Information Collection

The Safe Schools/Healthy Students (SS/HS) National Evaluation

IC 178968 under ICR 200703-0930-001 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Staff Climate Surv The Safe Schools/Healthy Students (SS/HS) National Evaluation	Form and Instruction
Staff Climate Surv Staff Climate Survey Attachment1.doc	Form and Instruction
OMB Supporting StatementAttachments2-4.doc Letters	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Staff Climate Survey	Staff Climate Survey	Attachment1.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 70,875

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	70,875	70,875
Annual IC Time Burden (Hours)	8,269	8,269
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Letters	OMB Supporting StatementAttachments2-4.doc

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