Electronic Mailing List Subscription Form - Nutrition and Food Safety State, Local, Tribal Government

Join Successtalk

Thank you for your interest in Successtalk, the online discussion group intended as a communication tool to link school health professionals, child nutrition educators, principals, teachers, parents, and community members who are interested in creating a healthy school nutrition environment.

OMB NO.: 0518-0036
EXPIRATION DATE: x-xx-xxx

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Full Name:

E-mail Address:

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Member Information: (All fields must be completed)

Affiliation: (school health professional, school administrator, child nutrition educator, parent, etc.)

Location: (school or school system):

Address: (city & state)

Telephone:

Please comment on how you work towards a healthier school nutrition environment.

According to the Paperwork Reduction act of 1995, an agency may not conduct or sponsor, and a person is not required to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is OMB 0518-0036. The time required to complete this information will vary based upon one’s relations to the resource being submitted. It is estimated to take 1 minute to complete this entire survey. This includes time for reviewing instruction, researching existing date sources, gathering and maintaining the data needed, and completing and reviewing the collection information. If you need help with this form, please contact us. Email address [email protected]. Telephone number: 301-504-6369. Bottom of Form

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