Information Collection

Evaluation of a District wide Implementation of a Professional Learning Community Iniative

IC 210092 under ICR 201401-1850-005 · OMB 1850-0906.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
RELMA_PLC_OMB_PartB_AppendixE_OMB comments_3 25 14-Clean.docx	Other-survey
Teacher Recruitment Email RELMA_PLC_OMB_PartB_AppendixA.docx	Form
Principal Recruitment Email RELMA_PLC_OMB_PartB_AppendixB.docx	Form
Notification Email RELMA_PLC_OMB_PartB_AppendixC.docx	Form
Post-Implementation Principal Interview Guide RELMA_PLC_OMB_PartB_AppendixD.docx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-survey			RELMA_PLC_OMB_PartB_AppendixE_OMB comments_3 25 14-Clean.docx	Yes	Yes	Paper Only
Form	n/a	Teacher Recruitment Email	RELMA_PLC_OMB_PartB_AppendixA.docx	Yes	Yes	Paper Only
Form	n/a	Principal Recruitment Email	RELMA_PLC_OMB_PartB_AppendixB.docx	Yes	Yes	Paper Only
Form	n/a	Notification Email	RELMA_PLC_OMB_PartB_AppendixC.docx	Yes	Yes	Paper Only
Form	n/a	Post-Implementation Principal Interview Guide	RELMA_PLC_OMB_PartB_AppendixD.docx	Yes	Yes	Paper Only

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 946

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 98 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	403	403
Annual IC Time Burden (Hours)	214	214
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.