RAS Symposium Fast Track

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB#: 0925-0642 Expiration Date: 08/31/2017)

TITLE OF INFORMATION COLLECTION: RAS Initiative Symposium Feedback Questionnaire

PURPOSE: In 2013, the NCI launched the RAS Initiative to mobilize the cancer research community to develop ways to understand and target cancers driven by mutant RAS in an open model of collaboration among government, academic, and industry researchers.  The hub of the Initiative’s research effort is overseen by Dr. Frank McCormick and is located at the Frederick National Lab for Cancer Research (FNLCR).   

In December 2015, the first international RAS Initiative Symposium was held in Frederick, MD. This two day community-wide symposium was a highly interactive forum that brought experts in areas ranging from structural biology to signaling pathways to novel therapeutic approaches to the FNLCR hub. 

In order to better prepare for future RAS Symposia, we would like to obtain feedback from the first RAS Initiative Symposium participants. An email will be sent to the symposia participants with a link to complete the survey.

DESCRIPTION OF RESPONDENTS: The meeting participants have a varied background. There were post-doctoral fellows, lab members, and lab leads from academia. There were all levels of industry scientists and executives. We will be obtaining feedback from 350 of the meeting participants.

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.

Name:_____Sonia Calcagno_____________________________

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

3. If Applicable, has a System or Records Notice been published? [ ] Yes [x] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [x] No

ESTIMATED BURDEN HOURS and COSTS

Category of Respondent	No. of Respondents	No. of Responses per Respondent	Time per Response (in hours)	Total Burden Hours
Meeting Participant	350	1	3/60	18
Totals	350	350		18

Category of Respondent	Total Burden Hours	Wage Rate*	Total Burden Cost
Individuals	18	$38.11	$686
Totals	18		$686

*Cite source per bls.gov:

Wage rate was calculated using occupation title life sciences – other and occupation code 19-1099 using this website: http://www.bls.gov/oes/current/oes191099.htm.

FEDERAL COST: The estimated annual cost to the Federal government is __$1,256.00___

Staff	Grade/Step	Salary	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight	13/2	$95,217.00	.5%		$476
Contractor Cost		$78,000.00	1%		$780
Travel					N/A
Other Cost					N/A
Total					$1,256.00

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? See attached survey. The survey will be sent only to RAS Initiative Symposium attendees

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.

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