Information Collection

2024 Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program All Grantee Meeting Evaluation Surveys

IC 263615 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⚠️ Notice: This information collection may be referencing outdated material.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 2024 Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program All Grantee Meeting Evaluation Surveys	Form
1 Conference Evaluation Survey Instrument A_Conference Evaluation Survey.docx	Form
1 Conference Evaluation Survey Instrument A_Conference Evaluation Survey.docx	Form
2 Plenary Session Evaluation Survey Instrument B_Plenary Session Evaluation Survey.docx	Form
2 Plenary Session Evaluation Survey Instrument B_Plenary Session Evaluation Survey.docx	Form
3 Concurrent Session Evaluation Survey Instrument C_Concurrent Session Evaluation Survey.docx	Form
3 Concurrent Session Evaluation Survey Instrument C_Concurrent Session Evaluation Survey.docx	Form
4 AGM Poster Session Evaluation Survey Instrument D_Poster Session Evaluation Survey.docx	Form
4 AGM Poster Session Evaluation Survey Instrument D_Poster Session Evaluation Survey.docx	Form
Fast track memo. MIECHV AGM.docx MIECHV Fast Track Memo 2024	IC Document
Fast track memo. MIECHV AGM.docx MIECHV Fast Track Memo 2024	IC Document

IC Title:

2024 Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program All Grantee Meeting Evaluation Surveys

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Conference Evaluation Survey	Instrument A_Conference Evaluation Survey.docx	Yes	Yes	Fillable Fileable
Form	2	Plenary Session Evaluation Survey	Instrument B_Plenary Session Evaluation Survey.docx	Yes	Yes	Fillable Fileable
Form	3	Concurrent Session Evaluation Survey	Instrument C_Concurrent Session Evaluation Survey.docx	Yes	Yes	Fillable Fileable
Form	4	AGM Poster Session Evaluation Survey	Instrument D_Poster Session Evaluation Survey.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,960

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	1,960	1,960
Annual IC Time Burden (Hours)	102	102
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
MIECHV Fast Track Memo 2024	Fast track memo. MIECHV AGM.docx	11/22/2023

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