Information Collection

Team Nutrition Educational Technology Environmental Scan

IC 222062 under ICR 201606-0584-008 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Attachment A_Consent Package for School Focus Groups.docx	Other-Attachment A_Consent Package f
Attachment B_Consent Package for SHAPE Conference Focus Groups.docx	Other-Attachment B_Consent Package f
Attachment C_Consent Package for Teacher of Health Education Survey.docx	Other-Attachment C_Consent Package f
Attachment D_Moderators Guide for Teacher Focus Groups.docx	Other-Attachment D_Moderators Guide
Attachment E_Teacher of Health Education Survey.docx	Other-Attachment E_Teacher of Health
Attachment F_Flyer for Focus Group Participation.pdf	Other-Attachment F_Flyer for Focus G
Attachment G_Introduction Email for School Focus Groups.docx	Other-Attachment G_Introduction Emai
Attachment H_Scheduling Email for School Focus Groups.docx	Other-Attachment H_Scheduling Email
Attachment I_Principal Letter of Agreement.docx	Other-Attachment I_Principal Letter
Attachment J_Introduction Email for Teacher of Health Education Survey.docx	Other-Attachment J_Introduction Emai
Environmental Scan_OMB Memo_Final Revised2.pdf Environmental Scan_OMB Memo_Final Revised2	IC Document

IC Title:

Team Nutrition Educational Technology Environmental Scan

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Attachment A_Consent Package for School Focus Groups	Attachment A_Consent Package for School Focus Groups.docx	No	Paper Only
Other-Attachment B_Consent Package for SHAPE Conference Focus Groups	Attachment B_Consent Package for SHAPE Conference Focus Groups.docx	No	Paper Only
Other-Attachment C_Consent Package for Teacher of Health Education Survey	Attachment C_Consent Package for Teacher of Health Education Survey.docx	No	Paper Only
Other-Attachment D_Moderators Guide for Teacher Focus Groups	Attachment D_Moderators Guide for Teacher Focus Groups.docx	No	Paper Only
Other-Attachment E_Teacher of Health Education Survey	Attachment E_Teacher of Health Education Survey.docx	No	Paper Only
Other-Attachment F_Flyer for Focus Group Participation	Attachment F_Flyer for Focus Group Participation.pdf	No	Paper Only
Other-Attachment G_Introduction Email for School Focus Groups	Attachment G_Introduction Email for School Focus Groups.docx	No	Paper Only
Other-Attachment H_Scheduling Email for School Focus Groups	Attachment H_Scheduling Email for School Focus Groups.docx	No	Paper Only
Other-Attachment I_Principal Letter of Agreement	Attachment I_Principal Letter of Agreement.docx	No	Paper Only
Other-Attachment J_Introduction Email for Teacher of Health Education Survey	Attachment J_Introduction Email for Teacher of Health Education Survey.docx	No	Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,980

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,980	2,980
Annual IC Time Burden (Hours)	501	501
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Environmental Scan_OMB Memo_Final Revised2	Environmental Scan_OMB Memo_Final Revised2.pdf	06/20/2016

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