Promoting Adolescent Health through School-Based HIV Prevention

OMB 0920-1275

OMB 0920-1275

The purpose of this request is to obtain a three-year approval for data collection using a Web-based program evaluation and monitoring system, the Program Evaluation and Reporting System (PERS), that will use questionnaires to allow the Division of Adolescent and School Health, (DASH) at the Centers for Disease Control and Prevention (CDC) to organize, plan, and track activities conducted by funded Local Education Agencies (LEAs) under NOFO PS18-1807 Promoting Adolescent Health through School-Based HIV/STD Prevention and School-Based Surveillance.

The latest form for Promoting Adolescent Health through School-Based HIV Prevention expires 2022-11-30 and can be found here.

OMB Details

Funded District Questionnaire

Federal Enterprise Architecture: Health - Public Health Monitoring

Form 0920-19AUKFunded District QuestionnaireFillable FileableForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.


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