Information Collection

District Level Administrator Interview

IC 213079 under ICR 201409-0920-007 · OMB 0920-1048.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1048 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
District Level Administrator Interview	Form
School Climate Index Interview Guide for District Level Att 9-CIIG-District-Level Admin.docx	Form
Att 18-Consent School Climate Interviews.docx School Climate Interview Informed Consent	IC Document

IC Title:

District Level Administrator Interview

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	School Climate Index Interview Guide for District Level Administrators	Att 9-CIIG-District-Level Admin.docx	None	No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1

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	1	1
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
School Climate Interview Informed Consent	Att 18-Consent School Climate Interviews.docx	09/10/2014

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