Classroom Data Collection

School Health Policies and Practices Study 2012

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0445 can be found here:

Documents and Forms

Document Name Document Type
Form 24 Classroom Data Collection Form and Instruction
24 Health Education Classroom Questionnaire Appendix G-21 Health Education_Classroom.doc Form and Instruction
25 Health Education Classroom Questionnaire Appendix G-22 Physical Education_Classroom.doc Form and Instruction
Appendix H-4 District Recruitment Script.doc Appendix H-4 District Recruitment Script IC Document
Appendix E-2 District Participant Notification Document.doc Appendix E-2 District Participant Notification Document IC Document
Appendix H-6 District-level Content Outlines.doc Appendix H-6 District-level Content Outlines IC Document
Appendix H-1 State Letter of Invitation.doc Appendix H-1 State Letter of Invitation IC Document
Appendix H-5 State-level Content Outlines.doc Appendix H-5 State-level Content Outlines IC Document
Appendix E-1 State Participant Notification Document-revised.docx Appendix E-1 State Participant Notification Document-revised IC Document
Appendix I-1 - School Letter of Invitation.doc Appendix I-1 - School Letter of Invitation IC Document
Appendix E-3 School Participant Notification Document.doc Appendix E-3 School Participant Notification Document IC Document
Appendix E-4 Classroom Participant Notification Document.doc Appendix E-4 Classroom Participant Notification Document IC Document
Appendix I-4 Classroom-level Content Outlines.doc Appendix I-4 Classroom-level Content Outlines IC Document

Information Collection (IC) Details

IC Title:	Classroom Data Collection	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	24	Health Education Classroom Questionnaire	Appendix G-21 Health Education_Classroom.doc		Yes	Yes	Fillable Fileable
Form and Instruction	25	Health Education Classroom Questionnaire	Appendix G-22 Physical Education_Classroom.doc		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,002	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,002	2,002
Annual IC Time Burden (Hours)	3,003	3,003
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix H-4 District Recruitment Script	Appendix H-4 District Recruitment Script.doc	04/29/2011
Appendix E-2 District Participant Notification Document	Appendix E-2 District Participant Notification Document.doc	04/29/2011
Appendix H-6 District-level Content Outlines	Appendix H-6 District-level Content Outlines.doc	04/29/2011
Appendix H-1 State Letter of Invitation	Appendix H-1 State Letter of Invitation.doc	05/02/2011
Appendix H-5 State-level Content Outlines	Appendix H-5 State-level Content Outlines.doc	05/02/2011
Appendix E-1 State Participant Notification Document-revised	Appendix E-1 State Participant Notification Document-revised.docx	05/02/2011
Appendix I-1 - School Letter of Invitation	Appendix I-1 - School Letter of Invitation.doc	05/02/2011
Appendix E-3 School Participant Notification Document	Appendix E-3 School Participant Notification Document.doc	05/02/2011
Appendix E-4 Classroom Participant Notification Document	Appendix E-4 Classroom Participant Notification Document.doc	05/02/2011
Appendix I-4 Classroom-level Content Outlines	Appendix I-4 Classroom-level Content Outlines.doc	05/02/2011

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