ERSG Facilitator Program Implementation Fidelity Measure

A Controlled Evaluation of Expect Respect Support Groups (ERSG): Preventing and Interrupting Teen Dating Violence among At-Risk Middle and High School Students

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0861 can be found here:

Documents and Forms

Document Name Document Type
ERSG Facilitator Program Implementation Fidelity Measure Form
Facilitator Program Implementation Fidelity Measure Appendix J - Facilitator Fidelity Measure - Clean Version 9.9.11.doc Form

Information Collection (IC) Details

IC Title:	ERSG Facilitator Program Implementation Fidelity Measure	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	none	Facilitator Program Implementation Fidelity Measure	Appendix J - Facilitator Fidelity Measure - Clean Version 9.9.11.doc		No	No	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 8	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	16	16
Annual IC Time Burden (Hours)	4	4
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.