Information Collection

Adolescent Session Evaluation Form (10 forms)

IC 188218 under ICR 200903-0990-001 · OMB 0990-0337.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0990-BodyWorks_pretest 1 29 09_parent.pdf	Other-questionnaire
0990-BodyWorks_posttest 1 29 09_parent.pdf	Other-questionnaire
0990-Parent BodyWorks Sessions 1 to 10 Evaluation Forms_012909.pdf	Other-Evalution Form
0990-Girls BodyWorks Evaluations_Sessions 1-10_012909.pdf	Other-questionnaire
0990-Parent BodyWorks Sessions Fideility Forms_1 29 09.pdf	Other-survey
0990-Parent BodyWorks Sessions 1 to 10 Evaluation Forms_012909.pdf	Other-survey

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	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-questionnaire	0990-BodyWorks_pretest 1 29 09_parent.pdf	Yes	Yes	Fillable Printable
Other-questionnaire	0990-BodyWorks_posttest 1 29 09_parent.pdf	Yes	Yes	Fillable Printable
Other-Evalution Form	0990-Parent BodyWorks Sessions 1 to 10 Evaluation Forms_012909.pdf	Yes	Yes	Fillable Fileable
Other-questionnaire	0990-Girls BodyWorks Evaluations_Sessions 1-10_012909.pdf	Yes	Yes	Fillable Printable
Other-survey	0990-Parent BodyWorks Sessions Fideility Forms_1 29 09.pdf	Yes	Yes	Fillable Printable
Other-survey	0990-Parent BodyWorks Sessions 1 to 10 Evaluation Forms_012909.pdf	Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 204

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,040	2,040
Annual IC Time Burden (Hours)	102	102
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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