Pilot Alumni Outcomes Generic Submission

Request for Approval under the “Generic Clearance for the Collection of Tests and Pilots” (OMB Control Number: 3045-0163)

TITLE OF INFORMATION COLLECTION:

Pilot Test AmeriCorps Alumni Outcomes Survey

PURPOSE:

Pilot testing of web-based AmeriCorps Alumni Outcomes Survey. This is part of a research project in the Office of Research and Evaluation at CNCS.

DESCRIPTION OF RESPONDENTS:

Alumni of AmeriCorps programs (NCCC, State and National, and VISTA) who completed their terms of service 2, 5, or 10 years ago.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [ ] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus Group [X] Other: Pilot test for research study

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: Diana Epstein

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	Burden
AmeriCorps Alumni	75	20 minutes	25 hrs
Totals			25 hrs

FEDERAL COST: The estimated annual cost to the Federal government is: This is a one-time research project and will not incur additional annual costs.

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 respondent universe of AmeriCorps alumni is divided into three programs (AmeriCorps NCCC, AmeriCorps State and National, and AmeriCorps VISTA) and then again into three cohorts (2, 5, and 10 years post-service) within each of those programs. Within each of those nine categories, respondents will be selected using a simple random sample methodology.

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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