Fast Track Short Form

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 2700-0153)

T ITLE OF INFORMATION COLLECTION: Challenge Activity - Educator Feedback

PURPOSE:

NASA Office of Education provides a unique opportunity called “Challenge” which is a hands-on, collaborative science, technology, engineering, and mathematics (STEM) activity for educators and students to learn about and engage NASA content and other STEM topics.

In order to continuously improve the development and delivery of this kind of activity, NASA Office of Education would like to survey educator participants for feedback on workshops they attend in preparation to share the Challenge activity content with student participants. The survey results will not be shared with the public.

DESCRIPTION OF RESPONDENTS:

Individuals who are educators and participate in NASA Office of Education challenges include the following individual types:

• Educators (in-service teachers, higher education teaching and research faculty)

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.

Name: Jeff Ehmen, Education Program Specialist, Academic Affairs Office, Office of Human Capital, NASA Marshall Space Flight Center, [email protected].

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? [ X ] Yes [ ] No

SORN: NASA 10EDUA, NASA Education Program Evaluation System - http://www.nasa.gov/privacy/nasa_sorn_10EDUA.html

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
Individuals	~100	10 minutes	~ 17 hours
Totals	~100	10 minutes	~ 17 hours

FEDERAL COST: The estimated annual cost to the Federal government is $269. The cost is based on an annualized effort of 8 person-hours at the evaluator’s rate of $33/hour for administering the test survey, collecting and analyzing responses. The cost also includes $5 postage for a maximum of 10% of educator responses returned via U.S. mail.

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?

Respondents are identified according to a tentative list comprised of individuals who have expressed interest in participating in the challenge activity.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[ ] Web-based or other forms of Social Media

[ ] Telephone

[X] In-person

[X ] 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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