Learning Experiences Survey (intensive)

Evaluation of the Child Welfare Capacity Building Collaborative

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0484 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Learning Experiences Survey (intensive) Form and Instruction
1 Learning Experiences Satisfaction Survey (inttensive) Learning Experiences Satisfaction Survey (Intensive)_revised.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Learning Experiences Survey (intensive)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Learning Experiences Satisfaction Survey (inttensive)	Learning Experiences Satisfaction Survey (Intensive)_revised.docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 900	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	900	900
Annual IC Time Burden (Hours)	72	72
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.