Appendix G5 Site Info Request

OMB Control No.:0584-NEW

Expiration Date: xx/xx/xxxx

Public reporting burden for this collection of information is estimated to average xx minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Department of Agriculture, Food and Nutrition Services, Office of Policy Support, 3101 Park Center Drive, Room 1014, Alexandria, VA 22302 ATTN: PRA (0584-xxxx*). Do not return the completed form to this address

Appendix G5 SITE INFO REQUEST

<Date>

USDA Food and Nutrition Service
Office of Policy Support
3101 Park Center Drive, Room 1014
Alexandria, VA 22302

RE: Site information request - <Sponsor Organization> - Participant Characteristics Study (AG-3198-C-13-0016)

Dear <Sponsor Organization Director’s Name>,

Thank you for your participation in the U.S. Department of Agriculture’s Food and Nutrition Service study on summer meals programs. Enclosed/attached you will find a list of questions and answers from the recent webcast that may be useful to you in your effort to help us with this study. In order to conduct this study, we need a complete list of the summer meals sites that you operate by <date>.

For each site, please provide the following information:

• Site name

• Sites address (street number, street, city, state, zip) in separate columns

• Site dates of operation (Start date | End date)

• Site average daily attendance (ADA)

• Meal types served at site (breakfast, lunch, snacks, etc.)

• Site type (open, restricted open, closed enrolled)

• Meal counts per site in 2014 or the number of meals by type you expect a new site to provide this summer

• New or returning site, i.e. did it operate in Summer 2014

You may email, fax, or mail your list using the contact information below:

Email: SFSP@optimalsolutionsgroup.com
Fax: (301) 985-3760
Mail: Optimal Solutions Group, Attention: SFSP Sites, 5825 University Research Ct., Ste 2800, College Park, MD 20740

If you have any questions or concerns about your participation in this study, please contact Optimal at 877-776-8501 or SFSP@optimalsolutionsgroup.com.

For inquiries about the authorization of this study, please contact Dr. Chan Chanhatasilpa at FNS Headquarters at 703-305-2115 or chanchalat.chanhatasilpa@fns.usda.gov.

Thank you for your time and cooperation.

Sincerely,

Dr. Mark Turner
Project Director

Enclosure