1- Supporting Statement (OMB 0420-0539)

Peace Corps—Office of Public Engagement
Paul D. Coverdell World Wise Schools
Speakers Match Online Request Form
OMB Approval Number: 0420-0539
Supporting Statement
Section A: Justification
1.

The Office of Public Engagement’s Coverdell World Wise Schools Speakers Match
Program supports 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 the
American people.” 22 U.S.C. § 2501(a). The Speakers Match program connects a
teacher with a Returned Peace Corps Volunteer who presents his or her overseas
experience to the teacher’s students. The interaction between the returned Volunteer, the
teacher, 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 match a teacher with a returned Volunteer, World Wise Schools requests basic
information, such as address, email address, grade level, number of students, and type of
speaking event, on the Speakers Match Online Request Form. This form is available on
the Peace Corps Coverdell World Wise Schools website under the Speakers Match
section.

2.

The Speakers Match Online Request Form is Peace Corps’ first point of contact with the
participating teacher. The information is used to make a suitable match between the
teacher and a Returned Peace Corps Volunteer in the teacher’s area of the country. The
information is collected on a continuous basis as teacher’s request to host Returned Peace
Corps Volunteer speakers.

3.

The information will be collected from an online form available on the Speakers Match
section of the Coverdell World Wise Schools website. The electronic submission of
information goes to the World Wise Schools email inbox, and is saved in a spreadsheet.

4.

The Peace Corps has reviewed this enrollment form in order to identify and avoid
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. There are no other forms collecting
information from teachers utilizing the Speakers Match program concerning the
presentation date, details about the speaking event, the educator’s preference for a
Volunteer’s program sector, or geographic region of service. The information collected is
unique in that it applies only to the Speakers Match program and elicits data regarding
educators’ preferences in order to fulfill the teacher’s request to host a returned Peace
Corps Volunteer speaker.

5.

The collection of information does not impact small businesses or other small entities.

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Peace Corps—Office of Public Engagement
Paul D. Coverdell World Wise Schools
Speakers Match Online Request Form
OMB Approval Number: 0420-0539
Supporting Statement
6.

Without input from teachers, Coverdell World Wise Schools cannot locate interested
teachers with whom Returned Peace Corps Volunteers can help Peace Corps meet its
mission of promoting a better understanding of other peoples on the part of the American
people.

7.

There are no special circumstances.

8.

The agency’s notice was published in the Federal Register on July 16, 2010. 75 FR 41556
(July 16, 2010). No public comments were received dur ing the 60-day period.

9.

Peace Corps will not provide any payments or gifts to respondents.

10.

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

11.

The request for speaker form does not contain any questions of a sensitive nature. The
information collected is necessary to match teachers with a Returned Peace Corps
Volunteer speaker who served in a particular region of the world, or performed a certain
kind of work, as requested by the hosting teacher.

12.

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

13.

Cost estimate to the respondent: $0.00

14.

Agency Cost estimates:
a) There is no start-up component associated with this submission as this is an OMB
approved online enrollment form currently in use and up for renewal.

300
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10 minutes
50 hours

b) Estimated labor costs associated with processing and maintaining the collected
information
Program Analyst:
$32.00/hour x 200 labor hours (10% of time)/fiscal year = $6,400.00
Federal Work Study students:
$4.00/hour x 125 labor hours (25% of time)/fiscal year = $500.00
2 CWWS Federal Work Study students = $1000.00
Total Labor Costs to the Federal Government (2010): $7,400.00
15.

N/A.

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Peace Corps—Office of Public Engagement
Paul D. Coverdell World Wise Schools
Speakers Match Online Request Form
OMB Approval Number: 0420-0539
Supporting Statement
16.

Coverdell World Wise Schools will not publish the results of the information collected to
request a speaker. Collection of information does not employ statistical methods. The
request for speaker 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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