Information Collection

Evaluating the Retired Mentors for New Teachers Program

IC 210283 under ICR 201402-1850-003 · OMB 1850-0908.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Attachment C Mento Evaluating the Retired Mentors for New Teachers Program	Form
Attachment C Mento Attachment C Mentor Focus Group OKCE 4.4.3 Attachment C.docx	Form
Attachment E: Mentor Information and Informed Consent OKCE_4.4.3Attachment_E[1].doc	Form and Instruction
Attachment D: Teacher Info and Informed Consent CE 4.4.3 OMB Clearance Attachment D 1-14-14.doc	Form
Mentee Survey 2013 CE 4.4.3 OMB Clearance Attachment A 1-14-14.pdf	Form and Instruction
OKCE_4.4.3_Attachement_H[1].doc OKCE_4	IC Document
CE 4.4.3 OMB Clearance Attachment G 1-14-14.doc Teacher Survey Invite	IC Document
CE 4 4 3 Affidavit Attachment J.docx CE 4 4 3 Affidavit Attachment J	IC Document

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
Form	Attachment C Mentor Focus Group	Attachment C Mentor Focus Group	OKCE 4.4.3 Attachment C.docx	No	No	Paper Only
Form and Instruction	N/A	Attachment E: Mentor Information and Informed Consent	OKCE_4.4.3Attachment_E[1].doc	Yes	Yes	Fillable Fileable
Form	n/a	Attachment D: Teacher Info and Informed Consent	CE 4.4.3 OMB Clearance Attachment D 1-14-14.doc	Yes	Yes	Paper Only
Form and Instruction	n/a	Mentee Survey 2013	CE 4.4.3 OMB Clearance Attachment A 1-14-14.pdf	Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 148

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 69 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	148	148
Annual IC Time Burden (Hours)	92	92
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OKCE_4	OKCE_4.4.3_Attachement_H[1].doc	10/23/2013
Teacher Survey Invite	CE 4.4.3 OMB Clearance Attachment G 1-14-14.doc	01/29/2014
CE 4 4 3 Affidavit Attachment J	CE 4 4 3 Affidavit Attachment J.docx	01/30/2014

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