Staff School Climate Survey

The Safe School/Healthy Student (SS/HS) Initiative National Evaluation

Documents and Forms

Document Name Document Type
Form Staff School Clima Staff School Climate Survey Form and Instruction
Staff School Clima Staff School Climate Survey 7. Staff School Climate Survey.doc Form and Instruction
9. GPRA Student Survey.doc GPRA Student Survey IC Document
1. SSHS Introduction letter.doc Introduction Letter IC Document
8. Sample Emails for Instruments.pdf Sample Emails for Instruments IC Document

Information Collection (IC) Details

IC Title:	Staff School Climate Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	Staff School Climate Survey	Staff School Climate Survey	7. Staff School Climate Survey.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 25,200	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	Previously Approved
Annual Number of Responses for this IC	25,200	-81,475	106,675
Annual IC Time Burden (Hours)	2,948	-13,483	16,431
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
GPRA Student Survey	9. GPRA Student Survey.doc	08/11/2011
Introduction Letter	1. SSHS Introduction letter.doc	08/11/2011
Sample Emails for Instruments	8. Sample Emails for Instruments.pdf	08/11/2011

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