School Administrators

Health Behaviors in School-Age Children Survey

Documents and Forms

Document Name Document Type
Form 1 School Administrators Form and Instruction
1 survey Attach 2.pdf Form and Instruction
09-CH-N023 Approval Memo.pdf 09-CH-N023 Approval Memo IC Document
09-CH-N023 IR.pdf 09-CH-N023 IR IC Document

Information Collection (IC) Details

IC Title:	School Administrators	Agency IC Tracking Number:

Is this a Common Form? No		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
Form and Instruction	1	survey	Attach 2.pdf		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 386	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	386	386
Annual IC Time Burden (Hours)	127	127
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
09-CH-N023 Approval Memo	09-CH-N023 Approval Memo.pdf	11/24/2008
09-CH-N023 IR	09-CH-N023 IR.pdf	11/24/2008

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