Interview with Middle Schoolers

Formative Research for and Community Uptake of the Eagle Books and Youth Books for American Indians and Alaska Natives

Documents and Forms

Document Name Document Type
Interview with Middle Schoolers Form
Discussion Guide for Middle Schoolers I-1 Middle Schoolers Youth Book Guide.doc Form
I-2 Middle Schoolers Parent Information Sheet.doc Att I2 - Info Sheet for Parents IC Document
I-3 Middle Schooler Parental Consent.doc Att I3 - Parental Consent IC Document
I-4 Middle Schooler Youth Assent Form.doc Att I4 - Youth Assent IC Document

Information Collection (IC) Details

IC Title:	Interview with Middle Schoolers	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	none	Discussion Guide for Middle Schoolers	I-1 Middle Schoolers Youth Book Guide.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 8	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	8	8
Annual IC Time Burden (Hours)	8	8
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Att I2 - Info Sheet for Parents	I-2 Middle Schoolers Parent Information Sheet.doc	07/20/2011
Att I3 - Parental Consent	I-3 Middle Schooler Parental Consent.doc	07/20/2011
Att I4 - Youth Assent	I-4 Middle Schooler Youth Assent Form.doc	07/20/2011

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