OMB Number: 0584-0611
Expiration Date: 11/30/2025
OMB BURDEN STATEMENT: This information is being collected to
determine what additional resources and information are
needed to advance racial equity in farm to school work. This
is a voluntary collection and FNS will use the information to carry
out EO 14058 “Advancing Racial Equity and Support for
Underserved Communities Through the Federal Government” to
ensure government is carrying out more equitable and effective
services. This collection does not request any personally
identifiable information under the Privacy Act of 1974. 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 less than one hour per response, including the time for
reviewing instructions and answering the survey questions. 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
Service, Office of Policy Support, 1320 Braddock Place, 5th Floor,
Alexandria, VA 22306 ATTN: PRA (0584-0611). Do not return the
completed form to this address.
Appendix D: Post Lab Experience Feedback Survey
Purpose: Gauge what/how cohort participants learned from their experience and how they plan to apply in their work - conversation/interview can include thinking around retention, application, key learnings after participation.
Full Name
How would you rate your overall experience participating in the Lab?
Insert Likert scale [Unsatisfied to Satisfied 1-5]
Did your experience in the Lab support and/or enhance your learning of historical racism found in the food system as well as other racial-equity centered topics in the food system and/or farm to school? Yes / No
Text - Reflecting back on your experience participating in the Lab, what new skills or knowledge did you glean?
What (if anything) are you going to do differently as a result of your participation in the Lab?
Share your thoughts on how the co-learning and co-creation format affected your experience as a learner?
Text - How can we continue to make the Lab experience more inclusive?
Text - What feedback do you have for us to continue to enhance the Lab experience?
Any other feedback or comments you would like to provide?
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Duncan-Hughes, Dionne - FNS |
File Modified | 0000-00-00 |
File Created | 2023-12-12 |