Information Collection

Consumer Research for Nutrition Education and Promotion Activities

IC 192056 under ICR 201207-0584-007 · OMB 0584-0524.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0524 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FNS-781 Team Nutrition School Enrollment Form Consumer Research for Nutrition Education and Promotion Activities	Form and Instruction
Form FNS-779 Gold Application for Recognizing Excellence in Nutrition and Physical Activity Consumer Research for Nutrition Education and Promotion Activities	Form and Instruction
Form FNS-780 Bronze/Silver Recognizing Excellence in Nutrition and Physical Activity Consumer Research for Nutrition Education and Promotion Activities	Form and Instruction
Form FNS-790 Hunger Champions Nomination Form Consumer Research for Nutrition Education and Promotion Activities	Form and Instruction
Form FNS-791 Promising Practices Submission Form Consumer Research for Nutrition Education and Promotion Activities	Form and Instruction
Form FNS-793 FNS Core Nutrition Messags Feedback Form Consumer Research for Nutrition Education and Promotion Activities	Form and Instruction
Form FNS 792 Golden Grocer Award Nomination Form Consumer Research for Nutrition Education and Promotion Activities	Form and Instruction
Form FNS 803 User Response Form Consumer Research for Nutrition Education and Promotion Activities	Form
Form FNS 804 Healthy Lifestyle User Response Consumer Research for Nutrition Education and Promotion Activities	Form
Form FNS 805 Kids User Response Consumer Research for Nutrition Education and Promotion Activities	Form
Form FNS 813 Power Partner Commitment Consumer Research for Nutrition Education and Promotion Activities	Form
Form FNS 807 Power Panther Request and Agreement Consumer Research for Nutrition Education and Promotion Activities	Form
Form FNS 808 Event Feedback (Power Panther) Consumer Research for Nutrition Education and Promotion Activities	Form
Form FNS 809 Promote and Support Breastfeeding Feedback Consumer Research for Nutrition Education and Promotion Activities	Form
Form FNS 810 Promote Fruits and Vegetables in Your Workplace Consumer Research for Nutrition Education and Promotion Activities	Form
Form FNS 811 User Response Card Consumer Research for Nutrition Education and Promotion Activities	Form
Form FNS 812 Activity Kit User Response Form Consumer Research for Nutrition Education and Promotion Activities	Form
Form FNS 779 Gold/Gold Award of Distinction Application Consumer Research for Nutrition Education and Promotion Activities	Form and Instruction
Form FNS 780 Bronze/Silver Award Application Consumer Research for Nutrition Education and Promotion Activities	Form and Instruction
Form FNS 816 Level I Feedback Consumer Research for Nutrition Education and Promotion Activities	Form
Form FNS 817 Level III Feedback Form Consumer Research for Nutrition Education and Promotion Activities	Form
Administrators Screener USDA Food Program.doc	Other-Screening Guide
CNP Benchmark Screen Shots USDA Food Program.doc www.globaltestmarket.com/survey/s.phtml?sn=151310&demo=1&lang=E&secid=daecaa	Other-Questionnaire
CNP Screen Shots USDA Food Program.doc www.globaltestmarket.com/survey/s.phtml?sn=151310&demo=1&lang=E&secid=daecaa	Other-Questionnaire
CNP Screener USDA Food Program.doc	Other-Screener Guide
Confidentiality_Agreements_USDA Food Program.doc	Other-Confidentiality Agreements
IDI_Script_USDA Food Program.doc	Other-Script
Parents_Guides_USDA Food Program.doc	Other-Parent Guide
Partner_Screener_USDA Food Program.doc	Other-Partner Screener
Recruitment_Screeners_USDA Food Program.doc	Other-Recruitment Screener
Teacher Benchmark Q USDA Food Program.doc	Other-Teacher Benchmark
Teacher Benchmark Screen Shots USDA Foods.doc mrd.saynation.com/MRDSAYNATION/QSurvey/?UID=panelist&SID=S195377173683131&TEST=1	Other-Teacher Benchmark
Teacher Screener - USDA Food Program.doc	Other-Teacher Screener
Teacher_Guide_USDA Food Program.doc	Other-Teacher Guide
FNS-781 Team Nutrition School Enrollment Form FNS-781 - Team Nutrition.pdf healthymeals.nal.usda.gov/hsmrs/hussc	Form and Instruction
FNS-779 Gold Application for Recognizing Excellence in Nutrition FNS-779.pdf	Form and Instruction
FNS-780 Bronze/Silver Recognizing Excellence in Nutrition and Ph FNS-780.pdf	Form and Instruction
FNS-790 Hunger Champions Nomination Form FNS-790.pdf www.fns.usda.gov//snap/outreach/default.htm	Form and Instruction
FNS-791 Promising Practices Submission Form FNS-791.pdf www.fns.usda.gov/snap/outreach/default.htm	Form and Instruction
FNS-793 FNS Core Nutrition Messags Feedback Form FNS-793.pdf	Form and Instruction
FNS 792 Golden Grocer Award Nomination Form FNS-792.pdf www.fns.usda.gov/snap/outreach/default.htm	Form and Instruction
FNS 803 User Response Form FNS 803 Wed Site User Response Form (ESPH Educators).doc [email protected]	Form
FNS 804 Healthy Lifestyle User Response FNS 804 Healthy Lifestyle Web User Response Form.doc [email protected]	Form
FNS 805 Kids User Response FNS-805 Kids Web Site User Response Form.doc [email protected]	Form
FNS 813 Power Partner Commitment FNS-813 Power Partner Commitment Form.doc [email protected]	Form
FNS 807 Power Panther Request and Agreement FNS-807 Power Panther Request and Agreement Form.doc	Form
FNS 808 Event Feedback (Power Panther) FNS 808- Event Feedback Form (Power Panther).doc [email protected]	Form
FNS 809 Promote and Support Breastfeeding Feedback FNS 809 Promote and support breasfeeding feedback form.doc www.fns.usda.gov/ora/SNAP/TakeAction/TakeAction.htm	Form
FNS 810 Promote Fruits and Vegetables in Your Workplace FNS 810 Promote Fruits and Vegetables in Your Workplace & Community.doc www.fns.usda.gov/ora/SNAP/TakeAction/TakeAction.htm	Form
FNS 811 User Response Card FNS -811 User Response Card-LYFFF.doc www.fns.usda.gov/snap/nutrition_education/	Form
FNS 812 Activity Kit User Response Form FNS-812 ACTIVITY KIT USER RESPONSE FORM(ESLS).doc www.fns.usda.gov/snap/nutrition_education/	Form
FNS 779 Gold/Gold Award of Distinction Application 779.pdf	Form and Instruction
FNS 780 Bronze/Silver Award Application FNS-780.pdf	Form and Instruction
FNS 816 Level I Feedback FNS-816.pdf www.fns.usda.gov/fns/outreach.htm.	Form
FNS 817 Level III Feedback Form FNS-817.pdf www.fns.usda.gov/fns/outreach.htm.	Form
Reminder_Email_Benchmark_USDA Food Program.doc Reminder Email	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Consumer Research for Nutrition Education and Promotion Activities

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FNS-781	http://healthymeals.nal.usda.gov/hsmrs/hussc	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FNS-779		No		Fillable Printable
Form and Instruction	FNS-780		No		Fillable Printable
Form and Instruction	FNS-790	http://www.fns.usda.gov//snap/outreach/default.htm	Yes	Yes	Fillable Fileable
Form and Instruction	FNS-791	http://www.fns.usda.gov/snap/outreach/default.htm	Yes	Yes	Fillable Fileable
Form and Instruction	FNS-793		No		Fillable Printable
Other-Screening Guide			No		Paper Only
Other-Questionnaire		http://www.globaltestmarket.com/survey/s.phtml?sn=151310&demo=1&lang=E&secid=daecaa	Yes	Yes	Fillable Fileable Signable
Other-Questionnaire		http://www.globaltestmarket.com/survey/s.phtml?sn=151310&demo=1&lang=E&secid=daecaa	Yes	Yes	Fillable Fileable Signable
Other-Screener Guide			No		Paper Only
Other-Confidentiality Agreements			No		Paper Only
Other-Script			No		Paper Only
Other-Parent Guide			No		Paper Only
Other-Partner Screener			No		Paper Only
Other-Recruitment Screener			No		Paper Only
Other-Teacher Benchmark			No		Paper Only
Other-Teacher Benchmark		http://mrd.saynation.com/MRDSAYNATION/QSurvey/?UID=panelist&SID=S195377173683131&TEST=1	Yes	Yes	Fillable Fileable Signable
Other-Teacher Screener			No		Paper Only
Other-Teacher Guide			No		Paper Only
Form and Instruction	FNS 792	http://www.fns.usda.gov/snap/outreach/default.htm	Yes	Yes	Fillable Fileable Signable
Form	FNS 803	[email protected]	Yes	Yes	Fillable Fileable Signable
Form	FNS 804	[email protected]	Yes	Yes	Fillable Fileable Signable
Form	FNS 805	[email protected]	Yes	Yes	Fillable Fileable Signable
Form	FNS 813	[email protected]	Yes	Yes	Fillable Fileable Signable
Form	FNS 807		No		Fillable Fileable
Form	FNS 808	[email protected]	Yes	Yes	Fillable Printable
Form	FNS 809	http://www.fns.usda.gov/ora/SNAP/TakeAction/TakeAction.htm	Yes	Yes	Fillable Fileable Signable
Form	FNS 810	http://www.fns.usda.gov/ora/SNAP/TakeAction/TakeAction.htm	Yes	Yes	Fillable Printable
Form	FNS 811	http://www.fns.usda.gov/snap/nutrition_education/	Yes	Yes	Fillable Printable
Form	FNS 812	http://www.fns.usda.gov/snap/nutrition_education/	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FNS 779		No		Paper Only
Form and Instruction	FNS 780		No		Paper Only
Form	FNS 816	http://www.fns.usda.gov/fns/outreach.htm.	Yes	Yes	Fillable Fileable Signable
Form	FNS 817	http://www.fns.usda.gov/fns/outreach.htm.	Yes	Yes	Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 2 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	38,000	38,000
Annual IC Time Burden (Hours)	14,000	14,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Reminder Email		03/04/2010

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

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