Fast Track SHort Form . Challenge Activity - Team Advisor Feedback

Request for Approval under the “Generic Clearance for the Collection of
Routine Customer Feedback” (OMB Control Number: 2700-0153)
TITLE OF INFORMATION COLLECTION: Challenge Activity - Team Advisor Customer
Satisfaction Feedback
PURPOSE:
NASA Office of Education provides a unique opportunity called a “Challenge Activity” which is a
hands-on, collaborative science, technology, engineering, and mathematics (STEM) endeavor
for educators and students. In an effort to continuously improve the development and delivery
of this activity, NASA Office of Education will collect information from participating Team
Advisors to gauge their satisfaction with the Challenge activity content and overall execution
strategy for the activity. The survey results will not be shared with the public.
DESCRIPTION OF RESPONDENTS:
Team Advisors (in-service teachers, higher education teachers, and research faculty) support the
students working in the field on the construction and engineering aspects of 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 Management, 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? [ X ] 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:
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Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to
participants? [ ] Yes [X] No
BURDEN HOURS
Category of Respondent
Individuals

No. of
Participation
Respondents Time
~70
10 minutes

Totals

~70

10 minutes

Burden
~ 12
hours
~ 12
hours

FEDERAL COST: The estimated annual cost to the Federal government is $169. The cost is
based on an annualized effort of 5 person-hours at the evaluator’s rate of $33/hour for
administering the test survey, collecting and analyzing responses. The cost also includes $4
postage for a maximum of 10% of Team Advisor 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
Respondents are individuals who have participated in the challenge activity in the role of a Team
Advisor (in-service teachers, higher education teachers, and research faculty) and support the
students working in the field on the construction and engineering aspects of Challenge
activities.
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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