Generic Template - Webinar TA Feedback Survey

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

TITLE OF INFORMATION COLLECTION: Reform Support Network Webinar TA Feedback

PURPOSE: This submission is a request for approval of a data collection activity that will support the improvement of Race to the Top Webinars conducted by the Reform Support Network (the Network) under contract to the U.S. Department of Education (ED). The Race to the Top Webinars are intended to provide Race to the Top grantees with online opportunities to receive and share information, tools, and strategies as well as collaboratively problem-solve issues around topics related to education reform.

In this package, we are requesting approval to administer a survey to participants at Webinars conducted, with the goal of ascertaining the usefulness of each Webinar overall.

There is no existing data collection that can provide us with information on the utility of providing support to Race to the Top grantees through Race to the Top Webinars. This data collection effort is essential for (a) determining whether the information is perceived as relevant and useful to its intended audience, and (b) determining how future Webinars might be improved.

The information collected will provide useful data to ED about how to more effectively target and meet the needs of Race to the Top grantees through Race to the Top Webinars. The survey data will allow ED to provide targeted follow-up support to Race to the Top grantees.

DESCRIPTION OF RESPONDENTS: The target population of this survey is state/local government employees in attendance at the Webinars. The group will consist of approximately 38 individuals. A 90 percent response rate is expected.

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:__Tate Gould______________________________________________

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

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

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
State/Local Government Employees	29	5 minutes	4 hours
Totals	29	5 minutes (.08 hours)	4 hours

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? [ ] Yes [ X] 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?

Administration of the Instrument

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

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

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

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

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