Information Collection

Youth Health and Climate School Survey

IC 212672 under ICR 201408-0920-006 · OMB 0920-1035.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1035 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Youth Health and Climate School Survey	Form
Youth Health and Climate School Survey Att 3 Youth Health And School Climate Questionnaire_2014-08-13.pdf	Form

IC Title:

Youth Health and Climate School Survey

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	none	Youth Health and Climate School Survey	Att 3 Youth Health And School Climate Questionnaire_2014-08-13.pdf		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 11,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	11,000	11,000
Annual IC Time Burden (Hours)	7,333	7,333
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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