Attachment R_Parent Information Collection Form for School and ECE Coordinators

Parent Information Collection Template for School/ECE Coordinators

	Parent’s Name	Parent’s Email Address	Parent’s Phone Number	Total # of Children in Household	Ages of Children in Parent’s Household

An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. OMB number: 0970-0373; Expiration date: XX/XX/XXXX