Pilot Survey Communications Fellowship (NCF) Program Application (NCI)

Formative Research, Pretesting, and Customer Satisfaction of NCI's Communication and Education Resources (NCI)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0046 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Pilot Survey Communications Fellowship (NCF) Program Application (NCI) Form
1 NCF Applications Attach1-NCF Application.pdf Form
2 NCF Feedback Survey Attach2-NCF Feedback Survey.docx Form
3 NCF References Attach3-NCF Reference.pdf Form and Instruction
mini SSA_NCF 01-10-2019.docx Mini SSA NCI Communication Fellowship Program Applicaiton IC Document
Attach4-NCF Automated Emails w Descriptions.docx NCF Automated Emails w Descriptions IC Document

Information Collection (IC) Details

IC Title:	Pilot Survey Communications Fellowship (NCF) Program Application (NCI)	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	NCF Applications	Attach1-NCF Application.pdf	Yes	Yes	Fillable Fileable
Form	2	NCF Feedback Survey	Attach2-NCF Feedback Survey.docx	Yes	Yes	Fillable Fileable
Form and Instruction	3	NCF References	Attach3-NCF Reference.pdf	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 360	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	480	480
Annual IC Time Burden (Hours)	246	246
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Mini SSA NCI Communication Fellowship Program Applicaiton	mini SSA_NCF 01-10-2019.docx	01/10/2019
NCF Automated Emails w Descriptions	Attach4-NCF Automated Emails w Descriptions.docx	01/10/2019

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