Information Collection

Trainee Ambassador Group Survey

IC 262807 under ICR 202312-0915-001 · OMB 0915-0212.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0212 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Trainee Ambassador Group Survey	Form and Instruction
1 Trainee Ambassador Group Survey Draft of Survey Questions.docx	Form and Instruction
1 Trainee Ambassador Group Survey Draft of Survey Questions.docx	Form and Instruction
Generic Justification for MCHB Trainee Ambassador Survey.docx Trainee Ambassador Group Survey	IC Document
Generic Justification for MCHB Trainee Ambassador Survey.docx Trainee Ambassador Group Survey	IC Document

IC Title:

Trainee Ambassador Group Survey

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Trainee Ambassador Group Survey	Draft of Survey Questions.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 90

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	90	90
Annual IC Time Burden (Hours)	23	23
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Trainee Ambassador Group Survey	Generic Justification for MCHB Trainee Ambassador Survey.docx	10/13/2023

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