5 Alabama Outreach Sign In Sheet

OMB # 0925-0701
Expiration Date: 07/31/2017

Alabama Safe Sleep Outreach Project
Sign-In Sheet
Public reporting burden for this collection of information is estimated to average 1 minute 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: NIH, Project
Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0701). Do not return the
completed form to this address.

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Alabama Safe Sleep Outreach Project Sign-In Sheet
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Alabama Safe Sleep Outreach Project Sign-In Sheet
Name (please print)

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