Information Collection

Booker T. Washington National Monument Formative Exhibition Evaluation Survey

IC 201681 under ICR 201203-1040-002 · OMB 1040-0001.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1040-0001 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
BOWA_Adult_Questionnaire_3-9-2012.docx	Other-Questionnaire
BOWA_Principal_e-mail.docx	Other-Email survey
BOWA_Youth_Questionnaire_3-8-2012.doc	Other-Questionnaire
Justification_for_BOWA_3-9-2012.docx Justification for BOWA Questionnaires	IC Document
BOWA_EvalLog_v1.pdf Evaluation Observation Log	IC Document
BOWA_Evaluation_Scripts_3-9-2012.docx BOWA Evaluation Scripts	IC Document

IC Title:

Booker T. Washington National Monument Formative Exhibition Evaluation Survey

Agency IC Tracking Number:

CSS-10

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Questionnaire	BOWA_Adult_Questionnaire_3-9-2012.docx	No		Paper Only
Other-Email survey	BOWA_Principal_e-mail.docx	Yes	Yes	Fillable Fileable
Other-Questionnaire	BOWA_Youth_Questionnaire_3-8-2012.doc	No		Paper Only

Line of Business: Natural Resources

Subfunction: Recreational Resource Management and Tourism

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 194

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	194	194
Annual IC Time Burden (Hours)	86	86
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification for BOWA Questionnaires	Justification_for_BOWA_3-9-2012.docx	03/24/2012
Evaluation Observation Log	BOWA_EvalLog_v1.pdf	03/24/2012
BOWA Evaluation Scripts	BOWA_Evaluation_Scripts_3-9-2012.docx	03/24/2012

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