Instrument 1 – Participant Survey

Creative Forces®: NEA Military Healing Arts Network Community Arts Engagement Subgranting Program Evaluation Forms

Documents and Forms

Document Name Document Type
Form Instrument 1 Instrument 1 – Participant Survey Form and Instruction
Instrument 1 Participant Survey Instrument 1 – Participant Survey.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Instrument 1 – Participant Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	Instrument 1	Participant Survey	Instrument 1 – Participant Survey.pdf		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 400	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 75 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	800	100	700
Annual IC Time Burden (Hours)	128	16	112
Annual IC Cost Burden (Dollars)	0	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.