Information Collection

Classroom Data Collection

IC 197640 under ICR 201105-0920-006 · OMB 0920-0445.

⚠️ Notice: This information collection may be referencing outdated material.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

2013-07-09 - Reinstatement with change of a previously approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 24 Health Education Classroom Questionnaire Classroom Data Collection	Form and Instruction
Form 25 Health Education Classroom Questionnaire 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

View Information Collection (IC)

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:

table that charts list of 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

Federal Enterprise Architecture Business Reference Module

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 %

table that charts list of burden
	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

table that charts IC Documents
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.