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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Baseline survey & Identifying and contact information – participants
Modified
1000
420
0
Other-Survey
Other-Identifying and contact information
Baseline survey & Identifying and contact information –staff
Modified
1040
420
0
Other-Survey
Other-Identifying and contact information
Cost workbook – staff
Modified
24
256
0
Other-Workbook
First follow-up survey – participants
Modified
3100
858
0
Other-Survey
In-depth participant interviews – participants
Modified
20
13
0
Other-Interview Guide
Program leadership survey – program leaders
Modified
5
1
0
Other-Survey
Second follow-up survey – participants
Modified
3360
930
0
Other-Survey
Semi-structured employer discussion guide – employers
Modified
8
3
0
Other-Discussion Guide
Semi-structured program discussion guide - program staff and providers
Modified
8
3
0
Other-Discussion Guide
Semi-structured program discussion guide -program supervisors and partners
Modified
8
3
0
Other-Discussion Guide
Semi-structured program discussion guide –program leaders
Modified
4
2
0
Other-Discussion Guide
Service receipt tracking – staff
Modified
12000
320
0
Other-
Staff characteristics survey – staff
Modified
20
3
0
Other-Survey
Total burden requested under this ICR:
20597
3232
0
To view an IC, click on IC Title