National Farm to School Network's (NFSN) information collection process for the Racial Equity Learning Lab

FNS Fast Track Clearance for the Collection of Routine Customer Feedback

Appendix D - Post Lab Experience Feedback Survey

National Farm to School Network's (NFSN) information collection process for the Racial Equity Learning Lab

OMB: 0584-0611

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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.

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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.


  1. Full Name

  2. How would you rate your overall experience participating in the Lab?

Insert Likert scale [Unsatisfied to Satisfied 1-5]

  1. 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

  2. Text - Reflecting back on your experience participating in the Lab, what new skills or knowledge did you glean?

  3. What (if anything) are you going to do differently as a result of your participation in the Lab?

  4. Share your thoughts on how the co-learning and co-creation format affected your experience as a learner? 

  5. Text - How can we continue to make the Lab experience more inclusive?

  6. Text - What feedback do you have for us to continue to enhance the Lab experience?

  7. Any other feedback or comments you would like to provide?







File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorDuncan-Hughes, Dionne - FNS
File Modified0000-00-00
File Created2023-12-12

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