School Level Survey

The Safe School/Healthy Student (SS/HS) Initiative National Evaluation

Documents and Forms

Document Name Document Type
Form School-Level Surve School Level Survey Form and Instruction
School-Level Surve School-Level Survey 6. School-Level Survey.doc Form and Instruction

Information Collection (IC) Details

IC Title:	School Level Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	School-Level Survey	School-Level Survey	6. School-Level Survey.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,300	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,300	2,300
Annual IC Time Burden (Hours)	966	966
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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