BUILD Mentee Mentor Assessment

Evaluation of the Enhancing Diversity of the NIH-funded Workforce Program for the National Institute of General Medical Sciences (NIGMS)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0747 can be found here:

Documents and Forms

Document Name Document Type
Form 8 BUILD Mentee Mentor Assessment Form and Instruction
8 Mentee Mentor Assessment Attachment_15_-_Mentee_Mentor_Assessment.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	BUILD Mentee Mentor 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 and Instruction	8	Mentee Mentor Assessment	Attachment_15_-_Mentee_Mentor_Assessment.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service,	FR Citation: 67 FR 187

Number of Respondents: 1,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	3,000	3,000
Annual IC Time Burden (Hours)	500	500
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.