CCTAN Registration Questions for PRA Approval - 2024_v2

Questions for Child Care Technical Assistance Network (CCTAN) All Hands Meeting – March 2024

[To be completed on the meeting registration site via online form]

1. First Name, Last Name

2. Prefix

3. Email

4. Role (Federal Employee, Invited Presenter or Guest, National Center Staff).

   • If selecting the National Center Staff, there is a drop down list to select the center)

5. Title

6. Organization

7. Address (City, State, Zip)

8. Phone

9. Do you have any special ADA needs? Fill in the blank

10. Emergency Contact Name

11. Emergency Contact Phone Number

12. How many years have you been with CCTAN?

    • Fewer than 2

    • 2-5

    • 5-8

    • 8+

13. What was your role or position prior to joining CCTAN? (Check any/all that apply)

    • Worked in CCDF lead agency

    • Worked in child care licensing

    • TA provider or trainer (state or local level)

    • Early care and education or school aged care provider

    • Other (option to specify)

14. If you an experienced CCTAN TA provider, what accomplishments in TA development/delivery are you most proud of and what factors do you think contributed to that success?

15. What barriers or challenges are you facing in your TA-related work?

16. What are you hoping to take away from this meeting?

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to inform planning for the March 2024 CCTAN All Hands Meeting. Public reporting burden for this collection of information is estimated to average 10 minutes per respondent, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This collection of information is voluntary. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. The OMB # is 0970-0617 and the expiration date is 09/30/2026. If you have any comments on this collection of information, please contact Patricia Haley ([email protected]).