REMS Online Courses User Feedback Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

REMS Generic Clearance Template Routine Customer Feedback 2012

REMS Online Courses User Feedback Survey

OMB: 1880-0542

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Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 1880-0542)

Shape1 TITLE OF INFORMATION COLLECTION:


PURPOSE:


The Readiness and Emergency Management for Schools (REMS) Technical Assistance (TA) Center provides training and makes accessible webinars and online trainings for institutions of higher education, districts and schools as well as non-public schools. The purpose of the customer-service oriented follow-up would be to determine if the webinars and online courses met their needs and whether or not it fully addressed their needs.


DESCRIPTION OF RESPONDENTS:


Survey respondents would be those persons who participated in the webinars and completed the online courses offered via the REMS TA Center Web site. The majority of training participants are State Education Agency, Local Education Agency officials, and officials from institutions of higher education. Others include community partners in school emergency management.


TYPE OF COLLECTION: (Check one)


[ ] Customer Comment Card/Complaint Form [X ] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[] Focus Group [ ] Other: ______________________


CERTIFICATION:


I certify the following to be true:

  1. The collection is voluntary.

  2. The collection is low-burden for respondents and low-cost for the Federal Government.

  3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

  4. The results are not intended to be disseminated to the public.

  5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

  6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.


Name:_Madeline Sullivan _______________________________________________


To assist review, please provide answers to the following question:


Personally Identifiable Information:

  1. Is personally identifiable information (PII) collected? [ ] Yes [X ] No

  2. If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No N/A

  3. If Applicable, has a System or Records Notice been published? [ ] Yes [ ] No N/A

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [X ] No





BURDEN HOURS


Category of Respondent

No. of Respondents

Participation Time

Burden

(3) State, local, or tribal governments (State Education Agencies (SEA), Local Education Agency (LEA) officials, institutions of higher education officials.)

100

3 minutes

5





Totals






FEDERAL COST: The estimated annual cost to the Federal government is _____$0_______


If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:


The selection of your targeted respondents

  1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [X] Yes [] No


If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?


The customer service-oriented survey would only be sent to those persons who registered for the webinars or online courses. This would not include general requests for general notifications (e.g., grant program competitions, training opportunities) and would be sent to those requesting guidance, resources, and tools for building school emergency management capacity.


Administration of the Instrument

  1. How will you collect the information? (Check all that apply)

[ X] Web-based or other forms of Social Media Web-based

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

  1. Will interviewers or facilitators be used? [ ] Yes [ X ] No

Please make sure that all instruments, instructions, and scripts are submitted with the request.


Instructions for completing Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback”


Shape2

TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is the subject of the request. (e.g. Comment card for soliciting feedback on xxxx)


PURPOSE: Provide a brief description of the purpose of this collection and how it will be used. If this is part of a larger study or effort, please include this in your explanation.


DESCRIPTION OF RESPONDENTS: Provide a brief description of the targeted group or groups for this collection of information. These groups must have experience with the program.


TYPE OF COLLECTION: Check one box. If you are requesting approval of other instruments under the generic, you must complete a form for each instrument.


CERTIFICATION: Please read the certification carefully. If you incorrectly certify, the collection will be returned as improperly submitted or it will be disapproved.


Personally Identifiable Information: Provide answers to the questions.


Gifts or Payments: If you answer yes to the question, please describe the incentive and provide a justification for the amount.


BURDEN HOURS:

Category of Respondents: Identify who you expect the respondents to be in terms of the following categories: (1) Individuals or Households;(2) Private Sector; (3) State, local, or tribal governments; or (4) Federal Government. Only one type of respondent can be selected.

No. of Respondents: Provide an estimate of the Number of respondents.

Participation Time: Provide an estimate of the amount of time required for a respondent to participate (e.g. fill out a survey or participate in a focus group)

Burden: Provide the Annual burden hours: Multiply the Number of responses and the participation time and divide by 60.


FEDERAL COST: Provide an estimate of the annual cost to the Federal government.


If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:


The selection of your targeted respondents. Please provide a description of how you plan to identify your potential group of respondents and how you will select them. If the answer is yes, to the first question, you may provide the sampling plan in an attachment.


Administration of the Instrument: Identify how the information will be collected. More than one box may be checked. Indicate whether there will be interviewers (e.g. for surveys) or facilitators (e.g., for focus groups) used.


Please make sure that all instruments, instructions, and scripts are submitted with the request.


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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleDOCUMENTATION FOR THE GENERIC CLEARANCE
Author558022
File Modified0000-00-00
File Created2021-01-31

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