NSLP/SBP Access, Participation, Eligibility, and Certification Study

OMB Approval No.: 0584-0530

Approval Expires:

^{NSLP AND SBP ACCESS, PARTICIPATION, ELIGIBILITY, AND CERTIFICATION STUDY}

(APEC-II)

SAMPLING INFORMATION FORM FOR MEAL TRANSACTIONS

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this collection is 0584-0530. The time required to complete this information collection is estimated to average 15 minutes per response, including the time to review instructions, searching existing data resources, gather the data needed, and complete and review the information collected.

^{SAMPLING INFORMATION FORM}

FOR MEAL TRANSACTIONS

_{School District:}

_{School District ID:}

_School:

_{School ID:}

OBSERVATION DAY: DATE: | | | / | | | /| | | | | Month Day Year

Complete the information listed below in the grids for all points of sale operating during the observation day, separately for breakfast and lunch.

(A) Breakfast

Separately for each line/cashier operating during breakfast, enter (a) the cash register number, (b) breakfast periods available during the meal occasion, and (c) the approximate number of transactions during breakfast. DO NOT INCLUDE POINTS OF SALE THAT ARE “A LA CARTE” ONLY.

POINTS OF SALE: SCHOOL BREAKFAST
(a) Cash Register No.	(b) Periods Operating	(c) Approximate Number of Daily Breakfast Transactions
1.	1 2 3 4 5 6
2.	1 2 3 4 5 6
3.	1 2 3 4 5 6
4.	1 2 3 4 5 6
5.	1 2 3 4 5 6
6.	1 2 3 4 5 6
7.	1 2 3 4 5 6
8.	1 2 3 4 5 6

(B) School Lunch

Separately for each line/cashier operating during lunch, enter (a) the cash register number, (b) lunch periods available during the meal occasion, and (c) the approximate number of daily transactions during lunch. DO NOT INCLUDE POINTS OF SALE THAT ARE “A LA CARTE” ONLY.

POINTS OF SALE: SCHOOL LUNCH
(a) Cash Register No.	(b) Periods Operating	(c) Approximate Number of Daily Lunch Transactions
1.	1 2 3 4 5 6
2.	1 2 3 4 5 6
3.	1 2 3 4 5 6
4.	1 2 3 4 5 6
5.	1 2 3 4 5 6
6.	1 2 3 4 5 6
7.	1 2 3 4 5 6
8.	1 2 3 4 5 6
9.	1 2 3 4 5 6
10.	1 2 3 4 5 6
11.	1 2 3 4 5 6
12.	1 2 3 4 5 6

period for breakfast. Record the information for breakfast in the grid below.

TRANSACTION SELECTIONS FOR OBSERVED POINTS OF SALE: SCHOOL BREAKFAST
Cash Register No.	Period	Observer	Transactions to Select
 			First Transaction to Observe: Sampling Interval:
 			First Transaction to Observe: Sampling Interval:
 			First Transaction to Observe: Sampling Interval:
 			First Transaction to Observe: Sampling Interval:
 			First Transaction to Observe: Sampling Interval:
 			First Transaction to Observe: Sampling Interval:
 			First Transaction to Observe: Sampling Interval:
 			First Transaction to Observe: Sampling Interval:

period for lunch. Record the information for lunch in the grid below.

TRANSACTION SELECTIONS FOR OBSERVED POINTS OF SALE: SCHOOL LUNCH
Cash Register No.	Period	Observer	Transactions to Select
 			First Transaction to Observe: Sampling Interval:
 			First Transaction to Observe: Sampling Interval:
 			First Transaction to Observe: Sampling Interval:
 			First Transaction to Observe: Sampling Interval:
 			First Transaction to Observe: Sampling Interval:
 			First Transaction to Observe: Sampling Interval:
 			First Transaction to Observe: Sampling Interval:
 			First Transaction to Observe: Sampling Interval:
 			First Transaction to Observe: Sampling Interval:
 			First Transaction to Observe: Sampling Interval:

Prepared by Mathematica Policy Research, Inc.