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State and Community Awardee Project Director/Project Coordinator Needs Assessment
Process Evaluation of "Teenage Pregnancy Prevention: Integrating Services, Programs, and Strategies through Community-Wide Initiatives"
OMB: 0920-0952
IC ID: 203974
OMB.report
HHS/CDC
OMB 0920-0952
ICR 201409-0920-009
IC 203974
( )
Documents and Forms
Document Name
Document Type
State and Community Awardee Project Director/Project Coordinator Needs Assessment
Form
New Web Survey
Attachment 7 (web) State and Community Awardee Project Coordinator Project Director Needs Assessment.pdf
Form
Attachment 7 (rev) State and Community Awardee Project Coordinator Project Director Needs Assessment.docx
Paper-based Survey
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
State and Community Awardee Project Director/Project Coordinator Needs Assessment
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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
New Web Survey
Attachment 7 (web) State and Community Awardee Project Coordinator Project Director Needs Assessment.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
9
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
9
0
0
0
0
9
Annual IC Time Burden (Hours)
7
0
0
0
0
7
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Paper-based Survey
Attachment 7 (rev) State and Community Awardee Project Coordinator Project Director Needs Assessment.docx
04/02/2013
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.