Information Collection Request

Office of Minority Health Research Coordination (OMHRC) Research Training and Mentor Programs Applications (NIDDK)

ICR 202405-0925-002 · OMB 0925-0748 · Active

Forms and Documents

Document	Type	Status	Availability
Form 1 NMRI Evaluation Form Day 3	Form and Instruction	Modified	Repair queued
Form 1 NMRI Evaluation Form Day 3	Form and Instruction	Modified	Repair queued
Form 1 NMRI Evaluation Form Day 2	Form and Instruction	Modified	Repair queued
Form 1 NMRI Evaluation Form Day 2	Form and Instruction	Modified	Repair queued
Form 1 NIH/NMA Academic Career Development Workshop Contact Information and Feedback Form	Form and Instruction	Unchanged	Available
Form 1 NIH/NMA Academic Career Development Workshop Contact Information and Feedback Form	Form and Instruction	Unchanged	Repair queued
Form 1 STEP-UP Participant Survey form	Form and Instruction	Unchanged	Repair queued
Form 1 STEP-UP Participant Survey form	Form and Instruction	Unchanged	Repair queued
Form 1 NIH/NHMA Feedback Form	Form and Instruction	Unchanged	Repair queued
Form 1 NIH/NHMA Feedback Form	Form and Instruction	Unchanged	Repair queued
Form 1 NIH/National Hispanic Medical Association (NHMA) Academic Career Fellow Travel Awards Application	Form and Instruction	Unchanged	Available
Form 1 NIH/National Hispanic Medical Association (NHMA) Academic Career Fellow Travel Awards Application	Form and Instruction	Unchanged	Repair queued
Form 1 NIH/NMA Feedback Form	Form and Instruction	Unchanged	Available
Form 1 NIH/NMA Feedback Form	Form and Instruction	Unchanged	Repair queued
Form 1 NIH/National Medical Association (NMA) Academic Career Fellow Travel Awards Application	Form and Instruction	Unchanged	Available
Form 1 NIH/National Medical Association (NMA) Academic Career Fellow Travel Awards Application	Form and Instruction	Unchanged	Repair queued
Form 1 NMRI Mentor-Mentee Agreement Form	Form and Instruction	Unchanged	Available
Form 1 NMRI Mentor-Mentee Agreement Form	Form and Instruction	Unchanged	Repair queued
Form 1 NMRI Survey Form	Form and Instruction	Unchanged	Repair queued
Form 1 NMRI Survey Form	Form and Instruction	Unchanged	Repair queued
Form 1 NMRI Evaluation Form Day 1	Form	Modified	Available
Form 1 NMRI Evaluation Form Day 1	Form	Modified	Repair queued
Form 1 Network of Minority Health Research Investigators (NMRI) Enrollment Form	Form and Instruction	Unchanged	Available
Form 1 Network of Minority Health Research Investigators (NMRI) Enrollment Form	Form and Instruction	Unchanged	Repair queued
Form 4 Diversity Summer Research Training Program (DSTRP) Feedback Form	Form and Instruction	Unchanged	Available
Form 4 Diversity Summer Research Training Program (DSTRP) Feedback Form	Form and Instruction	Unchanged	Repair queued
Form 2 STEP-UP Student Feedback Form	Form and Instruction	Unchanged	Repair queued
Form 2 STEP-UP Student Feedback Form	Form and Instruction	Unchanged	Repair queued
Form 1 Short-Term Research Experience Program to Unlock Potential (STEP-UP) Application	Form and Instruction	Unchanged	Repair queued
Form 1 Short-Term Research Experience Program to Unlock Potential (STEP-UP) Application	Form and Instruction	Unchanged	Repair queued
(8) NMRI Evaluation form Day 3 - Original with strikethrough.docx	Supplementary Document	Uploaded 2024-06-05	Available
(8) NMRI Evaluation form Day 3 - Original with strikethrough.docx	Supplementary Document	Uploaded 2024-06-05	Repair queued
(7) NMRI Evaluation form Day 2 - Original with strikethrough.docx	Supplementary Document	Uploaded 2024-06-05	Available
(7) NMRI Evaluation form Day 2 - Original with strikethrough.docx	Supplementary Document	Uploaded 2024-06-05	Repair queued
(6) NMRI Evaluation form Day 1 - Original with Strikethrough.docx	Supplementary Document	Uploaded 2024-06-05	Available
(6) NMRI Evaluation form Day 1 - Original with Strikethrough.docx	Supplementary Document	Uploaded 2024-06-05	Repair queued
NIDDK OMHRC Change Memo 0925-0748.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-06-05	Available
NIDDK OMHRC Change Memo 0925-0748.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-06-05	Repair queued
(17) National-Institutes-of-Health-9724-PIA-03-10-2023-205.pdf	Supplementary Document	Uploaded 2023-06-12	Available
(17) National-Institutes-of-Health-9724-PIA-03-10-2023-205.pdf	Supplementary Document	Uploaded 2023-06-12	Repair queued
(16) Approved Privacy Memo NIDDK OMHRC Research Training and Mentor Programs Applications.pdf	Supplementary Document	Uploaded 2023-06-12	Available
(16) Approved Privacy Memo NIDDK OMHRC Research Training and Mentor Programs Applications.pdf	Supplementary Document	Uploaded 2023-06-12	Repair queued
OMHRC Supporting Statement A.docx	Supporting Statement A	Uploaded 2023-06-12	Available
OMHRC Supporting Statement A.docx	Supporting Statement A	Uploaded 2023-06-12	Repair queued
NIDDK 30 day notice.pdf	Supplementary Document	Uploaded 2023-06-09	Available
NIDDK 30 day notice.pdf	Supplementary Document	Uploaded 2023-06-09	Repair queued

IC Document Collections

IC ID	Collection	Type	Status
260465	NMRI Evaluation Form Day 3	Form and Instruction	Modified
260465	NMRI Evaluation Form Day 3	Form and Instruction	Modified
260464	NMRI Evaluation Form Day 2	Form and Instruction	Modified
260464	NMRI Evaluation Form Day 2	Form and Instruction	Modified
241916	NIH/NMA Academic Career Development Workshop Contact Information and Feedback Form	Form and Instruction	Unchanged
241916	NIH/NMA Academic Career Development Workshop Contact Information and Feedback Form	Form and Instruction	Unchanged
241914	STEP-UP Participant Survey form	Form and Instruction	Unchanged
241914	STEP-UP Participant Survey form	Form and Instruction	Unchanged
238843	NIH/NHMA Feedback Form	Form and Instruction	Unchanged
238843	NIH/NHMA Feedback Form	Form and Instruction	Unchanged
238842	NIH/National Hispanic Medical Association (NHMA) Academic Career Fellow Travel Awards Application	Form and Instruction	Unchanged
238842	NIH/National Hispanic Medical Association (NHMA) Academic Career Fellow Travel Awards Application	Form and Instruction	Unchanged
238841	NIH/NMA Feedback Form	Form and Instruction	Unchanged
238841	NIH/NMA Feedback Form	Form and Instruction	Unchanged
238840	NIH/National Medical Association (NMA) Academic Career Fellow Travel Awards Application	Form and Instruction	Unchanged
238840	NIH/National Medical Association (NMA) Academic Career Fellow Travel Awards Application	Form and Instruction	Unchanged
238839	NMRI Mentor-Mentee Agreement Form	Form and Instruction	Unchanged
238839	NMRI Mentor-Mentee Agreement Form	Form and Instruction	Unchanged
238838	NMRI Survey Form	Form and Instruction	Unchanged
238838	NMRI Survey Form	Form and Instruction	Unchanged
238837	NMRI Evaluation Form Day 1	Form	Modified
238837	NMRI Evaluation Form Day 1	Form	Modified
238836	Network of Minority Health Research Investigators (NMRI) Enrollment Form	Form and Instruction	Unchanged
238836	Network of Minority Health Research Investigators (NMRI) Enrollment Form	Form and Instruction	Unchanged
238835	Diversity Summer Research Training Program (DSTRP) Feedback Form	Form and Instruction	Unchanged
238835	Diversity Summer Research Training Program (DSTRP) Feedback Form	Form and Instruction	Unchanged
238834	STEP-UP Student Feedback Form	Form and Instruction	Unchanged
238834	STEP-UP Student Feedback Form	Form and Instruction	Unchanged
238833	Short-Term Research Experience Program to Unlock Potential (STEP-UP) Application	Form and Instruction	Unchanged
238833	Short-Term Research Experience Program to Unlock Potential (STEP-UP) Application	Form and Instruction	Unchanged

ICR Details

Status	Active
Agency/Subagency	HHS/NIH
OMB Control No	0925-0748
Type of Information Collection	No material or nonsubstantive change to a currently approved collection
Previous ICR Reference No	202305-0925-005
Date Submitted to OIRA	2024-06-05
Requested Expiration Date	1969-12-31