Teacher Survey

An Impact Evaluation of a School-Based Violence Prevention Program

Documents and Forms

Document Name Document Type
Att_Appendix B Teacher Survey.pdf Other-survey
Att_1850-0814 Appendix K Teacher Survey Assent Form[1].pdf Attachment K Teacher Survey Assent Letter IC Document

Information Collection (IC) Details

IC Title:	Teacher Survey	Agency IC Tracking Number:	3941

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
Other-survey			Att_Appendix B Teacher Survey.pdf		No		Paper Only

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 960	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	960	960
Annual IC Time Burden (Hours)	480	480
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment K Teacher Survey Assent Letter	Att_1850-0814 Appendix K Teacher Survey Assent Form[1].pdf	03/27/2009

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