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Instrument 1 - Participant Entry Survey
OPRE Descriptive Study - Sexual Risk Avoidance Education Program Performance Analysis Study (SRAE PAS) [Descriptive Study - Performance Measures]
OMB: 0970-0536
IC ID: 236136
OMB.report
HHS/ACF
OMB 0970-0536
ICR 202411-0970-007
IC 236136
( )
Documents and Forms
Document Name
Document Type
Instrument 1_SRAE HS Entry Survey_0825_CLEAN_updated 103124.docx
Other-High School Entry Survey
Instrument 1a_SRAE MS Entry Survey_0825_updated CLEAN_103124.docx
Other-Middle School Entry Survey
Instrument 1b_SRAE IMPACT HS Entry Survey_110321_clean.docx
Other-High School Entry Survey (Shor
Instrument 1c_SRAE IMPACT MS Entry Survey_110321_clean.docx
Other-Middle School Entry Survey (Sh
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Instrument 1 - Participant Entry 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
Other-High School Entry Survey
Instrument 1_SRAE HS Entry Survey_0825_CLEAN_updated 103124.docx
Yes
Yes
Fillable Fileable
Other-Middle School Entry Survey
Instrument 1a_SRAE MS Entry Survey_0825_updated CLEAN_103124.docx
Yes
Yes
Fillable Fileable
Other-High School Entry Survey (Short Version)
Instrument 1b_SRAE IMPACT HS Entry Survey_110321_clean.docx
Yes
Yes
Fillable Fileable
Other-Middle School Entry Survey (Short Version)
Instrument 1c_SRAE IMPACT MS Entry Survey_110321_clean.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,391,697
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Requested
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
463,853
0
0
0
0
463,853
Annual IC Time Burden (Hours)
61,837
0
0
0
0
61,837
Annual IC Cost Burden (Dollars)
0
0
0
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.