FNS Office of Food Safety Fitness Training

Please note: Final design work to be completed based upon below content following OMB approval.

OFFICE OF FOOD SAFETY
FOOD AND NUTRTION SERIVCE, USDA
3101 PARK CENTER DRIVE
ALEXANDRIA, VA 22302

Back:
Thank you for participating in training sponsored by the United States Department of Agriculture’s Food and Nutrition Service
Office of Food Safety. We invite you to voluntarily provide feedback on the training you just received at the completion of the
course.

OMB Number: 0584-0611
Expiration Date: 09/30/2019

Name of Training:
Date of Final Training Session:
Please place a checkmark in the one box per row to rate your level of agreement or disagreement with each other the following statements:
Statement

Strongly Disagree

Disagree

Neither Agree nor
Disagree

Agree

Strongly Agree

Compared to before
the training, I feel
more knowledgeable
about how to keep
food safe.
Compared to before
the training, I feel
more motivated to
ensure that the food
we serve is safe.
Compared to before
the training, I feel
more able to ensure
that the food we
serve is safe.

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid
OMB control number for this information collection is 0584-0611. The time required to complete this information collection is estimated to average three (3) minutes per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of
this collection of information, including suggestions for reducing this burden, to: U.S. Department of Agriculture, Food and Nutrition Services, Office of Policy Support, 3101 Park Center Drive, Room 1014, Alexandria, VA
22302, ATTN: PRA (0584-0611). Do not return the completed form to this address.