Form 2 Site Visit Availability Calendar

Form Approved

OMB No. 0920-xxxx

Exp. Date xx/xx/xxxx

Site Visit Availability Calendar

for

Please designate your first, second and third choices of consecutive, 3-day time periods for the site visit. As you consider possible dates, please keep in mind our first interview is with the lead administrator (program director, school district superintendent, etc.) to orient ourselves with your program/policy. We anticipate this interview will last approximately two hours.  All other interviews should be approximately one hour.

MAY
	Monday	Tuesday	Wednesday	Thursday	Friday
	2nd	3rd	4th	5th	6th
Yes
No
	9th	10th	11th	12th	13th
Yes
No
	16th	17th	18th	19th	20th
Yes
No
	23rd	24th	25th	26th	27th
Yes
No
	30th	31st
Yes
No
JUNE
	Monday	Tuesday	Wednesday	Thursday	Friday
			1st	2nd	3rd
Yes
No
	6th	7th	8th	9th	10th
Yes
No
	13th	14th	15th	16th	17th
Yes
No
	20th	21st	22nd	23rd	24th
Yes
No
	27th	28th	29th	30th
Yes
No

Please return calendar marked with your preferred dates to:

Swest@icfi.com or fax (404) 321-3688 Thank You!

Public reporting burden of this collection of information is estimated to average one hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. 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.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN:  OMB 0920-XXXX.