Information Collection

Evaluation of the Early Warning and Intervention Monitoring System (EWIMS)

IC 210269 under ICR 201408-1850-004 · OMB 1850-0907.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Evaluation of the Early Warning and Intervention Monitoring System (EWIMS)	Form
JLREL MW 4 3 19_Ramp-Up Evaluation Phase 2 Fall staff survey.pdf	Other-survey
JLREL MW 4 3 19_Ramp-Up Evaluation Phase 2 Data request.pdf	Other-phase 2 data request
Staff Survey CBStaff survey.pdf	Form
Student Survey RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-2 Student Survey.pdf	Form
Extant Data RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-1 Extant Data Request.pdf	Form
March Interview RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-3 Interview Protocol.pdf	Form
Request for Extant RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-4 Request for Extant Documents.pdf	Form
Focus Group RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-6 Focus Group Protocol.pdf	Form
Study Staff Survey RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-7 Focus Group Protocol.pdf	Form
Instructional Log RELMW 4 2 09 Ramp-Up Implementation Study OMBIC-5 Instructional log.pdf	Form

IC Title:

Agency IC Tracking Number:

1630.06

Is this a Common Form? No

IC Status: Modified

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	n/a	Request for Extant	RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-4 Request for Extant Documents.pdf	Yes	Yes	Fillable Printable
Form	n/a	Focus Group	RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-6 Focus Group Protocol.pdf	Yes	Yes	Fillable Printable
Form	n/a	Study Staff Survey	RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-7 Focus Group Protocol.pdf	Yes	Yes	Paper Only
Form	n/a	Instructional Log	RELMW 4 2 09 Ramp-Up Implementation Study OMBIC-5 Instructional log.pdf	Yes	Yes	Paper Only
Other-survey			JLREL MW 4 3 19_Ramp-Up Evaluation Phase 2 Fall staff survey.pdf	Yes	Yes	Fillable Fileable
Other-phase 2 data request			JLREL MW 4 3 19_Ramp-Up Evaluation Phase 2 Data request.pdf	No		Paper Only
Form	n/a	Staff Survey	CBStaff survey.pdf	Yes	Yes	Paper Only
Form	n/a	Student Survey	RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-2 Student Survey.pdf	Yes	Yes	Paper Only
Form	n/a	Extant Data	RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-1 Extant Data Request.pdf	Yes	Yes	Paper Only
Form	n/a	March Interview	RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-3 Interview Protocol.pdf	Yes	Yes	Fillable Printable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 21,573

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 40 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	21,573	15,487	0	6,086
Annual IC Time Burden (Hours)	6,059	4,839	8	1,212
Annual IC Cost Burden (Dollars)	0	0	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.