Form 9600-036 Lead Awareness Curriculum Session Train-the-Trainer Foll

OMB Control No. 2030-0051

Expiration Date 5/31/2024

Lead Awareness Curriculum Session Train-the-Trainer Follow-up Survey (following attendance 6-months post Lead Awareness Curriculum Train-the-Trainer session)

 

This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2030-0051). Responses to this collection of information are voluntary (40 CFR §745). 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. The public reporting and recordkeeping burden for this collection of information is estimated to range from five to fifteen minutes per response. Send comments on the Agency’s need for this information, the accuracy of the provided burden estimates and any suggested methods for minimizing respondent burden to the Regulatory Support Division Director, U.S. Environmental Protection Agency (2821T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address. 

 

This survey is anonymous, and EPA will use your answers solely to improve outreach for upcoming sessions. We will not share this information with any third party. 

 

Thank you for your attendance at a Lead Awareness Curriculum Train-the-Trainer session. EPA is curious to learn if and how you have used the Lead Awareness Curriculum to educate others about lead, its impacts, and lead poisoning prevention efforts. Thank you for taking the time to answer our questions.  

Survey Questions: 

1. In which community are you located? 

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2. Have you or your organization used the Lead Awareness Curriculum to educate others about lead, its impacts, and lead poisoning prevention efforts?

   1. Yes

   2. No

3. If yes, how have you or your organization used the Lead Awareness Curriculum to educate others about lead, its impacts, and lead poisoning prevention efforts? EPA is looking for examples to share on how the Curriculum is being used.

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4. If yes, have you encountered any challenges in implementing the Lead Awareness Curriculum to educate others about lead, its impact and lead poisoning prevention efforts?

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5. If no, please list any challenges that have prevented you or your organization from using the Lead Awareness Curriculum.

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6. If no, have you encountered any challenges in implementing the Lead Awareness Curriculum to educate others about lead, its impact and lead poisoning prevention efforts?

   1. Textbox 

3. Approximately how many people have you been able to educate using information from the Lead Awareness Curriculum?

   1. Textbox 

Thank you for taking the time to fill out this survey! For more information about the Lead Awareness Curriculum, please visit: www.epa.gov/lead/tribal-lead-curriculum. For information about upcoming Lead Awareness Curriculum sessions, please visit: https://www.epa.gov/lead/community-lead-awareness-sessions

EPA Form: 9600-036