Information Collection

Classroom Data Collection

IC 197640 under ICR 201307-0920-004 · OMB 0920-0445.

Documents and Forms

Document Name Document Type
Form 24 Classroom Data Collection Form and Instruction
24 Health Education Classroom Questionnaire Appendix G-21 Health Education_Classroom.doc Form and Instruction
25 Health Education Classroom Questionnaire Appendix G-22 Physical Education_Classroom.doc Form and Instruction
Appendix H-4 District Recruitment Script.doc Appendix H-4 District Recruitment Script IC Document
Appendix E-2 District Participant Notification Document.doc Appendix E-2 District Participant Notification Document IC Document
Appendix H-6 District-level Content Outlines.doc Appendix H-6 District-level Content Outlines IC Document
Appendix H-1 State Letter of Invitation.doc Appendix H-1 State Letter of Invitation IC Document
Appendix H-5 State-level Content Outlines.doc Appendix H-5 State-level Content Outlines IC Document
Appendix E-1 State Participant Notification Document-revised.docx Appendix E-1 State Participant Notification Document-revised IC Document
Appendix I-1 - School Letter of Invitation.doc Appendix I-1 - School Letter of Invitation IC Document
Appendix E-3 School Participant Notification Document.doc Appendix E-3 School Participant Notification Document IC Document
Appendix E-4 Classroom Participant Notification Document.doc Appendix E-4 Classroom Participant Notification Document IC Document
Appendix I-4 Classroom-level Content Outlines.doc Appendix I-4 Classroom-level Content Outlines IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Classroom Data Collection	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	24	Health Education Classroom Questionnaire	Appendix G-21 Health Education_Classroom.doc		Yes	Yes	Fillable Fileable
Form and Instruction	25	Health Education Classroom Questionnaire	Appendix G-22 Physical Education_Classroom.doc		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,002	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	0	0	0	0	0	0
Annual IC Time Burden (Hours)	0	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix H-4 District Recruitment Script	Appendix H-4 District Recruitment Script.doc	04/29/2011
Appendix E-2 District Participant Notification Document	Appendix E-2 District Participant Notification Document.doc	04/29/2011
Appendix H-6 District-level Content Outlines	Appendix H-6 District-level Content Outlines.doc	04/29/2011
Appendix H-1 State Letter of Invitation	Appendix H-1 State Letter of Invitation.doc	05/02/2011
Appendix H-5 State-level Content Outlines	Appendix H-5 State-level Content Outlines.doc	05/02/2011
Appendix E-1 State Participant Notification Document-revised	Appendix E-1 State Participant Notification Document-revised.docx	05/02/2011
Appendix I-1 - School Letter of Invitation	Appendix I-1 - School Letter of Invitation.doc	05/02/2011
Appendix E-3 School Participant Notification Document	Appendix E-3 School Participant Notification Document.doc	05/02/2011
Appendix E-4 Classroom Participant Notification Document	Appendix E-4 Classroom Participant Notification Document.doc	05/02/2011
Appendix I-4 Classroom-level Content Outlines	Appendix I-4 Classroom-level Content Outlines.doc	05/02/2011

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