Scientific Conference Program Report Draft 2023.xlsx

Standardized Reporting Forms for Federally Funded Public Health Projects and Agreements

Scientific Conference Program Report Draft 2023.xlsx

OMB: 0910-0909

Document [xlsx]
Download: xlsx | pdf

Overview

Coversheet
ProgressNarrative
AddlQuestions
Personnel
Budget


Sheet 1: Coversheet









OMB Number: 0910-0909 Exp Date: XX/XX/XXXX See bottom of page for PRA statement









































Awardee Name (Select)
Select


Last 4 Grant Number
Select Awardee Name







Report Type
End of Year







Date Completed































Project Period Start Date
Select Awardee Name







Project End Date
Select Awardee Name







Budget Period Start Date
Select Awardee Name







Budget Period End Date
Select Awardee Name





























Principal Investigator (PI)




PI Email




PI Phone































































Sheet 2: ProgressNarrative
































































































































































































































































































































































































































































Meeting Objective 1:





































































Planned Start Date


New Start Date
Objective Status Select
























Planned End Date


New End Date
Objective Percent Complete Select
























Planned Meeting Objective Short Description
Progress Report (Use Alt+Enter for new line if desired)






























[Replace bracketed text with your response]
[Replace bracketed text with your response]




































































































Meeting Objective 2:





































































Planned Start Date


New Start Date
Objective Status Select
























Planned End Date


New End Date
Objective Percent Complete Select
























Planned Meeting Objective Short Description
Progress Report (Use Alt+Enter for new line if desired)






























[Replace bracketed text with your response]
[Replace bracketed text with your response]




































































































Meeting Objective 3:





































































Planned Start Date


New Start Date
Objective Status Select
























Planned End Date


New End Date
Objective Percent Complete Select
























Planned Meeting Objective Short Description
Progress Report (Use Alt+Enter for new line if desired)






























[Replace bracketed text with your response]
[Replace bracketed text with your response]




































































































Meeting Objective 4:





































































Planned Start Date


New Start Date
Objective Status Select
























Planned End Date


New End Date
Objective Percent Complete Select
























Planned Meeting Objective Short Description
Progress Report (Use Alt+Enter for new line if desired)






























[Replace bracketed text with your response]
[Replace bracketed text with your response]




































































































Meeting Objective 5:





































































Planned Start Date


New Start Date
Objective Status Select
























Planned End Date


New End Date
Objective Percent Complete Select
























Planned Meeting Objective Short Description
Progress Report (Use Alt+Enter for new line if desired)






























[Replace bracketed text with your response]
[Replace bracketed text with your response]




































































































Meeting Objective 6:





































































Planned Start Date


New Start Date
Objective Status Select
























Planned End Date


New End Date
Objective Percent Complete Select
























Planned Meeting Objective Short Description
Progress Report (Use Alt+Enter for new line if desired)






























[Replace bracketed text with your response]
[Replace bracketed text with your response]




































































































Meeting Objective 7:





































































Planned Start Date


New Start Date
Objective Status Select
























Planned End Date


New End Date
Objective Percent Complete Select
























Planned Meeting Objective Short Description
Progress Report (Use Alt+Enter for new line if desired)






























[Replace bracketed text with your response]
[Replace bracketed text with your response]




































































































Meeting Objective 8:





































































Planned Start Date


New Start Date
Objective Status Select
























Planned End Date


New End Date
Objective Percent Complete Select
























Planned Meeting Objective Short Description
Progress Report (Use Alt+Enter for new line if desired)






























[Replace bracketed text with your response]
[Replace bracketed text with your response]




































































































Meeting Objective 9:





































































Planned Start Date


New Start Date
Objective Status Select
























Planned End Date


New End Date
Objective Percent Complete Select
























Planned Meeting Objective Short Description
Progress Report (Use Alt+Enter for new line if desired)






























[Replace bracketed text with your response]
[Replace bracketed text with your response]




































































































Meeting Objective 10:





































































Planned Start Date


New Start Date
Objective Status Select
























Planned End Date


New End Date
Objective Percent Complete Select
























Planned Meeting Objective Short Description
Progress Report (Use Alt+Enter for new line if desired)






























[Replace bracketed text with your response]
[Replace bracketed text with your response]




































































































































































































































Sheet 3: AddlQuestions





















































Conference Information (If the conference has not yet happened confirm current status of the following metrics as applicable.):







Title [Replace bracketed text with your response]










Start Date (M/D/YYYY)







End Date (M/D/YYYY)







Location of Conference (venue, city, state or virtual) [Replace bracketed text with your response]










Projected Audience





Type of Audience Expected Number of Registrants Method of Selection




































































Percentage breakdown of Federal vs Non-Federal Employees
[(# Federal Employees/Total # Attendees) * 100]

%














In-Person Virtual





Conference Format (Select "Yes" for all applicable)
















Projected Agenda (may be attached) or provide a list of principal areas or topics to be addressed and speakers







[Replace bracketed text with your response]










Describe physical facilities and logistical arrangments







[Replace bracketed text with your response]










Justification of the conference(s), including the objectives, the problems it intends to clarify, and any developments it may stimulate; the public health need, timeliness, and usefulness of the conference/meeting to the scientific community

[Replace bracketed text with your response]










The following are a list of goals and priorities for the FDA Office of Regulatory Affairs and the Office of Partnerships. Please identify all goals and priorities your conference or meeting is aligned with by selecting Yes in the drop-downs provided for all relevant priorities (there must be at least one item that aligns with the goals of your event.










This Event will:




Select Yes below for all that apply:

Improve coordination and communication between FDA and regulatory and public health partners


Improve regulatory data sharing between FDA and regulatory and public health partners


Expand availability of tools, systems and equipment for regulatory and public health partners


Increase knowledge and skills of regulatory and public health partners


Promote equivalency of regulations between FDA and regulatory and public health partners for FDA-regulated commodities


Improve quality systems of regulatory and public health partners


Increased efficiency of FDA and public health partner resource use


Increase partnerships to enhance public health protections


Expand collective capability and capacity among partners


Increase mutual acceptance and reliance on public health partner work, data, and action






































Description of the composition and role of the organizing committee, and provide the names and credentials of key participants in the conference /meeting, including the basis for their selection and documentation of their agreement to participate 

[Replace bracketed text with your response]










Describe publicizing the conference/meeting to all interested participants and for publishing the proceedings.

[Replace bracketed text with your response]




Post-Conference only:







Enter the number of virtual attendees







Enter the number of in-person attendees







List the top performing topics (i.e. which topic session(s) have the most participants interested)







[Replace bracketed text with your response]










Enter the number of returning attendees or the number of attendees compared to previous years
















Federal SLTT Academic Industry International

Representatives in Attendance (mark "Yes" for all that apply)

















Compliance Officers Managers Inspectors Students Researchers

Professions represented (mark "Yes" for all that apply)















Region (e.g. soutwest, northeast, nationwide, international, etc.) [Replace bracketed text with your response]










Post-conference survey: Completion rate
%





Post-conference survey: Overall feedback results [Replace bracketed text with your response]










How did the meeting support the FDA mission?

[Replace bracketed text with your response]










Meeting Accomplishments

[Replace bracketed text with your response]













Public Heath Impacts (Required)


















Please describe the public health impact of your activities under this cooperative agreement.

[Replace bracketed text with your response]












Please describe how your activities have facilitated long-term improvements to the national food safety system under this cooperative agreement.

[Replace bracketed text with your response]















Optional: Use this space to report any additional information as needed that was not already reported elsewhere

[Replace bracketed text with your response]








































Sheet 4: Personnel




































































Name
(last name, first name)
Title Project Role Months Funded
(# calendar mos)


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Sheet 5: Budget





















































Expenses Total Budgeted Expended to Date Total Projected Expenses

1 Total Budget $0.00 $0.00 $0.00

2 Total Salary, Wages, and Fringe Benefits $0.00 $0.00 $0.00

3 Equipment $0.00 $0.00 $0.00

4 Travel $0.00 $0.00 $0.00

5 Materials and Supplies $0.00 $0.00 $0.00

6 Publication Costs $0.00 $0.00 $0.00

7 Consultant Services $0.00 $0.00 $0.00

8 ADP/Computer Services $0.00 $0.00 $0.00

9 Subawards/Contractual Costs $0.00 $0.00 $0.00

10 Equipment/Facility Rental/User Fees $0.00 $0.00 $0.00

11 Federal F&A (Indirect Costs) $0.00 $0.00 $0.00

12 Other 1 [Replace only bracketed text] $0.00 $0.00 $0.00

13 Other 2 [Replace only bracketed text] $0.00 $0.00 $0.00

14 Other 3 [Replace only bracketed text] $0.00 $0.00 $0.00

15 Other 4 [Replace only bracketed text] $0.00 $0.00 $0.00

16 Estimated current obligated funds $0.00



17 Carryover I will be requesting $0.00



18 New funding request $0.00



19 Total Requested for next budget period $0.00



20 Additional Budget Comments: [Replace bracketed text with your response]






































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