Information Collection

NSCH "Healthy and Ready to Learn" Questions 2020 (Self-administered/English)

IC 244069 under ICR 201807-0920-004 · OMB 0920-0222.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0222 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att 1 Healthy&Ready 2Learn Questionnaire.docx	Other-WORD
Att 3ab Healthy&Ready 2Learn Telephone Screener.docx	Other-WORD
Att 2 Healthy&Ready 2Learn AdFlyer.docx	Other-WORD
Att 5ab Healthy&Ready 2Learn Respondent Data Collection Sheet.docx	Other-WORD
Att 7 Healthy&Ready 2Learn Follow-up Interview.docx	Other-WORD
0920-0222 10-day letter-HealthyReady 2Learn 9.28.2020.docx 10-Day Letter (Request for Approval)	IC Document
Att 4ab Healthy&Ready 2Learn Informed Consent.docx Att 4ab Healthy&Ready 2Learn Informed Consent	IC Document
Att 6 Healthy&Ready 2Learn Thank You Letter.docx Att 6 Healthy&Ready 2Learn Thank You Letter	IC Document

IC Title:

NSCH "Healthy and Ready to Learn" Questions 2020 (Self-administered/English)

Agency IC Tracking Number:

0920-0222-20SK

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD	Att 1 Healthy&Ready 2Learn Questionnaire.docx	Yes	Yes	Fillable Fileable
Other-WORD	Att 3ab Healthy&Ready 2Learn Telephone Screener.docx	No		Paper Only
Other-WORD	Att 2 Healthy&Ready 2Learn AdFlyer.docx	No		Paper Only
Other-WORD	Att 5ab Healthy&Ready 2Learn Respondent Data Collection Sheet.docx	No		Paper Only
Other-WORD	Att 7 Healthy&Ready 2Learn Follow-up Interview.docx	No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 305

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	305	305
Annual IC Time Burden (Hours)	93	93
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
10-Day Letter (Request for Approval)	0920-0222 10-day letter-HealthyReady 2Learn 9.28.2020.docx	10/14/2020
Att 4ab Healthy&Ready 2Learn Informed Consent	Att 4ab Healthy&Ready 2Learn Informed Consent.docx	10/14/2020
Att 6 Healthy&Ready 2Learn Thank You Letter	Att 6 Healthy&Ready 2Learn Thank You Letter.docx	10/14/2020

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