Generic Template

DOCUMENTATION FOR THE GENERIC CLEARANCE

OF CUSTOMER SERVICE SATISFACTION COLLECTIONS

TITLE OF INFORMATION COLLECTION:

Presidential Symposium Leadership Interest Survey

[ X] SURVEY [ ] FOCUS GROUP [ ] SOFTWARE USABILITY TESTING

DESCRIPTION OF THIS SPECIFIC COLLECTION

Specify all relevant information, including

1. Intended purpose: The purpose of this survey is to gather data to measure the Minority-Serving and Under-Resourced Schools President’s interest in attending a proposed second Presidential Leadership Symposium

2. need for the collection: To gain customer feedback

3. planned use of the data: Specific feedback will help to determine if the second symposium will be held.

4. Date and location(s): The survey will be conducted June 7^th, 2019, electronically

5. collection procedures: Attendees/participants will be sent a link to the electronic survey using the email address they provided

6. number of focus groups, surveys, usability testing sessions: one survey per attendee

7. Description of respondents/participants. The participants will consist of University Presidents/Chancellors or their designated representative

State whether the data collection will be completed one time will be collected on an annual basis, or other. One Time

Attach a copy of the proposed collection instrument, e.g., survey questions, focus group script, usability testing plan. If a focus group also includes a survey, include both.

AMOUNT OF ANY PROPOSED STIPEND OR INCENTIVE: N/A

BURDEN HOUR COMPUTATION (Number of responses (X) estimated response or participation time in minutes (/60) = annual burden hours):

Category of Respondent	No. of Respondents	Participation Time	Burden
University Presidents/Chancellors	687	5 minutes	57 hours
Totals	687	5 minutes	57 hours

BURDEN COST COMPUTATION (this is only required when a stipend is being offered)

Category of Respondent	No. of Respondents	Hourly Rate	Response Time	Total
Totals

STATISTICAL INFORMATION

If statistical methods are to be used, fully describe the methodology, sample selection, expected response rates, and any other concepts needed to provide a full understanding of those methods.

REQUESTED APPROVAL DATE: 6/7/2019

NAME OF CONTACT PERSON: Freda Donald

TELEPHONE NUMBER: 202 377-3600

MAILING LOCATION: UCP Rm 31J1, 830 First Street NE, Washington, DC 20202

ED DEPARTMENT, OFFICE: Federal Student Aid, School Experience, Minority-Serving and Under-Resourced Schools Division

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