Administration for Native Americans Webinar Feedback Form

OMB CN: 0970-0401

Exp. Date: 5/31/2027

ANA Webinar Feedback Form

1. Date

2. Please rate the following on a scale of 1-5 (1 = Poor, 5 = Excellent)

   1. Information presented

   2. Presenter

3. How did you hear about this webinar?

4. What additional topics would be helpful?

5. Other comments to share

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to gathers information on the participants’ experience with the training and how ANA Training and Technical Assistance Providers can improve training opportunities. Public reporting burden for this collection of information is estimated to average 5 minutes per respondent, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a voluntary collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. The OMB # is 0970-0401 and the expiration date is 5/31/2027. If you have any comments on this collection of information, please contact Amy Zukowski@acf.hhs.gov.