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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Digital Nutrition Education Materials for Middle School Teachers (SLT) - IC 1 of 2
Agency IC Tracking Number:
IC Status:
New
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-Attachment A Consent Package for Teachers: Teacher Consent Cover Letter, Teacher Informed Consent Form, Questionnaire for Participation in Pilot
Attachment A_Consent Package for Teachers_Final.docx
No
Paper Only
Other-Attachment I Teacher Focus Group Guideline
Attachment I_Teacher Focus Group Guideline_FInal.docx
No
Paper Only
Other-Attachment J Teacher Interview Guideline: Grade 6
Attachment J_Teacher Interview Guideline_Grade 6 Final.docx
No
Paper Only
Other-Attachment K Teacher Journal: Grade 6
Attachment K_Teacher Journal Grade 6 Final.docx
No
Paper Only
Other-Attachment L Teacher Interview Guideline: Grade 7
Attachment L_Teacher Interview Guideline_Grade 7 Final.docx
No
Paper Only
Other-Attachment M Teacher Journal: Grade 7
Attachment M_Teacher Journal Grade 7 Final.docx
No
Paper Only
Other-Attachment N Teacher Interview Guideline: Grade 8
Attachment N_Teacher Interview Guideline_Grade 8 Final.docx
No
Paper Only
Other-Attachment O Teacher Journal: Grade 8
Attachment O_Teacher Journal Grade 8 Final.docx
No
Paper Only
Other-Attachment P Teacher and Principal Communication Documents: Initial Contact Email, Follow Up to Initial Contact Email, and Information about Pilot Opportunity
Attachment P_Teacher and Principal Communication Documents_Final.docx
No
Paper Only
Other-Attachment Q Principal Letter of Agreement
Attachment Q_Principal Letter of Agreement_Final.docx
No
Paper Only
Other-Attachment B Consent Package for Parent/Caregivers: Parent/Caregiver Consent Cover Letter, Parent/Caregiver Passive Consent Information
Attachment B_Consent Package for Parent Final.docx
No
Paper Only
Other-Attachment C Student Focus Group Package for Grade 6: Student Focus Group Guideline, Student Focus Group Questionnaire
Attachment C_Student Focus Group Package_Grade 6_Final.docx
No
Paper Only
Other-Attachment D Student Survey: Grade 6
Attachment D_Student Survey Grade 6 Final.docx
No
Paper Only
Other-Attachment E Student Focus Group Package for Grade 7: Student Focus Group Guideline, Student Focus Group Questionnaire
Attachment E_Student Focus Group Package_Grade 7 Final.docx
No
Paper Only
Other-Attachment F Student Survey: Grade 7
Attachment F_Student Survey Grade 7 Final.docx
No
Paper Only
Other-Attachment G Student Focus Group Package for Grade 8: Student Focus Group Guideline, Student Focus Group Questionnaire
Attachment G_Student Focus Group Package_Grade 8 Final.docx
No
Paper Only
Other-Attachment H Student Survey: Grade 8
Attachment H_Student Survey Grade 8 Final.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
Food and Nutrition Assistance
Privacy Act System of Records
Title:
FNS-8 FNS Studies and Reports
FR Citation:
56 FR 19078
Number of Respondents:
272
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 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
662
0
662
0
0
0
Annual IC Time Burden (Hours)
375
0
375
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment R-1 Grade 6 Lesson Plan
Attachment R-1_Grade 6 Lesson Plan Final.pdf
02/28/2017
Attachment R-2 Grade 6 Informational Text Articles
Attachment R-2_Grade 6 Informational Text Articles-Final.pdf
02/28/2017
Attachment R-3 Grade 6 Informational Text Teacher Guide & Student Assessment
Attachment R-3_Grade 6 Informational Text Teacher Guide + Student Assessment-Final.pdf
02/28/2017
Attachment R-4 Grade 6 Video Storyboard
Attachment R-4_Grade 6 Video Storyboard-Final.pdf
02/28/2017
Attachment R-5 Grade 6 Interactive Wireframe
Attachment R-5_Grade 6 Interactive Wireframe-Final.pdf
02/28/2017
Attachment S-1 Grade 7 Lesson Plan
Attachment S-1_Grade 7 Lesson Plan-Final.pdf
02/28/2017
Attachment S-2 Grade 7 Informational Text Articles
Attachment S-2_Grade 7 Informational Text Articles-Final.pdf
02/28/2017
Attachment S-3 Grade 7 Informational Text Teacher Guide & Student Assessment
Attachment S-3_Grade 7 Informational Text Teacher Guide + Student Assessment-Final.pdf
02/28/2017
Attachment S-4 Grade 7 Video Storyboard
Attachment S-4_Grade 7 Video Storyboard-Final.pdf
02/28/2017
Attachment S-5 Grade 7 Interactive Wireframe
Attachment S-5_Grade 7 Interactive Wireframe-Final.pdf
02/28/2017
Attachment T-1 Grade 8 Lesson Plan
Attachment T-1_Grade 8 Lesson Plan-Final.pdf
02/28/2017
Attachment T-2 Grade 8 Informational Text Articles
Attachment T-2_Grade 8 Informational Text Articles-Final.pdf
02/28/2017
Attachment T-3 Grade 8 Informational Text Teacher Guide & Student Assessment
Attachment T-3_Grade 8 Informational Text Article Teacher Guide + Student Assessment-Final.pdf
02/28/2017
Attachment T-4 Grade 8 Video Storyboard
Attachment T-4_Grade 8 Video Storyboard-Final.pdf
02/28/2017
Attachment T-5 Grade 8 Interactive Wireframe
Attachment T-5_Grade 8 Interactive Wireframe - Final.pdf
02/28/2017
20170223 Middle School Digital Nutrition Pilot_OMB Memo_FInal
20170223 Middle School Digital Nutrition Pilot_OMB Memo_FInal.pdf
02/28/2017
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.