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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
6th Grade Curricula Parent Satisfaction Questionnaire
Unchanged
1890
315
0
Form and Instruction
none
Parents Matter! for Dating Matters: Participant Satisfaction Questionnaire
7th Grade Curricula Parent Satisfaction Questionnaire
Unchanged
1890
315
0
Form and Instruction
none
Dating Matters for Parents: Participant Satisfaction Questionnaire
Instruction
Brand Ambassador Implementation Survey
Unchanged
160
53
0
Form and Instruction
None
Brand Ambassador Implementation Survey
Communications Campaign Tracking
Unchanged
16
5
0
Form and Instruction
None
Communications Campaign Tracking Form
Communications Focus Groups
Unchanged
96
144
0
Instruction
Instruction
Community Capacity/Readiness Assessment
Unchanged
80
80
0
Form and Instruction
none
Community Capacity/Readiness Assessment
Educator Outcome Evaluation Survey-Follow-up
Unchanged
1584
792
0
Form and Instruction
none
Educator Outcome Survey Follow-up
Educator Outcome Survey Baseline
Unchanged
1672
836
0
Form and Instruction
None
Educator Outcome Survey (Baseline)
Local Health Department Capacity and Readiness
Unchanged
16
32
0
Form
None
Local Health Department Capacity and Readiness
Parent Curricula Implementer Focus Group Guide
Unchanged
80
80
0
Form and Instruction
PPP
Parent Curricula Implementer Consent Form for Focus Group Participation
Other-Focus Group Guide
Parent Outcome Baseline Survey
Unchanged
1919
1919
0
Form and Instruction
none
Parent/Guardian Survey
Parent Outcome Follow-up Survey
Unchanged
1818
1818
0
Form and Instruction
None
Parent Outcome Survey Follow-up
Form and Instruction
none
Parent/Guardian Consent Form
Parent Program Fidelity 6th Grade Sessions 1-6
Unchanged
630
158
0
Form
M
Parent Program Fidelity 6th Grade Session 2
Form
N
Parent Program Fidelity 6th Grade Session 3
Form
O
Parent Program Fidelity 6th Grade Session 5
Form
Q
Parent Program Fidelity 6th Grade Session 6
Form
L
Parent Program Fidelity 6th Grade Session 2
Parent Program Fidelity 7th Grade Sessions 1, 3, 5
Unchanged
378
95
0
Form
T
Parent Program Fidelity 7th Grade Session 5
Form
R
Parent Program Fidelity 7th Grade Session 1
Form
S
Parent Program Fidelity 7th Grade Session 3
Parent Program Manager TA Tracking Form
Unchanged
200
33
0
Form
none
Parent Program Manager (PPM) Technical Assistance Tracking form
STUDENT PROGRAM MASTER TRAINER TECHNICAL ASSISTANCE TRACKING FORM
Unchanged
600
100
0
Form
None
Master Trainer TA Tracking Form
School Indicators
Unchanged
15048
3762
0
Form and Instruction
4
Attachment G: School Indicators
School Leadership Capacity and Readiness Survey
Unchanged
42
42
0
Form and Instruction
None
School Leadership Capacity and Readiness Survey
Student Curricula Implementer Focus Group Guide
Unchanged
80
80
0
Form and Instruction
OOO
Student Curricula Implementer Consent Form For Focus Group Participation
Other-Focus Group Guide
Student Outcome Survey Baseline
Unchanged
11286
8465
0
Form and Instruction
None
Student Outcome Survey Baseline
Student Outcome Survey Follow-up - High School
Unchanged
10692
8910
0
Form
none
Student Outcome Survey
Student Participant Focus Group
Unchanged
80
120
0
Instruction
Instruction
Student Program Fidelity 6th Grade Sessions 1 - 6
Unchanged
480
120
0
Form and Instruction
V
Student Program Fidelity 6th Grade Session 2
Form and Instruction
U
Student Program Fidelity 6th Grade Session 1
Form and Instruction
W
Student Program Fidelity 6th Grade Session 3
Form and Instruction
X
Student Program Fidelity 6th Grade Session 4
Form and Instruction
Y
Student Program Fidelity 6th Grade Session 5
Form and Instruction
Z
Student Program Fidelity 6th Grade Session 6
Student Program Fidelity 7th Grade Sessions 1 - 7
Unchanged
560
140
0
Form and Instruction
AA
Student Program Fidelity 7th Grade Session 1
Form and Instruction
BB
Student Program Fidelity 7th Grade Session 2
Form and Instruction
CC
Student Program Fidelity 7th Grade Session 3
Form and Instruction
DD
Student Program Fidelity 7th Grade Session 4
Form and Instruction
EE
Student Program Fidelity 7th Grade Session 5
Form and Instruction
FF
Student Program Fidelity 7th Grade Session 6
Form and Instruction
GG
Student Program Fidelity 7th Grade Session 7
Student Program Fidelity 8th Grade Sessions 1 - 10
Unchanged
800
200
0
Form and Instruction
HH
Student Program Fidelity 8th Grade Session 1
Form and Instruction
II
Student Program Fidelity 8th Grade Session 2
Form and Instruction
JJ
Student Program Fidelity 8th Grade Session 3
Form and Instruction
KK
Student Program Fidelity 8th Grade Session 4
Form and Instruction
LL
Student Program Fidelity 8th Grade Session 5
Form and Instruction
MM
Student Program Fidelity 8th Grade Session 6
Form and Instruction
NN
Student Program Fidelity 8th Grade Session 7
Form and Instruction
OO
Student Program Fidelity 8th Grade Session 8
Form and Instruction
PP
Student Program Fidelity 8th Grade Session 9
Form and Instruction
QQ
Student Program Fidelity 8th Grade Session 10
Student Program Fidelity 8th Grade Sessions 1 - 10 (Standard)
Unchanged
800
200
0
Form and Instruction
DDD
Student Program Fidelity 8th Grade Session 2
Form and Instruction
EEE
Student Program Fidelity 8th Grade Session 3
Form and Instruction
CCC
Student Program Fidelity 8th Grade Session 1 (Standard)
Form and Instruction
FFF
Student Program Fidelity 8th Grade Session 4
Form and Instruction
GGG
Student Program Fidelity 8th Grade Session 5
Form and Instruction
HHH
Student Program Fidelity 8th Grade Session 6
Form and Instruction
III
Student Program Fidelity 8th Grade Session 7
Form and Instruction
KKK
Student Program Fidelity 8th Grade Session 9
Form and Instruction
JJJ
Student Program Fidelity 8th Grade Session 8
Form and Instruction
LLL
Student Program Fidelity 8th Grade Session 10
Total burden requested under this ICR:
52897
28814
0
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