Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Consumer Research for Nutrition Education and Promotion Activities Unchanged 6000 3500 0 Form and Instruction FNS-781 Team Nutrition School Enrollment Form
Form and Instruction FNS-790 Hunger Champions Award Nomination Form
Form and Instruction FNS-791 Promising Practices Submission Form
Form and Instruction FNS-792 Golden Grocer Award Nomination Form
Form and Instruction FNS-793 FNS Core Nutrition Message Feedback Form
Form FNS-807 Power Panther Costume Request and Agreement Form Eat Smart. Play Hard
Form FNS-808 Power Panther Costume Event Feedback Form
Form FNS-811 User Response Card
Form FNS-816 Level 1 Event Feedback Form
Form FNS-817 Level 3 Event Feedback Form
Form FNS-854 Attendee Evaluation Form
Other-FNS 779-780 Screen Shots
Form and Instruction FNS 779 Food and Nutrition Service (FNS) HealthierUS School Challenge Recognizing Excellence in Nutrition and Physical Activity
FDD Distribution Costs to District for USDA Foods Unchanged 54 16 0 Other-FDD Survey Distribution Costs to District for USDA Foods
FDD Qualitative Food Survey Unchanged 4680 1461 0 Other-USDA Foods Product Feedback Survey
Other-Unseasoned Chicken Strip Evaluation Survey
HHFKA CACFP Focus Group (Business Provider Group: CCC, FDC & SO) Unchanged 4492 337 0 Other-Attachment A PRE-NOTIFICATION MESSAGE FOR CHILD CARE CENTERS
Other-Attachment A Spanish PRE-NOTIFICATION MESSAGE FOR CHILD CARE CENTERS
Other-Attachment B REMINDER MESSAGE FOR CHILD CARE CENTERS
Other-Attachment C CACFP Master Survey
Other-Attachment C Spanish CACFP Master Survey
Other-Attachment D CACFP FAQs
Other-Attachment D Spanish CACFP FAQs
Other-Attachment E Master Focus Group Screener
Other-Attachment F Master FG Discussion Guide
Other-Attachment G Project Verification Letter to Participants
Other-Attachment G Spanish Project Verification Letter to Participants
Other-Attachment H Telephone Contact Script for Survey
Other-Attachment H Spanish Telephone Contact Script for Survey
Other-Non Respondent Place Holder
Other-Attachment B-Spanish Reminder Notification
HHFKA CACFP State Agencies Unchanged 250 46 0 Other-Attachment A1 Pre-Notification to SA
Other-Attachment B1 REMINDER MESSAGE FOR STATE AND TRIBAL AGENCIES
Other-Attachment E1 FOCUS GROUP SCREENING AND DEMOGRAPHIC QUESTIONS for SA
Other-Attachment F CACFP Master FG Discussion Guide
Other-Attachment D FAQ English
Other-Attachment D Spanish FAQs
Middle School Digital Nutrition (SLT) Unchanged 316 88 0 Other-Attachment A_Consent Package for Teacher Focus Groups
Other-Attachment K_Teacher Focus Group Flyer
Other-Attachment I_Initial_Contact_Email
Other-Attachment D_Teacher_Focus_Group_Guideline_Grade 6
Other-Attachment F_Teacher_Focus_Group_Guideline_Grade 7
Other-Attachment H_Teacher_Focus_Group_Guideline_Grade 8
Other-Attachment M_Focus Group Stimulus_Grade 6-rev
Other-Attachment N_Focus Group Stimulus_Grade 7-rev
Other-Attachment O_Focus Group Stimulus_Grade 8-rev
Other-Attachment L_Scheduling Email for Teacher Focus Groups
Other-Attachment J_Principal Letter of Agreement-rev2
Middle School Digital Nutrition I/H Unchanged 1992 380 0 Other-Attachment B_Consent Package for Parent_Caregivers
Other-Attachment C_Student_Focus_Group_Guideline_Grade 6
Other-Attachment E_Student_Focus_Group_Guideline_Grade 7
Other-Attachment G_Student_Focus_Group_Guideline_Grade 8-rev
Other-Attachment M_Focus Group Stimulus_Grade 6
Other-Attachment N_Focus Group Stimulus_Grade 7
Other-Attachment O_Focus Group Stimulus_Grade 8
NSLP Verification II - Business IC (IC 2 of 2) Unchanged 9 18 0 Other-Attachment E - Rolling Assignment Procedure Logic Model
NSLP Verification II - SLT IC (IC 1 of 2) Unchanged 11378 502 0 Other-Attachment A - Verification Letter_Simplified
Other-Attachment B - Reminder Letter
Other-Attachment C - Intervention Reminder Call Script
Other-Attachment D - Protocol for Participating LEAs
Other-Attachment E - Rolling Assignment Procedure Logic Model
Other-Attachment F - Report Template for HH Contact & Responses
Other-Attachment G - State Recruitment Letter
Other-Attachment H - LEA Recruitment Letter v2
Nutrition Education and Promotion Toolkit for Teens - Focus Group Testing Unchanged 5772 913 0 Other-Attachment B Parent & Guardian Consent Form for Student Participation
Other-Attachment C-Moderator Discussion Guide for FGs with High School Students
Other-Attachment D-Focus Group Teacher Participant Qualifying Questionnaire
Other-Attachment E-Moderator Discussion Guide for FGs with High School Teachers
Other-Attachment A-Focus Group Student Participant Qualifying Questionnaire
Perform Research for Loving Support Campaign Update (Phase 1) Unchanged 108 31 0 Other-Attachment A - WIC Peer Counselor In-Depth Interview Guide
Other-Attachment B - WIC State Breastfeeding Coordinators In-Depth Interview Guide
Other-Attachment C - WIC Local Breastfeeding Coordinators and Staff In-Depth Interview Guide draft _3-24-15 PRAO recommendations 3-28
Other-Attachment D - Breastfeeding Subject Matter Experts In-Depth Interview Guid
Other-Attachment E - Home-Visiting Nurses Midwives Doulas In-Depth Interview Guide
Request Approval to Perform Research for Team Nutrition Posters-Phase 2 Unchanged 5760 876 0 Other-A_FNS Screener_Student Focus Groups
Other-B_FNS Discussion Guide_Elementary School
Other-C_FNS Discussion Guide_Middle School
Other-D1 USDA CLN 1 Elementary Poster Prototypes Rnd 2
Other-D2 USDA CLN 2 Middle School Poster Prototypes Rnd 2
Other-E_Agreement on Security of Comments.doc
Other-F_Parent Consent Form
Team Nutrition Educational Materials for Summer Meals Unchanged 9740 910 0 Other-20150224 Attachment A Screener for ParentCaregivers - English
Other-20150224 Attachment A Screener for ParentCaregivers - Spanish
Other-20150511 Attachment B_Consent Form for ParentsCaregivers - English
Other-20150511 Attachment B_Consent Form for ParentsCaregivers - Spanish
Other-20150224 Attachment C Moderator's Guide for ParentCaregiver Focus Groups - English
Other-20150224 Attachment C Moderator's Guide for ParentCaregiver Focus Groups - Spanish
Other-20150224 Attachment D_Worksheet for ParentCaregiver Focus Groups - English
Other-20150224 Attachment D_Worksheet for ParentCaregiver Focus Groups - Spanish
Other-Attachment E_ParentHandout - English
Other-Attachment E_ParentHandout - Spanish
Other-Attachment F_Infographic - English
Other-Attachment F_Infographic - Spanish
Team Nutrition Educational Materials for Summer Meals - Individuals/Households (IC 2 of 2) Unchanged 3388 409 0 Other-Attachment A Active Consent Package for ParentsCaregivers_Final
Other-Attachment B Passive Consent Package for ParentsCaregivers_Final
Other-Attachment D Moderators Guide for ParentCaregiver Focus Groups_Final
Other-Attachment E Worksheet for ParentCaregive Focus Groups_Final
Other-Attachment F Focus Group Flyer for ParentsCaregivers
Other-Attachment F Focus Group Flyer for ParentsCaregivers
Other-Attachment J Taste Test Ballot and Site Operator Script_5_28
Other-Attachment K Child Survey_Final
Other-Attachment L Verbal Child Assent Script_Final
Other-Attachment G ParentCaregiver Follow Up Letter and Phone Script_5_28
Team Nutrition Educational Materials for Summer Meals - SLT (IC1 of 2) Unchanged 84 137 0 Other-Attachment C Consent Package for Site Operators_Final
Other-Attachment H Individual Interview Guide for Site Operators_Final
Other-Attachment I Journal for Site Operators_Final
Team Nutrition Educational Technology Environmental Scan Unchanged 2980 501 0 Other- Attachment A_Consent Package for School Focus Groups
Other-Attachment B_Consent Package for SHAPE Conference Focus Groups
Other-Attachment C_Consent Package for Teacher of Health Education Survey
Other-Attachment D_Moderators Guide for Teacher Focus Groups
Other-Attachment E_Teacher of Health Education Survey
Other-Attachment F_Flyer for Focus Group Participation
Other-Attachment G_Introduction Email for School Focus Groups
Other-Attachment H_Scheduling Email for School Focus Groups
Other-Attachment I_Principal Letter of Agreement
Other-Attachment J_Introduction Email for Teacher of Health Education Survey
Test Modified Communication Protocols to Reduce Household Nonresponse in NSLP/SBP Verification Process - SLT Unchanged 42996 2114 0 Other-Attachment B - Reminder Letter Final 7.13.15
Other-Attachment C - Intervention-Reminder Call Script Final 7.13.15
Other-Attachment D - Protocol for Treatment LEAs Final 7.16.15
Other-Attachment E - Protocol for Control LEAs Final 7.16.15
Other-Attachment G - State Recruitment Letter Final 7.13.15
Other-Attachment H - LEA Recruitment Letter Final 7.13.15
Other-Attachment F - Rolling assignment procedure worksheet Final 7.22.15
Other-Attachment A - Modified Verification Letter 08-24
Yogurt Pilot Survey Unchanged 696 118 0 Other-SY15 Yogurt Pilot Survey 2. 24. 15
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 100695 12357 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
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