Information Collection

Alumni Fellows Survey

IC 212643 under ICR 202401-0930-001 · OMB 0930-0304.

Documents and Forms

Document Name Document Type
Form Alumni Fellows Alumni Fellows Survey Form and Instruction
Alumni Fellows Alumni Fellows ATTACHMENT_B-1-Alumni-Fellows-Survey_8-24-2023-_mtc_Clean 9.1 OBHE-LH_CLEAN_MTC_9-28-23.docx Form and Instruction
Alumni Fellows Alumni Fellows ATTACHMENT_B-1-Alumni-Fellows-Survey_8-24-2023-_mtc_Clean 9.1 OBHE-LH_CLEAN_MTC_9-28-23.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Alumni Fellows Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Alumni Fellows	Alumni Fellows	ATTACHMENT_B-1-Alumni-Fellows-Survey_8-24-2023-_mtc_Clean 9.1 OBHE-LH_CLEAN_MTC_9-28-23.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,000	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,000	3,000
Annual IC Time Burden (Hours)	1,260	1,260
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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