Monitoring and Evaluation of the NIDA goes Back to School National Dissemination Campaign

Documents and Forms

Document Name Document Type
Form 1 Monitoring and Evaluation of the NIDA goes Back to School National Dissemination Campaign Form
1 Community Leaders Community Leader Requestor Survey Instrument[1].doc Form
2 School Requestor School Requestor Survey Instrument[1].doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Monitoring and Evaluation of the NIDA goes Back to School National Dissemination Campaign	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	1	Community Leaders	Community Leader Requestor Survey Instrument[1].doc		Yes	Yes	Printable Only
Form	2	School Requestor	School Requestor Survey Instrument[1].doc		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,200	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	1,200	1,200
Annual IC Time Burden (Hours)	96	96
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.