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Classroom Data Collection
School Health Policies and Practices Study 2012
OMB: 0920-0445
IC ID: 197640
OMB.report
HHS/CDC
OMB 0920-0445
ICR 201307-0920-004
IC 197640
( )
Documents and Forms
Document Name
Document Type
Form 24
Classroom Data Collection
Form and Instruction
24 Health Education Classroom Questionnaire
Appendix G-21 Health Education_Classroom.doc
Form and Instruction
25 Health Education Classroom Questionnaire
Appendix G-22 Physical Education_Classroom.doc
Form and Instruction
Appendix H-4 District Recruitment Script.doc
Appendix H-4 District Recruitment Script
IC Document
Appendix E-2 District Participant Notification Document.doc
Appendix E-2 District Participant Notification Document
IC Document
Appendix H-6 District-level Content Outlines.doc
Appendix H-6 District-level Content Outlines
IC Document
Appendix H-1 State Letter of Invitation.doc
Appendix H-1 State Letter of Invitation
IC Document
Appendix H-5 State-level Content Outlines.doc
Appendix H-5 State-level Content Outlines
IC Document
Appendix E-1 State Participant Notification Document-revised.docx
Appendix E-1 State Participant Notification Document-revised
IC Document
Appendix I-1 - School Letter of Invitation.doc
Appendix I-1 - School Letter of Invitation
IC Document
Appendix E-3 School Participant Notification Document.doc
Appendix E-3 School Participant Notification Document
IC Document
Appendix E-4 Classroom Participant Notification Document.doc
Appendix E-4 Classroom Participant Notification Document
IC Document
Appendix I-4 Classroom-level Content Outlines.doc
Appendix I-4 Classroom-level Content Outlines
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Classroom Data Collection
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Removed
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
24
Health Education Classroom Questionnaire
Appendix G-21 Health Education_Classroom.doc
Yes
Yes
Fillable Fileable
Form and Instruction
25
Health Education Classroom Questionnaire
Appendix G-22 Physical Education_Classroom.doc
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Education
Subfunction:
Elementary, Secondary, and Vocational Education
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
2,002
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
95 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
0
0
0
0
0
0
Annual IC Time Burden (Hours)
0
0
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Appendix H-4 District Recruitment Script
Appendix H-4 District Recruitment Script.doc
04/29/2011
Appendix E-2 District Participant Notification Document
Appendix E-2 District Participant Notification Document.doc
04/29/2011
Appendix H-6 District-level Content Outlines
Appendix H-6 District-level Content Outlines.doc
04/29/2011
Appendix H-1 State Letter of Invitation
Appendix H-1 State Letter of Invitation.doc
05/02/2011
Appendix H-5 State-level Content Outlines
Appendix H-5 State-level Content Outlines.doc
05/02/2011
Appendix E-1 State Participant Notification Document-revised
Appendix E-1 State Participant Notification Document-revised.docx
05/02/2011
Appendix I-1 - School Letter of Invitation
Appendix I-1 - School Letter of Invitation.doc
05/02/2011
Appendix E-3 School Participant Notification Document
Appendix E-3 School Participant Notification Document.doc
05/02/2011
Appendix E-4 Classroom Participant Notification Document
Appendix E-4 Classroom Participant Notification Document.doc
05/02/2011
Appendix I-4 Classroom-level Content Outlines
Appendix I-4 Classroom-level Content Outlines.doc
05/02/2011
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.