Supporting Statement (OMB 0420-0540 and 0420-0513)

Peace Corps—Office of Public Engagement
Paul D. Coverdell World Wise Schools
Correspondence Match Educator Enrollment Form
OMB Approval Numbers: 0420-0540 (Online form) and 0420-0513 (Paper form)
Supporting Statement

Section A: Justification
1.

The Office of Public Engagement’s activities and publications support section 2 of the
Peace Corps Act, 22 USC § 2501, which states that one of the agency’s missions is to
“promote a better understanding of other peoples on the part of the American people.”
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 Educator Enrollment Form.

2.

The Correspondence Match Educator Enrollment Form is the first point of contact with
the participating educator. It is Coverdell World Wise Schools’ fundamental source of
information from educators interested in participating in the Correspondence Match
program. The information is used to make a suitable match between the educator and a
Peace Corps Volunteer serving overseas. The information will be collected continuously
as teachers choose to enroll, or continue participation, in the Correspondence Match
program.

3.

To improve efficiency in program administration and speed of enrollment, the
information will be collected from an online form on the Coverdell World Wise Schools’
website. The electronic submission of information is sent to the Coverdell World Wise
Schools’ email inbox, [email protected].
In addition to the online form option for voluntary enrollment in the Correspondence
Match program, teachers may chose to enroll using a paper enrollment form. These
paper enrollment forms are distributed to teachers at educational conferences and other
Coverdell World Wise Schools promotional events to offer teachers the opportunity to
participate in the program. This paper form will not be printed again in the future, so once
the current stock of paper forms is exhausted, Coverdell World Wise Schools will
exclusively use the online form.
For an unknown reason, the paper form has a different OMB approval number from the
online form. Peace Corps is requesting an extension of the online form number and as
well as the paper form number. The extension of the paper form number will allow
Peace Corps to continue to benefit from the paper form and to avoid wasting the
thousands of existing copies of the paper form. The survey that was connected to the
paper form will no longer be used. Peace Corps will only use the paper equivalent of the
online form attached to this request.

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Peace Corps—Office of Public Engagement
Paul D. Coverdell World Wise Schools
Correspondence Match Educator Enrollment Form
OMB Approval Numbers: 0420-0540 (Online form) and 0420-0513 (Paper form)
Supporting Statement
4.

Peace Corps has reviewed this enrollment form in order to avoid and identify
duplications. While there are Coverdell World Wise Schools’ forms that collect some
overlapping information, such as name, school affiliation, and contact information, each
form is specific to one program offered to educators by Coverdell World Wise Schools
and each form is distinctive in the additional information requested of the voluntary
teacher participant. Furthermore, the participants of each of the Coverdell World Wise
Schools programs are unique, in that the teachers participating in one program are not the
same as those participating in our other programs. For the Correspondence Match
program, there is no other information collected that can be used to make a suitable
match in the Correspondence Match program between currently serving Peace Corps
Volunteers and educators. The information collected is unique in that it applies only to
the Correspondence Match program and elicits data regarding educators’ preferences for
Peace Corps Volunteer partner participants.

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 group of educators may
participate in the program and Peace Corps has approximately a fifty percent change in
its Volunteers. This information is collected each time an educator enrolls or re-enrolls in
the Correspondence Match program. Re-enrollment occurs at the conclusion of the
matched Peace Corps Volunteer’s completion of service, early termination, separation, or
evacuation.

7.

There are no special circumstances.

8.

The agency’s notice was published in the Federal Register on July 16, 2010 [75 FR 161,
pages 41556]. No public comments were received during the 60-day period.

9.

No payment or gift is provided to respondents.

10.

Assurance of privacy provided to respondents is on the Privacy Act notice on the bottom
of the electronic form.

11.

No questions of a sensitive nature are asked.

12.

Number of Respondents:
Frequency of Response:
Completion Time:
x
Total Annual Hour Burden of Respondents:

13.

There is no total annual cost burden to respondents or record keepers.

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10,000
1
10 minutes
1667 hours

Peace Corps—Office of Public Engagement
Paul D. Coverdell World Wise Schools
Correspondence Match Educator Enrollment Form
OMB Approval Numbers: 0420-0540 (Online form) and 0420-0513 (Paper form)
Supporting Statement
14.

Agency Cost estimates:
a) There is no start-up component associated with this submission as this is an OMB
approved enrollment form currently in use and up for renewal.
b) Estimated labor costs associated with processing and maintaining the collected
information
Program Analyst:
$32.00/hour x 835 labor hours (40% of time)/fiscal year = $26,720.00
Federal Work Study students:
$4.00/hour x 375 labor hours (75% of time)/fiscal year = $1500.00
2 CWWS Federal Work Study students = $3000.00
Total Labor Costs to the Federal Government (2010): $29,720.00

15.

No questions of a sensitive nature are asked.

16.

Coverdell World Wise Schools will not publish the results of the enrollment information.
Collection of information does not employ statistical methods. The enrollment form is
intended for continuous use.

17.

The agency plans to display the expiration date for Office of Management and Budget
approval of the information collection on all instruments.

18.

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.

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