Form S Instrument

Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0542).  Do not return the completed form to this address.

OMB #: 0925-0542

Expiration Date: 4-30-08

FORM S

Brain Power!

The NIDA Junior Scientists Program

Parents of Students in Grades K-8

Parent Feedback Postcard

Please take a minute to look over the attached newsletters for each module that your child will be studying in the Brain Power! curriculum unit, then answer the questions below. Afterwards, please drop this pre-addressed, pre-paid postcard in any mailbox. We appreciate your timely response.

1. What grade is your child/children in? (Circle all that apply.) K 1 2 3 4 5 6 7 8

2. Do you feel that the information in the Brain Power! curriculum is age-appropriate for your children?

Yes Somewhat No Don’t know

3. Do you feel that it is important to teach children about the topics presented in the program?

Yes Somewhat No Don’t know

4. Do you think that Brain Power! materials will make you more comfortable talking to your child/children about drug use and abuse? Yes Somewhat No Don’t know

5. Do you think the content in Brain Power! is engaging for your child/children?

Yes Somewhat No Don’t know

6. Would you be willing to have a member of our evaluation team contact you to answer additional questions regarding Brain Power! materials? Yes No If yes, please provide a name and phone number and/or email address. _______________________________________________________

THANK YOU!