Online Survey for Point of Contact of Host Institutions

Process Evaluation of the NIH Director's Early Independence Award Program (EIA)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0665 can be found here:

Documents and Forms

Document Name Document Type
Form Attachment A8.1 Online Survey for Point of Contact of Host Institutions Form and Instruction
Attachment A8.1 Screenshots for Online survey for POCs @Host Institution Attachment A.8.1 - Screenshots Online Survey Point of Contact Host Institution.pdf Form and Instruction
Attachment A.8 - Online Survey Point of Contact Host Institution.doc Attachment A8 Online Survey for POCs @ Host Institutes (Paper Version) IC Document
Attachment B.2.2 - Protocols Online Survey POC Host Institution.doc On-line Survey Protocols IC Document

Information Collection (IC) Details

IC Title:	Online Survey for Point of Contact of Host Institutions	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 and Instruction	Attachment A8.1	Screenshots for Online survey for POCs @Host Institutions	Attachment A.8.1 - Screenshots Online Survey Point of Contact Host Institution.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 24	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	24	24
Annual IC Time Burden (Hours)	24	24
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment A8 Online Survey for POCs @ Host Institutes (Paper Version)	Attachment A.8 - Online Survey Point of Contact Host Institution.doc	09/17/2012
On-line Survey Protocols	Attachment B.2.2 - Protocols Online Survey POC Host Institution.doc	09/26/2012

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.