SNAP Teen Nutrition Pilot Test (State Agencies - Teachers)

FNS Generic Clearance For Pre-Testing, Pilot, And Field Test Studies

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0606 can be found here:

Documents and Forms

Document Name Document Type
Attachment A - Quantitative Evaluation Survey for High School Students 0...-1.docx krcresearch.az1.qualtrics.com/SE/?SID=SV_czIsBramP7KBuPb Other-Attachment A - Quantitative Ev
Attachment B - Moderator PRE - Discussion Guide for Focus Groups with Hi....docx Other-Attachment B - Moderator PRE -
Attachment C - Moderator POST - Discussion Guide for Focus Groups with High School Students060116.docx Other-Attachment C - Moderator POST
Attachment D - Moderator PRE - Discussion Guide for Focus Groups with High School Teachers 060116.docx Other-Attachment D - Moderator PRE -
Attachment E- Moderator POST - Discussion Guide for Focus Groups with High School Teachers 060116.docx Other-Attachment E- Moderator POST -
Attachment F - Parent Guardian Focus Group Consent Form for Student Participation 060116.docx Other-Attachment F - Parent Guardian
0584-0606 FNS SNAP Teen Nutrition Pilot Test OMB Package Memo 6-2-16 clean version-1.docx 0584-0606 FNS SNAP Teen Nutrition Pilot Test OMB Package Memo 6-2-16 clean version IC Document
Attachment G - Teen Nutrition and Physical Activity Program 060216.pdf Attachment G - Teen Nutrition and Physical Activity Program 060216 IC Document

Information Collection (IC) Details

IC Title:	SNAP Teen Nutrition Pilot Test (State Agencies - Teachers)	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Attachment B - Moderator PRE - Discussion Guide for Focus Groups with Hi...	Attachment B - Moderator PRE - Discussion Guide for Focus Groups with Hi....docx		No		Paper Only
Other-Attachment C - Moderator POST - Discussion Guide for Focus Groups with High School Students 060116	Attachment C - Moderator POST - Discussion Guide for Focus Groups with High School Students060116.docx		No		Paper Only
Other-Attachment D - Moderator PRE - Discussion Guide for Focus Groups with High School Teachers 052516	Attachment D - Moderator PRE - Discussion Guide for Focus Groups with High School Teachers 060116.docx		No		Paper Only
Other-Attachment E- Moderator POST - Discussion Guide for Focus Groups with High School Teachers 060116	Attachment E- Moderator POST - Discussion Guide for Focus Groups with High School Teachers 060116.docx		No		Paper Only
Other-Attachment A - Quantitative Evaluation Survey for High School Students 0...-1	Attachment A - Quantitative Evaluation Survey for High School Students 0...-1.docx	https://krcresearch.az1.qualtrics.com/SE/?SID=SV_czIsBramP7KBuPb	Yes	Yes	Fillable Fileable Signable
Other-Attachment F - Parent Guardian Focus Group Consent Form for Student Participation 060116	Attachment F - Parent Guardian Focus Group Consent Form for Student Participation 060116.docx		No		Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 11	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	33	33
Annual IC Time Burden (Hours)	55	55
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
0584-0606 FNS SNAP Teen Nutrition Pilot Test OMB Package Memo 6-2-16 clean version	0584-0606 FNS SNAP Teen Nutrition Pilot Test OMB Package Memo 6-2-16 clean version-1.docx	06/02/2016
Attachment G - Teen Nutrition and Physical Activity Program 060216	Attachment G - Teen Nutrition and Physical Activity Program 060216.pdf	06/02/2016

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.