Fast Track Short Form NASA Challenge Activity.Student Survey

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

T ITLE OF INFORMATION COLLECTION: NASA Challenge Activity - Student Feedback Survey

PURPOSE: NASA Office of Education provides a unique opportunity called a “challenge” that is a hands-on, collaborative science, technology, engineering, and mathematics (STEM) activity for students to learn about NASA content and other STEM topics. In an effort to continuously improve the development and delivery of this type of activity, NASA Office of Education will survey participating students to gather their feedback on the activity content and overall execution of the activity. The survey results will not be shared with the public.

DESCRIPTION OF RESPONDENTS:

Students who are 18-years of age and older, to include undergraduate and graduate students, who participate in NASA Challenge activities.

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	~630	10 minutes	~ 105 hours
Totals	~630	10 minutes	~ 105 hours

FEDERAL COST: The estimated annual cost to the Federal government is $1,583. The cost is based on an annualized effort of 47 person-hours at the evaluator’s rate of $33/hour for administering the test survey, collecting and analyzing responses. The cost also includes $32 for a maximum of 10% student responses returned via U.S. mail, if necessary.

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

Respondents are individuals (students) who have participated in the NASA 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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