Document

Example screenshots (PERS: District Assistance Questionnaire)

ICR 202209-0920-014 · OMB 0920-1275 · Object 125182301.

Document Viewer [docx]

Status: Original and derived artifacts are available for this document.

Download: docx | pdf | html

Primary: docxSource: application/vnd.openxmlformats-officedocument.wordprocessingml.document

Loading document viewer…

Document Metadata

Record metadata
File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
File Title	Example screenshots (PERS: District Assistance Questionnaire)
Author	Jones, Tiffany
Last Modified By	Writer
File Modified	2022-09-08
File Created	2026-08-31
Conversion State	complete

Extracted Text

Form Approved 
OMB No: 0920-1275
Exp. Date: XX/XX/XXXX




“Promoting Adolescent Health through School-Based HIV Prevention”


Attachment 8c
District Assistance Questionnaire Screenshots









Public reporting burden of this collection of information is estimated to average 7 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; Attn: OMB-PRA (0920-1275)