Maker/STEM Education Support for 21st Century Community Learning Centers Program Evaluation

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 21st CCLC youth in 21st CCLC youth interview	Form and Instruction	New	Available
Form 21st CCLC facilita 21st CCLC facilitator interview	Form and Instruction	New	Repair queued
Form 21st CCLC facilita 21st CCLC facilitator survey	Form and Instruction	New	Available
Form Maker Stem Ed Supp Museum/Science center partner interview	Form and Instruction	New	Available
Burden Estimates -- STEM CCLC IMLS Final 20170606.xlsx	Supplementary Document	Uploaded 2017-06-12	Available
STEM Maker Ed Support Part B Revised 2017-10-13.docx	Supporting Statement B	Uploaded 2017-10-16	Available
STEM Maker Ed Support Part A Revised 2017-10-13.docx	Supporting Statement A	Uploaded 2017-10-16	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
227156	21st CCLC youth interview	Form and Instruction	New
227155	21st CCLC facilitator interview	Form and Instruction	New
227154	21st CCLC facilitator survey	Form and Instruction	New
227153	Museum/Science center partner interview	Form and Instruction	New

ICR Details

OMB Control No: 3137-0108	ICR Reference No: 201706-3137-001
Status: Active	Previous ICR Reference No:
Agency/Subagency: IMLS	Agency Tracking No:
Title: Maker/STEM Education Support for 21st Century Community Learning Centers Program Evaluation
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 10/31/2017
	Date Received in OIRA: 06/12/2017
Terms of Clearance: Updated during review.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2020	36 Months From Approved
Responses	96	0	0
Time Burden (Hours)	29	0	0
Cost Burden (Dollars)	533	0	0

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Abstract: “Making” is a grassroots movement that celebrates creativity and innovation through the process of designing and making physical objects that blend high and low technologies. “Making” activities can be a means to engage people in exploring STEM concepts, practices and phenomena. NYSCI has developed a six activity Making curriculum for implementation with upper elementary and middle school students in 21st CCLC programs. As a train-the-trainer program model (figure 1), NYSCI first will train the six museum/science center partners on this curriculum. After the NYSCI training, each participating museum/science center will train facilitators from five geographically proximal 21st CCLC sites to implement the curriculum with youth. Once trained on the activities, the 21st CCLC facilitators and the museum/science center partner staff will co-implement the Making curriculum with up to 15 youth at each of the approximately 30 21st CCLC sites.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 28	02/13/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 111	06/12/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Museum/Science center partner interview	Maker Stem Ed Support form 1	Maker Stem Ed Support form 1
21st CCLC facilitator survey	21st CCLC facilitator survey form 1	21st CCLC facilitator survey form1
21st CCLC facilitator interview	21st CCLC facilitator interview form 1	21st CCLC facilitator interview form 1
21st CCLC youth interview	21st CCLC youth interview form 1	21st CCLC youth interview form 1

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	96	0	0	96	0	0
Annual Time Burden (Hours)	29	0	0	29	0	0
Annual Cost Burden (Dollars)	533	0	0	533	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Part A and B Justifications have been resubmitted with the OMB comments intact and responses to each one listed, along with explanations included in the text.

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Annual Cost to Federal Government: $4,760

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/12/2017

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