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 E: Follow Up Survey (6 months after participating in the Lab)
Demographic Questions:
Name:
Email Contact:
Location (City/State, Sovereign Nation, or Territory):
What is your ethnicity? Please select one.
Options: Not Hispanics/Latino/a/x/e; Hispanics/Latino/a/x/e; Decline to state; Write in (insert text box)
What is your race? Please select all that applies.
Options: Asian/Asian American; Black/African American; Indigenous American/Native Alaskan; Middle Eastern/Arab American; More than one race; Pacific Islanders/Native Hawaiian; White; Decline to state; Write in (insert text box).
Begin Survey Questions:
As a result of your participation in the Lab have you modified the way you collaborate with communities and facilitate training/workshops? (Yes/No).
If yes: Please share an example.
Have you used the resources shared from the Racial Equity Learning Lab webinar? (Yes/No).
A. If yes: Please share how you have used the resources.
B. If you answered “no” to the questions above: Please tell us how we can make the resources more available and useful for you.
Are you interested in scheduling a brief call with NFSN to discuss your efforts around embedding racial equity in farm to school? (Yes/No).
What other feedback do you have to share?
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Duncan-Hughes, Dionne - FNS |
File Modified | 0000-00-00 |
File Created | 2023-12-12 |