4th-5th Grade Student Survey (Baseline & First Follow Up)

Summer of Innovation #2 (Surveys)

Documents and Forms

Document Name Document Type
4th-5th Grade Student Survey (Baseline & First Follow Up) Form and Instruction
Appendix 2-4th-5th Grade Student Survey_6.8.doc Form and Instruction

Information Collection (IC) Details

IC Title:	4th-5th Grade Student Survey (Baseline & First Follow Up)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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	n/a	Appendix 2-4th-5th Grade Student Survey_6.8.doc		No		Paper Only

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,725	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	5,175	5,175
Annual IC Time Burden (Hours)	2,588	2,588
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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