Survey for Center (Site) Coordinators (Grades Preschool-Grade 3)

21st Century Community Learning Centers (21st CCLC): Early Childhood Best Practices Project

Documents and Forms

Document Name Document Type
Survey for Center (Site) Coordinators (Grades Preschool-Grade 3) Form and Instruction
Survey for Center (Site) Coordinators Att_EC_Site_Coordinator_Survey 10 05 2010.doc Form and Instruction
Att_Permission form for Site Coordinator survey 10 05 10.doc Permission Form for Site Coordinator Survey IC Document

Information Collection (IC) Details

IC Title:	Survey for Center (Site) Coordinators (Grades Preschool-Grade 3)	Agency IC Tracking Number:	4547

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	Survey for Center (Site) Coordinators	Att_EC_Site_Coordinator_Survey 10 05 2010.doc		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 82 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	80	80
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Permission Form for Site Coordinator Survey	Att_Permission form for Site Coordinator survey 10 05 10.doc	03/11/2011

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.