Great Lakes Trainers Activity Reporting

Fetal Alcohol Spectrum Disorders Regional Training Centers

Documents and Forms

Document Name Document Type
Great Lakes Trainers Activity Reporting Form
Great Lakes Trainers Activity Reporting E19_Great Lakes FASD RegionalTraining Center Training Activity.pdf Form

Information Collection (IC) Details

IC Title:	Great Lakes Trainers Activity Reporting	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	Great Lakes Trainers Activity Reporting	E19_Great Lakes FASD RegionalTraining Center Training Activity.pdf		No	No	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 180	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	180	180
Annual IC Time Burden (Hours)	6	6
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.