OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Consumer Research for Nutrition Education and Promotion Activities

IC 192056 under ICR 201007-0584-001 · OMB 0584-0524.

Documents and Forms
Document Name
Document Type
Other-Screening Guide
Other-Questionnaire
Other-Questionnaire
Other-Screener Guide
Other-Confidentiality Agreements
Other-Script
Other-Parent Guide
Other-Partner Screener
Other-Recruitment Screener
Other-Teacher Benchmark
Other-Teacher Benchmark
Other-Teacher Screener
Other-Teacher Guide
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form
Form
Form
Form
Form
Form
Form
Form
Form
Form
Form and Instruction
Form and Instruction
Form
Form
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Consumer Research for Nutrition Education and Promotion Activities
 
Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Teacher Benchmark Teacher Benchmark Screen Shots USDA Foods.doc http://mrd.saynation.com/MRDSAYNATION/QSurvey/?UID=panelist&SID=S195377173683131&TEST=1 Yes Yes Fillable Fileable Signable
Other-Teacher Screener Teacher Screener - USDA Food Program.doc No   Paper Only
Other-Teacher Guide Teacher_Guide_USDA Food Program.doc No   Paper Only
Form and Instruction FNS 792 Golden Grocer Award Nomination Form FNS-792.pdf http://www.fns.usda.gov/snap/outreach/default.htm Yes Yes Fillable Fileable Signable
Form FNS 803 User Response Form FNS 803 Wed Site User Response Form (ESPH Educators).doc [email protected] Yes Yes Fillable Fileable Signable
Form FNS 804 Healthy Lifestyle User Response FNS 804 Healthy Lifestyle Web User Response Form.doc [email protected] Yes Yes Fillable Fileable Signable
Form and Instruction FNS-781 Team Nutrition School Enrollment Form FNS-781 - Team Nutrition.pdf http://healthymeals.nal.usda.gov/hsmrs/hussc Yes Yes Fillable Fileable Signable
Form and Instruction FNS-779 Gold Application for Recognizing Excellence in Nutrition and Physical Activity FNS-779.pdf No   Fillable Printable
Form and Instruction FNS-780 Bronze/Silver Recognizing Excellence in Nutrition and Physical Activity FNS-780.pdf No   Fillable Printable
Form and Instruction FNS-790 Hunger Champions Nomination Form FNS-790.pdf http://www.fns.usda.gov//snap/outreach/default.htm Yes Yes Fillable Fileable
Form and Instruction FNS-791 Promising Practices Submission Form FNS-791.pdf http://www.fns.usda.gov/snap/outreach/default.htm Yes Yes Fillable Fileable
Form and Instruction FNS-793 FNS Core Nutrition Messags Feedback Form FNS-793.pdf No   Fillable Printable
Other-Screening Guide Administrators Screener USDA Food Program.doc No   Paper Only
Other-Questionnaire CNP Benchmark Screen Shots USDA Food Program.doc http://www.globaltestmarket.com/survey/s.phtml?sn=151310&demo=1&lang=E&secid=daecaa Yes Yes Fillable Fileable Signable
Other-Questionnaire CNP Screen Shots USDA Food Program.doc http://www.globaltestmarket.com/survey/s.phtml?sn=151310&demo=1&lang=E&secid=daecaa Yes Yes Fillable Fileable Signable
Other-Screener Guide CNP Screener USDA Food Program.doc No   Paper Only
Other-Confidentiality Agreements Confidentiality_Agreements_USDA Food Program.doc No   Paper Only
Other-Script IDI_Script_USDA Food Program.doc No   Paper Only
Other-Parent Guide Parents_Guides_USDA Food Program.doc No   Paper Only
Other-Partner Screener Partner_Screener_USDA Food Program.doc No   Paper Only
Other-Recruitment Screener Recruitment_Screeners_USDA Food Program.doc No   Paper Only
Other-Teacher Benchmark Teacher Benchmark Q USDA Food Program.doc No   Paper Only
Form FNS 805 Kids User Response FNS-805 Kids Web Site User Response Form.doc [email protected] Yes Yes Fillable Fileable Signable
Form FNS 813 Power Partner Commitment FNS-813 Power Partner Commitment Form.doc [email protected] Yes Yes Fillable Fileable Signable
Form FNS 807 Power Panther Request and Agreement FNS-807 Power Panther Request and Agreement Form.doc No   Fillable Fileable
Form FNS 808 Event Feedback (Power Panther) FNS 808- Event Feedback Form (Power Panther).doc [email protected] Yes Yes Fillable Printable
Form FNS 809 Promote and Support Breastfeeding Feedback FNS 809 Promote and support breasfeeding feedback form.doc http://www.fns.usda.gov/ora/SNAP/TakeAction/TakeAction.htm Yes Yes Fillable Fileable Signable
Form FNS 810 Promote Fruits and Vegetables in Your Workplace FNS 810 Promote Fruits and Vegetables in Your Workplace & Community.doc http://www.fns.usda.gov/ora/SNAP/TakeAction/TakeAction.htm Yes Yes Fillable Printable
Form FNS 811 User Response Card FNS -811 User Response Card-LYFFF.doc http://www.fns.usda.gov/snap/nutrition_education/ Yes Yes Fillable Printable
Form FNS 812 Activity Kit User Response Form FNS-812 ACTIVITY KIT USER RESPONSE FORM(ESLS).doc http://www.fns.usda.gov/snap/nutrition_education/ Yes Yes Fillable Fileable Signable
Form and Instruction FNS 779 Gold/Gold Award of Distinction Application 779.pdf No   Paper Only
Form and Instruction FNS 780 Bronze/Silver Award Application FNS-780.pdf No   Paper Only
Form FNS 816 Level I Feedback FNS-816.pdf http://www.fns.usda.gov/fns/outreach.htm. Yes Yes Fillable Fileable Signable
Form FNS 817 Level III Feedback Form FNS-817.pdf http://www.fns.usda.gov/fns/outreach.htm. Yes Yes Fillable Fileable Signable

Income Security Food and Nutrition Assistance

 

10,000 0
   
Individuals or Households
 
   2 %

  Requested 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 38,000 0 19,000 0 0 19,000
Annual IC Time Burden (Hours) 14,000 0 6,992 0 0 7,008
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Reminder Email Reminder_Email_Benchmark_USDA Food Program.doc 03/04/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.