Survey Support from Teachers

NATIONAL YOUTH PHYSICAL ACTIVITY AND NUTRITION STUDY

Documents and Forms

Document Name Document Type
Form 1 Survey Support from Teachers Form
1 Data Collection Checklist - NYPANS Appendix J - Data Collection Checklist and Make-up List and Instructions.doc Form
Appendix J1 - Letter to Teachers in Particpating Classes.doc Appendix J1 - Letter to Teachers in Particpating Classes IC Document

Information Collection (IC) Details

IC Title:	Survey Support from Teachers	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	1	Data Collection Checklist - NYPANS	Appendix J - Data Collection Checklist and Make-up List and Instructions.doc		No	No	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 400	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	400	400
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix J1 - Letter to Teachers in Particpating Classes	Appendix J1 - Letter to Teachers in Particpating Classes.doc	06/16/2009

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