OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

[PHIC] The Division of Workforce Development (DWD) Fellowship Alumni Assessment

ICR 202507-0920-017 · OMB 0920-1078 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-24IB Presidential Management Fellowship (PMF) Form Unchanged Available
Form 0920-24IB Presidential Management Fellowship (PMF) Form Unchanged Repair queued
Form 0920-1078 Att L_SAF Alumni Survey Form and Instruction Unchanged Repair queued
Form 0920-1078 SAF Alumni Form and Instruction Unchanged Available
Form 0920-1078 Att K_PHAP Alumni Survey Form and Instruction Unchanged Repair queued
Form 0920-1078 PHAP Alumni Form and Instruction Unchanged Repair queued
Form 0920-1078 Att J_PHIFP Alumni Survey Form and Instruction Unchanged Repair queued
Form 0920-1078 PHIFP Alumni Form and Instruction Unchanged Repair queued
Form 0920-1078 Att I_PE Alumni Survey Form and Instruction Unchanged Repair queued
Form 0920-1078 PE Fellowship Alumni Form and Instruction Unchanged Repair queued
Form 0920-1078 Att H_FLIGHT Alumni Survey Form and Instruction Unchanged Repair queued
Form 0920-1078 FLIGHT Alumni Form and Instruction Unchanged Missing upstream
LLS Alumni Survey Form and Instruction Modified Repair queued
EIS Alumni Survey Form and Instruction Modified Available
EIS/LLS Alumni Form and Instruction Modified Repair queued
Form 0920-1078 Att F_EFP Alumni Survey Form and Instruction Unchanged Repair queued
Form 0920-1078 EFP Alumni Form and Instruction Unchanged Repair queued
Form 0920-1078 Att E_EEP Alumni Survey Form and Instruction Unchanged Repair queued
Form 0920-1078 EEP Alumni Survey Form and Instruction Unchanged Repair queued
0920-1078 July2025 CR Memo.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-07-24 Repair queued
0920-1078 July2025 CR Memo.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-07-24 Repair queued
0920-1078 2025 EO CR Memo.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-05-05 Repair queued
0920-1078 2025 EO CR Memo.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-05-05 Repair queued
AttC_July2025_clean.docx Supplementary Document Uploaded 2025-07-24 Available
AttC_July2025_clean.docx Supplementary Document Uploaded 2025-07-24 Repair queued
Change_Justification_Dec2024.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-01-15 Repair queued
Change_Justification_Dec2024.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-01-15 Repair queued
Att O-1_PMF Alumni Survey Initial Email.docx Supplementary Document Uploaded 2024-08-28 Repair queued
Att O-1_PMF Alumni Survey Initial Email.docx Supplementary Document Uploaded 2024-08-28 Repair queued
Att O_PMF_Alum_Surv_Clean.docx Supplementary Document Uploaded 2024-08-28 Repair queued
Att O_PMF_Alum_Surv_Clean.docx Supplementary Document Uploaded 2024-08-28 Repair queued
0920-1078 Change Request_PMF.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-08-28 Available
0920-1078 Change Request_PMF.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-08-28 Repair queued
Att N_Acronym List.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att N_Acronym List.docx Supplementary Document Uploaded 2024-02-16 Missing upstream
Att M_Privacy Act Checklist.docx Supplementary Document Uploaded 2024-02-16 Available
Att M_Privacy Act Checklist.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att L-2_SAF Reminder Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att L-2_SAF Reminder Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att L-1_SAF Invitation Email.docx Supplementary Document Uploaded 2024-02-16 Available
Att L-1_SAF Invitation Email.docx Supplementary Document Uploaded 2024-02-16 Missing upstream
Att K-2_PHAP Reminder Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att K-2_PHAP Reminder Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att K-1_PHAP Initial Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att K-1_PHAP Initial Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att J-2_PHIFP Reminder Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att J-2_PHIFP Reminder Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att J-1_PHIFP Initial Email.docx Supplementary Document Uploaded 2024-02-16 Available
Att J-1_PHIFP Initial Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att I-2_PE Reminder Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att I-2_PE Reminder Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att I-1_PE Initial Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att I-1_PE Initial Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att H-2_FLIGHT Reminder Email.docx Supplementary Document Uploaded 2024-02-16 Available
Att H-2_FLIGHT Reminder Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att H-1_FLIGHT Initial Email.docx Supplementary Document Uploaded 2024-02-16 Available
Att H-1_FLIGHT Initial Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att G-2_EIS-LLS Reminder Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att G-2_EIS-LLS Reminder Email.docx Supplementary Document Uploaded 2024-02-16 Missing upstream
Att G-1_EIS-LLS Initial Email.docx Supplementary Document Uploaded 2024-02-16 Available
Att G-1_EIS-LLS Initial Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att F-2_EFP Reminder Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att F-2_EFP Reminder Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att F-1_EFP Initial Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att F-1_EFP Initial Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att E-2_EEP Reminder Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att E-2_EEP Reminder Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att E-1_EEP Initial Email.docx Supplementary Document Uploaded 2024-02-16 Available
Att E-1_EEP Initial Email.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att D_Alumni Survey Screen Shots.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att D_Alumni Survey Screen Shots.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Att A_Public Health Service Act.docx Supplementary Document Uploaded 2024-02-16 Available
Att A_Public Health Service Act.docx Supplementary Document Uploaded 2024-02-16 Repair queued
Attachment N_PHAP Alumni Survey Reminder Email 2-FINAL.docx Supplementary Document Uploaded 2020-12-01 Repair queued
Attachment N_PHAP Alumni Survey Reminder Email 2-FINAL.docx Supplementary Document Uploaded 2020-12-01 Repair queued
Attachment M_PHAP Alumni Survey Reminder Email-FINAL.docx Supplementary Document Uploaded 2020-12-01 Repair queued
Attachment M_PHAP Alumni Survey Reminder Email-FINAL.docx Supplementary Document Uploaded 2020-12-01 Repair queued
Attachment K_PHAP Alumni Survey Email Invitation_FINAL.docx Supplementary Document Uploaded 2020-12-01 Repair queued
Attachment K_PHAP Alumni Survey Email Invitation_FINAL.docx Supplementary Document Uploaded 2020-12-01 Repair queued
Attachment J_PHAP Host Site Supervisor Survey Final Reminder_FINAL.docx Supplementary Document Uploaded 2020-12-01 Repair queued
Attachment J_PHAP Host Site Supervisor Survey Final Reminder_FINAL.docx Supplementary Document Uploaded 2020-12-01 Repair queued
Attachment I_PHAP Host Site Supervisor Survey Second Reminder Email_FINAL.docx Supplementary Document Uploaded 2020-12-01 Repair queued
Attachment I_PHAP Host Site Supervisor Survey Second Reminder Email_FINAL.docx Supplementary Document Uploaded 2020-12-01 Repair queued
Attachment H_PHAP Host Site Supervisor Survey Reminder Email_FINAL.docx Supplementary Document Uploaded 2020-12-01 Repair queued
Attachment H_PHAP Host Site Supervisor Survey Reminder Email_FINAL.docx Supplementary Document Uploaded 2020-12-01 Missing upstream
Attachment G_PHAP Host Site Supervisor Survey Invitation Email_FINAL.docx Supplementary Document Uploaded 2020-12-01 Repair queued
Attachment G_PHAP Host Site Supervisor Survey Invitation Email_FINAL.docx Supplementary Document Uploaded 2020-12-01 Repair queued
Attachment E_PHAP Host Site Supervisor Survey Respondent Information_FINAL.docx Supplementary Document Uploaded 2020-12-01 Repair queued
Attachment E_PHAP Host Site Supervisor Survey Respondent Information_FINAL.docx Supplementary Document Uploaded 2020-12-01 Repair queued
Attachment D_Published 60 day_11022020.pdf Supplementary Document Uploaded 2020-12-01 Repair queued
Attachment D_Published 60 day_11022020.pdf Supplementary Document Uploaded 2020-12-01 Repair queued
Attachment A_Public Health Service Act_FINAL.docx Supplementary Document Uploaded 2020-12-01 Available
Attachment A_Public Health Service Act_FINAL.docx Supplementary Document Uploaded 2020-12-01 Missing upstream
DWD Alumni Survey ICR- Statement B Revision.docx Supporting Statement B Uploaded 2024-02-16 Repair queued
DWD Alumni Survey ICR- Statement B Revision.docx Supporting Statement B Uploaded 2024-02-16 Available
DWD Alumni ICR- Statement A Revision.docx Supporting Statement A Uploaded 2024-02-16 Repair queued
DWD Alumni ICR- Statement A Revision.docx Supporting Statement A Uploaded 2024-02-16 Missing upstream
IC Document Collections
IC IDCollectionTypeStatusForm
270147 Presidential Management Fellowship (PMF) Form UnchangedPresidential Management Fellowship (PMF)
270147 Presidential Management Fellowship (PMF) Form Unchanged
265458 SAF Alumni Form and Instruction UnchangedAtt L_SAF Alumni Survey
265458 SAF Alumni Form and Instruction Unchanged
265457 PHAP Alumni Form and Instruction UnchangedAtt K_PHAP Alumni Survey
265457 PHAP Alumni Form and Instruction Unchanged
265456 PHIFP Alumni Form and Instruction UnchangedAtt J_PHIFP Alumni Survey
265456 PHIFP Alumni Form and Instruction Unchanged
265455 PE Fellowship Alumni Form and Instruction UnchangedAtt I_PE Alumni Survey
265455 PE Fellowship Alumni Form and Instruction Unchanged
265454 FLIGHT Alumni Form and Instruction UnchangedAtt H_FLIGHT Alumni Survey
265454 FLIGHT Alumni Form and Instruction Unchanged
265453 EIS/LLS Alumni Form and Instruction ModifiedLLS Alumni Survey
265453 EIS/LLS Alumni Form and Instruction ModifiedEIS Alumni Survey
265453 EIS/LLS Alumni Form and Instruction Modified
265452 EFP Alumni Form and Instruction UnchangedAtt F_EFP Alumni Survey
265452 EFP Alumni Form and Instruction Unchanged
265415 EEP Alumni Survey Form and Instruction UnchangedAtt E_EEP Alumni Survey
265415 EEP Alumni Survey Form and Instruction Unchanged
ICR Details
0920-1078 202507-0920-017
Active 202505-0920-001
HHS/CDC 0920-25-0144
[PHIC] The Division of Workforce Development (DWD) Fellowship Alumni Assessment
No material or nonsubstantive change to a currently approved collection   Yes
Regular
Approved without change 09/05/2025
Retrieve Notice of Action (NOA) 07/28/2025
  Inventory as of this Action Requested Previously Approved
03/31/2027 03/31/2027 03/31/2027
695 0 695
182 0 182
0 0 0
This information collection request (ICR) is to gain three-year approval to follow alumni career progression following participation in the Public Health Associate Program (PHAP). The subpopulations to be studied are the PHAP Host Site Supervisors and PHAP Alumni. Information will be collected through online surveys. Findings will be used to assess the quality and value of the PHAP. This change requests minor edits to the core questions and to the EIS and LLS surveys.
US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  88 FR 74193 10/30/2023
89 FR 9150 02/09/2024
Yes
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 695 695 0 0 0 0
Annual Time Burden (Hours) 182 182 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
This request seeks to add the Presidential Management Fellowship (PMF). The PMF is a 2 year training fellowship administered by the US Office of Personnel Management. The addition of the PMF is intended to parallel other fellowship’s use of the DWD Alumni Survey.
$60,145
Yes Part B of Supporting Statement
    No
    No
No
No
No
No
Kevin Joyce 404 639-1944 [email protected]
  Yes
 
Agency/Sub Agency RCF ID RCF Title RCF Status IC Title
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
07/28/2025