CPTED Administration by Teachers

Crime Prevention Through Environmental Design: Linking Observed School Environments with Student and School-wide Experiences of Violence and Fear

Documents and Forms

Document Name Document Type
Form 2 CPTED Administration by Teachers Form and Instruction
2 CPTED Student Survey APPENDIX G_CPTED Student Survey.doc Form and Instruction
1 CPTED School Site Data Form APPENDIX F_CPTED School Site Data Form.doc Form and Instruction
3 CRIME PREVENTION THROUGH ENVIRONMENTAL DESIGN (CPTED) ST APPENDIX N 3459~1.DOC Form
APPENDIX E.docx APPENDIX E IC Document
APPENDIX K_School Administrator Consent Form_OMB.doc APPENDIX K_School Administrator Consent Form_OMB IC Document
APPENDIX H 1362~1.DOC APPENDIX H 1362~1 IC Document
APPENDIX I_CPTED Parental Permission Form and Survey Fact Sheet.doc APPENDIX I_CPTED Parental Permission Form and Survey Fact Sheet IC Document
APPENDIX J_Parental Permission Form Reminder Notice_OMB.doc APPENDIX J_Parental Permission Form Reminder Notice_OMB IC Document
APPENDIX P_CPTED Student Survey Make-Up List_OMB_110410.doc APPENDIX P_CPTED Student Survey Make-Up List_OMB_110410 IC Document
APPENDIX Q_CPTED Student Survey Administration Guide_OMB.doc APPENDIX Q_CPTED Student Survey Administration Guide_OMB IC Document
APPENDIX R_Summary of School Arrangements Form_OMB.doc APPENDIX R_Summary of School Arrangements Form_OMB IC Document

Information Collection (IC) Details

IC Title:	CPTED Administration by 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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	2	CPTED Student Survey	APPENDIX G_CPTED Student Survey.doc	No	No	Paper Only
Form and Instruction	1	CPTED School Site Data Form	APPENDIX F_CPTED School Site Data Form.doc	Yes	Yes	Fillable Fileable
Form	3	CRIME PREVENTION THROUGH ENVIRONMENTAL DESIGN (CPTED) STUDENT SURVEY	APPENDIX N 3459~1.DOC	No	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
APPENDIX E	APPENDIX E.docx	05/16/2011
APPENDIX K_School Administrator Consent Form_OMB	APPENDIX K_School Administrator Consent Form_OMB.doc	05/16/2011
APPENDIX H 1362~1	APPENDIX H 1362~1.DOC	05/16/2011
APPENDIX I_CPTED Parental Permission Form and Survey Fact Sheet	APPENDIX I_CPTED Parental Permission Form and Survey Fact Sheet.doc	05/16/2011
APPENDIX J_Parental Permission Form Reminder Notice_OMB	APPENDIX J_Parental Permission Form Reminder Notice_OMB.doc	05/16/2011
APPENDIX P_CPTED Student Survey Make-Up List_OMB_110410	APPENDIX P_CPTED Student Survey Make-Up List_OMB_110410.doc	05/16/2011
APPENDIX Q_CPTED Student Survey Administration Guide_OMB	APPENDIX Q_CPTED Student Survey Administration Guide_OMB.doc	05/16/2011
APPENDIX R_Summary of School Arrangements Form_OMB	APPENDIX R_Summary of School Arrangements Form_OMB.doc	05/16/2011

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