Geothermal Technologies Program Online Event Feedback Survey Generic Clearance Form

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 1910-5160)

T ITLE OF INFORMATION COLLECTION:

Geothermal Technologies Program Online Event Feedback Survey

PURPOSE:

The U.S. Department of Energy Office of Energy Efficiency and Renewable Energy (EERE)’s Geothermal Technologies Program (GTP) hosts several webinars, i.e., Web-based seminars/presentations/lectures/workshops/ meetings, every year. Audiences are of varying sizes and include: the general public, researchers, partners, awardees, and other stakeholders.

GTP requests OMB approval for the use of a post-webinar survey to collect feedback from online event participants. The survey will enable event hosts, i.e., GTP leadership and project managers to:

• gauge stakeholder satisfaction with program-sponsored online events

• identify areas for improvement, enhancing the delivery of EERE’s services

• provide a means for stakeholders to provide their input and be heard.

The survey questions are simple and brief. GTP would like to send online event participants 3-5 questions (with no more than 1 open-ended question) at the conclusion of each online event. Questions would be selected from a bank of 9 OMB-approved questions. GTP plans to administer up to 10 of these feedback surveys per year.

Collection of responses: The survey will be administered using either Survey Gizmo (an online survey tool) or the survey feature in webinar conferencing tools like GoToWebinar. The survey link will only be sent to online event participants who have provided an email address. Participation is completely voluntary, and timing of participation will be determined by each participant.

Data collected will be for GTP’s internal use only and will not be publically shared.

Burden to public: The survey would take each respondent no more than 4 minutes to answer. The total burden to the public each time the survey is administered is estimated to be no more than10 hours, assuming approximately 150 respondents per event. The total burden for 10 implementations of this survey is 100 hours.

DESCRIPTION OF RESPONDENTS:

The survey respondents will consist of people who attended a GTP online event and choose to complete the survey. The survey is completely voluntary.

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.

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, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

3. If Yes, has an up-to-date System of Records Notice (SORN) 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/Respondent	Burden
Per Event	150	4 mins	10 hours
x Number of Events	x 10 events
Totals	1,500	4 mins	100 hours

* Note that this is the total number of respondents to whom the survey will be sent.  We expect that only a percentage of them will complete the survey, so the actual total burden may be less than the 100 hours indicated here (but will not be more).

FEDERAL COST: The total estimated cost to the government is less than $4,000. This includes staff and contractor time for administering and analyzing the survey 10 times and the cost of the software. The program will use existing staff and contracts to conduct the test and evaluate the results.

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 feedback form would be sent to anyone who chooses to participate in one of GTP’s online events.

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

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”

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. Note: Agencies should only collect PII to the extent necessary, and they should only retain PII for the period of time that is necessary to achieve a specific objective.

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 per row.

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.

Submit all instruments, instructions, and scripts are submitted with the request.

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