Peace Corps—Office of Domestic Programs
Paul D. Coverdell World Wise Schools
Correspondence Match Program Enrollment Form
OMB Approval Number: 0420-0513
Supporting Statement
Section A: Justification
1. The Peace Corps’ Office of Domestic Programs builds awareness of the continuing benefits that former Peace Corps Volunteers bring back to the United States after their service. The Office of Domestic Programs comprises Paul D. Coverdell World Wise Schools, the Masters International program, the Fellows/USA graduate fellowship program, Returned Volunteer Services, and Peace Corps Week. The Office of Domestic Programs’ activities and publications support section 2 of the Peace Corps Act, which states that one of the agency’s missions is to “promote a better understanding of other peoples on the part of all Americans.” Coverdell World Wise Schools was established in 1989 in order to bring the cross-cultural experience of Peace Corps Volunteers into the classrooms of the United States. Within the purview of Coverdell World Wise Schools, the Correspondence Match program connects an educator with a Peace Corps Volunteer serving overseas. The correspondence between the Volunteer, the educator, and his or her students is used to foster classroom activities and learning experiences relating to the Volunteer’s country of service and the Peace Corps. In order to participate in the program and be matched with a Volunteer, the educator must complete the Correspondence Match Enrollment Form.
2. The Correspondence Match Enrollment Form is the first point of contact with the participating educator. It is Coverdell World Wise Schools’ fundamental source of information from educators. Information to be collected includes educator name, school name, school address (including street number, city, state, and zip code), school phone, home phone, e-mail address, grade taught, subject area taught, number of students to participate in the program, educators’ preferences (including specific Volunteer name and country of service and geographic region of service), composition of school student body, description of school, and permission to release information. Respondents include educators interested in promoting global education in the classroom. The information is used to make a suitable match between the educator and a Peace Corps Volunteer. The information will be collected by mail. The information will be collected annually on a continuous basis and with permission may be shared with the media, Congress, returned Volunteer groups, educational institutions, and other government agencies.
3. Currently there is no accessible information technology available that would reduce the collection burden.
4. Peace Corps has reviewed this enrollment form in order to avoid and identify duplications.
5. The collection of information does not impact small businesses or other small entities.
6. This information cannot be collected less frequently than annually, nor does similar information exist, since each year a substantially different groups of educators may participate in the program.
7. There are no special circumstances. Collection will be conducted in a consistent manner with CFR 1320.6 guidelines.
a. The collection does not require respondents to report information to the agency more often than quarterly.
b. The collection does not require respondents to prepare a written response in fewer than 30 days after receipt.
c. The collection does not require respondents to submit more than an original or facsimile copy of the form.
d. The collection does not require respondents to retain records for more than three years.
e. The collection is not designed to produce valid and reliable results that can be generalized to the universe of study.
f. The collection does not require the use of a statistical data classification that has not been reviewed and approved by the Office of Management and Budget.
g. The collection does not include a pledge of confidentiality.
h. The collection does not require respondents to submit proprietary trade secrets or other confidential information.
8. There has been no decision to provide any payment or gift to respondents.
9. There is no assurance of confidentiality provided to respondents.
10. The enrollment form does not contain any questions of a sensitive nature, such as sexual behavior and attitudes, religious beliefs, etc.
11. Affected public: Primary
12. Obligated to respond: Voluntary
13. Number of Respondents: 10,000
Frequency of Response: 1
Completion Time: x 10 minutes
Total Annual Hour Burden: 1667 hours
13. Cost estimate to the respondent: $0.00 The enrollment form features postage-paid indicia.
14. Printing: $5,000
Postage: +$3,900 ($0.39 x 10,000)
Cost to the Federal Government (2006): $8,900
Increase in postage rates.
Coverdell World Wise Schools does not intend to publish the enrollment information. Collection of information does not employ statistical methods. The enrollment form is intended for continuous use.
The agency plans to display the expiration date for Office of Management and Budget approval of the information collection on all instruments.
The agency is able to certify compliance with all provisions under Item 19 of OMB Form 83-I.
Section B: Collection of Information Employing Statistical Methods
The collection of information does not employ statistical methods.
| File Type | application/msword |
| File Title | Peace Corps—Office of Domestic Programs |
| Author | Amy Clark |
| Last Modified By | Caroline Allen |
| File Modified | 2007-01-26 |
| File Created | 2007-01-26 |