ENDED] | |
| EEP | 7.1.1.4.a | Change type: Question addition In Orientation Travel section, add: What challenges, if any, did you experience traveling to Atlanta for orientation? [OPEN ENDED] | |
| EEP | 7.1.1.4.a | Change type: Question addition In Orientation Travel section, add: What do you recommend to improve the travel and lodging process for EEP students traveling for orientation in the future? [OPEN ENDED] | |
| EEP | 7.1.2.1.f | Change type: Response option revision Change to: What did your supervisor do to enhance your EEP experience? (Select all that apply) 
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| EEP | 7.1.2.1.f | Change type: Question addition Add: I received adequate support from my host site supervisor to complete my projects. (strongly agree, agree, neither agree nor disagree, disagree, strongly disagree) | 
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| EEP | 7.1.2.1.f | Change type: Question addition Add: Overall, I was satisfied with the guidance I received from my host site for my projects. (strongly agree, agree, neither agree nor disagree, disagree, strongly disagree) | |
| EEP | 45/7.1.2.1.f | Change type: Question addition Add: My supervisor provided me with resources to help me complete my project(s). (strongly agree, agree, neither agree nor disagree, disagree, strongly disagree) | |
| EEP | 7.1.2.1.f | Change type: Question addition Add: My supervisor provided me with timely feedback on my work. (strongly agree, agree, neither agree nor disagree, disagree, strongly disagree) | |
| EEP | 7.1.2.1.f | Change type: Question addition Add: Overall, I was satisfied with the mentorship I received at my host site. (strongly agree, agree, neither agree nor disagree, disagree, strongly disagree) | |
| EEP | 7.1.2.1.g | Change type: Question revision Change to: Did you assist in a public health response activity (e.g., an Epi-Aid, EOC deployment, field investigation, other large-scale response, or similar)? | 
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| EEP | 7.1.2.1.g | Change type: Question addition Add new question for EEP: Which type(s) of public health response activities did you participate in? Select all that apply: 
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| EEP | 7.1.2.1.g | Change type: Question revision Change question to: Which CDC Center/Institute/Office(s) did you support during your public health response activity (e.g., an Epi-Aid, EOC deployment, field investigation, other large-scale response, or similar)? (Select all that apply) | 
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| EEP | 7.1.2.1.g | Change type: Response option revision Change values to allow EEP student to select from the Center/Division/Branch Lookup OR choose one of the following options: 
 
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| EEP | 7.1.2.1.h | Change type: Question revision Change to: Briefly describe your responsibilities in the public health response activity (e.g., an Epi-Aid, EOC deployment, field investigation, other large-scale response, or similar): | 
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| EEP | 7.1.2.1.h | Change type: Question revision Change to: Participation in a public health response activity (e.g., an Epi-Aid, EOC deployment, field investigation, other large-scale response, or similar) increased my understanding of public health concepts through hands-on experience. | 
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| EEP | 7.1.2.1.h | Change type: Question revision Change to: Participation in a public health response activity (e.g., an Epi-Aid, EOC deployment, field investigation, other large-scale response, or similar) increased my interest in pursuing a public health career. | |
| EEP | 7.1.2.1.h | Change type: Question revision Change to: Participation in a public health response activity (e.g., an Epi-Aid, EOC deployment, field investigation, other large-scale response, or similar) connected me with additional public health professionals. | |
| EEP | 7.1.2.3.a | Change type: Question addition Add [for all students]: Overall, I am satisfied with my host site experience. (Strongly disagree, disagree, neither agree nor disagree, agree, strongly agree) | 
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| EEP | 7.1.2.3.a | Change type: Question addition Add [for all students]: What were the most valuable parts of your host site experience? [OPEN-ENDED] | 
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| EEP | 7.1.2.3.a | Change type: Question addition Add [for all students]: What were the most challenging parts of your host site experience? [OPEN-ENDED] | |
| SAF | 7.2.1.1.a | Change type: Question revision Change to: 
 
 
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| SAF | 7.2.1.1.a | Change type: Question revision Change to: 4. In the upcoming school year, do you plan to teach an entire course related to public health? 1. Yes, I plan to in the next
				year.  5. N/A | 
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| SAF | 8.1.2.a | Change type: Question deletion Remove section 8.1.2.a from SAF Activity Tracking module | N/A – Fields/section will be removed for SAF Activity Tracking. | 
| SAF | 8.2.3.a | Change type: Question deletion Remove section 8.2.3.a from SAF Activity Tracking module | N/A – Fields/section will be removed for SAF Activity Tracking. | 
| SAF | 8.3.2.a | Change type: Question deletion Remove section 8.3.2.a from SAF Activity Tracking module | N/A – Fields/section will be removed for SAF Activity Tracking. | 
| SAF | 8.4.2.b | Change type: Question deletion Remove section 8.4.2.b from SAF Activity Tracking module | N/A – Fields/section will be removed for SAF Activity Tracking. | 
| SAF | 8.6.2.b | Change type: Question deletion Remove section 8.6.2.b from SAF Activity Tracking module | N/A – Fields/section will be removed for SAF Activity Tracking. | 
| EIS | 8.6.2.a Activity Review Fields | Change type: Question revision On a scale of 1-5 where 1=very poor and 5=excellent, please rate the overall quality of this activity or its associated deliverables/products. 
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| All | 
 | Change type: Response option revision Add American Samoa | 
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document | 
| Author | Davis, Meagan (CDC/DDPHSS/CSELS/DSEPD) | 
| File Modified | 0000-00-00 | 
| File Created | 2022-03-28 |